Medical Insurance, Moral Hazard Control Mechanism

With the gradual deepening Social Medical SecuritySystem reform,the traditional pattern of the socialized medicineis broken and paying the fee by the government has alreadybecome history 。So it's an opportunity to develop healthinsurance and relieving the financial pressure of government 。In fact, the development in health insurance is very slow andthe medical expenses is still high 。The author thinks thatmedical expenses' constant expansion is the key reason thatinsurance companies can not manage business in healthinsurance。 How to control and reduce medical expenses'expansion is very difficult for insurance companies。 It'sdifficult not only to Chinese insurance companies but also to allinsurance companies。 This thesis points out from moral hazardaspect that moral hazard is the crucial reasons for the troubleresulting in hindering commercialized operation of the medicalexpenses' constant expansion 。The functioning of insurancemechanism must consider to control 。 moral hazard becausemoral hazard is the reason that lead to medical expenses'constant expansion。 So to study how to control moral hazard isthe way to find how to control medical expenses' constantexpansion。 So as to develop medical insurance we must tocontrol moral hazard 。From this paper we know the reason whythe moral hazard come into being。 The author hopes more andmore people could be concerned with moral hazard in healthinsurance , which will lead to the health insurance'sdevelopment。 The thesis includes four chapters。 In the firstchapter。 The author introduces some basic components ofmoral hazard 。In the second chapter,the author addresses howthe moral hazard comes into being。 Then so as to controlmoral hazard how to develop the medical system 。then so asto decrease the moral hazard ,what the insurance companiescan do to control the doctor and the hospital 。The insurers candesign the clause of policy to distinguish consumers betweenhigh risk type and low risk type。 In the third chapter, theauthor analyzes a series of problems about moral hazard。Firstly, the consumers' behaviors will result in moral hazard。Secondly, the medical institution's behaviors will producemoral hazard。The medical institution's behaviors are analyzedthrough employing principal-agent theory。 The author pointsout insurers should design an efficient incentive contract inorder to standardize the behaviors of medical institution andreach the goal of insurers。 In the fourth chapter, American Managed Care isdistinguished in cost control 。In this chapter ,introduces itsdifferent forms, merits and valid cost control measures, Thekey of managed care is that insurers directly participate in themanagement of medical care providing system。 Managed careis sort of health insurance model summing op medical careprovision and funds management。 It promises the care qualitywhile keeps expense in control It is very attractive to the insuredin nowadays The author gives some suggestions on solving the problemabout moral hazard。 First of all, corporate governance shouldbe set up in insurance company。Secondly,the insurers shouldreduce consumers ' behaviors of moral hazard throughunderwriting and designing the policy。 Finally, the insurersshould strengthen to control the behaviors of the insured andmedical institution。...