摘要
本文首次把医疗的药单费用和疗效看成是一种随机"产出",并运用委托代理理论建立了一类医患交易契约模型。模型提示我们:医院企业和医疗保险企业一体化,成立"保险互助医疗有限公司",可以在很大程度上解决医师的道德风险问题,因为医保一体化就相当于医师在事前收取了一个固定的诊治费,使其将药单成本内部化,只要依据疗效适当地确立赔偿规则,他就有积极性既努力降低药单费用,又努力尽可能地提高疗效。就社会整体来看,"保险互助医疗有限公司"是用健康者的保费补贴病人,是有劳动能力的人补贴失去一定劳动能力的人,它是对当前"医院"或"保险公司+医院"两种医疗制度的帕累托改进,是当前我国医疗体制改革值得考虑的模式。
Regarding the medical costs and the treatment effect as a kind of random output for the first time, this thesis sets up a model of transaction contract between doctors and patients based on principal-agent theory. The model enlightens us that the integration of hospitals and the medical insurance corporation to establish insurance and mutual aid Medical Corporation Limited can solve the moral hazard of the doctors to a large extent because the medical insurance integration is equal to a fixed treatment fee paid to the doctors in advance, which can internalize the medical costs and as long as the compensation regulations are established appropriately according to the effect of the treatment, the doctor will have initiative to reduce the cost of the medicine and to improve the curing effect at the same time. From the perspective of the whole society, the mutual aid medical Insurance Corporation Limited means to subsidize the patients with the insurance fee of the healthy people and to subsidize the people losing the capability to work with the insurance fee of those people with capacity to work. This model deserves consideration for our medical system reform, as it is a Pareto Improvement of the present medical system of ＂hospital＂ or ＂Insurance Corporation and hospital＂.
出处
《经济研究》
CSSCI
北大核心
2007年第12期72-81,共10页
Economic Research Journal
关键词
委托代理
道德风险
代理成本
医患交易契约
医疗制度改革
Principal-agent
Moral Risk
Agent Cost
Transaction Contract Between Doctors and Patients
Medical System Reform
