The Game Analysis Of Related Subjects Of Medical Insurance Payment

In the background of building a harmonious society, It is an important task to construct the harmonious society that every one can obtain basic medical insurance. The decision of related subjects including medical institution, medical insurance institution and the patient can influence achievement of the goal which not only affects the level of social security, the safety and sustainability of health insurance funds, but also social equity.Combining theoretical analysis and case study method, the paper analyses the game among medical institution, medical insurance institution and the patient. Through establishing and analyzing game model, it finds the equilibrium factors of the game. The game analysis results:(1) (P1, P2) is the Nash equilibrium of medical service institutions and medical insurance institutions game. Namely medical institutions to abide by agreement in terms of Pi (1-Z(m[a(R+E)+E]))probability, while medical insurance institutions is in terms of P2(E/(m[E+a(R+E)])) probability for examination. And in equilibrium condition, P1 is negative correlation with examination cost (Z)of insurance institutions and is positive correlation with the probability of successful examining(m), punishment intensity (a). Insurance institutions examining probability P2 is positive correlation with extra income which medical service institutions don't comply with the agreement and negative correlation with successful examination probability of medical insurance institution(m) and punishment intensity(a).(2) (P3, P4) is the Nash equilibrium of medical service institutions and insured patients game. Namely medical service institutions abide by agreement in terms of P3 (1-(C2)/(m2X)) probability, while insured patients is in terms of P4 ((R2+R3)/(m2X)probability for examination. And in equilibrium condition, P3 is negative correlation with examination cost (Z)of insured patients and is positive correlation with the probability of successful examining(m2) and compensation(X). Insured patients'examining probability P4 is positive correlation with income and is negative correlation with the probability of successful examining(m2) and compensation(X).The analysis of doctors and patients game proved that both doctors and patients can achieve non-zero and the cooperative game after infinite games.When doctors provide reasonable treatments, the patient will trust doctors.Then they can achieve a balanced portfolio and realize the overall optimal interests. But also in the process of game analysis, the information and reputation have an important influence on the balance of the game. In the analysis, the game between patients and doctors is affected by the information. Information Factor is a crucial factor which can change the status. The reputation is helpful to increase mutual trust, promote cooperation and reduce costs in order to achieve cooperation.(3) (P5, P6) is the Nash equilibrium of patients and medical insurance institutions game. Namely patients choose fraudulent in terms of P5 (C/(a(M+E)-E))probability, while medical insurance institutions is in terms of P6 (E/(a(M+E)+E))probability for examination. And in equilibrium condition, the nash equilibrium is affected by profits of patients(M), extra income (E),examination cost (C)of insurance institutions and punishment intensity(a).P5 is positive correlation with examination cost (C) and extra income(E).Meanwhile it is negative correlation with punishment intensity(a).P6 is positive correlation with extra income. Meanwhile it is negative correlation with punishment intensity(a).Finally, for influencing factors of health insurance institution, medical service institution and patients, it offers some reasonable proposals to improve the game conditions and realize cooperative game. Such as:improving the health insurance payment; carrying out basic medical services the uniform medicine pricing system and medical separation institution; establishing a credit rating system for hospitals and health services information disclosure mechanisms; reasonable incentive mechanism, expanding health insurance coverage; improving the cost of pay system; increasing public awareness; establishing and making full use of health services information systems and computer network information platform; strengthen the system construction and intensify supervision and punishment and so on.