“成本病”是否导致了“看病贵”? ——来自中国省级层面的经验证据

Does Baumol’s Cost Disease Exacerbate the Increase in Per Capita Healthcare Costs?--Empirical Evidence from the Provincial Level in China

新医改后,“看病贵”问题并未得到实质性缓解,医疗费用增长过快偏离新医改初衷并削弱了政府不断增加投入的效果,为此,从人均医疗总费用及其构成角度表征看病贵,利用鲍莫尔的不平衡增长模型揭示了医疗费用增长的理论逻辑,并基于2003—2017年中国省级层面数据,实证考察了“成本病”对医疗费用增长的影响。研究发现:中国医疗费用持续快速增长有其必然性,这种必然性来自于“成本病”,“成本病”不仅与医疗服务特性有关,也与医疗行业组织低效率有关,这一效应长期存在;东部地区是“成本病”的重灾区,中西部地区的“成本病”效应并不显著,新医改后“成本病”效应明显弱化。启示在于,应正视“成本病”引致的医疗费用增长必然性,将重点转移到医疗行业组织治理上,加快提升医疗行业效率。

From the perspective of total healthcare expenditure per capita and its composition,we can characterize the expensive medical treatment problem.Using unbalanced growth theory to reveal the theoretical logic of healthcare expenditure growth,we examined the effect of cost disease on the growth of medical expenses based on 2003-2017 Chinese provincial-level data.The study found that:first,there is an inevitability for sustained and rapid growth of medical expenses in China,and the cause is“cost disease”,which is not only related to the characteristics of healthcare services,but also to the inefficiency of healthcare industry organizations;second,the“cost disease”effect in the eastern region has already been highlighted,but the central and western regions have not yet appeared;third,the“cost disease”effect has been weakened significantly after the new healthcare reform.The enlightenment of this paper is that the inevitability of the increase in healthcare expenses caused by the“cost disease”should be taken seriously,and the focus should be shifted to the organization and governance of the healthcare industry.