整合后医疗保险购买医疗服务机制研究

Study on the mechanism of integrated medical insurance purchasing medical care

患者购买服务机制,花自己的钱让其关注医疗费用,办自己的事让其关注医疗质量。但是,由于医疗需求的低价格弹性和供求双方的信息不对称,这种花自己钱办自己事的患者购买服务机制并不能有效发挥控制医疗费用和保障医疗质量的作用。医疗保险付费方式实际上是医疗保险机构替代患者购买服务的机制。这种第三方支付机制有利于重构医疗服务供求关系,有能力保障医疗质量和控制医疗费用,有条件治理供求双方的道德风险。

Patients purchasing service mechanism conforms to spend-money and doing-thing theory, the mechanism of spending their own money let he pay attention to the medical expenses, the mechanism of doing their own thing let he pay attention to medical quality. However, because of the information asymmetry and low price elasticity, patients purchasing service mechanism of spending their own money and doing their own thing can not effectively control medical expenses and guarantee medical quality. Medical insurance payment model is actually a mechanism of medical insurance institutions purchase medical service alternative in patients, the third party payment mechanism is helpful to reconstruct the relationship between supplier and demander of medical service, have the ability to guarantee medical quality and control medical cost, have the condition to guarding against moral risk of medical supplier and medical demander.