医疗保险谈判博弈模型构建及分析

Establishing the Health Insurance Bargaining Model and Relevant Analysis

根据国际上的谈判模式分类,医保谈判模型可分为两类:个体谈判模型和集体谈判模型。个体谈判模型分析,医院如果长期恶性竞争,势必都争取不到更多的医疗收入,因此对于医院来讲,合作是最佳的选择,这种合作博弈的结果是正和博弈;集体谈判模型则认为,医保联盟合作博弈是一种理性选择,医保分会道德风险会造成医院的损失,可通过医院的集体威胁行为来防范协会的道德风险,降低各医院的权益损失。

Based on international classification, health insurance bargaining models could be divided into two categories：individual negotiation model and collective negotiation model. As for the individual negotiation model, the author held that if hospitals opted for vicious competition and didn＇t control medical expenses ,they would be unable to increase their income in the long run. Thus for the hospitals their cooperation was the best option, and would yield a non-zero sum game result. As for the collective bargaining model, it was in nature a bilateral monopoly model and a moral hazard model. The bilateral monopoly model showed that the rational choice was to form a hospitalinsurance alliance, while the moral hazard model showed that separation of hospital and insurance would resulted in hospital losses. In this case, threatening by the collective behavior of the hospital association could prevent moral hazards and reduce hospital losses.