我国社会医疗保险中的道德风险表现及治理
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摘要
社会医疗保险是我国社会保障制度中的重要组成部分,医疗服务关系到每个公民的切身利益。目前我国正在实行的社会医疗保险制度,在保障人民群众健康和分散疾病风险方面起到了积极的作用。但是我国社会医疗保险制度运行的时间较短,仍然存在着严重的制度缺陷,导致医疗市场中产生了大量和形式多样的道德风险问题,阻碍了医疗保险制度的正常运行,影响了社会医疗保险基金的正常运转。
由于我国经济的城乡二元结构,相应的社会医疗保险制度分为城镇医疗保险体系和农村医疗保险体系。城镇医疗保险制度经历了多个阶段的改革,最初的城镇医疗保险制度为公费医疗和劳保医疗制度,在这种制度下参保人及其家属都可享受完全免费或非常便宜的医疗服务,造成了医疗资源的大量浪费。之后随着经济的发展,各个城市和地区都根据自身的情况对公费医疗和劳保医疗进行了改革,最为著名的就是“两江试点”。农村的社会医疗保险制度改革较之城镇晚了很多,并且进度也较慢,从1998年开始政府在农村推行新型农村合作医疗制度,农村的新型社会医疗保险制度开始建立。
新的社会医疗保险制度建立起来之后,参保人在支付了一定的保险费用的情况下,享有一定量的社会医疗保险,由于共付制的实行,在一定程度上控制了需方的道德风险。但是新的社会医疗保险制度并没有解决供给方道德风险的问题。由于市场化的进一步推行和政府财政投入的不足,医院的公益性质逐渐被经济利益所侵蚀,为了维持自身的发展和技术设备的更新,医疗机构不断侵占患者的利益,开大处方,做不必要的检查,使得医患关系紧张,医患矛盾加深,患者失去了对医生和医疗机构的信任。另一方面,患者在购买了医疗保险之后由于预算约束的放松,产生了过度消费的主观愿望。由此产生了医患合谋的现象,人情处方,分解处方,挂床住院的现象频繁出现,患者和医疗机构串通,共同套取社保基金,一方面浪费了大量的社会医疗资源,另一方面也严重威胁了基金的收支平衡。
道德风险也被称作败德行为,目前对道德风险并没有一个统一的定义,本文对道德风险的定义为由于信息不对称,个人在追求其自身效用最大化时产生负外部性的行为。在医疗市场上,道德风险分为需求方道德风险和供给方道德风险以及二者之间的合谋。供方道德风险主要表现为过度检查、过度用药、住院期间重复收取费用,提高药品价格等；需方道德风险主要表现为过度诊疗和过度开药,一人参保,全家吃药等；二者合谋的道德风险主要表现为人情方、分解处方、以药串药和挂床住院等。由于保险的加入,使得供给方和需求方在策略选择上有了更大的空间,也为道德风险的产生和存在提供了一定的制度基础。
通过对某市的三家三级甲等医院费用的调研,明显发现医疗保险的加入对医疗费用具有较大的影响。将参保组和非参保组进行比较,可知：在年龄分布上,非参保组的患者更加分散,相对于参保患者来说年龄的构成更加年轻,住院患者参保组的总费用明显高于非参保组的总费用,且二者之间的差异明显；在各项费用构成上西药费、检查费、其他费、床位费、治疗费、护理费参保组均明显高于非参保组,并且二者之间差异明显；手术费用是构成住院费用的主要组成部分,同时因为手术可以影响患者的住院天数和用药数量,所以是否接受手术成为了影响患者住院费用的最主要因素。在接受手术的患者中,参保患者的西药费、检查费、床位费、其他费均明显高于非参保患者；经过单病种的费用及住院天数分析,可以更加清晰地看到参保患者比非参保患者具有更高的住院天数,同时也消耗了更多的医疗资源,这一现象在慢性病以及复杂疾病病例中尤为明显。调研的结果与兰德医疗保险实验的结果相一致,没有参加医保的患者对医疗产品及服务的使用要低于参加医保的患者,医保患者住院时间高于非医保患者；同时参加医保的患者医疗费用支出也明显高于没有参加医保的患者,共付制度对个人的行为选择产生了较为显著的影响。
三者在进行博弈时,作为理性的经济人,需求方和供给方的策略集合为(合谋,不合谋),保险机构的策略集合为(审核,不审核)。将复杂的三方博弈分解为多个简单博弈之后,得到了一些有用的结果：对于保险机构来说,当保险机构审核的成本小于其不审核而受到的由于额外虚报医药费而造成的损失,则保险机构一定会选择审核策略。患者和保险机构的博弈均衡策略为患者选择不合谋,保险机构选择不审核。患者和医疗机构之间的博弈结果为一个混合博弈结果,根据惩罚的力度和合谋所得之间的差额不同而不同。如果加大对患者合谋行为的惩罚,虽然在短期内会抑制合谋的行为,但是长期看来只能增加医疗机构合谋的概率,并不能改善合谋的问题。如果保险机构加大对医疗机构合谋的惩罚,在短期会使医疗机构选择不合谋策略,而且长期也会减少患者合谋的行为。
最终在博弈模型的基础上,借助CTAM模型并对其进行修正可以得到更加适合我国国情的新的模型,并且分别建立供方和需方道德风险控制模型,可知：共付比与个人所需要支付的费用成正相关,共付比越高,个人需要支付的费用就越多,合理的共付比例可以抑制个人过度消费,降低需求方的道德风险；对于供方而言,保险机构可以设定一个医疗费用x,如果x在医疗机构低水平努力时出现的概率大于高水平努力时出现的概率,医疗机构在该x的收入就向下调整；反之,则向上调整。在信息不对称的情况下,保险机构是根据所观测到的患者的医疗费用x推断医疗机构是否努力控制费用,进而对医疗机构进行奖惩。如果为低努力水平则采取惩罚措施,如果为高努力水平则采取奖励措施,这样就可以有效地控制供给方的道德风险。
这一理论的结果在实际应用中就表现为对需求方采取设置起付线和最高限额,对于供给方则将传统的支付方式改变为预付制,通过支付方式的改变来限制供需双方的道德风险。同时进一步完善我国社会医疗保险制度及配套措施,以保证政策实施的有效性。
Social medical insurance is the most important part of the society guarantee system, medical service relates to the benefits of each citizen.The current social medical insurance system, is playing the active role in the aspects of guaranteeing the health of the people and scattering the disease risk.But the social medical insurance system is still a new policy, so there are some serious system blemish in it, lead to a great deal moral hazard problem in the medical market, obstruct the normal movement of medical insurance system, influence the normal operation of social medical insurance fund.
Because of the dual economic structure, the social medical insurance system is be divided into the town medical insurance system and the village medical insurance system.The town medical insurance system experienced the reform of several stages, at first the town medical insurance system is public-fund medical insurance and labor protection insurance medical system, the people who having the medical insurance and his family memberseses can enjoy completely free or dirt cheap medical treatment service, resulted in a great deal of waste of medical resources.With the development and of the economy, many city and regions all carried on reform to the public-fund medical treatment and the labor insurance medical treatment according to the circumstance of oneself, the most famous is "liang-jiang reform".The reforms of village social medical insurance system is later, and the progress is also more slow, the government began to promote NCMS in the village since 1998, the new social medical insurance system of village starts building up.
