摘要
现代医疗服务中的多重委托代理关系和虚拟社会空间,使传统熟人社会基于特定地域和社会关系的医疗信用约束失效,催生了道德风险、逆向选择等医疗信用难题。源于第三方的外生性政府监管方案或市场化方案都难以解决信息不对称、制度不完善以及信息与制度难以协同演化的问题。在医疗保障资源兼具非排他性和竞争性财产属性而与公共池塘资源相似的背景下,互联网信息技术与虚拟社会的构建、医疗卫生领域的利益竞争结构,为自组织集体行动的信用制度方案提供了适用空间。基于自组织集体行动信用制度的供给、承诺和监督,当下应建立各医疗主体共同参与的信息服务平台并完善组织与个体的公共信用档案,构建医疗信用信息公示系统并实现信息互通,制定信用结果的共同运用尤其是联合惩戒制度,从外部环境和内在约束两方面保障医疗卫生集体行动共同体信用制度的正常运行。
The multiple principal-agent relationship and virtual social space in modern medical service makes the traditional society’s medical credit constraint based on specific regions and social relations invalid,resulting in medical credit problems such as moral hazard and adverse selection.The exogenous government supervision scheme or marketization scheme originated from the third party can hardly solve the problem of information asymmetry,imperfect system and lack of co-evolution between information and system.Since healthcare resources have non-exclusive and competitive property features and thus resemble common-pool resource,the internet information technology and the construction of virtual society,and the structure of competing interests in healthcare service makes the application of self-organizing collective action in medical care credit system possible.Focused on the supply,commitment and supervision of the self-organizing collective action credit system,it is time to set up an information service platform on which all medical organizations and individuals establish and improve public credit profiles,build a medical credit information disclosure system and enable information exchange,formulate the joint use of the credit results especially the joint disciplinary system,and guarantee the normal operation of the collective credit system from both the external and internal environment.
作者
郁建兴
汪基强
向淼
Yu Jianxing;Wang Jiqiang;Xiang Miao
出处
《南京社会科学》
CSSCI
北大核心
2020年第6期65-72,共8页
Nanjing Journal of Social Sciences
基金
国家自然科学基金重点招标项目“提升基层医疗卫生服务能力研究”(71734005)
浙江省自然科学基金重大项目“基层医疗卫生机构综合运行机制研究”(D19G030003)的阶段性成果
中央高校基本科研业务费专项资金资助。
关键词
医疗
信用
自组织
集体行动
制度
healthcare service
credit system
self-organization
collective action
institution
