醫療保險需求
醫療保險需求
buchongyiliaobaoxianzuoweiwoguoyiliaobaoxiangaigedechanwu,wulunshililunshangdeyanjiuhaishishijianzhongdetansuo,douhaizhishiganggangqibu。buchongyiliaobaoxianjiangruhefazhan,zheliwomentanyixiegerendekanfa。
從個案地區的情況看補充醫療保險的現實需求
為(wei)了(le)展(zhan)望(wang)補(bu)充(chong)醫(yi)療(liao)保(bao)險(xian)的(de)發(fa)展(zhan),有(you)必(bi)要(yao)先(xian)了(le)解(jie)補(bu)充(chong)醫(yi)療(liao)保(bao)險(xian)的(de)現(xian)實(shi)需(xu)求(qiu)。這(zhe)裏(li)我(wo)們(men)以(yi)四(si)川(chuan)的(de)情(qing)況(kuang)為(wei)例(li)進(jin)行(xing)一(yi)些(xie)初(chu)步(bu)的(de)分(fen)析(xi)。該(gai)個(ge)案(an)地(di)區(qu)的(de)情(qing)況(kuang)原(yuan)出(chu)自(zi)四(si)川(chuan)省(sheng)勞(lao)動(dong)保(bao)障(zhang)部(bu)門(men)於(yu)1998年10月至12月對省內部分地區用人單位和職工進行的醫療保險情況抽樣調查。此次調查的單位樣本共189家(機關、事業單位108家,企業81家),共有職工 92630入,男女職工比例為 8:5(機關和事業單位為3:l,企業為5:2),離退休人員占職工總數的25%(機關和事業單位為24%,企業為26%)。81家企業單位中經濟效益較好的占4.8%,一般的占31.l%,較差的占55.4%。所調查的單位1997年職工人均年度工資為6056.50元(機關和事業單位7337.80元,企業5633.21元)。通過對調查結果的分析,關於補充醫療保險,我們得出如下幾點印象和結論(不排除這些印象因調查地點和時間段的有限性而不能完全反映全國的普遍情況)。
(一)大多數單位(機關和事業單位占93.l%,企業占 85.2%)指出他們能夠接受的"基本醫療"部分的籌資比例在8%以下,能夠接受的封頂線為當地社會年平均工資的3至5倍。超過半數的單位(機關事業單位為67%,企業為54.3%)不願為單位職工投保補充醫療保險,不願意投保的主要原因是單位負擔不起;願意投保的單位能接受的繳費比例約為職工工資的2%左zuo右you。這zhe反fan映ying出chu許xu多duo企qi業ye特te別bie是shi國guo有you大da中zhong型xing企qi業ye負fu擔dan較jiao重zhong的de實shi際ji情qing況kuang。因yin此ci,補bu充chong醫yi療liao保bao險xian方fang案an隻zhi能neng采cai取qu非fei強qiang製zhi性xing的de自zi願yuan參can保bao方fang式shi,保bao險xian費fei亦yi不bu能neng定ding得de過guo高gao。
(二)願意自辦或為職工投保補充醫療保險的單位大多希望參加社會保險經辦機構開辦的補充醫療保險,並願意用不超過職工工資總額的3%laizibanhuocanjiashehuibaoxianjingbanjigoukaibandebuchongyiliaobaoxian。zheshuomingyoushehuiyiliaobaoxianguanlijigoukaibanziyuancanbaodebuchongyiliaobaoxianzuoweijibenyiliaobaoxiandebuchong,chujuyoudetianduhoudeyoushiwai,yefuheguangdazhigonghedanweideyuanwang。
(三)大多數職工(占68.7%)認為所在單位不會為其購買商業醫療保險。超過60.9%的職工個人不願意投保商業醫療保險,不願意投保的主要原因是經濟上負擔不起和對商業保險公司缺乏信任感,願意投保的個人大多(占56.1%)僅願意每年拿出不多於100元來購買商業醫療保險。這在一定程度上表明,商業保險公司雖然具有靈活、gaoxiaohefuwuzhoudaodengyoudian,danyouyumuqianwoguozhenggeshangyeyiliaobaoxiandefazhanhaichuyuqibujiaduan,guangdazhigonghedanweiduibaoxiangongsidexinrendubugao,duiqizhifunenglihaibufangxin。zheshishangyebaoxiangongsizaishejibuchongyiliaobaoxianchanpinshiyingdangjiayikaolvdeyinsu。
醫療保險需求形成的條件[2]
(1)醫療保險消費意願。人ren們men對dui醫yi療liao保bao險xian的de需xu求qiu,是shi源yuan於yu對dui自zi己ji生sheng命ming安an全quan和he健jian康kang保bao障zhang的de需xu要yao。當dang無wu法fa預yu料liao的de自zi然ran疾ji病bing和he意yi外wai事shi故gu發fa生sheng時shi,會hui給gei人ren們men造zao成cheng身shen心xin傷shang害hai,帶dai來lai經jing濟ji損sun失shi,影ying響xiang人ren們men的de生sheng活huo。這zhe就jiu會hui使shi人ren們men在zai心xin理li上shang產chan生sheng一yi種zhong對dui患huan病bing的de擔dan憂you和he恐kong懼ju,並bing尋xun找zhao某mou種zhong手shou段duan來lai避bi免mian、應付或減少疾病發生時所造成的損失。因此,人們一般都具有購買醫療保險以求平安、穩定、正常的願望,這種消費意願成為購買保險的首要因素。
(2)貨幣支付能力。在(zai)商(shang)品(pin)經(jing)濟(ji)條(tiao)件(jian)下(xia),保(bao)險(xian)機(ji)構(gou)與(yu)參(can)保(bao)人(ren)之(zhi)間(jian)也(ye)是(shi)一(yi)種(zhong)商(shang)品(pin)經(jing)濟(ji)關(guan)係(xi)。人(ren)們(men)要(yao)想(xiang)獲(huo)得(de)保(bao)險(xian),必(bi)須(xu)支(zhi)付(fu)一(yi)定(ding)量(liang)保(bao)險(xian)費(fei)。人(ren)們(men)對(dui)醫(yi)療(liao)保(bao)險(xian)需(xu)要(yao)的(de)滿(man)足(zu),受(shou)到(dao)其(qi)貨(huo)幣(bi)支(zhi)付(fu)能(neng)力(li)的(de)限(xian)製(zhi)。因(yin)此(ci),醫(yi)療(liao)保(bao)險(xian)需(xu)求(qiu)就(jiu)是(shi)人(ren)們(men)在(zai)一(yi)定(ding)的(de)保(bao)險(xian)費(fei)率(lv)(premium rate)(價格)條件下由貨幣支付能力決定的對醫療保險的需要量。
(3)醫療保險需求者所投保的標的物符合醫療保險機構的經濟技術的要求。jicanbaorenxiangtoubaodeyiliaobaoxianxianzhonghebaoxianjigoushejidexianzhongxiangwenhe,zheshigouchengyiliaobaoxianxuqiudebibeitiaojian。ruguoxuqiuzhesuotoubaodebiaodeshibaoxianjigouzaijishushangnanyizuodaode,yebunenggouchengyouxiaodeyiliaobaoxianxuqiu。lirutoubaoaizibing。zongzhi,queshaoshangshusangetiaojian,renmenxiangdedaodeyiliaobaozhangxuyaojiubunenghuonanyizhuanhuaweizhenzhengyouxiaodeyiliaobaoxianxuqiu。
[編輯]
醫療保險需求的經濟理論[3]
1.財富邊際效用遞減
jinguanrenmenduicaifushipianhaode,dansuizheyongyoudecaifushuliangzengjia,jinguancaifugeirenmendailaidezongxiaoyongzaibuduanzengjia,danzengjiadecaifugeirenmendailaidebianjixiaoyongshidijiande。
2.消費者追求效用最大化
疾病是不可預測的,人們無法知道自己會在什麼時候患病、患病的嚴重程度以及患病可能帶來的經濟損失,為了能在疾病發生時保持效用最大化,可以在自我保險、購買保險兩種方法中選擇。
[編輯]
醫療保險需求的形式[2]
醫療保險需求有兩種表現形式:①youxingdejingjibaozhangxingshi,jizaiwuzhifangmian,tixianzairenmenhuanbinghezaoyuyiwaishanghaishi,yiliaobaoxianjigouanzhaoyiliaobaoxianhetongzhongguidingdechangfufanwei,duifashengyiliaofeiyongdecanbaorengeiyubufenhuoquanbudebuchanghuogeifu,huotongguoyiliaojigouzhijietigongmianfei、部分免費或低價的醫療服務;②無形的心理安全保障形式,體現在轉嫁疾病風險,獲得醫療保險保障,解除人們因病致貧的後顧之憂,從而獲得心理上的安全保障。
