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商业保险公司承办大病保险研究——基于各利益相关方的博弈分析


全文字数:13000字左右  原创时间:<=2022年

【内容摘要】

商业保险公司承办大病保险研究——基于各利益相关方的博弈分析


商业保险公司承办城乡居民大病保险涉及城乡居民、保险公司、医疗服务机构、医疗经办机构和政府五方主体,各方的利益诉求决定了医疗费用的管控是影响大病保险开展的关键因素。通过博弈分析可知,完全信息状态下资质较高的商业保险公司在赢得政府大病保险招标方面更具优势,信息不对称条件下城乡居民和医疗服务机构更倾向于通过骗保和诱导消费等手段获得更多利益,商业保险公司应加强医疗费用的监督核查。
关键词:城乡居民大病保险;商业保险公司;利益相关方;博弈

Study of Commercial Insurance Company to Undertake Major Illness Medical Insurance--Base on Game Analysis of Stakeholders
ABSTRACT
Commercial insurance company to undertake major illness medical insurance related to five main parts: urban and rural residents, insurance companies, medical institutions, social medical insurance institutions and government. The profit and characteristic of each part turn the medical costs into the key factor during the major illness medical insurance development. Game analysis shows that, under the complete information condition, the commercial insurance company which has higher qualification is easier to win when the government calling for tenders. In the incomplete information condition, commercial insurance company should strengthen checking and supervision of medical costs, because of that urban and rural residents and medical institutions are inclined to get more profit by insurance cheating and inducing consumption.
Keywords: Major illness medical insurance; Commercial insurance company; Stakeholders; Game

 

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