Study On Control Moral Hazard Of Chinese Commercial Medical Insurance Market

Health care reform issue is a worldwide problem,has been plagued by theinsurance theory and practice.In recent years,commercial health insurance as animportant force involved in health care reform,and its importance has been more andmore attention.Commercial health insurance at the same time has also beenconsiderable development,the original premium income reached112349604700yuanin2013,and has established a PICC Health,safe and healthy, Kunlun health, Fredhealth, sunshine health professional these five health insurance companies. AlthoughChina’s commercial health insurance has made remarkable achievements,but still cannot cover the development of some of the problems that exist.Unlike other types ofinsurance, medical insurance involves the insurer,the insured and the health careproviders of the three.Between these parties in order to maximize their own interestsamong each other with the game,but the game between the three often much morecomplicated than the game between the two,which determines the specificity of thecommercial health insurance.Moral hazard from the insured and the health careprovider is the largest commercial health insurance development constraints.Commercial health insurance through the comparative study of moral hazardanalysis,risk of moral hazard into moral hazard from the supply and demand frommoral hazard.Supply moral hazard in the kind of health care performance by excesssupply of medical services,achieve the purpose of maximizing their own interests;moral hazard on the demand side is manifested after the insured,the insured person’sbehavior and awareness activities of daily living changed dramatically increase theprobability of occurrence of disease and excessive consumption of medical services.This paper studies the primary means of commercial health insurance in the currentresponse to the moral hazard,based on the reference U.S.managed care,that thesuccessful experience of health maintenance organizations.Presented in this waymanaged care to control our moral hazard. Moral hazard, hindering the developmentof commercial health insurance insurance companies,thereby affecting thedevelopment of the commercial health insurance market.Which prompted frequentincidents of moral hazard fundamental reason is that our current third-party payment mechanism, this mechanism forcing insurers independent of the health caresystem,health care costs can not be controlled.Managed care can fundamentallychange this shortcoming,so insurers to participate fully in the process of health caredelivery into in order to achieve effective control of health care costs,to effectivelycircumvent the intention of moral hazard.