城镇职工基本医疗保险制度相关主体行为的经济学分析

Economic analysis of the behavior of the primary medicare for town employees

首先分析城镇职工基本医疗保险制度在涵盖范围与深度、资金筹措与运用、医患供求双方三方面的特征。从理论上分析了该制度涉及的五个直接主体在基本医疗保险基金初始筹集及运行中可能的道德风险与合谋 ,以及对职工基本医疗保险基金的初始筹集与运行中收支平衡的影响。最后提出了建立疾病预防机制。

This paper first analyzes the three characteristics of the primary medicare for town employees-its horizontal and vertical structures, funds raising and operating, and supply and need sides of medical treatment. It then discusses theoretically the moral hazard and collusion of the five participants in the original funds-raising and operating, as well as their impacts on the balance of revenue and expenditure. Finally it suggests building disease defensive mechanism, expense controlling-payment-mechanism, and carrying out the whole reform.