In the new social medical insurance system, people who paid certain insurance expenses all can enjoy a certain amount of social medical services, because of the co-payment systerm, the moral hazard be controled in some extent.But the mew social medical insurance system has never solved the moral hazard of supply side.Because of the market reform and the shortage of government the public finance in medical, the public-spirited property of hospital is gradually eroded by the economic benefits, for the sake of the development of oneself and the renewal of the technique and equipments, the medical organization continuously seizes the sufferer's benefits and opens big prescription, and has an otiose check, and make to cure to suffer from relating to nervous, cure to suffer from an antinomy to deepen, the sufferer lost the trust to the doctor and the medical organization.On the other hand, because of purchasing medical insurance the sufferer's buget is relax, produced the subjective wishes of excesssive con sumption. So produced to cure to suffer from the phenomenon that matches to strive for, decomposition prescription, the phenomenon that artificial hospitalization multifarious emergence, sufferer and medical organization conspire to take of the medical insurance fund, on the other hand a great deal of social medical resources being wasted, also seriously threaten the balanced budget of fund.
The morals hazard is also called immoral behavior, there isn't an unified definition to the morals hazard currently, the definition of morals hazard in this article is because of the information dissymmetry, individual cause the negative externalities while maximizing his own benifit. At medical market, the morals hazard is divided into a need side morals hazard and supply side morals hazard and the matching of strive.Supply side morals hazardmainly performance as excesssive check, excessively use of medicine, and raise drugs price etc.;Need side morals hazard's mainly expressing is excesssive diagnosis and treatment and excessively prescribe a medicine, a ginseng protects, the whole family takes medicine etc.;Two match to strive of morals hazard mainly performance as, resolve prescription, with medicine string medicine with artificial hospitalization etc..Because the insurance joins and makes there are more choices in choosing strategy, were also provide certain system foundation creation and existence for morals risk.
We did a investigation in three 3-class first grade hospitals, can know that the joining of medical insurance has the bigger influence on medical expense:In distributing age, the sufferer who do not have the medical insurance is to scatter more, and younger, hospitalized sufferer who in insurance's the total expenses of set is more obviously high than the one who don't have insurance, and the difference of the two is obvious;Be constituting each expenses the last western medicine fee and check a fee, other fees and bed fee, cure a fee, nursing fee the insuranced set is aller obviously high than not insuranced set, and the difference of the two is obvious;Surgical operation expenses is constitute to go to hospital expenses of mainly constitute part, at the same time the surgical operation can influence the sufferer's hospitalized day and the amount of medicines, so whether had an operation to become to the most important factor of influencng a sufferer's expenses.At the operation set, insuranced sufferer's western medicine fee, check fee and bed fee, other feeses is aller obviously high than the not insuranced one; The insuranced sufferer also have higher hospitalized day, also consumed more medical resourceses at the same time, this phenomenon is particularly obvious in the chronic disease and the complicated disease case. The result is consistent with the Rand experiment, the sufferer not in the medical insurance will use less resources than the sufferer in insurance, the hospitalized day of the insuranced one is longer than the one who is not;Sufferer's medical expense that takes part in the insurance at the same time expends more obviously high than the one who is not in the insurance, co-payment system have many important influence to personal behavior choice.
While carrying on a game, as a rational economic person, the strategy between need side and supply side is(cooperative,uncooperative), the strategy of insurance organization is(examine, unexamine).We got some useful results after be splited to many simple gamesr:Is the cost that the insurance organization examines is smaller than to insurance organization it doesn't examine but be subjected to of result in because of additionally make false report medical expenses of loss, the insurance organization then will definitely choose to examine strategy.The game balanced strategy of the sufferer and insurance organization brings trouble to choose to be unsuited to cooperative the insurance organization chooses not to examine.The game result of sufferer and medical organization is a hybrid game result, according to the strength for punishment is different and different from the difference in amount that matches an of striving for the income.If the enlargement matches the punishment of striving for the behavior to the sufferer, although the behavior that will repress to match to cooperative in the short run,in a long period of time can increase medical organization to match to strive for of all rate, can not improve to match the problem for striving for.If the insurance organization enlargement matches the punishment for striving for to the medical organization, it will make medical organization choose uncooperative for strategy in the short date, and the long term will also reduce a sufferer to match cooperative.
On the foundation of game model, we use of the CTAM model, and respectively establishment provide side and need side morals hazard control model, can know:the ratio of co-payment of personal paying is just related with the need, the rate is high, person need paying expenses more, the totally paying proportion can repress an individual excessively consume, lower need side's morals hazard;the insurance organization can set a medical expense x, if x appear more at low level, the medical organization gets down adjustment in the x income;Whereas, then adjust upward.Under the circumstance of information dissymmetry, the insurance organization predicts if the medical organization makes great effort to control expenses and then carries on a prize or punishment to the medical organization according to the sufferer's medical expense x prognosticated.If then adopt to punish measure for low effort level, if then adopt to praise measure for high effort level, so can availably control supply square's morals risk.
The use of this theory conclusion in practice applying express to adopt constitution to pay line and the tallest quota to the square of need, for supply side then tradition way of pay be changed as advancement system, through the changing of the paying the way to limit the supply and demand sides' morals hazadr.At the same time to complete our country social medical insurance system is the indemnification of these measures.
由于我国经济的城乡二元结构,相应的社会医疗保险制度分为城镇医疗保险体系和农村医疗保险体系。城镇医疗保险制度经历了多个阶段的改革,最初的城镇医疗保险制度为公费医疗和劳保医疗制度,在这种制度下参保人及其家属都可享受完全免费或非常便宜的医疗服务,造成了医疗资源的大量浪费。之后随着经济的发展,各个城市和地区都根据自身的情况对公费医疗和劳保医疗进行了改革,最为著名的就是“两江试点”。农村的社会医疗保险制度改革较之城镇晚了很多,并且进度也较慢,从1998年开始政府在农村推行新型农村合作医疗制度,农村的新型社会医疗保险制度开始建立。
