医疗保障协商谈判机制的德国经验及借鉴

The German Experience and Reference of Negotiation Mechanism between Medical Insurance Administrative Agencies and Medical Institutions

近年来,我国各地开展了一系列医疗保障协商谈判的实践与探索,在取得成绩的同时仍存在协商谈判主体之间地位、议价能力不平衡等问题,不利于医疗保障的高质量发展。德国是具有丰富的医保协商谈判经验的典型国家之一,其法定医疗保险协商谈判以社会自治为主,尽量避免政府介入,核心思路是构建力量均衡的协商谈判参与主体、确定激励相容的协商谈判内容和完善的协商谈判配套机制,为我国完善医保协商谈判机制提供了有益经验。

In recent years,various regions in China have carried out a series of practices and explorations in medical security negotiation.While achievements have been made,there are still problems such as imbalanced status and bargaining power among the negotiation parties,which are not conducive to the high-quality development of healthcare insurance.The practice of healthcare insurance negotiation can be traced back to Germany,where the negotiation of statutory health insurance focuses on social autonomy and avoids government intervention as much as possible.The core idea is to establish balanced negotiation parties,determine incentive-compatible negotiation content,and establish a complete supporting mechanism for negotiation.The German practice provides useful experience for improving the healthcare insurance negotiation mechanism in China.