医疗保险的特性与管理——基于美国医改案例的分析

Characteristics of Medical Insurance and Management——Analysis of Cases from American Medical Reform

美国的医疗保险体系以商业医疗保险制度为主,研究奥巴马医疗改革方案的内容和变革走向,有助于认识医疗保险的特征和管理方法,并从中获取新的有益的启示。本文通过对美国医疗改革法案的分析认为,医疗保险是准公共产品,不能完全依靠市场机制来解决;医疗保险是重要的公共管理事务;医疗保险制度的建立重在公平性;医疗保险的管理必须强化政府责任,强化对保险机构和医疗服务机构的监管。

In the system of American medical system, commercial medical insurance is the mainstay. To research the medical reform project of Obama is helpful to knowing the characteristics of medical insur- ance and management and getting useful revelation. This paper thinks that medical insurance is quasi - public goods, which can ~t be completely solved by market system. Medical insurance belong to public management affairs. The system of medical insurance must be fair. Governments must play an important role in medical insurance, and strengthen the supervision of insurance and medical agencies.