新的社会医疗保险制度建立起来之后,参保人在支付了一定的保险费用的情况下,享有一定量的社会医疗保险,由于共付制的实行,在一定程度上控制了需方的道德风险。但是新的社会医疗保险制度并没有解决供给方道德风险的问题。由于市场化的进一步推行和政府财政投入的不足,医院的公益性质逐渐被经济利益所侵蚀,为了维持自身的发展和技术设备的更新,医疗机构不断侵占患者的利益,开大处方,做不必要的检查,使得医患关系紧张,医患矛盾加深,患者失去了对医生和医疗机构的信任。另一方面,患者在购买了医疗保险之后由于预算约束的放松,产生了过度消费的主观愿望。由此产生了医患合谋的现象,人情处方,分解处方,挂床住院的现象频繁出现,患者和医疗机构串通,共同套取社保基金,一方面浪费了大量的社会医疗资源,另一方面也严重威胁了基金的收支平衡。
道德风险也被称作败德行为,目前对道德风险并没有一个统一的定义,本文对道德风险的定义为由于信息不对称,个人在追求其自身效用最大化时产生负外部性的行为。在医疗市场上,道德风险分为需求方道德风险和供给方道德风险以及二者之间的合谋。供方道德风险主要表现为过度检查、过度用药、住院期间重复收取费用,提高药品价格等；需方道德风险主要表现为过度诊疗和过度开药,一人参保,全家吃药等；二者合谋的道德风险主要表现为人情方、分解处方、以药串药和挂床住院等。由于保险的加入,使得供给方和需求方在策略选择上有了更大的空间,也为道德风险的产生和存在提供了一定的制度基础。
通过对某市的三家三级甲等医院费用的调研,明显发现医疗保险的加入对医疗费用具有较大的影响。将参保组和非参保组进行比较,可知：在年龄分布上,非参保组的患者更加分散,相对于参保患者来说年龄的构成更加年轻,住院患者参保组的总费用明显高于非参保组的总费用,且二者之间的差异明显；在各项费用构成上西药费、检查费、其他费、床位费、治疗费、护理费参保组均明显高于非参保组,并且二者之间差异明显；手术费用是构成住院费用的主要组成部分,同时因为手术可以影响患者的住院天数和用药数量,所以是否接受手术成为了影响患者住院费用的最主要因素。在接受手术的患者中,参保患者的西药费、检查费、床位费、其他费均明显高于非参保患者；经过单病种的费用及住院天数分析,可以更加清晰地看到参保患者比非参保患者具有更高的住院天数,同时也消耗了更多的医疗资源,这一现象在慢性病以及复杂疾病病例中尤为明显。调研的结果与兰德医疗保险实验的结果相一致,没有参加医保的患者对医疗产品及服务的使用要低于参加医保的患者,医保患者住院时间高于非医保患者；同时参加医保的患者医疗费用支出也明显高于没有参加医保的患者,共付制度对个人的行为选择产生了较为显著的影响。
三者在进行博弈时,作为理性的经济人,需求方和供给方的策略集合为(合谋,不合谋),保险机构的策略集合为(审核,不审核)。将复杂的三方博弈分解为多个简单博弈之后,得到了一些有用的结果：对于保险机构来说,当保险机构审核的成本小于其不审核而受到的由于额外虚报医药费而造成的损失,则保险机构一定会选择审核策略。患者和保险机构的博弈均衡策略为患者选择不合谋,保险机构选择不审核。患者和医疗机构之间的博弈结果为一个混合博弈结果,根据惩罚的力度和合谋所得之间的差额不同而不同。如果加大对患者合谋行为的惩罚,虽然在短期内会抑制合谋的行为,但是长期看来只能增加医疗机构合谋的概率,并不能改善合谋的问题。如果保险机构加大对医疗机构合谋的惩罚,在短期会使医疗机构选择不合谋策略,而且长期也会减少患者合谋的行为。
最终在博弈模型的基础上,借助CTAM模型并对其进行修正可以得到更加适合我国国情的新的模型,并且分别建立供方和需方道德风险控制模型,可知：共付比与个人所需要支付的费用成正相关,共付比越高,个人需要支付的费用就越多,合理的共付比例可以抑制个人过度消费,降低需求方的道德风险；对于供方而言,保险机构可以设定一个医疗费用x,如果x在医疗机构低水平努力时出现的概率大于高水平努力时出现的概率,医疗机构在该x的收入就向下调整；反之,则向上调整。在信息不对称的情况下,保险机构是根据所观测到的患者的医疗费用x推断医疗机构是否努力控制费用,进而对医疗机构进行奖惩。如果为低努力水平则采取惩罚措施,如果为高努力水平则采取奖励措施,这样就可以有效地控制供给方的道德风险。
这一理论的结果在实际应用中就表现为对需求方采取设置起付线和最高限额,对于供给方则将传统的支付方式改变为预付制,通过支付方式的改变来限制供需双方的道德风险。同时进一步完善我国社会医疗保险制度及配套措施,以保证政策实施的有效性。
Social medical insurance is the most important part of the society guarantee system, medical service relates to the benefits of each citizen.The current social medical insurance system, is playing the active role in the aspects of guaranteeing the health of the people and scattering the disease risk.But the social medical insurance system is still a new policy, so there are some serious system blemish in it, lead to a great deal moral hazard problem in the medical market, obstruct the normal movement of medical insurance system, influence the normal operation of social medical insurance fund.
Because of the dual economic structure, the social medical insurance system is be divided into the town medical insurance system and the village medical insurance system.The town medical insurance system experienced the reform of several stages, at first the town medical insurance system is public-fund medical insurance and labor protection insurance medical system, the people who having the medical insurance and his family memberseses can enjoy completely free or dirt cheap medical treatment service, resulted in a great deal of waste of medical resources.With the development and of the economy, many city and regions all carried on reform to the public-fund medical treatment and the labor insurance medical treatment according to the circumstance of oneself, the most famous is "liang-jiang reform".The reforms of village social medical insurance system is later, and the progress is also more slow, the government began to promote NCMS in the village since 1998, the new social medical insurance system of village starts building up.
In the new social medical insurance system, people who paid certain insurance expenses all can enjoy a certain amount of social medical services, because of the co-payment systerm, the moral hazard be controled in some extent.But the mew social medical insurance system has never solved the moral hazard of supply side.Because of the market reform and the shortage of government the public finance in medical, the public-spirited property of hospital is gradually eroded by the economic benefits, for the sake of the development of oneself and the renewal of the technique and equipments, the medical organization continuously seizes the sufferer's benefits and opens big prescription, and has an otiose check, and make to cure to suffer from relating to nervous, cure to suffer from an antinomy to deepen, the sufferer lost the trust to the doctor and the medical organization.On the other hand, because of purchasing medical insurance the sufferer's buget is relax, produced the subjective wishes of excesssive con sumption. So produced to cure to suffer from the phenomenon that matches to strive for, decomposition prescription, the phenomenon that artificial hospitalization multifarious emergence, sufferer and medical organization conspire to take of the medical insurance fund, on the other hand a great deal of social medical resources being wasted, also seriously threaten the balanced budget of fund.
The morals hazard is also called immoral behavior, there isn't an unified definition to the morals hazard currently, the definition of morals hazard in this article is because of the information dissymmetry, individual cause the negative externalities while maximizing his own benifit. At medical market, the morals hazard is divided into a need side morals hazard and supply side morals hazard and the matching of strive.Supply side morals hazardmainly performance as excesssive check, excessively use of medicine, and raise drugs price etc.;Need side morals hazard's mainly expressing is excesssive diagnosis and treatment and excessively prescribe a medicine, a ginseng protects, the whole family takes medicine etc.;Two match to strive of morals hazard mainly performance as, resolve prescription, with medicine string medicine with artificial hospitalization etc..Because the insurance joins and makes there are more choices in choosing strategy, were also provide certain system foundation creation and existence for morals risk.
We did a investigation in three 3-class first grade hospitals, can know that the joining of medical insurance has the bigger influence on medical expense:In distributing age, the sufferer who do not have the medical insurance is to scatter more, and younger, hospitalized sufferer who in insurance's the total expenses of set is more obviously high than the one who don't have insurance, and the difference of the two is obvious;Be constituting each expenses the last western medicine fee and check a fee, other fees and bed fee, cure a fee, nursing fee the insuranced set is aller obviously high than not insuranced set, and the difference of the two is obvious;Surgical operation expenses is constitute to go to hospital expenses of mainly constitute part, at the same time the surgical operation can influence the sufferer's hospitalized day and the amount of medicines, so whether had an operation to become to the most important factor of influencng a sufferer's expenses.At the operation set, insuranced sufferer's western medicine fee, check fee and bed fee, other feeses is aller obviously high than the not insuranced one; The insuranced sufferer also have higher hospitalized day, also consumed more medical resourceses at the same time, this phenomenon is particularly obvious in the chronic disease and the complicated disease case. The result is consistent with the Rand experiment, the sufferer not in the medical insurance will use less resources than the sufferer in insurance, the hospitalized day of the insuranced one is longer than the one who is not;Sufferer's medical expense that takes part in the insurance at the same time expends more obviously high than the one who is not in the insurance, co-payment system have many important influence to personal behavior choice.
