Study on the reimbursement rules of catastrophic disease health insurance in China
10.3969/j.issn.1674-2982.2016.02.001
- VernacularTitle:我国大病医疗保险报销规则研究
- Author:
Jin FENG
;
Jingkai HUANG
- Publication Type:Journal Article
- Keywords:
Catastrophic disease health insurance;
Reimbursement rule;
Moral hazard
- From:
Chinese Journal of Health Policy
2016;9(2):1-5
- CountryChina
- Language:Chinese
-
Abstract:
Moral hazard in the catastrophic disease health insurance has challenged the sustainability of med-ical budget funds. This paper studies the health care reimbursement rule to counteract moral hazard. Theoretical a-nalysis shows that in the target to maximize social welfare, the optimal rule is to provide consumers who choose low-cost treatment with subsidies and charge a co-payment to those who choose high-cost one. Adopting simulation ap-proach shows that this difference with respect to single reimbursement rules, healthcare expenses and medical insur-ance premiums will be significantly reduced compared to a unified co-payment ratio. This paper also selects the sensitivity test simulation parameters and the results show that different values will not change the herein disclosed mechanism results.
