| In China,the irrationality of medical resource,the medical supply level hasn’t satisfied people’s health demand.An important reason for this problem is that the supply of the medical institutions hasn’t satisfied the demand of those.The equilibrium point of supply and demand in hygienic system is to solve the disequilibrium of medical services and health services fundamentally.The disequilibrium of medical supply and demand also makes the existent medical cost high and innovation progress slow in our country.As a kind of public goods,medical services have the public characteristics,hence the reform the adjustment should be made from the aspect of the whole countries’public expenses and profits,and improve the hygienic institutions and system systemically.To dwellers in a country,health is the basis of all the producing activities.Only with the health can people create profits for the society and promote social development in all kinds of social activities.If denizens are with low health level,the social income and national development will reduce inevitably.There are deficiencies in our medical institutions,so that many negative phenomena still exist,as it is hard for people to see a doctor,the medicine cost is high,and the hospitals absorb money from expensive medicines and excessive cure,etc..Moreover,China has a vast territory,the economic developments among areas present imbalances,and the huge diversities in the level of medical care and great disequilibrium in medical situation exist.To eliminate these phenomena and diversities,it is necessary to make a reform in the medical system fundamentally to raise the people’s proceeds of health.According to the difference situation between areas,seeking the reasons to the disequilibrium and drawing up corresponding reformational plans are the suitable moves.In Chinese hygienic field nowadays,there are several reasons for the disequilibrium of hygienic system and the low output of people’s health as below:（1）As a primary institution to provide most medical services,hospitals receive most profit cost by people.Nevertheless,public hospitals are dominant in the hygienic market,but a great deal of operating factors from market economy has permeated into them,which leads that the patients’ paying ability becomes the standard to decide whether he or she will receive the cure and how much treatment he or she will get.So that people’s medical demand can not be satisfied and the seriours structural unbalance appears,and people’s medical demand can’t be satisfied.（2）There are great differences among public hospitals in resource allocation and patients’ quantity,even though they are in the same area.Largescale hospitals located in big cities are equipped with advanced apparatuses and can employ medical staff who have good skills,high educational background and rich experience.All these elements overload the big hospitals by attracting more patients.On the contrary,small scale hospitals,like ones located in counties,are lack of equipment and experienced staff,and the real clinical reception is far lower than their scope.They seldom become the first choice for people when they want to receive treatments,hence some medical resources left unused.（3）Though we are engaged in the construction of health insurances over the whole people,there are some problems in proportion,classification and process of reimbursement caused by nowadays social basic health insurance system.In addition,there are so many constraints in the reimbursement of some serious and knotty illness’cost,and sometimes people with such disease even need to afford all by theirselves.Besides,the nation’s consciousness for buying health insurance hasn’t awakened,so the commercial insurance hasn’t played a role in a wide extent as a supplement of social health insurance.On the other hand,the two-way crisis of confidence between commercial insurance and policyholder hasn’t rescinded,so the nation’s insurance resources can not or can not effectively serve the development of medical and hygienic field.（4）In our country,the economic incentives for the medical staff aren’t enough.Doctors and nurses are engaged in high load work for a long time,but their incomes are disproportionate to their labor:The conflicts happened in many areas between doctors and patients make a lot of troubles for the medical stuff and the job gets riskier,hence the medical human resource is in short supply.It is unilaterally to administer backhanders in medicine to cut down doctors’ gray income,because it can reduce people’s cost on medicine in a restricted way,whereas it has no effect on increasing the quantity of the medical staff,even decreasing instead,not to mention the increasing number of outstanding doctors.That makes the reason for people getting cure difficultly.The unbalanced situation of medical supply and demand,as people hard get a chance to see a doctor,can not be changed for a long time,then it will cause extraordinary rise in the cost of medical services,that is to say,the tense medical human resources can make the rise of medical price.According to the supply-demand effect on the price,the profits of the entire society hasn’t risen,the health expectation of people can’t get the proper level either.According to the existent problems,the research objectives of the paper are:On the basis of existing researches on hygienic situation and reform measures,through expounding the concept of health expectation and building the models of health expectation、production function and hygienic system equilibrium,this paper deeply analyses a variety of factors that affect people’s health expectation.Besides,this paper also discusses how the government’s rules and regulations、economic development and environment affect the people’s medical and health standard,and then finds the methods to reach the equilibrium of the hygienic systenm.The researching content in this paper contains 7 chapters,the main research states the content as follows:（1）It analyzes the theory of life value,and states the marketable evolution process since the "reform and opening-up" period and fairness proceeding of hygienic reforms since new century.It also contains analysis after the statement.