While carrying on a game, as a rational economic person, the strategy between need side and supply side is(cooperative,uncooperative), the strategy of insurance organization is(examine, unexamine).We got some useful results after be splited to many simple gamesr:Is the cost that the insurance organization examines is smaller than to insurance organization it doesn't examine but be subjected to of result in because of additionally make false report medical expenses of loss, the insurance organization then will definitely choose to examine strategy.The game balanced strategy of the sufferer and insurance organization brings trouble to choose to be unsuited to cooperative the insurance organization chooses not to examine.The game result of sufferer and medical organization is a hybrid game result, according to the strength for punishment is different and different from the difference in amount that matches an of striving for the income.If the enlargement matches the punishment of striving for the behavior to the sufferer, although the behavior that will repress to match to cooperative in the short run,in a long period of time can increase medical organization to match to strive for of all rate, can not improve to match the problem for striving for.If the insurance organization enlargement matches the punishment for striving for to the medical organization, it will make medical organization choose uncooperative for strategy in the short date, and the long term will also reduce a sufferer to match cooperative.
On the foundation of game model, we use of the CTAM model, and respectively establishment provide side and need side morals hazard control model, can know:the ratio of co-payment of personal paying is just related with the need, the rate is high, person need paying expenses more, the totally paying proportion can repress an individual excessively consume, lower need side's morals hazard;the insurance organization can set a medical expense x, if x appear more at low level, the medical organization gets down adjustment in the x income;Whereas, then adjust upward.Under the circumstance of information dissymmetry, the insurance organization predicts if the medical organization makes great effort to control expenses and then carries on a prize or punishment to the medical organization according to the sufferer's medical expense x prognosticated.If then adopt to punish measure for low effort level, if then adopt to praise measure for high effort level, so can availably control supply square's morals risk.
The use of this theory conclusion in practice applying express to adopt constitution to pay line and the tallest quota to the square of need, for supply side then tradition way of pay be changed as advancement system, through the changing of the paying the way to limit the supply and demand sides' morals hazadr.At the same time to complete our country social medical insurance system is the indemnification of these measures.
引文
[1]Arrow, Kenneth J., Uncertainty and the Welfare Economics of Medical Care, American Economic Review (1963),53(5):941-973.
[2]M Grossman, The Demand for Health:A Theoretical and Empirical Investigation, New York:Columbia University Press for NBER(1972)
[3]Spence, Michael & Zeckhauser, Richard, Insurance, Information, and Individual Action, American Economic Review, American Economic Association(1971), vol. 61(2), pages 380-87, May.
[4]Pauly, M.. The Economics of Moral Hazard:Comment, American Economic Review(1968),58,531-536.
[5]J P Newhouse,1970, Toward a theory nonprofit institutions, AER, (March), Vol.60, pp.604-713
[6]Arrow, KJ, The Economics of Moral Hazard:Further Comment, American Economic Review,58 (June,1968),537-539.
[7]Rothschild, M. and F. Stiglitz,1976, Equilibrium in Competitive Insurance Markets:An Essay on the Economics of Imperfect Information, Quarterly Journal of Economics 90:4,630-699.
[8]Ehrlich, I. and G. becker, Market Insurance, Self-Insurance, and Self-Protection. Journal of Political Economy(1972,),80:623-648.
[9]Feldstein, MS, The Welfare Loss of Excess Health Insurance, Journal of Political Economy,81, March/April,1973,251-280.
[10]Cropper, M L,. Health, Investment in Health, and Occupational Choice, Journal of Political Economy, University of Chicago Press(1977), vol.85(6), pages 1273-94, December
[11]Parkin D., McGuire A., Yule B..Aggregate Health Expenditures and National Income:Is Health Care a Luxury Good. Journal of Health Economics.1987,6.109-127
[12]Kihlstrom R.E.and A.E. Roth. Risk Aversion and the Negotiation of Insurance Contracts[J]. The Journal of Risk and Insurance,1982,(49):372-387
[13]Roth A. A note on Risk Aversion in a Perfect Equilibrium Model of Bargaining[J]. Econometrics,1985,(53):207-211
[14]Shan Cretin et.al.Models for Setiting Health Insurance Premiums,July,1987
[15]Cooper, R. and T. W. Ross, Product Warranties and Double Moral Hazard, in:Rand Journal of Economics(1985),16,103-113.
[16]M V Pauly, Nonprofit firms in medical markets, American Economic Review(1987), (May) Vol.77, pp.257-274
[17]Manning, Willard G., et al. Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment, American Economic Review/1987),77(3), 251-277
[18]Cho and Kreps, Signaling Games and Stable Equilibria, Quarterly Journal of Economics,1987.
[19]Mailath, Incentive Compatibility in Signaling Games with a Continuum of Types, Econometrica,1987.
[20]Crawford and Sobel, Strategic Information Transmission, Econometrica,1982.
[21]Milgrom and Roberts, Limit Pricing and Entry under Incomplete Information:An Equilibrium Analysis, Econometrica,1982
[22]Eckstein, Z. and K. Wolpin,1989, The Specification and estimation of Dynamic Stochastic Discrete Choice Models-A Survey. Journal of Human Resources 24(4): 562-98.
[23]Diamond, P.. Organizing the health insurance market. Econometrica(1992) 60(6): 1233-1254.
[24]Zweifel P.Breyer F, Health economics 1997
[25]Supply-Side and Demand-Side Cost Sharing in Health Care, Randall P. Ellis and Thomas G. McGuire The Journal of Economic Perspectives Vol.7, No.4 (Autumn, 1993), pp.135-151
[26]Welfare-Improving Health Expenditure Subsidies, William Jack and Louise Sheiner, The American Economic Review Vol.87, No.1 (Mar.,1997), pp.206-221
[27]The Effect of Deductibles on the Demand for Medical Care Services, Joseph P. Newhouse, John E. Rolph, Bryant Mori and Maureen Murphy Journal of the American Statistical Association Vol.75, No.371 (Sep.,1980), pp.525-533
[28]The demand for episodes of treatment in the health insurance experiment Volume (Year):7 (1988) Issue (Month):4 (December) Pages:337-367
[29]Ching-To Albert Ma and ThomasGMcguire,Optimal Health Insurance and provider payment,American Economic Review, Volume 87,1997(4):685.704.
[30]Coase, Ronald, The new institutional economics. American Economic(1998) Review,88(2):72-74.
[31]Fehr,E, and Gaechter,S., Do Incentive Contracts Crowd Out Voluntary Cooperation? IERE Working Paper No.34. University of Zurich.196,2000
[32]Jabanna Jacob and Douglas Lundin,A Median Voter Model of Health Insurance with Ex Post Moral Hazard, Journal of Health Economics, Volume 24, Issue 2, 2005(3):407-426
[33]Frederik T. Schut and Wolter H. J. Hassink, Managed Competition and Consumer Price Sensitivity in Social Health Insurance. Journal of Health Economics, Volume 21, Issue 6,2002(11):1009-1029
[34]Gintis and Bowles, Evolution of Strong Reciprocity:Cooperation in heterogeneous Populations. Journal of Theoretical Biologe (2004),322-35.
[35]Gintis.H,,Strong Reciprocity and Human Sociality,Journal of Theoretical Biology(2000)216:169-179.
[36]Gintis, Bowles, Boyd and Fehr., Explaining altruistic behavior in humans. Evolution and human behavior(2003),24153-172.
