总额预付影响供方行为的经济学分析

Economics Analysis of Supplier Behavior under Prepaid Mode of Total Medical Insurance Expense

目前,总额预付作为控制医疗费用不合理快速增长的最简单有效的方式而被大部分医保试点城市所采用。本文运用经济学解释总额预付对供方行为的影响,分析医方推诿病重医保病人、减少新技术的使用,医保方总额支付形式单一、政策激励不到位等问题,提出设定合理的医保总额、建立多样化的支付方式组合及对供方实施激励措施,以期完善现有政策。

From the supply-side, the paper explains the effects of prepaid mode of total medical insurance expense on the suppliers by economics. The effects in the reality are shuffling patients in medicare, reducing the use of new technologies, unitary medical insurance payment form, and Lack of the incentive policies. Corresponding improvement measures, which are reasonable medical insurance total, combination of various payment methods, and incentive measure, are proposed to improve the existing policy.