新型农村合作医疗的逆向选择和道德风险问题研究

2003年新型农村合作医疗制度开始在全国试点,新农合缓解了“因病致贫,因病返贫”问题,但也存在着急需解决的问题.由于信息不对称、制度设计的弊端、第三方付费模式的弊端等,新农合运行过程中出现了逆向选择和道德风险,文章提出合理设置起付线和封顶线,完善新农合制度设计,加强对医疗机构的监管,切实发挥财政的主导作用等建议.

A Study on the Adverse Selection and Moral Hazard of the New Rural Cooperative Medical System

In 2003, the new rural cooperative medical care system started a pilot in the country. It alleviated the problem of ＂poverty due to illness＂. But as the medical insurance, due to factors such as information asymmetry, the disadvantages of system design and the disadvantages of a third party pays model, it is accompanied with the adverse selection and moral hazard. This article put forward suggestions that set up reasonable limit to start to pay and the maximum payment, perfect the system design, strengthen the supervision of medical institutions, play the leading role of the finance and so on.