[37]Irene Oi Ling Wong, Wa-Sum Chart,Sarah Choi, Su—Vui Lo, Gabriel Matthew Leung and on behalf of the Health Care Financing Study Group:Moral Hazard or Realized Access to Care?Empirical Observations in Hong Kong, Health Policy,Volume 75, Issue 3,2006(2):251-261
[38]Eggleston K,risk Selection and Optimal Health Insurance-provider payment systems, The Journal of Risk and Insurance,2000(2):173-196
[39]Ma A. C., Riordan M. H., Insurance, Moral Hazard and Managed Care, Journal of Economics&Management Strategy,2002(1):49-63
[40]Bac, C. and Le Pen, Y. An International Comparison of Health Care Expenditure Determinants,10th International Conference on Panel Data, Berlin. (2002)
[41]Manfred Huber, Ph.D. and Eva Orosz, Ph.D., Health Expenditure Trends in OECD Countries,1990-2001, Health Care Financing Review, fall 2003
[42]Firat Bilgel, The Determinants of Canadian Provincial Health Expenditures: Evidence from Dynamic Panel; CEA 38th Annual Meetings June 6,2004
[43]Robetrs M. et al.; Getting health reform right. Political analysis and political strategies[M]:Word Bank.2002.51-75
[44]Andrew Ang, Angela Maddaloni, Do Demographic Changes Affect Risk Premiums? Evidence From International Data[J]. Working Paper for National Bureau of Economic Research,2003.
[45]James Poterba, The Impact of Population Aging on Financial Markets[J]. Working Paper,2004.
[46]Takashi Oshio, Social Security and Trust Fund Management[J]. Working Paper for National Bureau of Economic Research,2004.
[47]Abel, A.B. The social security and trust fund, the riskless interest rate, and capital accumulation [J]. Risk Aspects of investment-based Social Security Reform. Chicago: The University of Chicago Press,2001:153-193
[48]Cutler, David M..Equality, Efficiency, and Market Fundamentals: theDynamics of International Medical-Care.Journal of Economic Literature (2002), September40 (3):881-906.
[49]Grossman, Michael..The Human Capital Moder of the Demand for Health. Working Paper(1999), No.7078, National Bureau of Economic Research.
[50]william N. Evans; W.Kip Viscusi Jncome effects and the value of health [M],The journal of human resources, Vol.28,No,3,497-518)
[51]Emmett B.Keelere, Daniel Morrow;Joseph Newhouse, The demand for supplementary health insurance or do deductibles matter [M] The Journal of Political Economy, Vol.85,No.4,789-80
[52]Charles P.Hall, Jr, Deductibles in Health Insurance:An Evaluation[M], The Journal of Risk and Insurance, Vol.33,No.2,253-263
[53]Derrig.R.A.Insurance Fraud[J].The Journal of Risk and Insurance.2002,:271-281
[54]John Sabelhaus, Michael Simpson, Julie Topoleski. Incorporating Longevity Effects into Long-term Medicare Projections[R].Washington, DC:Congressional Budget Office, January 2004.p4-21.
[55]Petretto, A. Optimal social health insurance with supplementary private insurance, Journal of Health Economics(1999),18,727-745.
[56]Udo Schneider, Asymmetric information and demand for Health Care-the case of double moral hazard,Diskussionspapier 02-03, ISSN1611-3837,2003
[57]Meara, Ellen, Chapin White, and David M. Cutler, Trends in Medical Spending by Age,1963-2000, Health Affairs, July/August 2004,23 (4),176-183.
[58]Livio Di Matteo; The macro determinants of health expenditure in the United States and Canada:assessing the impact of income, age distribution and time; Health Policy 71 (2005) 23-42
[59]Charles I.Jones, Why Have Health Expenditures as a Share of GDP Risen So Much, http://elsa.berkeley.edu/chad,2004,may 5
[60]Lawson, A., Biggeri, A., Bohning, D., Lesaffre, E., Viel, J.-F., and Bertollini, R., editors (1999)Disease Mapping and Risk Assessment for Public Health. West Sussex, UK:John Wiley & Sons Ltd.Le, N., Petkau, A., and Rosychuk, R. (1996). Surveillance of clustering near point sources.Statistics in Medicine,15,727-740.
[61]Krupnick, Alan & Alberini, Anna & Simon, Nathalie & Itaoka, Kenshi & Akai, Makoto & Cropper, Maureen,2005. Age, Health, and the Willingness to Pay for Mortality Risk Reductions:A Contingent Valuation Survey in Japan,
[62]Zweifel, P. and W. G. Manning. Moral hazard and consumer incentives in health care. Handbook of health economics(2000). A. J. C. a. J. P. Newhouse. North-Holland.1: 409-459.
[63]Acemoglu, D., D. Cutler, et al.. Did Medicare Induce Pharmaceutical Innovation? National Bureau of Economic Research Working Paper Series (2006) No.11949.
[64]Finkelstein, A. The Aggregate Effects of Health Insurance:Evidence from the Introduction of Medicare. The Quarterly Journal of Economics (2007) 122(1):
[65]Carrin, G. and C. James. Social health insurance:key factors affecting the transition towards universal coverage. International Social Security Review(2005) 58(1)
[66]Cubanski J. Is incremental change working? Or is it time to reconsider universal coverage? The Commonwealth Fund,Issue Brief. (2004)
[67]Cebul, R. D., J. B. Rebitzer, et al..Unhealthy Insurance Markets:Search Frictions and the Cost and Quality of Health Insurance. National Bureau of Economic Research Working Paper Series(2008) No.14455.
[68]Mark V. Pauly, S. Nicholson, D. Polsky, M. Berger, C. Sharda, Markets Without Magic:How Competition Might Save Medicare, AEI Press,2008.
[69]Mark V. Pauly, A. Dor, M.A. Eichleay, P.J. Held, Valuing Reductions in On-the-Job Illness:'Presenteeism' from Managerial and Economic Perspectives, Health Economics, 17.4:469-485 (April 2008).
[70]Mark V. Pauly, B. Herring, End-stage Renal Disease and Economic Incentives:The International Study of Health Care Organization and Financing, International Journal of Health Care Finance and Economics,7.2/3:73-111 (September 2007).
[71]Mark V. Pauly, M.K. Bundorf, Pooling and Regulation:Policy and Reality in Today's Individual Health Insurance Market, Health Affairs,26.3:770-779 (May/June 2007).
[72]Mark V. Pauly, J.A. Pagan, Is Health Insurance Affordable for the Uninsured?, Journal of Health Economics,25.4:650-673 (July 2006).