在zai實shi際ji生sheng活huo中zhong,人ren們men往wang往wang比bi較jiao注zhu重zhong帶dai來lai經jing濟ji保bao障zhang的de實shi物wu形xing態tai需xu求qiu,而er對dui心xin理li安an全quan保bao障zhang的de無wu形xing需xu求qiu則ze認ren識shi不bu足zu。有you的de個ge人ren和he參can保bao單dan位wei,由you於yu在zai保bao險xian有you效xiao期qi內nei沒mei發fa生sheng保bao險xian責ze任ren範fan圍wei內nei的de疾ji病bing損sun失shi,閩min而er沒mei有you得de到dao經jing濟ji補bu償chang和he給gei付fu,就jiu認ren為wei參can加jia醫yi療liao保bao險xian是shi白bai花hua了le錢qian,甚shen至zhi對dui投tou保bao持chi消xiao極ji的de態tai度du。這zhe種zhong認ren識shi是shi片pian麵mian的de。事shi實shi上shang,社she會hui的de發fa展zhan和he人ren們men生sheng活huo的de安an定ding,對dui上shang述shu兩liang種zhong形xing式shi的de需xu求qiu都dou是shi客ke觀guan存cun在zai和he必bi要yao的de。而er且qie,對dui於yu參can保bao人ren來lai講jiang,得de到dao和he沒mei有you得de到dao補bu償chang的de經jing濟ji意yi義yi是shi相xiang同tong的de。之zhi所suo以yi得de到dao補bu償chang是shi因yin為wei其qi患huan病bing受shou到dao了le損sun失shi,按an照zhao損sun失shi補bu償chang的de原yuan則ze,所suo得de到dao的de補bu償chang額e沒mei有you超chao過guo實shi際ji損sun失shi額e,參can保bao人ren並bing未wei得de到dao額e外wai的de利li益yi;而沒有得到給付是因為其身體健康沒有遭受損失,但參保人卻得到了心理上的安全保障。
[編輯]
醫療保險需求的影響因素[1]
1.疾病發生的概率和損失程度
yiliaobaoxianchengbaode。shijibingfengxian,jibingfengxiandecunzaishiyiliaobaoxianxuqiucunzaideqiantihejichu。renmengoumaiyiliaobaoxiandemudezhuyaoshiyinweicunzaizhejibingfengxian,tadefashengbujindailaiqutishangdetongku,erqiedaozhijingjishangdesunshi}有you時shi這zhe種zhong經jing濟ji損sun失shi是shi難nan以yi承cheng受shou的de。顯xian然ran,醫yi療liao保bao險xian需xu求qiu強qiang度du與yu疾ji病bing風feng險xian的de存cun在zai程cheng度du成cheng正zheng比bi。疾ji病bing風feng險xian發fa生sheng的de可ke能neng性xing越yue大da,程cheng度du越yue高gao,給gei人ren們men帶dai來lai的de經jing濟ji損sun失shi越yue大da,人ren們men購gou買mai醫yi療liao保bao險xian的de積ji極ji性xing以yi及ji願yuan意yi支zhi付fu的de醫yi療liao保bao險xian費fei就jiu會hui越yue高gao,醫yi療liao保bao險xian需xu求qiu也ye就jiu越yue大da;反之,醫療保險需求就小。因此,疾病風險的發生概率和程度是影響消費者購買醫療保險的主要因素。
2.醫療保險的價格
醫療保險的需求量與醫療保險價格呈反方向變化。如果醫療保險費率即醫療保險的價格較低,可刺激醫療保險需求量的增加;xiangfan,ruguoyiliaobaoxiandejiagepiangao,gerenhuodanweihuixuejianzijideyiliaobaoxianxuqiu。zhidinghelideyiliaobaoxianjiage,bujinnengshiyiliaobaoxianjigoudeshouzhidadaopingheng,youkexiyingengduoderencanjiabaoxian。
3.消費者的收入
在(zai)一(yi)般(ban)情(qing)況(kuang)下(xia),醫(yi)療(liao)保(bao)險(xian)需(xu)求(qiu)應(ying)隨(sui)著(zhe)人(ren)們(men)收(shou)入(ru)的(de)增(zeng)加(jia)而(er)增(zeng)加(jia)。這(zhe)是(shi)醫(yi)療(liao)保(bao)險(xian)與(yu)經(jing)濟(ji)收(shou)入(ru)的(de)基(ji)本(ben)關(guan)係(xi)。隨(sui)著(zhe)個(ge)人(ren)收(shou)人(ren)的(de)日(ri)益(yi)增(zeng)多(duo),人(ren)們(men)用(yong)於(yu)消(xiao)費(fei)的(de)部(bu)分(fen)不(bu)斷(duan)增(zeng)加(jia),消(xiao)費(fei)結(jie)構(gou)也(ye)在(zai)變(bian)化(hua),消(xiao)費(fei)方(fang)式(shi)呈(cheng)現(xian)多(duo)元(yuan)化(hua)。人(ren)們(men)不(bu)僅(jin)要(yao)求(qiu)滿(man)足(zu)衣(yi)食(shi)住(zhu)行(xing)的(de)基(ji)本(ben)需(xu)求(qiu),而(er)且(qie)希(xi)望(wang)在(zai)發(fa)生(sheng)疾(ji)病(bing)時(shi),也(ye)能(neng)保(bao)持(chi)相(xiang)當(dang)的(de)生(sheng)活(huo)水(shui)平(ping)。因(yin)此(ci),當(dang)安(an)全(quan)的(de)需(xu)求(qiu)成(cheng)為(wei)人(ren)們(men)日(ri)常(chang)消(xiao)費(fei)中(zhong)不(bu)可(ke)缺(que)少(shao)的(de)部(bu)分(fen)時(shi),就(jiu)擴(kuo)大(da)了(le)人(ren)們(men)對(dui)醫(yi)療(liao)保(bao)險(xian)的(de)需(xu)求(qiu)。由(you)於(yu)不(bu)同(tong)收(shou)人(ren)水(shui)平(ping)的(de)人(ren)群(qun)對(dui)醫(yi)療(liao)保(bao)險(xian)的(de)需(xu)求(qiu)量(liang)不(bu)同(tong),因(yin)此(ci),對(dui)醫(yi)療(liao)保(bao)險(xian)的(de)提(ti)供(gong)者(zhe)來(lai)說(shuo),能(neng)否(fou)提(ti)供(gong)可(ke)以(yi)滿(man)足(zu)不(bu)同(tong)收(shou)入(ru)水(shui)平(ping)的(de)多(duo)層(ceng)次(ci)醫(yi)療(liao)保(bao)險(xian)服(fu)務(wu),將(jiang)是(shi)提(ti)高(gao)醫(yi)療(liao)保(bao)險(xian)需(xu)求(qiu)的(de)關(guan)鍵(jian)。
4.承保範圍
醫(yi)療(liao)保(bao)險(xian)的(de)承(cheng)保(bao)範(fan)圍(wei)是(shi)指(zhi)醫(yi)療(liao)保(bao)險(xian)所(suo)提(ti)供(gong)的(de)醫(yi)療(liao)服(fu)務(wu)項(xiang)目(mu)。如(ru)果(guo)醫(yi)療(liao)保(bao)險(xian)機(ji)構(gou)提(ti)供(gong)的(de)醫(yi)療(liao)保(bao)險(xian)項(xiang)目(mu)不(bu)是(shi)投(tou)保(bao)人(ren)所(suo)希(xi)望(wang)得(de)到(dao)的(de),人(ren)們(men)將(jiang)不(bu)會(hui)購(gou)買(mai)保(bao)險(xian)機(ji)構(gou)所(suo)提(ti)供(gong)的(de)險(xian)種(zhong),從(cong)而(er)影(ying)響(xiang)到(dao)醫(yi)療(liao)保(bao)險(xian)的(de)需(xu)求(qiu)。
5.醫療費用的負擔方式
不(bu)同(tong)的(de)醫(yi)療(liao)費(fei)用(yong)負(fu)擔(dan)方(fang)式(shi)影(ying)響(xiang)著(zhe)人(ren)們(men)對(dui)醫(yi)療(liao)保(bao)險(xian)的(de)需(xu)求(qiu)。自(zi)付(fu)的(de)醫(yi)療(liao)費(fei)用(yong)比(bi)例(li)越(yue)高(gao),人(ren)們(men)參(can)保(bao)的(de)積(ji)極(ji)性(xing)就(jiu)越(yue)低(di),反(fan)之(zhi)亦(yi)然(ran)。根(gen)據(ju)醫(yi)療(liao)費(fei)用(yong)的(de)分(fen)擔(dan)方(fang)式(shi),我(wo)們(men)可(ke)將(jiang)醫(yi)療(liao)保(bao)險(xian)分(fen)為(wei)扣(kou)除(chu)保(bao)險(xian)、共付保險、限額保險和混合保險。采用不同醫療費用分擔方式的醫療保險,將對醫療服務需方的行為產生不同程度的影響。
(1)扣除保險(deductible insurance):被保險人在就醫時先自付一筆錢,當自付的金額超過一定限額(起付線)時(shi),被(bei)保(bao)險(xian)人(ren)不(bu)再(zai)支(zhi)付(fu),其(qi)餘(yu)的(de)醫(yi)療(liao)費(fei)由(you)醫(yi)療(liao)保(bao)險(xian)機(ji)構(gou)承(cheng)付(fu),這(zhe)種(zhong)保(bao)險(xian)稱(cheng)為(wei)扣(kou)除(chu)保(bao)險(xian)。扣(kou)除(chu)保(bao)險(xian)對(dui)醫(yi)療(liao)保(bao)險(xian)需(xu)方(fang)的(de)影(ying)響(xiang)程(cheng)度(du)取(qu)決(jue)於(yu)起(qi)付(fu)線(xian)的(de)高(gao)低(di)。起(qi)付(fu)線(xian)過(guo)低(di),可(ke)導(dao)致(zhi)人(ren)們(men)過(guo)多(duo)地(di)利(li)用(yong)醫(yi)療(liao)服(fu)務(wu),造(zao)成(cheng)衛(wei)生(sheng)資(zi)源(yuan)的(de)浪(lang)費(fei);起qi付fu線xian過guo高gao,又you會hui使shi許xu多duo正zheng常chang的de醫yi療liao服fu務wu需xu求qiu被bei抑yi製zhi,一yi部bu分fen人ren的de基ji本ben醫yi療liao難nan以yi得de到dao保bao證zheng。因yin此ci,確que定ding適shi宜yi的de起qi付fu線xian是shi十shi分fen重zhong要yao的de,它ta既ji可ke在zai一yi定ding程cheng度du上shang增zeng加jia病bing人ren的de費fei用yong意yi識shi,約yue束shu病bing人ren的de行xing為wei,又you能neng保bao證zheng消xiao費fei者zhe對dui基ji本ben醫yi療liao服fu務wu的de需xu求qiu。
