Theoretical Discussion And Empirical Research Of Moral Hazard In Medical Insurance

Health insurance is an insurance that compensation for the medical expenses spent by people. Moral hazard problems are arised from several reasons, for example, the high degree of professionalism of the medical and health services, the interests of doctors and patients are not totally consistent and so on. The moral hazard has seriously disrupted the normal operation of the health insurance function and interfered with the efficient allocation of resources in health. Health insurance including ex-ante moral hazard and ex-post moral hazard. And the ex-post moral hazard affects the medical insurance more.There are four aspects relate to medical insurance, including the government, insurance agencies, medical service providers and the insured person. The government only plays a role of supervision and policy support and not directly involved in the specific operation of medical insurance. Therefore, the moral hazard in the medical insurance comes mainly from insurance agencies, medical service providers and the insured person. In the process to solve the moral hazard of health insurance, medical service provider is the key to solve the problem, as well as the important factors affecting the insured person’s moral hazard.This article through case study, based on the changes in the cost of medical before and after payment reform from a top three hospital obstetric in Tianjin, researching the affect of payment reform on both doctors and patients of moral hazard. On the one hand, expounded moral hazard of medical insurance and it’s effect factors in theory. On the other hand, combined with practical experience in reform of payment for medical care from a top three hospitals in the Tianjin, further thinking about how to promote the medicare payment to the scientific and rational direction. In order to protect the stability of the medical insurance fund, fairness and accessibility of health services, it is necessary to study the moral hazard of medical service providers and its preventive measures.