[73]陈佳贵：中国社会保障发展报告[M],北京社会科学文献出版社,2001
[74]成思危：中国社会保障体系的改革与完善[M],民主与建设出版社,2000
[75]张晓,刘蓉：社会医疗保险概论[M],中国劳动社会保障出版社,2004
[76]孙光德,董克用：社会保障概论[M],中国人民大学出版社,2000
[77]罗元文：国际社会保障制度比较[M],中国经济出版社,2001
[78]赵曼：社会医疗保险费用约束机制与道德风险规避[J],财贸经济,2003(6)
[79]赵曼：医疗保险费用约束机制与医患双方道德风险规避[J],中南财经大学学报,1997(1)
[80]赵曼、吕国营：关于社会医疗保险承保范围的分析[J],财政研究,2002(3)
[81]赵曼：社会医疗保险费用约束机制与道德风险规避[J],财贸经济,2003(2)
[82]史文璧,黄丞：道德风险与医疗保险风险控制[J],经济问题探索,2005(2)
[83]胡苏云：医疗保险中的道德风险分析[J],中国卫生资源,2000(3)
[84]赵小苏等：我国城镇职工基本医疗保险的道德风险及其防范[J],卫生经济研究,2001(7)
[85]郑秉文：信息不对称与医疗保险[J],经济社会体制比较,2002(6)
[86]周云：不完全竞争医疗保健市场的福利状况分析[J],卫生经济研究,2003(5)
[87]金春林：控制医疗费用的策略重点应着眼于宏观层面[J],中国卫生资源,2000,3(6)
[88]国锋、孙林岩：健康保险中道德风险影响研究[J],经济科学,2003,(6)
[89]国锋、孙林岩：患者道德风险与医生诱导需求的影响与控制[J],中国卫生经济,2004(7)
[90]祝向军：不对称信息与医疗保险有效供给的经济分析[J].保险研究,2002,(9)
[91]孟庆跃：医疗保险支付方式改革对费用控制的影响分析[J],卫生经济研究,2002(9)
[92]陈钢：医疗保险市场道德风险的经济分析[J],中国卫生事业管理,2005(9)
[93]李娟：我国社会医疗保险中道德风险的表现[J],卫生软科学,2005(12)
[94]毛瑛,李娇凤：城镇职工基本医疗保险道德风险的防范研究[J],中国医学伦 理学,2005(8)
[95]史文璧,黄丞：道德风险与医疗保险风险控制[J],经济问题探索,2005(2)
[96]祝向军,金兆新：不对称信息与医疗保险有效供给的经济分析[J],保险研究2002(9)
[97]代志明,周浩杰：试论社会医疗保险中的道德风险及防范[J],卫生经济研究,2005(5)
[98]朱捷：浅析健康保险中的道德风险及其控制机制[J],保险研究,2004(9)
[99]史晓滨：论在信息不对称状况下健康险的管理[J],保险研究,2005(2)
[100]张玉启,郭继志,王伟：医疗卫生领域信息不对称的伦理问题及对策[J],中国医学伦理学,2005(10)
[101]周丽涛,毛瑛：医疗保险中医生的双重代理身份及其带来问题的研究[J],中国医学伦理学,2005(6)
[102]王晓燕：医疗保险个人帐户制的激励性初探[J],人口与经济,2004(2)
[103]刘慧侠,赵守国：我国政府介入医疗保险的政策研究[J],中国软科学,2004(11)
[104]吴传俭,王玉芳：我国社会医疗保险基金风险管理问题[J],医学与哲学,2005(8)
[105]仇雨临：国外医疗保险制度的主要问题与改革[J],卫生经济研究,2002(5)
[106]杨敬宇,李岳峰：关于卫生服务的性质与产业化[J],卫生经济研究,2005(3)
[107]应心：信息不对称影响过度医疗的伦理思考[J],医学与哲学,2004(11)
[108]张帆,姚俭,吴承琪：基于激励理论的医疗保险领域道德风险防范研究[J],上海理工大学学报,2006(3)
[109]赵小苏：我国城镇职工基本医疗保险的道德风险及其防范[J],中国卫生事业管理,2001(8)
[110]李玮,黄丞,蒋馥：社会医疗保险中欺诈问题的博弈分析.上海交通大学学报.第38卷,第3期.3,2004:470-473
[111]赵曼,吕国营：社会医疗保险中的道德风险[M].北京：中国劳动社会保障出版社,2007,(4)
[112]林俊荣：基本医疗保险中的道德风险及其控制[J].辽宁工程技术大学学报,2006,(7)
[113]王锦锦：论社会医疗保险中的道德风险及其制度消解[J].人口与经济,2007,(3)
[114]赵曼：社会保障中的道德风险及其规避[M].北京：中国计划出版社.1997
[115]赵曼：社会保障制度结构与运行分析[M].北京：中国计划出版社.1997
[116]赵曼,柯国年：医疗保险费用约束机制与医患双方道德风险规避[J],中南财经大学学报,1997(1)
[117]朴明根：论保险市场信息不对称[J],保险研究2002(6)
[118]刘喜华：信息不对称与最优保险设计[J],中国软科学2003(10)
[119]衰定清：健康保险与第三方健康管理[J],保险研究2004(1)
[120]国家卫生部,2007年中国卫生统计年鉴[M]
[121]国家统计局,2006年国家统计年鉴[M]
[122]国家统计局,2007年国家统计年鉴[M]
[122]国家统计局,2008年国家统计年鉴[M]
[123]国家统计局,2009年国家统计年鉴[M]
[124]中国社会保障网http://www.chss.cn
[125]中国劳动和社会保障网http://www.zgldbz.cn
[126]中华人民共和国卫生部：第三次国家卫生服务调查主要结果.www.moh.gov.cn
[127]国家卫生服务研究1993年第一次国家卫生服务调查分析报告[EB].www.moh.gov.cn/statistics/ronhs/prologue.htm.
[128]国家卫生服务研究1998年第二次国家卫生服务调查分析报告[EB].www.moh.gov.cn/statistics/ronhs98/.
[2]M Grossman, The Demand for Health:A Theoretical and Empirical Investigation, New York:Columbia University Press for NBER(1972)
[3]Spence, Michael & Zeckhauser, Richard, Insurance, Information, and Individual Action, American Economic Review, American Economic Association(1971), vol. 61(2), pages 380-87, May.
[4]Pauly, M.. The Economics of Moral Hazard:Comment, American Economic Review(1968),58,531-536.
[5]J P Newhouse,1970, Toward a theory nonprofit institutions, AER, (March), Vol.60, pp.604-713
[6]Arrow, KJ, The Economics of Moral Hazard:Further Comment, American Economic Review,58 (June,1968),537-539.
[7]Rothschild, M. and F. Stiglitz,1976, Equilibrium in Competitive Insurance Markets:An Essay on the Economics of Imperfect Information, Quarterly Journal of Economics 90:4,630-699.
[8]Ehrlich, I. and G. becker, Market Insurance, Self-Insurance, and Self-Protection. Journal of Political Economy(1972,),80:623-648.
[9]Feldstein, MS, The Welfare Loss of Excess Health Insurance, Journal of Political Economy,81, March/April,1973,251-280.
[10]Cropper, M L,. Health, Investment in Health, and Occupational Choice, Journal of Political Economy, University of Chicago Press(1977), vol.85(6), pages 1273-94, December
[11]Parkin D., McGuire A., Yule B..Aggregate Health Expenditures and National Income:Is Health Care a Luxury Good. Journal of Health Economics.1987,6.109-127
[12]Kihlstrom R.E.and A.E. Roth. Risk Aversion and the Negotiation of Insurance Contracts[J]. The Journal of Risk and Insurance,1982,(49):372-387
[13]Roth A. A note on Risk Aversion in a Perfect Equilibrium Model of Bargaining[J]. Econometrics,1985,(53):207-211
[14]Shan Cretin et.al.Models for Setiting Health Insurance Premiums,July,1987
[15]Cooper, R. and T. W. Ross, Product Warranties and Double Moral Hazard, in:Rand Journal of Economics(1985),16,103-113.
[16]M V Pauly, Nonprofit firms in medical markets, American Economic Review(1987), (May) Vol.77, pp.257-274
[17]Manning, Willard G., et al. Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment, American Economic Review/1987),77(3), 251-277
[18]Cho and Kreps, Signaling Games and Stable Equilibria, Quarterly Journal of Economics,1987.
[19]Mailath, Incentive Compatibility in Signaling Games with a Continuum of Types, Econometrica,1987.
[20]Crawford and Sobel, Strategic Information Transmission, Econometrica,1982.