（2）Through the analysis on the supply and demand of health in our country,it builds a health expectation model to find the difference between supply and demand,and then analyzes it.（3）It analyzes the reforms of medical system and health care insurance system,by means of discussing the disequilibrium of medical system profit and choke point of health,and the phenomenon of moral risk in health care insurance.（4）It builds an equilibrium model of hygienic system,and proposes the related problems between the interest group and hygienic system’s equilibrium,through which infers it the adjustment and development of hygienic policies.This paper comes to some conclusions as follows:（1）By using "health production function" we can make strategic decisions on various factor input or improving situation of health intuitively.So in this paper,it analyze the reasons leading to the disequilibrium of medical demand and supply structure,including uneven distributions of medical resources caused by different regional economies development;the medical tripartite system reform isn’t used widely;the health care insurance fraction of coverage and ratio of medical cost reimbursement doesn’t get the level,etc..（2）As a special public goods,medical services should be used both to serve the public for the characteristic of commonweal,and also considered as a related part of the market.Through the analysis,we find that the medical market in our country has the characteristic of disequilibrium in demand and supply,technology monopolies,lack of competitions and so on.So the pluralistic competitions of medical services haven’t been actualized yet.As to the health care insurance,because of the great population and low government’s input,it fragmentizes heavily,and shows low coverage of commercial health care insurances.Thus we come to the conclusion that to raise the medical situation of the whole country,it is necessary to launch competitions between public hospitals and private hospitals,the point of which should be the patient’s degree of satisfaction instead of scrambling the government’s subsidies.In the aspect of health care insurance,the institutions should be completed to make both parties in the insurance share the risks and interests.The government should give some subsidies to raise the patients’ interests and improve the quality of good insurance projects,so that the innovative insurance mode as"medical care+insurance" can be developed.（3）By analyzing the health demand,we can get directly the reasons which affect the consumers’ choices and the utilization of medical services.On the other hand,through the analysis of the health supply,it reflects the problems about the allocation of medical resources,supply of superior medical services,currencies and supply of medicines,coverage of health care insurance and the distribution of medical educational resources.Accordingly built health production function can present that "health producing" should be considered as a kind of health input instead of output.To raise the standard of health needs the increase of medical technologies’level,pluralism of medical services,completing the medical system,improvement of the environment and dissemination of the public’s medical consciousness.So the "health producing" is an investing behavior that aims to enhance the public’s health situation.Moreover,building the model of health expectation helps to get the conclusion that the public’s health demand is not only about the medical facilities and services,but also derivative demand for equilibrium of nation’s hygienic and medical systems caused by medical services.In other words,to reach the expectant standard of health,we must make optimized adjustments in the basic problems,such as systems,allocations,educations,capital inputs and so on.（4）Through the analysis of health care insurance’s developing process in our country,though we are achieving "the whole public coverage" in the social health insurance,there are such big defects as limits of insurance,equalization of everyone,the whole inclusiveness of serious illness and so on.Besides,one of the main factors for the weakness of the public health care insurance’s measure is the deficiency of commercial health care insurances.Combined with the concept of"health interest",we come to this conclusion:There are inseparable connections between the public’s health situation and economic development,the increase of the public’s health level has the active effect on the countries’ economy,in which are expansion of the insurance’s coverage and heightening the power an important segment.Subsidies on the insurance industry and disseminations on commercial insurance consciousness can receive higher profits by lower costs,and make the whole societies’ profit plus.（5）By means of building the equilibrium model of hygienic system and analyzing the situations of equilibrium and disequilibrium with the concept of interest group,we come to the conclusion that the existing of interest group has a connection with the equilibrium of hygienic system,which expounds that under the unbalanced hygienic systems,the policies on the allocation of medical resources and health insurances should be adjusted.To promote the equilibrium of hygienic system,the interreaction between government’s policies and social groups and interest groups should be modified,which is with great significance for deepening the reforms of hygienic system.The innovations this paper tries to make are as following:（1）It systematically expounds the theory of health expectation.Conventional health expectation is about people’s expecting lifespan,but in this paper health expectation is not only on the lifespan but also on the manners and environments of healthy life,which belongs to the concept of the health production function.Current scholars do the researches of health expectation mainly on the definitions,extending the lifespan and reducing the death rate.There are rare researches on the appeals of the public’s health,medical reforms,calculating the degree of deviation between insurance system’s situation along with its reforming objectives and insurances’structure.This paper makes innovations and perfections on the theories mentioned above.