(2)共付保險。(又稱合作保險,Co-insurance):指(zhi)醫(yi)療(liao)保(bao)險(xian)機(ji)構(gou)和(he)病(bing)人(ren)共(gong)同(tong)承(cheng)擔(dan)醫(yi)療(liao)費(fei)用(yong)的(de)一(yi)種(zhong)醫(yi)療(liao)保(bao)險(xian)形(xing)式(shi),即(ji)當(dang)病(bing)人(ren)發(fa)生(sheng)醫(yi)療(liao)費(fei)用(yong)時(shi),醫(yi)療(liao)保(bao)險(xian)機(ji)構(gou)為(wei)病(bing)人(ren)償(chang)付(fu)一(yi)部(bu)分(fen)醫(yi)療(liao)費(fei)用(yong),其(qi)餘(yu)部(bu)分(fen)自(zi)病(bing)人(ren)自(zi)己(ji)承(cheng)擔(dan)。實(shi)行(xing)共(gong)付(fu)保(bao)險(xian),讓(rang)病(bing)人(ren)承(cheng)擔(dan)一(yi)部(bu)分(fen)醫(yi)療(liao)費(fei)用(yong),可(ke)增(zeng)強(qiang)病(bing)人(ren)的(de)費(fei)用(yong)意(yi)識(shi),從(cong)而(er)改(gai)變(bian)病(bing)人(ren)的(de)消(xiao)費(fei)行(xing)為(wei)。共(gong)付(fu)保(bao)險(xian)對(dui)醫(yi)療(liao)服(fu)務(wu)需(xu)求(qiu)者(zhe)的(de)影(ying)響(xiang)程(cheng)度(du)取(qu)決(jue)於(yu)共(gong)付(fu)率(lv)(醫療保險機構支付醫療費用的比例)的高低。共付率(Co-insurancerate)較(jiao)低(di)時(shi),患(huan)者(zhe)自(zi)付(fu)的(de)比(bi)例(li)就(jiu)會(hui)增(zeng)加(jia),因(yin)此(ci),將(jiang)會(hui)抑(yi)製(zhi)病(bing)人(ren)的(de)正(zheng)常(chang)需(xu)求(qiu),尤(you)其(qi)對(dui)於(yu)收(shou)入(ru)較(jiao)低(di)的(de)病(bing)人(ren),由(you)於(yu)無(wu)力(li)支(zhi)付(fu)所(suo)應(ying)共(gong)付(fu)的(de)那(na)部(bu)分(fen)醫(yi)療(liao)費(fei)用(yong)而(er)影(ying)響(xiang)到(dao)他(ta)們(men)的(de)健(jian)康(kang)。但(dan)如(ru)果(guo)共(gong)付(fu)率(lv)較(jiao)高(gao),則(ze)會(hui)使(shi)病(bing)人(ren)的(de)費(fei)用(yong)意(yi)識(shi)降(jiang)低(di),醫(yi)療(liao)保(bao)險(xian)機(ji)構(gou)通(tong)過(guo)需(xu)方(fang)對(dui)醫(yi)療(liao)費(fei)用(yong)的(de)控(kong)製(zhi)力(li)度(du)也(ye)會(hui)降(jiang)低(di)。
(3)限額保險(limited insurance):限額保險指為病人的醫療費用的補償設立一個最高金額限製(maximum liability limit),或最大服務量限製,超出部分由病人自付,即通常所說的"封頂"。這(zhe)種(zhong)方(fang)式(shi)限(xian)製(zhi)了(le)醫(yi)療(liao)服(fu)務(wu)提(ti)供(gong)者(zhe)提(ti)供(gong)高(gao)額(e)或(huo)過(guo)度(du)的(de)醫(yi)療(liao)服(fu)務(wu),降(jiang)低(di)了(le)醫(yi)療(liao)保(bao)險(xian)成(cheng)本(ben),但(dan)對(dui)於(yu)患(huan)大(da)病(bing)而(er)又(you)無(wu)力(li)支(zhi)付(fu)的(de)病(bing)人(ren)來(lai)說(shuo),則(ze)將(jiang)會(hui)影(ying)響(xiang)到(dao)他(ta)們(men)的(de)健(jian)康(kang)。
(4)混合保險(mixed insurance):混合保險是將各種費用支付方式結合起來使用的一種醫療保險形式。當在疾病發生概率較高、醫療服務需求量較大、qiemeibiyiliaofeiyongyibandouzaiqifuxianyishangshi,kecaiyongkouchubaoxiandexingshi,yijianshaoyiliaobaoxiandechengben。ruzaiqifuxianzhifengdingxianzhijiandebufencaiyonggongfubaoxiandexingshiyizengqiangxufangdefeiyongyishi,jianshao"道德損害"(moral hazard),降低醫療費用及保險成本,又可通過患者對醫療服務的選擇(優質低價)來提高醫療服務的提供效率;在封頂線以上部分設立巨額保險,以達到風險分攤的目的。
6.醫療服務的供給
醫療保險的需求受醫療服務的價格、種類、yiliaofeiyongshuipingyijiyiliaofuwutigongzhedefuwutaiduhezhiliangdeyingxiang。suizheyiliaofuwujiagejiyiliaoxiaofeishuipingdetigao,yiliaozhichuzaishourenzhongsuozhandebizhongbuduanzengda,renmenduiyiliaobaoxiandexuqiujiuhuigengjiapoqie。ruguoyiliaofuwudezhongleijizhiliangbunengmanzurenmenduiyiliaofuwudexuqiu,jishicanjialeyiliaobaoxian,yebunenggouhuoderenmensuoxuyaode、滿意的醫療服務,那麼就會影響人們對醫療保險的需求。
7.醫療保健製度
參保前的醫療保健製度對醫療保險的需求也有很大影響。長期以來,我國城鎮實行"公費醫療"和"勞保醫療",絕jue大da部bu分fen醫yi療liao服fu務wu費fei用yong由you國guo家jia預yu算suan和he企qi業ye財cai務wu開kai支zhi,使shi人ren們men產chan生sheng了le免mian費fei就jiu醫yi的de心xin理li慣guan性xing,而er參can加jia醫yi療liao保bao險xian發fa生sheng醫yi療liao費fei用yong後hou自zi付fu的de比bi例li往wang往wang會hui有you所suo提ti高gao,因yin而er影ying響xiang了le人ren們men參can加jia醫yi療liao保bao險xian的de需xu求qiu。從cong經jing濟ji學xue的de觀guan點dian看kan,當dang替ti代dai品pin(公費、勞保醫療)的價格近乎為零時,被替代的商品(醫療保險)dexuqiuzaibeitidaidefanweineijihuweiling,yincizaigongfeiyiliaohelaobaoyiliaozhiduxia,renmenmeiyoucanjiayiliaobaoxiandebiyao,yebuhuichanshengyiliaobaoxiandeyouxiaoxuqiu。danduiyuguoqujiuyixuzifuyiliaofeiyongzhe,canjiayiliaobaoxiankeyijianqingtamendejingjifudan,yinerduiyiliaobaoxiandexuqiujiuhuijiaogao。
8.保險意識
是指人們對"醫療保險"這zhe一yi客ke觀guan事shi由you的de主zhu觀guan認ren識shi。有you疾ji病bing風feng險xian存cun在zai,且qie經jing濟ji收shou入ru已yi達da到dao一yi定ding水shui平ping,就jiu產chan生sheng了le對dui醫yi療liao保bao險xian需xu求qiu的de可ke能neng性xing,但dan從cong可ke能neng性xing變bian為wei現xian實shi性xing,需xu要yao人ren的de主zhu觀guan意yi識shi的de推tui動dong作zuo用yong。因yin此ci在zai其qi他ta條tiao件jian不bu變bian的de情qing況kuang下xia,人ren們men的de醫yi療liao保bao險xian意yi識shi越yue強qiang,對dui醫yi療liao保bao險xian的de需xu求qiu就jiu越yue大da;反之則越小。由於"免費就醫"的慣性影響,加之正在試行的社會醫療保險起點低、覆蓋麵窄,給人們帶來實惠的"示範效應"buqiang,renmenpubianquefayiliaobaoxianyishi,yineryizhileyiliaobaoxianxuqiudekuaisuzengchang。baoxianyishidelingyizhongbiaoxiangjiushibixianxintai,butongdexiaofeizheduifengxiandexingweishibutongde,daduoshuxiaofeizhedouhuibiaoxianchubixianxingwei,bixianxintaiyuezhongdexiaofeizhe,duiyiliaobaoxiandexuqiuyejiuyueda。yucixiangfan,mianduifengxianbiaoxianchumaoxianxingweidexiaofeizhejiubuhuigoumaiyiliaobaoxian。
