摘要
近年来,伴随着医疗费用的快速上涨,中国多地的医疗保险基金陷入入不敷出困境。在财政收入增速下降的经济新常态下,"开源"难度较大,"节流"不失为更佳选择。如何更有效率的"节流",是当前学术界和政策制定者关注的焦点问题之一。从历史演进视角认真梳理国际上医疗保险支付方式的发展历程,是完成这一任务的必不可少一环。本文择要阐述了医疗服务价格形成机制的演变过程,重点讨论了医疗保险制度引入后医疗服务供方、需方和医疗保险三方互动确定和调整医保支付方式的过程。阐明医疗保险制度下的医保支付机制即为医疗服务价格形成机制,这一机制是引导医疗资源配置和医患双方诊疗行为的关键。同时,通过国际经验比较,阐述了这一机制有效发挥作用所需的基础性制度安排。
Many local healthcare funds have been in debt recently as medical expenditures increaserapidly.Given the new economic normal state,in which economic growth slows and financialrevenues decline,it is better for China to improve management of existing resources thanseeking to expand sources of incomes.Therefore,how to raise the distribution efficiency of thecountry's limited medical resources has become a focus of discussion by Chinese scholars andpolicymakers.To that end,it is indispensible to first examine the evolution of healthcarepayment methods in other countries.This article summarizes the evolution of the formationmechanism of healthcare service prices and mainly discusses how the healthcare paymentmethods are determined and adjusted by medical service providers,patients,and insurancecompanies after the introduction of the healthcare system.The article finds that under thehealthcare system,the health service payment mechanism,or the healthcare paymentmechanism,plays a key role in guiding healthcare resource distribution and behavior ofmedical service providers and patients.Meanwhile,through international comparison,thearticle also discusses the fundamental systematic arrangements that are needed to bring out therole of such a healthcare payment mechanism.
出处
《国际经济评论》
CSSCI
北大核心
2018年第1期24-38,4,共15页
International Economic Review
