差別取價在健保機制下的效益實證
Date Issued
2005
Date
2005
Author(s)
魏志定
DOI
zh-TW
Abstract
Before the National Health Insurance (NHI) is officially launch in Taiwan, more than 8.7 millions of elder, housewife and children are not included in any insurance scheme which force them to take medical risk by their own. This problem has cause injustice among social system. After 10 years of NHI, total 23 million populations is covered under insurance reimbursement program. Although the satisfactory rate of NHI is higher by years, but financial dispute have push the system to the edge of bankruptcy.
The role of Taiwan medical industry is situated in a multi- dimensional and very complicated environment. From the professional consideration of medical view to the political consideration for public election; wondering between social insurance system and social welfare benefit; or an industry that provide health care service to people and create economic value as other industries does.
The research findings are as follows:
1. Consumer surplus in NHI system will encourage the public to enlarge their spending in medical care; consumption will increase due to low costing.
2. In the Game theory—The Prisoner's Dilemma scenarios, hospitals will adopt expanding strategic and completing heavily on sales to fight for limited global budget. Medical resources will waste severely under the global budget.
3. Third party payer creates multi-layer agency relationship in NHI system. The moral hazard and agency cost will expand due to such structure.
4. NHI payment scheme have change the distribution of physician to unbalance. In long term the medical service quality will be impair unless the financial balance get improved.
In the case study of out-patient service from Shin Kong Hospital we found that price discrimination will convert consumer surplus into true revenue if new value can be delivered to patient. Patient of different needs will choice the service according to option and generate wellness to pay for higher charge service. From the out-patient survey we found also that patient’s demographic character and specific requirement on medical service is different by department. According to this study, patient’s medical service requirement is multi-dimensional and demand intensity is different by demographic. When specific requirement has meet, patient is willing to pay extra charge for service that suit for themselves.
Price discrimination act as another resource of financial support for NHI is highly possible according to this study. With the government supporting on policy and legislation, price discrimination can create new income for medical service and enhance satisfactory of patient by the delivery of new service value. Thus, without the needs in increasing NHI premium, new financial support will inject into medical industry. When financial quandary of NHI is improved and reaches self-contained and self-sufficient financially, which is the only way that NHI can be maintain and develop in healthy environment.
Subjects
差別取價
全民健保
賽局理論
自費醫療
Price discrimination
National Health Insurance
Game theory
Type
other
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