9.其他
除上述影響因素外,還要其他很多因素均在不同程度上影響醫療保險的需求。如消費者的健康狀況、年齡、性別、職業、文化水平等。健康狀況對醫療保險需求的影響,一般來說應該是健康愈差的人,參加保險的可能性愈大;相反,可能性愈小。但一些研究結果與上述假設相反。造成這種現象的原因,一方麵是由於收人、文化水平等原因,沒有參加保險,以致小病得不到及時的治療,造成健康狀況差;另一方麵是由於保險公司把那些身體狀況極差的人排斥在保險之外。
jinguanjibingfengxiandecunzaishirenmencanjiayiliaobaoxiandezhuyaoyuanyin,danshitajinshiyizhongkeguanyinsu。wenhuachengduduiyiliaobaoxianxuqiuchanshengzhengxiangyingxiang,wenhuashuipinggaoderen,bijiaoxiangxinherongyijieshouyiliaobaoxian,duiyiliaobaoxiandexuqiuyejiuyueduo。ruguorenmenduiyiliaobaoxianmeiyourenshi,meiyoucanjiayiliaobaoxiandezhuguanyuanwang,yejiubuhuichanshengduiyiliaobaoxiandexuqiu。
[編輯]
什麼是醫療保險需求
醫療保險需求是指在一定時期內、一yi定ding價jia格ge水shui平ping上shang消xiao費fei者zhe願yuan意yi並bing且qie能neng夠gou購gou買mai的de醫yi療liao保bao險xian服fu務wu量liang,即ji醫yi療liao保bao險xian機ji構gou所suo提ti供gong的de一yi定ding價jia格ge條tiao件jian下xia的de經jing濟ji保bao障zhang需xu要yao量liang,用yong貨huo幣bi計ji量liang單dan位wei表biao示shi即ji為wei醫yi療liao保bao險xian金jin額e。醫yi療liao保bao險xian需xu求qiu的de主zhu體ti即ji醫yi療liao保bao險xian消xiao費fei者zhe,醫yi療liao保bao險xian的de被bei保bao險xian人ren。在zai一yi定ding費fei用yong條tiao件jian下xia,被bei保bao險xian人ren抗kang疾ji病bing風feng險xian的de情qing況kuang、健jian康kang狀zhuang況kuang以yi及ji他ta們men對dui醫yi療liao保bao險xian方fang案an的de滿man意yi程cheng度du,是shi衡heng量liang和he評ping價jia一yi種zhong醫yi療liao保bao險xian製zhi度du或huo方fang案an最zui根gen本ben的de標biao準zhun。被bei保bao險xian人ren既ji是shi醫yi療liao保bao險xian市shi場chang中zhong的de買mai方fang,又you是shi醫yi療liao服fu務wu的de消xiao費fei對dui象xiang。他ta們men在zai醫yi療liao保bao險xian的de籌chou資zi和he使shi用yong過guo程cheng中zhong的de行xing為wei,將jiang對dui保bao險xian的de效xiao果guo和he效xiao益yi產chan生sheng重zhong大da影ying響xiang。[1][編輯]
醫療保險需求形成的條件[2]
(1)醫療保險消費意願。人ren們men對dui醫yi療liao保bao險xian的de需xu求qiu,是shi源yuan於yu對dui自zi己ji生sheng命ming安an全quan和he健jian康kang保bao障zhang的de需xu要yao。當dang無wu法fa預yu料liao的de自zi然ran疾ji病bing和he意yi外wai事shi故gu發fa生sheng時shi,會hui給gei人ren們men造zao成cheng身shen心xin傷shang害hai,帶dai來lai經jing濟ji損sun失shi,影ying響xiang人ren們men的de生sheng活huo。這zhe就jiu會hui使shi人ren們men在zai心xin理li上shang產chan生sheng一yi種zhong對dui患huan病bing的de擔dan憂you和he恐kong懼ju,並bing尋xun找zhao某mou種zhong手shou段duan來lai避bi免mian、應付或減少疾病發生時所造成的損失。因此,人們一般都具有購買醫療保險以求平安、穩定、正常的願望,這種消費意願成為購買保險的首要因素。(2)貨幣支付能力。在(zai)商(shang)品(pin)經(jing)濟(ji)條(tiao)件(jian)下(xia),保(bao)險(xian)機(ji)構(gou)與(yu)參(can)保(bao)人(ren)之(zhi)間(jian)也(ye)是(shi)一(yi)種(zhong)商(shang)品(pin)經(jing)濟(ji)關(guan)係(xi)。人(ren)們(men)要(yao)想(xiang)獲(huo)得(de)保(bao)險(xian),必(bi)須(xu)支(zhi)付(fu)一(yi)定(ding)量(liang)保(bao)險(xian)費(fei)。人(ren)們(men)對(dui)醫(yi)療(liao)保(bao)險(xian)需(xu)要(yao)的(de)滿(man)足(zu),受(shou)到(dao)其(qi)貨(huo)幣(bi)支(zhi)付(fu)能(neng)力(li)的(de)限(xian)製(zhi)。因(yin)此(ci),醫(yi)療(liao)保(bao)險(xian)需(xu)求(qiu)就(jiu)是(shi)人(ren)們(men)在(zai)一(yi)定(ding)的(de)保(bao)險(xian)費(fei)率(lv)(premium rate)(價格)條件下由貨幣支付能力決定的對醫療保險的需要量。(3)醫療保險需求者所投保的標的物符合醫療保險機構的經濟技術的要求。jicanbaorenxiangtoubaodeyiliaobaoxianxianzhonghebaoxianjigoushejidexianzhongxiangwenhe,zheshigouchengyiliaobaoxianxuqiudebibeitiaojian。ruguoxuqiuzhesuotoubaodebiaodeshibaoxianjigouzaijishushangnanyizuodaode,yebunenggouchengyouxiaodeyiliaobaoxianxuqiu。lirutoubaoaizibing。zongzhi,queshaoshangshusangetiaojian,renmenxiangdedaodeyiliaobaozhangxuyaojiubunenghuonanyizhuanhuaweizhenzhengyouxiaodeyiliaobaoxianxuqiu。[編輯]
醫療保險需求的經濟理論[3]
1.財富邊際效用遞減jinguanrenmenduicaifushipianhaode,dansuizheyongyoudecaifushuliangzengjia,jinguancaifugeirenmendailaidezongxiaoyongzaibuduanzengjia,danzengjiadecaifugeirenmendailaidebianjixiaoyongshidijiande。2.消費者追求效用最大化疾病是不可預測的,人們無法知道自己會在什麼時候患病、患病的嚴重程度以及患病可能帶來的經濟損失,為了能在疾病發生時保持效用最大化,可以在自我保險、購買保險兩種方法中選擇。[編輯]
醫療保險需求的形式[2]
醫療保險需求有兩種表現形式:①youxingdejingjibaozhangxingshi,jizaiwuzhifangmian,tixianzairenmenhuanbinghezaoyuyiwaishanghaishi,yiliaobaoxianjigouanzhaoyiliaobaoxianhetongzhongguidingdechangfufanwei,duifashengyiliaofeiyongdecanbaorengeiyubufenhuoquanbudebuchanghuogeifu,huotongguoyiliaojigouzhijietigongmianfei、部分免費或低價的醫療服務;②無形的心理安全保障形式,體現在轉嫁疾病風險,獲得醫療保險保障,解除人們因病致貧的後顧之憂,從而獲得心理上的安全保障。在zai實shi際ji生sheng活huo中zhong,人ren們men往wang往wang比bi較jiao注zhu重zhong帶dai來lai經jing濟ji保bao障zhang的de實shi物wu形xing態tai需xu求qiu,而er對dui心xin理li安an全quan保bao障zhang的de無wu形xing需xu求qiu則ze認ren識shi不bu足zu。有you的de個ge人ren和he參can保bao單dan位wei,由you於yu在zai保bao險xian有you效xiao期qi內nei沒mei發fa生sheng保bao險xian責ze任ren範fan圍wei內nei的de疾ji病bing損sun失shi,閩min而er沒mei有you得de到dao經jing濟ji補bu償chang和he給gei付fu,就jiu認ren為wei參can加jia醫yi療liao保bao險xian是shi白bai花hua了le錢qian,甚shen至zhi對dui投tou保bao持chi消xiao極ji的de態tai度du。這zhe種zhong認ren識shi是shi片pian麵mian的de。事shi實shi上shang,社she會hui的de發fa展zhan和he人ren們men生sheng活huo的de安an定ding,對dui上shang述shu兩liang種zhong形xing式shi的de需xu求qiu都dou是shi客ke觀guan存cun在zai和he必bi要yao的de。而er且qie,對dui於yu參can保bao人ren來lai講jiang,得de到dao和he沒mei有you得de到dao補bu償chang的de經jing濟ji意yi義yi是shi相xiang同tong的de。之zhi所suo以yi得de到dao補bu償chang是shi因yin為wei其qi患huan病bing受shou到dao了le損sun失shi,按an照zhao損sun失shi補bu償chang的de原yuan則ze,所suo得de到dao的de補bu償chang額e沒mei有you超chao過guo實shi際ji損sun失shi額e,參can保bao人ren並bing未wei得de到dao額e外wai的de利li益yi;而沒有得到給付是因為其身體健康沒有遭受損失,但參保人卻得到了心理上的安全保障。[編輯]
