我国农村合作医疗体制变迁的博弈研究及启示

The Game Research and the Enlightenment of Rural Cooperative Medical Care System in China

新中国成立以来,以"筹资"为核心,农村经历了毛泽东时代合作医疗、后毛泽东时代合作医疗和新型农村合作医疗三个鲜明的体制变迁阶段。尤其是从第一阶段到第三阶段,实质是完全信息静态向完全信息动态博弈的转变,从合作向非合作的转变,使得合作医疗偏离了集体利益最大化。对比第一和第三阶段博弈发现:合作医疗的顺利展开需要三个条件,一是各参与方给出完全的信息,二是信息的完全可置信,三是博弈参与方行动策略符合其权责范畴。

After the foundation of P.R.C., rural cooperative care system has experienced three times of transition, from the cooperative medical care in Chairman Mao＇s time, the cooperative medical care in post-Chairman Mao＇s time, to the new form of rural cooperative medical care. The transition from the first period to the third period is actually a game changing from infortnation static state to information dynamic state. The transition from cooperativeness to non-cooperativeness makes medical care far from the optimization of collecti~＇e interests. Three conditions are required for the smooth conduction of cooperative medical care, namely, full information of all parties, full credibility of all information, and full obligation of all parties.