【摘要】：新型農(nóng)村合作醫(yī)療制度自2003年實(shí)施以來(lái),緩解了“看病難、看病貴”的問(wèn)題,保障了農(nóng)民的基本權(quán)益,適應(yīng)了農(nóng)村社會(huì)經(jīng)濟(jì)發(fā)展,同時(shí)又有利于提高我國(guó)醫(yī)療保障制度的公平性。但由于醫(yī)療市場(chǎng)的特殊性及新農(nóng)合制度實(shí)施環(huán)境的復(fù)雜性,新型農(nóng)村合作醫(yī)療在實(shí)施過(guò)程中遇到諸多問(wèn)題,如不合理費(fèi)用的增長(zhǎng)、監(jiān)管機(jī)制的不完善及新農(nóng)合基金入不敷出等。這些問(wèn)題既損害了新農(nóng)合運(yùn)行的效率,又影響了新農(nóng)合制度的可持續(xù)發(fā)展。隨著新農(nóng)合制度的不斷完善,政府補(bǔ)貼增加,道德風(fēng)險(xiǎn)隨之而來(lái)。道德風(fēng)險(xiǎn)最早源于海上保險(xiǎn),近年來(lái)才逐漸運(yùn)用各個(gè)領(lǐng)域。道德風(fēng)險(xiǎn)即是擁有信息較多的一方利用信息優(yōu)勢(shì)做出損害信息較弱一方的行為。在醫(yī)療市場(chǎng)中,由于醫(yī)療需求方、醫(yī)療提供方和醫(yī)療監(jiān)督方之間掌握的信息不對(duì)稱,再加上醫(yī)療體制的不合理及個(gè)人機(jī)會(huì)主義傾向等原因,道德風(fēng)險(xiǎn)問(wèn)題愈演愈烈。道德風(fēng)險(xiǎn)的存在使醫(yī)療費(fèi)用不合理增長(zhǎng),同時(shí)抑制了農(nóng)民合理的衛(wèi)生需求,損害了新型農(nóng)村合作醫(yī)療的公平發(fā)展。本文以湖南省某縣為例,通過(guò)個(gè)案訪談、參與觀察法、文獻(xiàn)分析法等途徑,探求湖南省省級(jí)貧困縣的新型農(nóng)村合作醫(yī)療制度在運(yùn)行過(guò)程中道德風(fēng)險(xiǎn)的表現(xiàn)及產(chǎn)生的內(nèi)在機(jī)理。道德風(fēng)險(xiǎn)的表現(xiàn)主要從醫(yī)療需求方、醫(yī)療提供方和醫(yī)療監(jiān)管方三個(gè)方面來(lái)論述,內(nèi)在機(jī)理主要從醫(yī)療市場(chǎng)的特殊性、醫(yī)療體制的不合理及個(gè)人的機(jī)會(huì)主義傾向來(lái)闡述;其次通過(guò)利用2003-2013年中國(guó)衛(wèi)生統(tǒng)計(jì)年鑒的數(shù)據(jù)進(jìn)行高級(jí)統(tǒng)計(jì)分析,深入分析道德風(fēng)險(xiǎn)問(wèn)題是否在全國(guó)范圍內(nèi)普遍存在,最后從宏觀和微觀層面論述如何規(guī)避道德風(fēng)險(xiǎn),以期找尋有效解決道德風(fēng)險(xiǎn)的舉措。
[Abstract]:Since the implementation of the new rural cooperative medical system in 2003, it has alleviated the problem of "difficult to see a doctor and expensive to see a doctor", guaranteed the basic rights and interests of farmers, and adapted to the social and economic development of rural areas. At the same time, it helps to improve the fairness of our medical security system. However, due to the particularity of the medical market and the complexity of the implementation environment of the new rural cooperative medical system, there are many problems encountered in the implementation of the new rural cooperative medical system, such as the increase of unreasonable expenses, the imperfection of the supervision mechanism and the income of the new rural cooperative fund. These problems not only impair the efficiency of NCMS operation, but also affect the sustainable development of NCMS system. With the continuous improvement of the new rural cooperation system, the government subsidy increases, moral hazard follows. Moral hazard originated from marine insurance and has been gradually used in various fields in recent years. Moral hazard is the behavior that the party with more information makes use of the advantage of information to harm the weaker party. In the medical market, due to the asymmetry of information between the medical demand side, the medical provider and the medical supervisor, coupled with the unreasonable medical system and the tendency of individual opportunism, the moral hazard becomes more and more serious. The existence of moral hazard makes the medical expenses increase unreasonably, at the same time restrains the farmer's reasonable health demand, and damages the fair development of the new rural cooperative medical system. This paper takes a county in Hunan Province as an example to explore the expression of moral hazard and the internal mechanism of moral hazard in the process of operation of the new rural cooperative medical system in the poor counties of Hunan province by means of case interview, participation observation method, literature analysis and so on. The expression of moral hazard is mainly discussed from three aspects: the medical demand side, the medical provider side and the medical supervision party. The internal mechanism is mainly explained from the particularity of the medical market, the unreasonable medical system and the individual opportunism tendency. Secondly, by using the data of China Health Statistics Yearbook from 2003 to 2013 to carry out advanced statistical analysis, this paper makes a deep analysis on whether the moral hazard problem exists in the whole country. Finally, it discusses how to avoid moral hazard from macro and micro levels. In order to find effective measures to solve moral hazard.
【學(xué)位授予單位】：湖南師范大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R197.1;F842.684;F323.89

