价格规制、激励扭曲与医疗费用上涨

How Does Price Regulation on Medical Service Affect Medical Expenditure:a Model Based on Incentive Theory

本文认为,我国目前对于基本医疗服务价格和大型设备检查/药品价格的分别规制,使得作为代理人的医生/医院行为出现扭曲,医生的努力水平低于次优水平且分配不对称,导致以降低医疗支出为目的的价格规制不仅无助于控制医疗费用的上涨,反而可能作为一种对医院的间接补偿手段产生更大的医疗支出。并且,不对称的努力会为患者带来比只存在医生道德风险和有限责任的次优状态时更大的福利损失,也会降低整个社会的福利。因此,改革的方向,在于改变对不同服务分别规制的现状,实行基于总成本的统一规制。

Since per capita medical expenditure in China is rising quickly over recent years, the price regulation on medical service, which aims at controlling medical expenditure, proves to be a failure. Our model, using incentive theory, explains how the current price regulation policy affects expenditure controlling through its influence on the efforts of physicians. We find that under asymmetric price regulation, physicians would make less effort than under the second best, and also the effort is distributed on different tasks asymmetrically. This helps the raise of expenditure and causes loss in both patients＇ welfare and social welfare as a whole. Therefore, annulling the asymmetric price regulation would be our main suggestion.