卖方医疗市场中健康保险的专业化发展之路

The Path of Development for Specialized Health Insurance Business in a Seller's Medical Service Market

在基本医疗保险与卖方医疗市场的博弈中,医疗机构一直掌握着主动权。借鉴基本医疗保险十余年所走过的曲折道路,专业化的健康保险公司发展之路必须规避医疗信息不对称带来的道德风险,同时还要在同业竞争中面对创业和展业过程中的一系列困难。健康保险业要历经起步、健康资源整合和稳定发展三个必然的历程而成熟。专业化的健康保险经历发展壮大之后,会衍生出重要的、专业化的医疗行为监理职能。

The Chinese medical service market is a seller＇s market, The medical organization is the winner in the tussle between the hospital and the basic medicare system. As a lesson learned from the tortuous path of the basic medicare system over more than ten years time, specialized health insurance companies must avoid moral risks arising out of asymmetry of medical information and, at the same time, face up against a series of difficulties in establishing a foothold in this industry and expanding its business due to growing competition. A health insurance company must go through three stages, namely getting started, health resources consolidation and stabile development, to become mature. When a specialized health insurance company becomes stronger, it will bring into being an important and specialized monitoring function on medical activities.