城乡医保普及对居民医疗费用控制的影响分析

Analysis on Impact of Health Insurance Universal on Medical Expense Containment for Residents

目的:从我国现行体制下医保与医疗机构的主体特征角度,分析城乡医保普及对医疗费用增长的影响.方法:选取2003年以来我国医保普及前后医疗费用增长的统计数据,比较医疗费用的变化趋势.结果:我国医保具有预算软约束特征,医疗机构有较强的诱导需求动机;根据统计数据,在2009年医保普及前后,我国综合医院的医疗费用处于稳定的增长状态,直到2015年政府对医疗费用直接干预,居民医疗费用的增长率急剧下降.结论:医保的主体地位不突出,影响了医保控费的效果,政府应加强医保的外部制衡作用,提高医保在医患保三者关系中的核心地位,并逐步建立以需求方为导向的医疗价格形成机制.

Objective:To analyze the impact of health insurance universal on medical expense containment from view of character of medical insurance and hospital at current medical system in China.Methods:Statistical data on medical expense before and after medical insurance universal since 2003 was used to compare with the changes of medical expenditure.Results:There were soft budget constraint of medical insurance and strong motivation of induced demand of physician.According to health statistics,medical expenditure have increased steadily both before and after popularization of medical insurance in 2009.The growth rate of medical expense began to drop sharply only when direct intervention policy to medical expense were announced in 2015.Conclusion:The position of medical insurance was not outstanding to reduce effect of containment by medical insurance.It was suggested that external power of balance to physician should be increased to raise center position of medical insurance in the relationship among physician,patient and health insurance.The demand-oriented formation mechanism of medical prices should be established.