Adverse Selection Problems In The Social Health Insurance Study

Our country's society system of medical care insurance has established already near ten years. In these years, it is played the very major role in many aspects, such as safeguarding our health, Lightening the family responsibilities, Promoting the social stability and the economic development, but it also has so many problems. And adverse selection is a quite serious issue.This article from the society medical insurance implement process, the government, managment organization, insured individual as well as the hospital interacts to obtain in every way, analysis the relational characteristic of society medical insurance interacts in every way, participates in the benefit between the main body being contradictory, analyzes the relationship between compulsory and adverse selection, pointed out that in the society medical insurance has the problem of adverse selection.Divides the society medical insurance main body into four parts: the insurance side, the insured side, the hospital and the insured patient, pointed out the phenomenon of adverse selection. The policy holder insures realizes lowly, uses own information dominance, the rejection either postpones the insured, the rejection, the concealment, the escape or the reduced payment. The insurance side to insured side to use oneself information dominance of the system movement, controls the safe coverage, the aggravation personally in the insurance burden and so on. The medical establishment in situation of DRGs system, to avoid own loss, presents the adverse selection. The performance is, the high quality hospital withdraws from the market, shifts responsibility onto others the medical insurance critically ill patient, reduces the medical service quality.As the reason of the adverse selection appears in society medical insurance. This article from economic angle analysis, the medical insurance market is different with the standard of the traditional economic research market model,and medical insurance incomplete contract attribute. Thinks that in the social security the reason of adverse selection to lie in the compulsory social insurance system not to achieve the complete compulsion, by the effect of environmental, all quarters participation main body for chase economic interest, using the asymmetric information between the main body which still exists carries on the adverse selection. And moral hazard's existence also accelerates the behavior of adverse selection.Finally, proposed that the question's solution about adverse selection lies in the asymmetric information as well as the compulsory system's consummation. From the system environment, the contract design as well as the system consummation and so on several aspects elaborated how to carry on the rules and regulations to the adverse selection.