醫療保險需求的影響因素[1]
1.疾病發生的概率和損失程度yiliaobaoxianchengbaode。shijibingfengxian,jibingfengxiandecunzaishiyiliaobaoxianxuqiucunzaideqiantihejichu。renmengoumaiyiliaobaoxiandemudezhuyaoshiyinweicunzaizhejibingfengxian,tadefashengbujindailaiqutishangdetongku,erqiedaozhijingjishangdesunshi}有you時shi這zhe種zhong經jing濟ji損sun失shi是shi難nan以yi承cheng受shou的de。顯xian然ran,醫yi療liao保bao險xian需xu求qiu強qiang度du與yu疾ji病bing風feng險xian的de存cun在zai程cheng度du成cheng正zheng比bi。疾ji病bing風feng險xian發fa生sheng的de可ke能neng性xing越yue大da,程cheng度du越yue高gao,給gei人ren們men帶dai來lai的de經jing濟ji損sun失shi越yue大da,人ren們men購gou買mai醫yi療liao保bao險xian的de積ji極ji性xing以yi及ji願yuan意yi支zhi付fu的de醫yi療liao保bao險xian費fei就jiu會hui越yue高gao,醫yi療liao保bao險xian需xu求qiu也ye就jiu越yue大da;反之,醫療保險需求就小。因此,疾病風險的發生概率和程度是影響消費者購買醫療保險的主要因素。2.醫yi療liao保bao險xian的de價jia格ge醫yi療liao保bao險xian的de需xu求qiu量liang與yu醫yi療liao保bao險xian價jia格ge呈cheng反fan方fang向xiang變bian化hua。如ru果guo醫yi療liao保bao險xian費fei率lv即ji醫yi療liao保bao險xian的de價jia格ge較jiao低di,可ke刺ci激ji醫yi療liao保bao險xian需xu求qiu量liang的de增zeng加jia;xiangfan,ruguoyiliaobaoxiandejiagepiangao,gerenhuodanweihuixuejianzijideyiliaobaoxianxuqiu。zhidinghelideyiliaobaoxianjiage,bujinnengshiyiliaobaoxianjigoudeshouzhidadaopingheng,youkexiyingengduoderencanjiabaoxian。3.消費者的收入在(zai)一(yi)般(ban)情(qing)況(kuang)下(xia),醫(yi)療(liao)保(bao)險(xian)需(xu)求(qiu)應(ying)隨(sui)著(zhe)人(ren)們(men)收(shou)入(ru)的(de)增(zeng)加(jia)而(er)增(zeng)加(jia)。這(zhe)是(shi)醫(yi)療(liao)保(bao)險(xian)與(yu)經(jing)濟(ji)收(shou)入(ru)的(de)基(ji)本(ben)關(guan)係(xi)。隨(sui)著(zhe)個(ge)人(ren)收(shou)人(ren)的(de)日(ri)益(yi)增(zeng)多(duo),人(ren)們(men)用(yong)於(yu)消(xiao)費(fei)的(de)部(bu)分(fen)不(bu)斷(duan)增(zeng)加(jia),消(xiao)費(fei)結(jie)構(gou)也(ye)在(zai)變(bian)化(hua),消(xiao)費(fei)方(fang)式(shi)呈(cheng)現(xian)多(duo)元(yuan)化(hua)。人(ren)們(men)不(bu)僅(jin)要(yao)求(qiu)滿(man)足(zu)衣(yi)食(shi)住(zhu)行(xing)的(de)基(ji)本(ben)需(xu)求(qiu),而(er)且(qie)希(xi)望(wang)在(zai)發(fa)生(sheng)疾(ji)病(bing)時(shi),也(ye)能(neng)保(bao)持(chi)相(xiang)當(dang)的(de)生(sheng)活(huo)水(shui)平(ping)。因(yin)此(ci),當(dang)安(an)全(quan)的(de)需(xu)求(qiu)成(cheng)為(wei)人(ren)們(men)日(ri)常(chang)消(xiao)費(fei)中(zhong)不(bu)可(ke)缺(que)少(shao)的(de)部(bu)分(fen)時(shi),就(jiu)擴(kuo)大(da)了(le)人(ren)們(men)對(dui)醫(yi)療(liao)保(bao)險(xian)的(de)需(xu)求(qiu)。由(you)於(yu)不(bu)同(tong)收(shou)人(ren)水(shui)平(ping)的(de)人(ren)群(qun)對(dui)醫(yi)療(liao)保(bao)險(xian)的(de)需(xu)求(qiu)量(liang)不(bu)同(tong),因(yin)此(ci),對(dui)醫(yi)療(liao)保(bao)險(xian)的(de)提(ti)供(gong)者(zhe)來(lai)說(shuo),能(neng)否(fou)提(ti)供(gong)可(ke)以(yi)滿(man)足(zu)不(bu)同(tong)收(shou)入(ru)水(shui)平(ping)的(de)多(duo)層(ceng)次(ci)醫(yi)療(liao)保(bao)險(xian)服(fu)務(wu),將(jiang)是(shi)提(ti)高(gao)醫(yi)療(liao)保(bao)險(xian)需(xu)求(qiu)的(de)關(guan)鍵(jian)。4.承保範圍醫(yi)療(liao)保(bao)險(xian)的(de)承(cheng)保(bao)範(fan)圍(wei)是(shi)指(zhi)醫(yi)療(liao)保(bao)險(xian)所(suo)提(ti)供(gong)的(de)醫(yi)療(liao)服(fu)務(wu)項(xiang)目(mu)。如(ru)果(guo)醫(yi)療(liao)保(bao)險(xian)機(ji)構(gou)提(ti)供(gong)的(de)醫(yi)療(liao)保(bao)險(xian)項(xiang)目(mu)不(bu)是(shi)投(tou)保(bao)人(ren)所(suo)希(xi)望(wang)得(de)到(dao)的(de),人(ren)們(men)將(jiang)不(bu)會(hui)購(gou)買(mai)保(bao)險(xian)機(ji)構(gou)所(suo)提(ti)供(gong)的(de)險(xian)種(zhong),從(cong)而(er)影(ying)響(xiang)到(dao)醫(yi)療(liao)保(bao)險(xian)的(de)需(xu)求(qiu)。5.醫療費用的負擔方式不(bu)同(tong)的(de)醫(yi)療(liao)費(fei)用(yong)負(fu)擔(dan)方(fang)式(shi)影(ying)響(xiang)著(zhe)人(ren)們(men)對(dui)醫(yi)療(liao)保(bao)險(xian)的(de)需(xu)求(qiu)。自(zi)付(fu)的(de)醫(yi)療(liao)費(fei)用(yong)比(bi)例(li)越(yue)高(gao),人(ren)們(men)參(can)保(bao)的(de)積(ji)極(ji)性(xing)就(jiu)越(yue)低(di),反(fan)之(zhi)亦(yi)然(ran)。根(gen)據(ju)醫(yi)療(liao)費(fei)用(yong)的(de)分(fen)擔(dan)方(fang)式(shi),我(wo)們(men)可(ke)將(jiang)醫(yi)療(liao)保(bao)險(xian)分(fen)為(wei)扣(kou)除(chu)保(bao)險(xian)、共付保險、限額保險和混合保險。采用不同醫療費用分擔方式的醫療保險,將對醫療服務需方的行為產生不同程度的影響。(1)扣除保險(deductible insurance):被保險人在就醫時先自付一筆錢,當自付的金額超過一定限額(起付線)時(shi),被(bei)保(bao)險(xian)人(ren)不(bu)再(zai)支(zhi)付(fu),其(qi)餘(yu)的(de)醫(yi)療(liao)費(fei)由(you)醫(yi)療(liao)保(bao)險(xian)機(ji)構(gou)承(cheng)付(fu),這(zhe)種(zhong)保(bao)險(xian)稱(cheng)為(wei)扣(kou)除(chu)保(bao)險(xian)。扣(kou)除(chu)保(bao)險(xian)對(dui)醫(yi)療(liao)保(bao)險(xian)需(xu)方(fang)的(de)影(ying)響(xiang)程(cheng)度(du)取(qu)決(jue)於(yu)起(qi)付(fu)線(xian)的(de)高(gao)低(di)。起(qi)付(fu)線(xian)過(guo)低(di),可(ke)導(dao)致(zhi)人(ren)們(men)過(guo)多(duo)地(di)利(li)用(yong)醫(yi)療(liao)服(fu)務(wu),造(zao)成(cheng)衛(wei)生(sheng)資(zi)源(yuan)的(de)浪(lang)費(fei);起qi付fu線xian過guo高gao,又you會hui使shi許xu多duo正zheng常chang的de醫yi療liao服fu務wu需xu求qiu被bei抑yi製zhi,一yi部bu分fen人ren的de基ji本ben醫yi療liao難nan以yi得de到dao保bao證zheng。因yin此ci,確que定ding適shi宜yi的de起qi付fu線xian是shi十shi分fen重zhong要yao的de,它ta既ji可ke在zai一yi定ding程cheng度du上shang增zeng加jia病bing人ren的de費fei用yong意yi識shi,約yue束shu病bing人ren的de行xing為wei,又you能neng保bao證zheng消xiao費fei者zhe對dui基ji本ben醫yi療liao服fu務wu的de需xu求qiu。(2)共付保險。