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 李銀才;;管辦不分:公立醫(yī)院醫(yī)生道德風(fēng)險(xiǎn)的本源[J];現(xiàn)代經(jīng)濟(jì)探討;2014年06期

2 寧滿秀;楊志武;劉進(jìn);;新農(nóng)合的福利效果與改革方向——基于供給者誘導(dǎo)需求的分析框架[J];中南大學(xué)學(xué)報(bào)(社會(huì)科學(xué)版);2013年05期

3 牟俊霖;許素友;;對(duì)我國(guó)醫(yī)療保險(xiǎn)中道德風(fēng)險(xiǎn)的測(cè)量[J];衛(wèi)生經(jīng)濟(jì)研究;2011年08期

4 伍林生;劉文;;新型農(nóng)村合作醫(yī)療制度中監(jiān)管方的道德風(fēng)險(xiǎn)及對(duì)策[J];特區(qū)經(jīng)濟(jì);2009年06期

5 楊金俠;江啟成;王章澤;溫麗娜;;新型農(nóng)村合作醫(yī)療醫(yī)療費(fèi)用控制實(shí)證研究:不合理醫(yī)療費(fèi)用控制模型與實(shí)施方略[J];中國(guó)衛(wèi)生經(jīng)濟(jì);2009年05期

6 周娟;;新型農(nóng)村合作醫(yī)療不合理費(fèi)用分析及控制[J];北京科技大學(xué)學(xué)報(bào)(社會(huì)科學(xué)版);2009年01期

7 趙曼;呂國(guó)營(yíng);;管辦分離:醫(yī)改的第三條道路[J];中國(guó)社會(huì)保障;2008年07期

8 劉衛(wèi)斌;李長(zhǎng)遠(yuǎn);;新型農(nóng)村合作醫(yī)療中醫(yī)療服務(wù)供方道德風(fēng)險(xiǎn)的防控[J];衛(wèi)生經(jīng)濟(jì)研究;2008年03期

9 夏子堅(jiān);;新型農(nóng)村合作醫(yī)療中的道德風(fēng)險(xiǎn)及其規(guī)避——以湖南省隆回縣為例[J];武漢理工大學(xué)學(xué)報(bào)(社會(huì)科學(xué)版);2007年06期

10 干春暉;周習(xí);鄭若谷;;不完美信息、供給者誘導(dǎo)需求與醫(yī)療服務(wù)質(zhì)量[J];財(cái)經(jīng)研究;2007年08期

相關(guān)碩士學(xué)位論文 前1條

1 馮英;蕪湖市社會(huì)醫(yī)療保險(xiǎn)道德風(fēng)險(xiǎn)及其防控研究[D];安徽大學(xué);2011年

，

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