The Research Of Constructing Medical Service Purchase Mechanisms Under The Perspective Of Managed Competition

Rising medical costs is common problem which was faced by countries around the world. Rising costs directly led to declining the patients’satisfaction and those patients take part in the insurance for medical care, reducing the security level, and burdening the fund payment. Specific to our country, along with the increasing in coverage of social medical insurance system, constantly improving the reimbursement ratio, both urban and rural insured patients can have pay cheaper medical fees than ever,and the huge demand for medical and health services gets released. However, because of the running environmental weakness and system installation defects about medical insurance system, the medical expenses also present the fast growth tendency. Most countries’ government tirelessly pursuit to explore the suitable method for controlling the medical and health costs. Managed competition theory emphasizes that government and market should play their functions cooperatively, avoiding market failure and government dereliction duty, and emphasizes micro-domination from market mechanism besides macro-supervision and regulation from government management.Management competition theory conforms to the current trend of international social public service reform fields, so many countries had been set up new mechanism system which suit for their folk national conditions based on the theory exploration. Health service’s purchasing and obtaining should meet the market system arrangement, and they are determined by the price mechanism. However, the medical and health services possess both public goods and private goods attributes. The design of medical insurance system arrangement refers to universal health care and the social public security and stability, and the government must take the comprehensive responsibility for supervision and management. Therefore, the scientific system design should be used to regulate and restrict the government and the market power when the medical and health service is getting reformed. Holland implementation of medical insurance system reform since2006and China’s Shanxi Shenmu county "universal free medical treatment" are the Practical results for managed competition theory. Both of them show their superiority of system succeeded in improving medical healthy efficiency and reducing health care costs, and they also provide our country beneficial enlightenment and reference for current deepening medical system reform and setting up perfect, covering national medical and health service management system.The first part is the introduction about the background and significance for choosing the mechanism of medical services to buy as the research object. This paper briefly introduces the paper’s research methods and writing framework in order to provide a panoramic view for the later discussion.The second part mainly makes a literature review, and uses relevant content to carry on the simple review and summary, explains and discusses the management competition theory from the aspects of definition, theory origin and objective.The third and the fourth part mainly introduce international competition and domestic practice patterns of the management theory. Particularly introduces Holland medical insurance system reform and China’s Shanxi Shenmu county "universal free medical treatment", and set up a mechanism of innovation and the purchase application.The fifth part analyses the advantages and difficulties of promoting international experience and domestic advanced mode, and analyses the principle orientation and goal orientation of our country health service purchase mechanism.Finally, in the sixth end part, the author puts forward some shortages in this paper, the mechanism construction significance, the main content of the follow-up study, in order to pay more attention in the future time, or have the opportunity to expand the follow-up study.