[21]Milgrom and Roberts, Limit Pricing and Entry under Incomplete Information:An Equilibrium Analysis, Econometrica,1982
[22]Eckstein, Z. and K. Wolpin,1989, The Specification and estimation of Dynamic Stochastic Discrete Choice Models-A Survey. Journal of Human Resources 24(4): 562-98.
[23]Diamond, P.. Organizing the health insurance market. Econometrica(1992) 60(6): 1233-1254.
[24]Zweifel P.Breyer F, Health economics 1997
[25]Supply-Side and Demand-Side Cost Sharing in Health Care, Randall P. Ellis and Thomas G. McGuire The Journal of Economic Perspectives Vol.7, No.4 (Autumn, 1993), pp.135-151
[26]Welfare-Improving Health Expenditure Subsidies, William Jack and Louise Sheiner, The American Economic Review Vol.87, No.1 (Mar.,1997), pp.206-221
[27]The Effect of Deductibles on the Demand for Medical Care Services, Joseph P. Newhouse, John E. Rolph, Bryant Mori and Maureen Murphy Journal of the American Statistical Association Vol.75, No.371 (Sep.,1980), pp.525-533
[28]The demand for episodes of treatment in the health insurance experiment Volume (Year):7 (1988) Issue (Month):4 (December) Pages:337-367
[29]Ching-To Albert Ma and ThomasGMcguire,Optimal Health Insurance and provider payment,American Economic Review, Volume 87,1997(4):685.704.
[30]Coase, Ronald, The new institutional economics. American Economic(1998) Review,88(2):72-74.
[31]Fehr,E, and Gaechter,S., Do Incentive Contracts Crowd Out Voluntary Cooperation? IERE Working Paper No.34. University of Zurich.196,2000
[32]Jabanna Jacob and Douglas Lundin,A Median Voter Model of Health Insurance with Ex Post Moral Hazard, Journal of Health Economics, Volume 24, Issue 2, 2005(3):407-426
[33]Frederik T. Schut and Wolter H. J. Hassink, Managed Competition and Consumer Price Sensitivity in Social Health Insurance. Journal of Health Economics, Volume 21, Issue 6,2002(11):1009-1029
[34]Gintis and Bowles, Evolution of Strong Reciprocity:Cooperation in heterogeneous Populations. Journal of Theoretical Biologe (2004),322-35.
[35]Gintis.H,,Strong Reciprocity and Human Sociality,Journal of Theoretical Biology(2000)216:169-179.
[36]Gintis, Bowles, Boyd and Fehr., Explaining altruistic behavior in humans. Evolution and human behavior(2003),24153-172.
[37]Irene Oi Ling Wong, Wa-Sum Chart,Sarah Choi, Su—Vui Lo, Gabriel Matthew Leung and on behalf of the Health Care Financing Study Group:Moral Hazard or Realized Access to Care?Empirical Observations in Hong Kong, Health Policy,Volume 75, Issue 3,2006(2):251-261
[38]Eggleston K,risk Selection and Optimal Health Insurance-provider payment systems, The Journal of Risk and Insurance,2000(2):173-196
[39]Ma A. C., Riordan M. H., Insurance, Moral Hazard and Managed Care, Journal of Economics&Management Strategy,2002(1):49-63
[40]Bac, C. and Le Pen, Y. An International Comparison of Health Care Expenditure Determinants,10th International Conference on Panel Data, Berlin. (2002)
[41]Manfred Huber, Ph.D. and Eva Orosz, Ph.D., Health Expenditure Trends in OECD Countries,1990-2001, Health Care Financing Review, fall 2003
[42]Firat Bilgel, The Determinants of Canadian Provincial Health Expenditures: Evidence from Dynamic Panel; CEA 38th Annual Meetings June 6,2004
[43]Robetrs M. et al.; Getting health reform right. Political analysis and political strategies[M]:Word Bank.2002.51-75
[44]Andrew Ang, Angela Maddaloni, Do Demographic Changes Affect Risk Premiums? Evidence From International Data[J]. Working Paper for National Bureau of Economic Research,2003.
[45]James Poterba, The Impact of Population Aging on Financial Markets[J]. Working Paper,2004.
[46]Takashi Oshio, Social Security and Trust Fund Management[J]. Working Paper for National Bureau of Economic Research,2004.
[47]Abel, A.B. The social security and trust fund, the riskless interest rate, and capital accumulation [J]. Risk Aspects of investment-based Social Security Reform. Chicago: The University of Chicago Press,2001:153-193
[48]Cutler, David M..Equality, Efficiency, and Market Fundamentals: theDynamics of International Medical-Care.Journal of Economic Literature (2002), September40 (3):881-906.
[49]Grossman, Michael..The Human Capital Moder of the Demand for Health. Working Paper(1999), No.7078, National Bureau of Economic Research.
[50]william N. Evans; W.Kip Viscusi Jncome effects and the value of health [M],The journal of human resources, Vol.28,No,3,497-518)
[51]Emmett B.Keelere, Daniel Morrow;Joseph Newhouse, The demand for supplementary health insurance or do deductibles matter [M] The Journal of Political Economy, Vol.85,No.4,789-80
[52]Charles P.Hall, Jr, Deductibles in Health Insurance:An Evaluation[M], The Journal of Risk and Insurance, Vol.33,No.2,253-263
[53]Derrig.R.A.Insurance Fraud[J].The Journal of Risk and Insurance.2002,:271-281
[54]John Sabelhaus, Michael Simpson, Julie Topoleski. Incorporating Longevity Effects into Long-term Medicare Projections[R].Washington, DC:Congressional Budget Office, January 2004.p4-21.
[55]Petretto, A. Optimal social health insurance with supplementary private insurance, Journal of Health Economics(1999),18,727-745.
[56]Udo Schneider, Asymmetric information and demand for Health Care-the case of double moral hazard,Diskussionspapier 02-03, ISSN1611-3837,2003
[57]Meara, Ellen, Chapin White, and David M. Cutler, Trends in Medical Spending by Age,1963-2000, Health Affairs, July/August 2004,23 (4),176-183.
[58]Livio Di Matteo; The macro determinants of health expenditure in the United States and Canada:assessing the impact of income, age distribution and time; Health Policy 71 (2005) 23-42
[59]Charles I.Jones, Why Have Health Expenditures as a Share of GDP Risen So Much, http://elsa.berkeley.edu/chad,2004,may 5
[60]Lawson, A., Biggeri, A., Bohning, D., Lesaffre, E., Viel, J.-F., and Bertollini, R., editors (1999)Disease Mapping and Risk Assessment for Public Health. West Sussex, UK:John Wiley & Sons Ltd.Le, N., Petkau, A., and Rosychuk, R. (1996). Surveillance of clustering near point sources.Statistics in Medicine,15,727-740.
[61]Krupnick, Alan & Alberini, Anna & Simon, Nathalie & Itaoka, Kenshi & Akai, Makoto & Cropper, Maureen,2005. Age, Health, and the Willingness to Pay for Mortality Risk Reductions:A Contingent Valuation Survey in Japan,
[62]Zweifel, P. and W. G. Manning. Moral hazard and consumer incentives in health care. Handbook of health economics(2000). A. J. C. a. J. P. Newhouse. North-Holland.1: 409-459.
[63]Acemoglu, D., D. Cutler, et al.. Did Medicare Induce Pharmaceutical Innovation? National Bureau of Economic Research Working Paper Series (2006) No.11949.
