Medical Uncertainty,accountability And Market Effeicency

In Chinese medical market,undertreatment has been a long-standing problem generally and has caused a grim phenomenon called "Yi'nao"."Yi'nao" has been exacerbating doctor-patient contradiction,triggering the alarm of China's medical system reform.In the medical treatment process,doctors rely on professional knowledge to grasp more information than patients.Doctors can use information advantages to deceive patients,and patients cannot judge whether doctors are responsible due to information disadvantages.A high degree of information asymmetry can lead to doctor-patient conflicts.Based on the credence-goods attributes and high-risk characteristics of medical service,we introduced medical uncertainty into traditional theoretical models of credence goods market and designed an accountability mechanism.The system works as follows: patients need to pay a certain cost to blame the doctor first,and the doctor will be directly punished by the loss of reputation for the patient's accountability.If the third part institution further verifies that the patient's insufficient treatment is the doctor's fault,Then the doctor finally needs to compensate the patient.Through a theoretical model and laboratory experiment,we confirmed the positive role of accountability in improving the efficiency of medical market.Then,we explored how to promote the effectiveness of accountability via its three characteristics.We found that the accountability mechanism with high liability works best,and the punishment path of liability plays a greater role than the compensation path.Finally,we designed an extreme accountability to characterize "Yi'nao".The experimental results showed that extreme accountability effectively reduces undertreatment while increasing overtreatment greatly,leading to a decrease in market efficiency overall.Therefore,only a reasonably-designed accountability mechanism can bring about a significant increase in market efficiency,so the way of "Yi'nao" is inefficient.The accountability mechanism designed and demonstrated in this paper provides an important inspiration for the policy design about alleviating doctor-patient contradiction and improving social welfare.