医疗保险市场道德风险防范初探

Initial Exploration on Moral Hazard and Risk Control in the Market of Medical Insurance

商业医疗保险的市场潜力巨大,但发展缓慢。医疗保险的风险控制能力,特别是对医疗保险市场上道德风险的控制,决定了保险公司发展商业医疗保险的意愿,是医疗保险的核心问题。我国医疗保险市场上的道德风险既有普遍性,又有特殊性,其后果是医疗费用的膨胀和保险公司经营困难。保险企业应该对来自投保人和医疗机构的道德风险采取不同的措施进行控制,以发展我国的医疗保险事业。

The market of commercial medical insurance has been evolving positively but at a slow pace, in spite of the immense potentialities that it possesses. In the final analysis, the willingness of insurers＇ for tapping this market is dependent upon their abilities in controlling the risks arising from medical insurance, and especially in stemming the moral hazard in the medical insurance market, which is known as the core issue in the realm of medical insurance. In China＇ s medical insurance market, moral hazard appears a factor of both ubiquity and specificity, and has already led up to soaring medicare costs and difficulties against insurance companies. Insurance enterprises shall take all different measures to take control the moral hazard arising from both insurants and medical organizations, so as to give a boost to the country＇s medical insurance cause.