[64]Finkelstein, A. The Aggregate Effects of Health Insurance:Evidence from the Introduction of Medicare. The Quarterly Journal of Economics (2007) 122(1):
[65]Carrin, G. and C. James. Social health insurance:key factors affecting the transition towards universal coverage. International Social Security Review(2005) 58(1)
[66]Cubanski J. Is incremental change working? Or is it time to reconsider universal coverage? The Commonwealth Fund,Issue Brief. (2004)
[67]Cebul, R. D., J. B. Rebitzer, et al..Unhealthy Insurance Markets:Search Frictions and the Cost and Quality of Health Insurance. National Bureau of Economic Research Working Paper Series(2008) No.14455.
[68]Mark V. Pauly, S. Nicholson, D. Polsky, M. Berger, C. Sharda, Markets Without Magic:How Competition Might Save Medicare, AEI Press,2008.
[69]Mark V. Pauly, A. Dor, M.A. Eichleay, P.J. Held, Valuing Reductions in On-the-Job Illness:'Presenteeism' from Managerial and Economic Perspectives, Health Economics, 17.4:469-485 (April 2008).
[70]Mark V. Pauly, B. Herring, End-stage Renal Disease and Economic Incentives:The International Study of Health Care Organization and Financing, International Journal of Health Care Finance and Economics,7.2/3:73-111 (September 2007).
[71]Mark V. Pauly, M.K. Bundorf, Pooling and Regulation:Policy and Reality in Today's Individual Health Insurance Market, Health Affairs,26.3:770-779 (May/June 2007).
[72]Mark V. Pauly, J.A. Pagan, Is Health Insurance Affordable for the Uninsured?, Journal of Health Economics,25.4:650-673 (July 2006).
[73]陈佳贵：中国社会保障发展报告[M],北京社会科学文献出版社,2001
[74]成思危：中国社会保障体系的改革与完善[M],民主与建设出版社,2000
[75]张晓,刘蓉：社会医疗保险概论[M],中国劳动社会保障出版社,2004
[76]孙光德,董克用：社会保障概论[M],中国人民大学出版社,2000
[77]罗元文：国际社会保障制度比较[M],中国经济出版社,2001
[78]赵曼：社会医疗保险费用约束机制与道德风险规避[J],财贸经济,2003(6)
[79]赵曼：医疗保险费用约束机制与医患双方道德风险规避[J],中南财经大学学报,1997(1)
[80]赵曼、吕国营：关于社会医疗保险承保范围的分析[J],财政研究,2002(3)
[81]赵曼：社会医疗保险费用约束机制与道德风险规避[J],财贸经济,2003(2)
[82]史文璧,黄丞：道德风险与医疗保险风险控制[J],经济问题探索,2005(2)
[83]胡苏云：医疗保险中的道德风险分析[J],中国卫生资源,2000(3)
[84]赵小苏等：我国城镇职工基本医疗保险的道德风险及其防范[J],卫生经济研究,2001(7)
[85]郑秉文：信息不对称与医疗保险[J],经济社会体制比较,2002(6)
[86]周云：不完全竞争医疗保健市场的福利状况分析[J],卫生经济研究,2003(5)
[87]金春林：控制医疗费用的策略重点应着眼于宏观层面[J],中国卫生资源,2000,3(6)
[88]国锋、孙林岩：健康保险中道德风险影响研究[J],经济科学,2003,(6)
[89]国锋、孙林岩：患者道德风险与医生诱导需求的影响与控制[J],中国卫生经济,2004(7)
[90]祝向军：不对称信息与医疗保险有效供给的经济分析[J].保险研究,2002,(9)
[91]孟庆跃：医疗保险支付方式改革对费用控制的影响分析[J],卫生经济研究,2002(9)
[92]陈钢：医疗保险市场道德风险的经济分析[J],中国卫生事业管理,2005(9)
[93]李娟：我国社会医疗保险中道德风险的表现[J],卫生软科学,2005(12)
[94]毛瑛,李娇凤：城镇职工基本医疗保险道德风险的防范研究[J],中国医学伦 理学,2005(8)
[95]史文璧,黄丞：道德风险与医疗保险风险控制[J],经济问题探索,2005(2)
[96]祝向军,金兆新：不对称信息与医疗保险有效供给的经济分析[J],保险研究2002(9)
[97]代志明,周浩杰：试论社会医疗保险中的道德风险及防范[J],卫生经济研究,2005(5)
[98]朱捷：浅析健康保险中的道德风险及其控制机制[J],保险研究,2004(9)
[99]史晓滨：论在信息不对称状况下健康险的管理[J],保险研究,2005(2)
[100]张玉启,郭继志,王伟：医疗卫生领域信息不对称的伦理问题及对策[J],中国医学伦理学,2005(10)
[101]周丽涛,毛瑛：医疗保险中医生的双重代理身份及其带来问题的研究[J],中国医学伦理学,2005(6)
[102]王晓燕：医疗保险个人帐户制的激励性初探[J],人口与经济,2004(2)
[103]刘慧侠,赵守国：我国政府介入医疗保险的政策研究[J],中国软科学,2004(11)
[104]吴传俭,王玉芳：我国社会医疗保险基金风险管理问题[J],医学与哲学,2005(8)
[105]仇雨临：国外医疗保险制度的主要问题与改革[J],卫生经济研究,2002(5)
[106]杨敬宇,李岳峰：关于卫生服务的性质与产业化[J],卫生经济研究,2005(3)
[107]应心：信息不对称影响过度医疗的伦理思考[J],医学与哲学,2004(11)
[108]张帆,姚俭,吴承琪：基于激励理论的医疗保险领域道德风险防范研究[J],上海理工大学学报,2006(3)
[109]赵小苏：我国城镇职工基本医疗保险的道德风险及其防范[J],中国卫生事业管理,2001(8)
[110]李玮,黄丞,蒋馥：社会医疗保险中欺诈问题的博弈分析.上海交通大学学报.第38卷,第3期.3,2004:470-473
[111]赵曼,吕国营：社会医疗保险中的道德风险[M].北京：中国劳动社会保障出版社,2007,(4)
[112]林俊荣：基本医疗保险中的道德风险及其控制[J].辽宁工程技术大学学报,2006,(7)
[113]王锦锦：论社会医疗保险中的道德风险及其制度消解[J].人口与经济,2007,(3)
[114]赵曼：社会保障中的道德风险及其规避[M].北京：中国计划出版社.1997
[115]赵曼：社会保障制度结构与运行分析[M].北京：中国计划出版社.1997
[116]赵曼,柯国年：医疗保险费用约束机制与医患双方道德风险规避[J],中南财经大学学报,1997(1)
[117]朴明根：论保险市场信息不对称[J],保险研究2002(6)
[118]刘喜华：信息不对称与最优保险设计[J],中国软科学2003(10)
[119]衰定清：健康保险与第三方健康管理[J],保险研究2004(1)
[120]国家卫生部,2007年中国卫生统计年鉴[M]
[121]国家统计局,2006年国家统计年鉴[M]
[122]国家统计局,2007年国家统计年鉴[M]
[122]国家统计局,2008年国家统计年鉴[M]
[123]国家统计局,2009年国家统计年鉴[M]
[124]中国社会保障网http://www.chss.cn
[125]中国劳动和社会保障网http://www.zgldbz.cn
[126]中华人民共和国卫生部：第三次国家卫生服务调查主要结果.www.moh.gov.cn
[127]国家卫生服务研究1993年第一次国家卫生服务调查分析报告[EB].www.moh.gov.cn/statistics/ronhs/prologue.htm.
[128]国家卫生服务研究1998年第二次国家卫生服务调查分析报告[EB].www.moh.gov.cn/statistics/ronhs98/.