（2）It proposes the concept of health production function with the Austrian school’s theories as the basis,and builds the model of health expectation and the equilibrium model of hygienic system.Nowadays,there are little researches on the health production function in the academia at home and abroad,especially using the Austrian school’s theories to discuss the medical issues as theoretical principles,which is the innovation of this paper.The Austrian school considers that the society is an aggregation of individuals,and personal economic activities are epitomes of the national economy."Economic man" can be considered as an individual who pursues the satisfaction of"consuming desires".The degree of desiring gives the product value,and the product obtains the objective value when it satisfies the condition of "rarity".In other words,not the capital goods give its values to its products,but the products’ values endow capital goods with values.So we say when people have the expectation on health,then the medical services which can "produce health" have values."Health" as a personal’s physical situation,is seldom considered as a production factor which can produce profits.In this paper,it describes the people’s health expectations,so then shows the value of medical services.The deficiencies on the medical resources supply increase peoples’ objective measure of medical services,which further demonstrates the unbalanced supply problems of the medical field.Moreover,the researches on the health demand and supply propose the concept "health production",and make it an imagery embodied product with economic meanings,and effective on the whole societies’ expenditures and proceeds.This paper makes a research on the public’s health expectation and the derivation between the expectation and medical level.Then it builds a health expectation model and a hygienic system model to analyze the problems of medical demand-supply and hygienic policies,which should be adjusted,and find the corresponding reforming policies.（3）In this dissertation there will be a new definition about the concept of institutional equilibrium by means of the normative analysis.The definition of hygienic institutional equilibrium is a kind of balance between social demand for health and medical care in the consideration of social marginal revenue,and social supply for heath and medical care based on social marginal cost analysis.In the medical market,if people’s total demand for hygienic institutional resources and services raises,it will promote the moving of the curve to the right side.Under the certain institutional supply,it causes the rise of the hygienic institutional social cost.If hygienic institutions have been improved to increase the quantity of the hygienic institutional resources and services,people get the increasing marginal revenue from consuming hygienic institutional sources,it will give impetus to the adaptation between hygienic institutional social marginal revenue and cost,so that the new hygienic institutional equilibrium will appear.On the contrary,when people’s total demand for hygienic institutional resources and services decreases,it will promote the moving of the curve to the left side.Under the certain institutional supply,it causes the decline of the hygienic institutional social revenue,so that it will leave some hygienic institutional resources and services unused and waste.In such condition,if hygienic institutions have been improved to decrease the quantity of the hygienic institutional resources and services,the medical system get the depressed marginal cost from hygienic institutional resources and services,it will give impetus to the adaptation between hygienic institutional social marginal revenue and cost,then the hygienic institutions tend to get a new equilibrium.（4）On account of our country’s public health objectives,it analyzes the health care insurances’ situation.China has a large territorial area and develops as a socialism modern country,and as to the specialities of the nation’s scope and political policies,we have the health care insurance system which is different from most other countries.The researches abroad on the health care insurance are not suitable for our national conditions,whereas domestic researches on the health care insurance are only the analyses about health care insurance system itself,not the connections with the public’s health expectation.This paper analyzes the people’s health expectation and expounds the unbalanced situation of hygienic system from the demand and supply aspects,in which the medical cost one of the important factors affecting the health expectation is.Adding the factor of health care insurance into the model to discuss,including the social health care insurance and the commercial health care insurance,has a great guiding function for the conclusion of adjusting hygienic system policies.In summary,in the process of medical reforms,to achieve people’s total expectation of health level and the equilibrium of hygienic system,it needs a long-term developments and researches.Though "the whole nation’s health care insurance" policy is being implemented,the problems of high medical costs and deficiencies in the medical resources supply will exist for a long time."Health" is a basic requirement in lifetime,and also the most difficult level.It is a key point to make reforms in the hygienic field,also the primary condition to increase social proceeds,and it is a task which needs a long-term research made by the academia.This dissertation will continue to focus on the dynamic conditions in the hygienic field,and optimize the research,offer reforming suggestions for realizing the equilibrium of the hygienic system,so as to make an academic contribution to the improvement on the public’s health level. |
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