基于郡管理的瑞士医保调剂金制度

Risk Adjustment System in Switzerland Health Insurance on the Level of County

为缓解竞争性医保市场可能出现的风险选择问题,瑞士自1994年建立了基于郡管理的医保风险调剂金制度。此后,瑞士医保经办服务市场的竞争激烈程度有所缓和,保险人风险选择行为有所收敛,同时,瑞士高速的医疗费用增长也得以缓解。不过,事后补偿易诱导医疗费用支出增加、计算因子科学性不足等问题也使其饱受诟病。

] In order to alleviate Switzerland since 1994 were established competitive medical insurance market possible risk selection problem, based on the county medical insurance risk management system adjusts gold. Since then, the Swiss orgnaization of service of medical insurance market competition degree has eased, the underwriter risk choice behavior have convergence, and at the same time, the Swiss high medical costs growth also ease. However, afterwards compensation easy induced medical expenses increased, calculation factor scientific problems also make the much-maligned.