长期护理保险道德风险形成机制研究——以上海市为例

A Research on the Moral Hazard Formation Mechanism of Long-term Care Insurance--A case study of Shanghai

长期护理保险具有长服务周期和主体多元的特征,易出现道德风险并对制度可持续性产生深远影响。根据长护险主体间的信息分布及委托—代理关系,可将道德风险分为参保人道德风险和服务机构诱导需求。基于上海市长期护理保险制度试点运行情况,将评估机构纳入考量,把供方道德风险进一步分为直接诱导需求与间接诱导需求,分析不同类型道德风险的形成机制,并指出服务机构间接诱导需求与需方道德风险是试点中的主要道德风险类型。最后,指出回归制度保险属性、实现独立第三方评估、完善服务行业管理有助于化解道德风险。

With the characteristics of long service cycle and multiple subjects and the liability to pose moral hazard,long-term care insurance has a profound impact on the sustainability of the system.According to the information distribution between the subjects of LTCI and the principal-agent relationship,moral hazard can be divided into the moral hazard of the insured and the induced demand of service organization.In the case of the pilot operation of the long-term care insurance system in Shanghai,the evaluation agency is taken into consideration and the supplier’s moral hazard is further divided into direct induced demand and indirect induced demand.Having analyzing the formation mechanism of different types of moral hazard,the paper points out that the indirect induced demand of service organization and the demand-side moral hazard are the main types of moral hazard in the pilot.Finally,it is believed that returning to the insurance attribute of the system,implementing independent third-party evaluation,and improving the management of service trades would help to defuse moral hazard.