(又稱合作保險,Co-insurance):指(zhi)醫(yi)療(liao)保(bao)險(xian)機(ji)構(gou)和(he)病(bing)人(ren)共(gong)同(tong)承(cheng)擔(dan)醫(yi)療(liao)費(fei)用(yong)的(de)一(yi)種(zhong)醫(yi)療(liao)保(bao)險(xian)形(xing)式(shi),即(ji)當(dang)病(bing)人(ren)發(fa)生(sheng)醫(yi)療(liao)費(fei)用(yong)時(shi),醫(yi)療(liao)保(bao)險(xian)機(ji)構(gou)為(wei)病(bing)人(ren)償(chang)付(fu)一(yi)部(bu)分(fen)醫(yi)療(liao)費(fei)用(yong),其(qi)餘(yu)部(bu)分(fen)自(zi)病(bing)人(ren)自(zi)己(ji)承(cheng)擔(dan)。實(shi)行(xing)共(gong)付(fu)保(bao)險(xian),讓(rang)病(bing)人(ren)承(cheng)擔(dan)一(yi)部(bu)分(fen)醫(yi)療(liao)費(fei)用(yong),可(ke)增(zeng)強(qiang)病(bing)人(ren)的(de)費(fei)用(yong)意(yi)識(shi),從(cong)而(er)改(gai)變(bian)病(bing)人(ren)的(de)消(xiao)費(fei)行(xing)為(wei)。共(gong)付(fu)保(bao)險(xian)對(dui)醫(yi)療(liao)服(fu)務(wu)需(xu)求(qiu)者(zhe)的(de)影(ying)響(xiang)程(cheng)度(du)取(qu)決(jue)於(yu)共(gong)付(fu)率(lv)(醫療保險機構支付醫療費用的比例)的高低。共付率(Co-insurancerate)較(jiao)低(di)時(shi),患(huan)者(zhe)自(zi)付(fu)的(de)比(bi)例(li)就(jiu)會(hui)增(zeng)加(jia),因(yin)此(ci),將(jiang)會(hui)抑(yi)製(zhi)病(bing)人(ren)的(de)正(zheng)常(chang)需(xu)求(qiu),尤(you)其(qi)對(dui)於(yu)收(shou)入(ru)較(jiao)低(di)的(de)病(bing)人(ren),由(you)於(yu)無(wu)力(li)支(zhi)付(fu)所(suo)應(ying)共(gong)付(fu)的(de)那(na)部(bu)分(fen)醫(yi)療(liao)費(fei)用(yong)而(er)影(ying)響(xiang)到(dao)他(ta)們(men)的(de)健(jian)康(kang)。但(dan)如(ru)果(guo)共(gong)付(fu)率(lv)較(jiao)高(gao),則(ze)會(hui)使(shi)病(bing)人(ren)的(de)費(fei)用(yong)意(yi)識(shi)降(jiang)低(di),醫(yi)療(liao)保(bao)險(xian)機(ji)構(gou)通(tong)過(guo)需(xu)方(fang)對(dui)醫(yi)療(liao)費(fei)用(yong)的(de)控(kong)製(zhi)力(li)度(du)也(ye)會(hui)降(jiang)低(di)。(3)限額保險(limited insurance):限額保險指為病人的醫療費用的補償設立一個最高金額限製(maximum liability limit),或最大服務量限製,超出部分由病人自付,即通常所說的"封頂"。這(zhe)種(zhong)方(fang)式(shi)限(xian)製(zhi)了(le)醫(yi)療(liao)服(fu)務(wu)提(ti)供(gong)者(zhe)提(ti)供(gong)高(gao)額(e)或(huo)過(guo)度(du)的(de)醫(yi)療(liao)服(fu)務(wu),降(jiang)低(di)了(le)醫(yi)療(liao)保(bao)險(xian)成(cheng)本(ben),但(dan)對(dui)於(yu)患(huan)大(da)病(bing)而(er)又(you)無(wu)力(li)支(zhi)付(fu)的(de)病(bing)人(ren)來(lai)說(shuo),則(ze)將(jiang)會(hui)影(ying)響(xiang)到(dao)他(ta)們(men)的(de)健(jian)康(kang)。(4)混合保險(mixed insurance):混合保險是將各種費用支付方式結合起來使用的一種醫療保險形式。當在疾病發生概率較高、醫療服務需求量較大、qiemeibiyiliaofeiyongyibandouzaiqifuxianyishangshi,kecaiyongkouchubaoxiandexingshi,yijianshaoyiliaobaoxiandechengben。ruzaiqifuxianzhifengdingxianzhijiandebufencaiyonggongfubaoxiandexingshiyizengqiangxufangdefeiyongyishi,jianshao"道德損害"(moral hazard),降低醫療費用及保險成本,又可通過患者對醫療服務的選擇(優質低價)來提高醫療服務的提供效率;在封頂線以上部分設立巨額保險,以達到風險分攤的目的。6.醫療服務的供給醫療保險的需求受醫療服務的價格、種類、yiliaofeiyongshuipingyijiyiliaofuwutigongzhedefuwutaiduhezhiliangdeyingxiang。suizheyiliaofuwujiagejiyiliaoxiaofeishuipingdetigao,yiliaozhichuzaishourenzhongsuozhandebizhongbuduanzengda,renmenduiyiliaobaoxiandexuqiujiuhuigengjiapoqie。ruguoyiliaofuwudezhongleijizhiliangbunengmanzurenmenduiyiliaofuwudexuqiu,jishicanjialeyiliaobaoxian,yebunenggouhuoderenmensuoxuyaode、滿意的醫療服務,那麼就會影響人們對醫療保險的需求。7.醫療保健製度參保前的醫療保健製度對醫療保險的需求也有很大影響。長期以來,我國城鎮實行"公費醫療"和"勞保醫療",絕jue大da部bu分fen醫yi療liao服fu務wu費fei用yong由you國guo家jia預yu算suan和he企qi業ye財cai務wu開kai支zhi,使shi人ren們men產chan生sheng了le免mian費fei就jiu醫yi的de心xin理li慣guan性xing,而er參can加jia醫yi療liao保bao險xian發fa生sheng醫yi療liao費fei用yong後hou自zi付fu的de比bi例li往wang往wang會hui有you所suo提ti高gao,因yin而er影ying響xiang了le人ren們men參can加jia醫yi療liao保bao險xian的de需xu求qiu。從cong經jing濟ji學xue的de觀guan點dian看kan,當dang替ti代dai品pin(公費、勞保醫療)的價格近乎為零時,被替代的商品(醫療保險)dexuqiuzaibeitidaidefanweineijihuweiling,yincizaigongfeiyiliaohelaobaoyiliaozhiduxia,renmenmeiyoucanjiayiliaobaoxiandebiyao,yebuhuichanshengyiliaobaoxiandeyouxiaoxuqiu。danduiyuguoqujiuyixuzifuyiliaofeiyongzhe,canjiayiliaobaoxiankeyijianqingtamendejingjifudan,yinerduiyiliaobaoxiandexuqiujiuhuijiaogao。8.保險意識是指人們對"醫療保險"這zhe一yi客ke觀guan事shi由you的de主zhu觀guan認ren識shi。有you疾ji病bing風feng險xian存cun在zai,且qie經jing濟ji收shou入ru已yi達da到dao一yi定ding水shui平ping,就jiu產chan生sheng了le對dui醫yi療liao保bao險xian需xu求qiu的de可ke能neng性xing,但dan從cong可ke能neng性xing變bian為wei現xian實shi性xing,需xu要yao人ren的de主zhu觀guan意yi識shi的de推tui動dong作zuo用yong。因yin此ci在zai其qi他ta條tiao件jian不bu變bian的de情qing況kuang下xia,人ren們men的de醫yi療liao保bao險xian意yi識shi越yue強qiang,對dui醫yi療liao保bao險xian的de需xu求qiu就jiu越yue大da;反之則越小。由於"免費就醫"的慣性影響,加之正在試行的社會醫療保險起點低、覆蓋麵窄,給人們帶來實惠的"示範效應"buqiang,renmenpubianquefayiliaobaoxianyishi,yineryizhileyiliaobaoxianxuqiudekuaisuzengchang。baoxianyishidelingyizhongbiaoxiangjiushibixianxintai,butongdexiaofeizheduifengxiandexingweishibutongde,daduoshuxiaofeizhedouhuibiaoxianchubixianxingwei,bixianxintaiyuezhongdexiaofeizhe,duiyiliaobaoxiandexuqiuyejiuyueda。yucixiangfan,mianduifengxianbiaoxianchumaoxianxingweidexiaofeizhejiubuhuigoumaiyiliaobaoxian。9.其他除上述影響因素外,還要其他很多因素均在不同程度上影響醫療保險的需求。如消費者的健康狀況、年齡、性別、職業、文化水平等。健康狀況對醫療保險需求的影響,一般來說應該是健康愈差的人,參加保險的可能性愈大;相反,可能性愈小。但一些研究結果與上述假設相反。造成這種現象的原因,一方麵是由於收人、文化水平等原因,沒有參加保險,以致小病得不到及時的治療,造成健康狀況差;另一方麵是由於保險公司把那些身體狀況極差的人排斥在保險之外。jinguanjibingfengxiandecunzaishirenmencanjiayiliaobaoxiandezhuyaoyuanyin,danshitajinshiyizhongkeguanyinsu。wenhuachengduduiyiliaobaoxianxuqiuchanshengzhengxiangyingxiang,wenhuashuipinggaoderen,bijiaoxiangxinherongyijieshouyiliaobaoxian,duiyiliaobaoxiandexuqiuyejiuyueduo。ruguorenmenduiyiliaobaoxianmeiyourenshi,meiyoucanjiayiliaobaoxiandezhuguanyuanwang,yejiubuhuichanshengduiyiliaobaoxiandexuqiu。
