The Research On Moral Hazard In Social Medical Insurance

Social medical insurance plays an important role in improving people's medical condition and promoting social harmony. In practice, however, in recent years a rapid increase in medical cost has restricted the role of medical insurance and the development of medical industry. Medical expenses raising that caused by economy development, medical technology advancement and so on is reasonable; but the raising of medical expenses that brought about by moral hazard in the medical insurance has made the supply of medical resources unbalanced and the efficiency of social medical insurance system low, then restrict their long-term development. Therefore, how to recognize the risk of moral hazard and how to control it effectively are urgently to resolve, and this problem is also the key of cost controlling for medical insurance agencies.First this paper uses economic models and real cases to analyze the features, reasons and impact of moral hazard in social medical insurance. The moral hazard in medical insurance system can be divided into supply-side moral hazard and demand-side moral hazard. The supply-side moral hazard mainly refers to irregular examinations and induced demand. The demand-side moral hazard mainly refers to excessive consumption of health care and the irregular use of medical insurance card. The asymmetry of information, the specificity of health care consumption, the flaws of medical insurance system, and so on, led to the occurrence of moral hazard. And then through the game analysis of both sides of medical services and medical insurance agencies, this paper find the factors that affect the probability of Game. It put forwards measures that control these factors to achieve the purpose of inhibiting moral hazard. Based on this, this paper obtain some enlightments through the analysis of successful measures that control moral hazard in other countries. Finally, this paper put forwards control measures for moral hazard in social medical insurance. The interior design only, such as insurance contract with incentive mechanisms, can control demand-side moral hazard fundamentally. But the control of supply-side moral hazard needs the reforms on health an medical service system, in addition to cutting off the link between its own utility and the supply of medical services.It is a subject of great difficulty to avoid moral hazard effectively, and to control medical expenses to meet people's basic medical needs. The specificity of social medical insurance system determines that moral hazard has a huge space. Therefor, it needs further analysis and research on moral hazard in social medical insurance.