医疗服务价格管制的经济学分析

2005*(0)[e-mail];[e-mail]*AbstractInthispaperwedevelopaframeworktoappraisethepoliciesconcerningpricecontrolsofhealthservice.Firstly,weanalyzethelinkbetweenpricecontrolsofhealthserviceandtheformationofChina’shealthcaresystem,inwhichunderpaiddoctorswerecompensatedbyexcessivemedicinefeeandexaminationfee.Secondly,wearguethat,innature,thesystemisanindirectpricingmechanismandthatthismechanismgenerallymakesthelevelofutilityofpatientslowerthanthesecondbestlevelofutilityundermoralhazardandlimitedliability.Finally,weprovidesomesuggestionspertinenttothereformofChina’shealthcaresystem.JELClassificationI18D82K23affordability199333.7%199833.20%200345.8%20032622.244660.38(1851.8)200520052003220041200339120041.81.9234220034445200432000720001045SMkekekk=6q()Sq0S′0S′′()00S=qqqq()SqS=()SqS=t1p72p12tpp=+1p1p110pp≤2p862005698-9978(),Vqt()(),VqtSqt=-()()(),Uetutey=-()utt0u′0u′′()eyee0y′0y′′()00y=Inadacondition()00y′=()1y′′=+∞[]0,1e∈Pr(|)()qqeep==%[]0,1e∈()eep=(){}tq%qqttqqtt0t≥10t≥2(){},ttearge=[]()()0,1max1eetetey∈+--%%%33()ttey′-=4()()()(),1EVqteSqteSqt⎡⎤=-+--⎡⎤⎣⎦⎣⎦5()P()P(){}()(),,max11ettEVeSeSetet=+----..st124120t=0t4()ey′t()P()P′()P′[]()()0,1max1eEVeSeSeey∈′=+--0y′′′e()P′()()SBSBSBSSeeeyy′′′-=+6SBeSBe6e*()SSey*′-=9()ey6eSBet()SBSBtey′=()S•()y•SBtSBt12tpp=+9SBee*20025.2.212SBSBSBtpp=+1SBp2SBp11110SBppp≤2112ˆSBSBSBSBptptpp=--=110pp≤11SBpp106()y•SSS-=ΔSBeSBtSBeSBt1()y•SΔSBt1SΔ()S•()p•10e1e2e1e2eqq1,2i=iSS=SiS()1ep()2ep2SS+S2S(){}ˆ,,TTTTˆTT11{}()0,11,2iei∈=1p1qS0pqS1210pp2y1y0y2100yyy=212yy12qqq==%%ˆ(0)TTT==22120TTpyp-≥7212101TTpyppy-≥-8778212yy()2122110101max,Tyyyyppppppp⎧⎫-≥=⎨⎬Δ+Δ+⎩⎭910pppΔ=-912()P′′()P′′{}()()()()221111max22121TSTSSSpppp-+-++-..st9()P′′9()212210SBCpyppp=Δ+()()()2122111021SBVSSpyppppp=+--Δ+102e2qq=%1ˆTyp=Δ111SBCpyp=Δ()()111110011SBVSSSSpyppppp=+-++--Δ112SBV1SBV22112210Spypp≤Δ-21SBSBVVSΔ1y12210ppp-kk=ke13120p20p()22110ppp-11pAverch-JohnsonModel()()()()()2121121111100102111SBSBVVSSSSSSpypypppppppppp-=+--------+Δ+Δ()()()1121001110SSppyppppyppp⎛⎞=-+-+-⎜⎟⎜⎟Δ+⎝⎠()()()11210110SSppyppyppp⎛⎞=--+-⎜⎟⎜⎟Δ+⎝⎠()112110Sppypyppp⎛⎞=ΔΔ+-⎜⎟⎜⎟Δ+⎝⎠()1121100Sppypyppp⎛⎞ΔΔ+-⎜⎟⎜⎟Δ+⎝⎠()112110Sppypyppp⎛⎞ΔΔ-⎜⎟⎜⎟Δ+⎝⎠2002111111Spppyyyppp⎛⎞ΔΔ-++⎜⎟⎝⎠212yy200111111Spppyyppp⎛⎞ΔΔ≤++⎜⎟⎝⎠200111111Spppyppp⎛⎞⎛⎞ΔΔ-≤+⎜⎟⎜⎟⎝⎠⎝⎠112210Spypp≤Δ-21SBSBVVAverchH.andLelandL.JohnsonBehavioroftheFirmUnderRegulatoryConstrainAmericanEconomicReview196252(5)1052-1069DaughetyA.RegulationandIndustrialOrganizationJournalofPoliticalEconomy198492(5)932-953MyersS.ASimpleModelofFirmBehaviorunderRegulationandUncertaintyBellJournalofEconomicsandManagementScience19734(1)304315