道德风险防范制度在新农合中的移植——以番禺新农合按人头定额支付制为例

The Transplanting of the Moral Risk Precaution into Rural Cooperating Medical System——A Case on the Introduction and Practice of Ration Charge Mode by per Person in Panyu

按人头定额支付制作为防范医生道德风险的一种制度设置,2010年被引入番禺新农合门诊报销中。这一制度的运行可分为前后两个阶段,前一阶段出现了很多问题,医生道德风险问题仍然泛滥,把制度的相关环节,主要是药品购销调整理顺之后,开始进入平稳运转阶段,并较为有效地抑制了医生的道德风险。两个阶段的差异,说明了一个问题,即利益均衡是制度稳定运转的关键。这一制度在番禺的运作过程,还呈现出了一个显著特征,即依托于行政权力,以行政权力为基础与后盾,构建了基本框架。

As the system to restraining the moral risk of doctors' moral risk ration charge mode by per person was imported into rural cooperating medical system in Panyu in 2010.In the first stage,the rate of moral risk problem was still very high.But after the further rectifying in purchase and sale,the system began to run better and better,and has restrained the moral risk of doctors effectively.The difference of the two stages show that equilibrium of interest being the key of system.The running of the system in Panyu has also taken on its character that the system relying on administration power.