"commissioned - Agent" Perspective Public Medical Institution Research The Incentive Mechanism In Our Country

Since1978,China has experienced a big change from a planned economy to a market economy,and market forces continue to deepen in the field of China’s economy. At the same time, our society (including institutions) began to take some attempts in market-oriented, and brought some debatable social consequences.In this context,the paper talks about the transformation of the incentive behind the change,considering the market-oriented reforms that the public health agencies are carrying out the incentive are different from the planned economy.Due to the transformation of the incentives,China’s public medical institutions gradually turn from doing everything by rules under the planning system to an active participant in the medical services market, They gradually become a profit-earnings main,but not the commitment of the social welfare,pursuing revenue maximization as their major goal.The new health care reform policy introduced in2009shew that China’s public hospitals faced a second turning point,the public welfare of the public hospitals will be the guiding ideology of the reform.Relying on some cases,the paper studies the incentive problems of the public medical institutions under the "principal-agent "theory perspective.lt combs from the overall evolution of the incentives of public medical institutions,summarizes policy changes and focuses on studying the incentives of the public medical institutions in the market transition phase.Firstly, the paper analyzes the incentives of public medical institutions in the transition stage, In respect of compensation, the lack of financial investment; for the management, expanding the hospital autonomy;taking dual design of medical price of running.The consequences of the incentives for change were:extraordinary rapid growth in medical costs, the public welfare diluting in public hospitals, the medical technology value of doctors can not be realized,"low-income" groups do not have the ability to getting ill. secondly, the paper explores the failure of the incentives.Because the "principal-agent"relationship did not really set up,the paper deems the incentives failure from two aspects that the design of the system of government and public medical institutions,which brought about the public welfare increasingly dilute and the high medical expenses did not fall,which go against the original intention of the reform.In the new medical reform stage,the reform of the public medical institutions can be seen to reshape the "principal-agent" relationship,attempting to expect the public hospitals to return to the public welfare.Finally,basing on the description incentives experience of the public hospitals change in Singapore,from three levels of government, public hospitals, and social,the paper advances some suggestions and opinions about how to make the public hospital to return to the public welfare.