什麼是醫療保險需求
醫療保險需求是指在一定時期內、一(yi)定(ding)價(jia)格(ge)水(shui)平(ping)上(shang)消(xiao)費(fei)者(zhe)願(yuan)意(yi)並(bing)且(qie)能(neng)夠(gou)購(gou)買(mai)的(de)醫(yi)療(liao)保(bao)險(xian)服(fu)務(wu)量(liang),即(ji)醫(yi)療(liao)保(bao)險(xian)機(ji)構(gou)所(suo)提(ti)供(gong)的(de)一(yi)定(ding)價(jia)格(ge)條(tiao)件(jian)下(xia)的(de)經(jing)濟(ji)保(bao)障(zhang)需(xu)要(yao)量(liang),用(yong)貨(huo)幣(bi)計(ji)量(liang)單(dan)位(wei)表(biao)示(shi)即(ji)為(wei)醫(yi)療(liao)保(bao)險(xian)金(jin)額(e)。
醫療保險需求的主體即醫療保險消費者,醫療保險的被保險人。在一定費用條件下,被保險人抗疾病風險的情況、健jian康kang狀zhuang況kuang以yi及ji他ta們men對dui醫yi療liao保bao險xian方fang案an的de滿man意yi程cheng度du,是shi衡heng量liang和he評ping價jia一yi種zhong醫yi療liao保bao險xian製zhi度du或huo方fang案an最zui根gen本ben的de標biao準zhun。被bei保bao險xian人ren既ji是shi醫yi療liao保bao險xian市shi場chang中zhong的de買mai方fang,又you是shi醫yi療liao服fu務wu的de消xiao費fei對dui象xiang。他ta們men在zai醫yi療liao保bao險xian的de籌chou資zi和he使shi用yong過guo程cheng中zhong的de行xing為wei,將jiang對dui保bao險xian的de效xiao果guo和he效xiao益yi產chan生sheng重zhong大da影ying響xiang。
[編輯]
醫療保險需求形成的條件[2]
(1)醫療保險消費意願。人ren們men對dui醫yi療liao保bao險xian的de需xu求qiu,是shi源yuan於yu對dui自zi己ji生sheng命ming安an全quan和he健jian康kang保bao障zhang的de需xu要yao。當dang無wu法fa預yu料liao的de自zi然ran疾ji病bing和he意yi外wai事shi故gu發fa生sheng時shi,會hui給gei人ren們men造zao成cheng身shen心xin傷shang害hai,帶dai來lai經jing濟ji損sun失shi,影ying響xiang人ren們men的de生sheng活huo。這zhe就jiu會hui使shi人ren們men在zai心xin理li上shang產chan生sheng一yi種zhong對dui患huan病bing的de擔dan憂you和he恐kong懼ju,並bing尋xun找zhao某mou種zhong手shou段duan來lai避bi免mian、應付或減少疾病發生時所造成的損失。因此,人們一般都具有購買醫療保險以求平安、穩定、正常的願望,這種消費意願成為購買保險的首要因素。
(2)貨幣支付能力。在(zai)商(shang)品(pin)經(jing)濟(ji)條(tiao)件(jian)下(xia),保(bao)險(xian)機(ji)構(gou)與(yu)參(can)保(bao)人(ren)之(zhi)間(jian)也(ye)是(shi)一(yi)種(zhong)商(shang)品(pin)經(jing)濟(ji)關(guan)係(xi)。人(ren)們(men)要(yao)想(xiang)獲(huo)得(de)保(bao)險(xian),必(bi)須(xu)支(zhi)付(fu)一(yi)定(ding)量(liang)保(bao)險(xian)費(fei)。人(ren)們(men)對(dui)醫(yi)療(liao)保(bao)險(xian)需(xu)要(yao)的(de)滿(man)足(zu),受(shou)到(dao)其(qi)貨(huo)幣(bi)支(zhi)付(fu)能(neng)力(li)的(de)限(xian)製(zhi)。因(yin)此(ci),醫(yi)療(liao)保(bao)險(xian)需(xu)求(qiu)就(jiu)是(shi)人(ren)們(men)在(zai)一(yi)定(ding)的(de)保(bao)險(xian)費(fei)率(lv)(premium rate)(價格)條件下由貨幣支付能力決定的對醫療保險的需要量。
(3)醫療保險需求者所投保的標的物符合醫療保險機構的經濟技術的要求。jicanbaorenxiangtoubaodeyiliaobaoxianxianzhonghebaoxianjigoushejidexianzhongxiangwenhe,zheshigouchengyiliaobaoxianxuqiudebibeitiaojian。ruguoxuqiuzhesuotoubaodebiaodeshibaoxianjigouzaijishushangnanyizuodaode,yebunenggouchengyouxiaodeyiliaobaoxianxuqiu。lirutoubaoaizibing。zongzhi,queshaoshangshusangetiaojian,renmenxiangdedaodeyiliaobaozhangxuyaojiubunenghuonanyizhuanhuaweizhenzhengyouxiaodeyiliaobaoxianxuqiu。
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醫療保險需求的經濟理論[3]
1.財富邊際效用遞減
jinguanrenmenduicaifushipianhaode,dansuizheyongyoudecaifushuliangzengjia,jinguancaifugeirenmendailaidezongxiaoyongzaibuduanzengjia,danzengjiadecaifugeirenmendailaidebianjixiaoyongshidijiande。
2.消費者追求效用最大化
疾病是不可預測的,人們無法知道自己會在什麼時候患病、患病的嚴重程度以及患病可能帶來的經濟損失,為了能在疾病發生時保持效用最大化,可以在自我保險、購買保險兩種方法中選擇。
[編輯]
醫療保險需求的形式[2]
醫療保險需求有兩種表現形式:①youxingdejingjibaozhangxingshi,jizaiwuzhifangmian,tixianzairenmenhuanbinghezaoyuyiwaishanghaishi,yiliaobaoxianjigouanzhaoyiliaobaoxianhetongzhongguidingdechangfufanwei,duifashengyiliaofeiyongdecanbaorengeiyubufenhuoquanbudebuchanghuogeifu,huotongguoyiliaojigouzhijietigongmianfei、部分免費或低價的醫療服務;②無形的心理安全保障形式,體現在轉嫁疾病風險,獲得醫療保險保障,解除人們因病致貧的後顧之憂,從而獲得心理上的安全保障。
在zai實shi際ji生sheng活huo中zhong,人ren們men往wang往wang比bi較jiao注zhu重zhong帶dai來lai經jing濟ji保bao障zhang的de實shi物wu形xing態tai需xu求qiu,而er對dui心xin理li安an全quan保bao障zhang的de無wu形xing需xu求qiu則ze認ren識shi不bu足zu。有you的de個ge人ren和he參can保bao單dan位wei,由you於yu在zai保bao險xian有you效xiao期qi內nei沒mei發fa生sheng保bao險xian責ze任ren範fan圍wei內nei的de疾ji病bing損sun失shi,閩min而er沒mei有you得de到dao經jing濟ji補bu償chang和he給gei付fu,就jiu認ren為wei參can加jia醫yi療liao保bao險xian是shi白bai花hua了le錢qian,甚shen至zhi對dui投tou保bao持chi消xiao極ji的de態tai度du。這zhe種zhong認ren識shi是shi片pian麵mian的de。事shi實shi上shang,社she會hui的de發fa展zhan和he人ren們men生sheng活huo的de安an定ding,對dui上shang述shu兩liang種zhong形xing式shi的de需xu求qiu都dou是shi客ke觀guan存cun在zai和he必bi要yao的de。而er且qie,對dui於yu參can保bao人ren來lai講jiang,得de到dao和he沒mei有you得de到dao補bu償chang的de經jing濟ji意yi義yi是shi相xiang同tong的de。之zhi所suo以yi得de到dao補bu償chang是shi因yin為wei其qi患huan病bing受shou到dao了le損sun失shi,按an照zhao損sun失shi補bu償chang的de原yuan則ze,所suo得de到dao的de補bu償chang額e沒mei有you超chao過guo實shi際ji損sun失shi額e,參can保bao人ren並bing未wei得de到dao額e外wai的de利li益yi;而沒有得到給付是因為其身體健康沒有遭受損失,但參保人卻得到了心理上的安全保障。
[編輯]
醫療保險需求的影響因素[1]
1.疾病發生的概率和損失程度
