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我国商业医疗保险中的道德风险及对策 被引量:10

The causes for moral risks with commercial medical insurance in China and countermeasures
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摘要 医疗行为的信息不对称以及疾病的客观性、严重性、复杂性、多样性等本质特征导致医疗保险成为道德风险发生频率最高、造成损失最大、又最难以有效规避风险的险种。道德风险是医疗保险市场失灵的重要表现。本文通过分析我国医疗保险市场逆选择和事后道德风险的不同形成原因,以期探讨有效的风险控制方法,从而降低商业医疗保险的经营风险,为促进其合理发展并最终满足居民更全面的健康需求提供帮助。 Information asymmetry in medical behaviors and nature of disease (objectivity, severity, complexity, diversity) make medical insurance the victim of most frequent moral risks and the highest level of losses. Moreover,these moral risks are the most difficult to avoid by insurers. Moral risks are a major sign of market failure. The mor- al risk occurs before application is called anti-selection risk and that occurs after policy being issued is called ex- post moral risk. The article aimed to assess and analyze different causes for adverse selection and ex post moral risks with commercial medical insurance in China. It also explored various effective risk control methods, aiming to reduce the operational risks for commercial medical insurance, promote its healthy development, and as an ultimate goal, satisfy people's demands fro more comprehensive health insurance protection.
作者 章瑛 周霓
出处 《保险研究》 北大核心 2010年第8期30-35,共6页 Insurance Studies
关键词 商业医疗保险 道德风险 逆选择 事后道德风险 福利收益 第三方支付 commercial medical insurance, moral risk, adverse selection, ex-post moral risk, third-party payment
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