A Study On Collusion Between Patients And Hospitals In Medical Insurance

Moral hazard exits in the medical insurance area extensively. Because there are three main parts in medical insurance market: the supplier of medical insurance (insurance company), the supplier of medical treatment (hospital) and insurant of medical insurance (the costumer of medical insurance, or the embracer of medical treatment, or patient).Further more, there are dissymmetrical information among the insurance companies, hospitals and patients, the Moral hazard in the medical insurance area exits seriously.In this paper, we use the relate knowledge about game theory and economic information, and analysis collusion between patients and hospital, and give the three side equilibrium outcome and restraining method. We hope this paper will give some help to insurance company.In part I,we put forward the question and the conception based on the comprehensive review of the relevant documents.In part II, we introduce the relevant knowledge used in this paper.In part III,we establish game theory model of the collusion problem between patients and hospital in single phase medical insurance, and solve the three side equilibrium outcome of the game theory model, and certify other outcomes in off-equilibrium path are not equilibrium outcome.In part IV, we establish the reputation model and discuss the collusion between patients and hospital in multiply phase medical insurance, and give conditions of patients and hospitals'different strategies.In part V, We apply the principal and agent theory ,introduce the incentive model and give punishment and awards for attracting patients and hospital to giving up colluding and indirectly promoting the incoming of insurance company . At the end of the paper, we make a summary and a concise announcement of the deficiency in it and draw out the problem worthy to be studied in later research.