A Study On Expenditure Control And Mechanism Innovation Of Social Health Insurance

The coverage of our country's urban basic health insurance system has been expanded constantly when it was set up in 1998. It has solved the fund problem of health care tentatively, yet it does not work well in the supply of health service. We have not set up internal incentive mechanisms that the supply side utilizes medical resources more effectively. Though many polices to restrain the cost restrain of the demand side has been taken during the reform, the upward trend of health care expenditure has not been restrained effectively. Therefore, we need to further perfect the existing policies and measures, and explore the new governance mechanism of health insurance to provide medical service more effectively.The beginning of this thesis is the introduction of social health insurance expenditure concept and the significance of the expenditure control of health insurance. Then it analyzes the systematic and non- systematic factors that lead to the steadily raising of the health care expenditure, and discusses the supplier control strategy and restraining mechanism of the demand. The author of this thesis adopts the theory of economics to analyze the supplier incentive mechanisms, and then uses the contract theory and trade cost economics to analyze the governance mechanisms of the health insurance. To supply medical service effectively and reduce the health care expenditure, the author proposes to create hybrid governance mechanisms to match with the complex characteristics of health service trade. Then the author makes a brief summary of the health care expenditure control policies which have been taken by foreign countries. Finally the author returns to the practices of our country, and analyzes the existing problems of expenditure control of the social health insurance. The author suggests some policies to strengthen health care expenditure control, promote the competition and to raise the efficiency of health service supply.