The Research Of The Moral Hazard On Doctors In The Social Medical Insurance

The aging of the population, the increase of the residents'income, the rising of the health awareness, the application of the high technology and other factors could lead to the rising of the medical expenses. However, the most important reason of the escalating medical expenses is the moral hazard on doctors caused by the existing medical insurance system deficiencies. Due to the moral hazard on doctors, the offering of the social medical insurance tend to making excessive supply of medical services, resulting in a tremendous waste of medical resources. In fact, the moral hazard on doctors in the social medical insurance has been a hot issue to the states.Moral hazard exists in the area of the social insurance widely, it's the medical insurance that the moral hazard on doctors in the medical insurance that has the highest frequency, widest distributing, greatest loss and hardest evading method. In the social medical insurance, the moral hazard on doctors is a kind of opportunism behavior that because of the driver out of the economic interests, the offering square of the medical service make use of the information advantage, which will cause the social medical insurance expenses absurdity increase. Actually, the "third parties" in the social medical insurance system is the fundamental reason of the moral hazard on doctors. In this system, because of the information dissymmetry, the uncertainty of the treatment, particularity of the medical consumption and the medical insurance system's loophole, the overspread of the moral hazard in the social medical insurance of our country comes into being. The moral hazard inclines to bringing the negative social trends that will prevent the social development, usually lead to the significant increase of the medical expenses, aggravate the burden of the nation, business enterprises and the individuals, and cause the low efficiency of the social medical insurance system, even undermine the social fairness, spoil the social atmosphere. The moral hazard on doctors is impossible exterminated completely, but we can evade it, and reduce its negative effect to the lowest extent.The developed countries have a relatively successful experience about the moral hazard on doctors which gives us a good insight. After 1950s western countries had established a more perfect medical insurance system. But the problems about the insurance have become more and more trouble since 1970s especially 1980s. An important aspect is that the irrational increasing of the medical expenses because of the existing of the moral hazard on doctors. Consequently, the western countries adopted a series of measure to control the medical expenses. For example, the introduction of internal competition, categorization referral system, the strength of the management and supervision of medical institutions in England; the reference pricing system, the co-payment system, the spending cap system in Germany and so on. These measures have solved the problem of moral hazard on doctors in their countries to a certain extent.From a planned economy to a market economy, from the government to private, there is a painful process with a change in the traditional ways of thinking and practicing in China. As health care has become a huge industry, it need for a strong economic support increasingly. With the improvement of material and cultural life of the whole community, the medical staffs have been paying more and more attention to their own revenue; the providing of the health services has become a means of profit increasingly. Some of the medical staffs and hospital administrators relax the self-education and the cultivation of professional ethics, life and values distorted, utilitarian inflated. In such circumstances, traditional moral education or moral self-discipline has been unable to avoid moral hazard on doctors effectively. It has posed a challenge to China on how to choose a path to circumvent the problem of moral hazard on doctors. In my opinion, in order to solve this problem, we should start from the external constraint system, according to the establishment of a scientific monitoring system for the prevention and punishment mechanism to achieve the integration of the internal system and the external system. Only in this way can we avoid the moral hazard on doctors effectively and stop the trend of rising medical expenses to achieve a reasonable distribution and utilization of the medical expenses among the members of the society, and achieve the purpose of protecting people's basic health.Based on the successful experiences from abroad, in light of China's actual conditions, taking the external system as the main point, we can use the way of integrating the internal and the external systems to avoid the moral hazard on doctors in the social medical insurance. The specific measures including, the separation of the medical and medicine, improving the medical service price compensation mechanism; introducing binding mechanism to exploring new ways to pay medical expenses; the introduction of experts to establish the mechanism for disseminating information about health services; using the implementation mechanism to construct a scientific supervision and reward-punishment mechanism; using the credit education to strengthen the entire health care system of the moral self-discipline.