yiliaobaoxianchengbaode。shijibingfengxian,jibingfengxiandecunzaishiyiliaobaoxianxuqiucunzaideqiantihejichu。renmengoumaiyiliaobaoxiandemudezhuyaoshiyinweicunzaizhejibingfengxian,tadefashengbujindailaiqutishangdetongku,erqiedaozhijingjishangdesunshi}有you時shi這zhe種zhong經jing濟ji損sun失shi是shi難nan以yi承cheng受shou的de。顯xian然ran,醫yi療liao保bao險xian需xu求qiu強qiang度du與yu疾ji病bing風feng險xian的de存cun在zai程cheng度du成cheng正zheng比bi。疾ji病bing風feng險xian發fa生sheng的de可ke能neng性xing越yue大da,程cheng度du越yue高gao,給gei人ren們men帶dai來lai的de經jing濟ji損sun失shi越yue大da,人ren們men購gou買mai醫yi療liao保bao險xian的de積ji極ji性xing以yi及ji願yuan意yi支zhi付fu的de醫yi療liao保bao險xian費fei就jiu會hui越yue高gao,醫yi療liao保bao險xian需xu求qiu也ye就jiu越yue大da;反之,醫療保險需求就小。因此,疾病風險的發生概率和程度是影響消費者購買醫療保險的主要因素。
2.醫療保險的價格
醫療保險的需求量與醫療保險價格呈反方向變化。如果醫療保險費率即醫療保險的價格較低,可刺激醫療保險需求量的增加;xiangfan,ruguoyiliaobaoxiandejiagepiangao,gerenhuodanweihuixuejianzijideyiliaobaoxianxuqiu。zhidinghelideyiliaobaoxianjiage,bujinnengshiyiliaobaoxianjigoudeshouzhidadaopingheng,youkexiyingengduoderencanjiabaoxian。
3.消費者的收入
在(zai)一(yi)般(ban)情(qing)況(kuang)下(xia),醫(yi)療(liao)保(bao)險(xian)需(xu)求(qiu)應(ying)隨(sui)著(zhe)人(ren)們(men)收(shou)入(ru)的(de)增(zeng)加(jia)而(er)增(zeng)加(jia)。這(zhe)是(shi)醫(yi)療(liao)保(bao)險(xian)與(yu)經(jing)濟(ji)收(shou)入(ru)的(de)基(ji)本(ben)關(guan)係(xi)。隨(sui)著(zhe)個(ge)人(ren)收(shou)人(ren)的(de)日(ri)益(yi)增(zeng)多(duo),人(ren)們(men)用(yong)於(yu)消(xiao)費(fei)的(de)部(bu)分(fen)不(bu)斷(duan)增(zeng)加(jia),消(xiao)費(fei)結(jie)構(gou)也(ye)在(zai)變(bian)化(hua),消(xiao)費(fei)方(fang)式(shi)呈(cheng)現(xian)多(duo)元(yuan)化(hua)。人(ren)們(men)不(bu)僅(jin)要(yao)求(qiu)滿(man)足(zu)衣(yi)食(shi)住(zhu)行(xing)的(de)基(ji)本(ben)需(xu)求(qiu),而(er)且(qie)希(xi)望(wang)在(zai)發(fa)生(sheng)疾(ji)病(bing)時(shi),也(ye)能(neng)保(bao)持(chi)相(xiang)當(dang)的(de)生(sheng)活(huo)水(shui)平(ping)。因(yin)此(ci),當(dang)安(an)全(quan)的(de)需(xu)求(qiu)成(cheng)為(wei)人(ren)們(men)日(ri)常(chang)消(xiao)費(fei)中(zhong)不(bu)可(ke)缺(que)少(shao)的(de)部(bu)分(fen)時(shi),就(jiu)擴(kuo)大(da)了(le)人(ren)們(men)對(dui)醫(yi)療(liao)保(bao)險(xian)的(de)需(xu)求(qiu)。由(you)於(yu)不(bu)同(tong)收(shou)人(ren)水(shui)平(ping)的(de)人(ren)群(qun)對(dui)醫(yi)療(liao)保(bao)險(xian)的(de)需(xu)求(qiu)量(liang)不(bu)同(tong),因(yin)此(ci),對(dui)醫(yi)療(liao)保(bao)險(xian)的(de)提(ti)供(gong)者(zhe)來(lai)說(shuo),能(neng)否(fou)提(ti)供(gong)可(ke)以(yi)滿(man)足(zu)不(bu)同(tong)收(shou)入(ru)水(shui)平(ping)的(de)多(duo)層(ceng)次(ci)醫(yi)療(liao)保(bao)險(xian)服(fu)務(wu),將(jiang)是(shi)提(ti)高(gao)醫(yi)療(liao)保(bao)險(xian)需(xu)求(qiu)的(de)關(guan)鍵(jian)。
4.承保範圍
醫(yi)療(liao)保(bao)險(xian)的(de)承(cheng)保(bao)範(fan)圍(wei)是(shi)指(zhi)醫(yi)療(liao)保(bao)險(xian)所(suo)提(ti)供(gong)的(de)醫(yi)療(liao)服(fu)務(wu)項(xiang)目(mu)。如(ru)果(guo)醫(yi)療(liao)保(bao)險(xian)機(ji)構(gou)提(ti)供(gong)的(de)醫(yi)療(liao)保(bao)險(xian)項(xiang)目(mu)不(bu)是(shi)投(tou)保(bao)人(ren)所(suo)希(xi)望(wang)得(de)到(dao)的(de),人(ren)們(men)將(jiang)不(bu)會(hui)購(gou)買(mai)保(bao)險(xian)機(ji)構(gou)所(suo)提(ti)供(gong)的(de)險(xian)種(zhong),從(cong)而(er)影(ying)響(xiang)到(dao)醫(yi)療(liao)保(bao)險(xian)的(de)需(xu)求(qiu)。
5.醫療費用的負擔方式
不(bu)同(tong)的(de)醫(yi)療(liao)費(fei)用(yong)負(fu)擔(dan)方(fang)式(shi)影(ying)響(xiang)著(zhe)人(ren)們(men)對(dui)醫(yi)療(liao)保(bao)險(xian)的(de)需(xu)求(qiu)。自(zi)付(fu)的(de)醫(yi)療(liao)費(fei)用(yong)比(bi)例(li)越(yue)高(gao),人(ren)們(men)參(can)保(bao)的(de)積(ji)極(ji)性(xing)就(jiu)越(yue)低(di),反(fan)之(zhi)亦(yi)然(ran)。根(gen)據(ju)醫(yi)療(liao)費(fei)用(yong)的(de)分(fen)擔(dan)方(fang)式(shi),我(wo)們(men)可(ke)將(jiang)醫(yi)療(liao)保(bao)險(xian)分(fen)為(wei)扣(kou)除(chu)保(bao)險(xian)、共付保險、限額保險和混合保險。采用不同醫療費用分擔方式的醫療保險,將對醫療服務需方的行為產生不同程度的影響。
(1)扣除保險(deductible insurance):被保險人在就醫時先自付一筆錢,當自付的金額超過一定限額(起付線)時(shi),被(bei)保(bao)險(xian)人(ren)不(bu)再(zai)支(zhi)付(fu),其(qi)餘(yu)的(de)醫(yi)療(liao)費(fei)由(you)醫(yi)療(liao)保(bao)險(xian)機(ji)構(gou)承(cheng)付(fu),這(zhe)種(zhong)保(bao)險(xian)稱(cheng)為(wei)扣(kou)除(chu)保(bao)險(xian)。扣(kou)除(chu)保(bao)險(xian)對(dui)醫(yi)療(liao)保(bao)險(xian)需(xu)方(fang)的(de)影(ying)響(xiang)程(cheng)度(du)取(qu)決(jue)於(yu)起(qi)付(fu)線(xian)的(de)高(gao)低(di)。起(qi)付(fu)線(xian)過(guo)低(di),可(ke)導(dao)致(zhi)人(ren)們(men)過(guo)多(duo)地(di)利(li)用(yong)醫(yi)療(liao)服(fu)務(wu),造(zao)成(cheng)衛(wei)生(sheng)資(zi)源(yuan)的(de)浪(lang)費(fei);起qi付fu線xian過guo高gao,又you會hui使shi許xu多duo正zheng常chang的de醫yi療liao服fu務wu需xu求qiu被bei抑yi製zhi,一yi部bu分fen人ren的de基ji本ben醫yi療liao難nan以yi得de到dao保bao證zheng。因yin此ci,確que定ding適shi宜yi的de起qi付fu線xian是shi十shi分fen重zhong要yao的de,它ta既ji可ke在zai一yi定ding程cheng度du上shang增zeng加jia病bing人ren的de費fei用yong意yi識shi,約yue束shu病bing人ren的de行xing為wei,又you能neng保bao證zheng消xiao費fei者zhe對dui基ji本ben醫yi療liao服fu務wu的de需xu求qiu。
(2)共付保險。(又稱合作保險,Co-insurance):指(zhi)醫(yi)療(liao)保(bao)險(xian)機(ji)構(gou)和(he)病(bing)人(ren)共(gong)同(tong)承(cheng)擔(dan)醫(yi)療(liao)費(fei)用(yong)的(de)一(yi)種(zhong)醫(yi)療(liao)保(bao)險(xian)形(xing)式(shi),即(ji)當(dang)病(bing)人(ren)發(fa)生(sheng)醫(yi)療(liao)費(fei)用(yong)時(shi),醫(yi)療(liao)保(bao)險(xian)機(ji)構(gou)為(wei)病(bing)人(ren)償(chang)付(fu)一(yi)部(bu)分(fen)醫(yi)療(liao)費(fei)用(yong),其(qi)餘(yu)部(bu)分(fen)自(zi)病(bing)人(ren)自(zi)己(ji)承(cheng)擔(dan)。實(shi)行(xing)共(gong)付(fu)保(bao)險(xian),讓(rang)病(bing)人(ren)承(cheng)擔(dan)一(yi)部(bu)分(fen)醫(yi)療(liao)費(fei)用(yong),可(ke)增(zeng)強(qiang)病(bing)人(ren)的(de)費(fei)用(yong)意(yi)識(shi),從(cong)而(er)改(gai)變(bian)病(bing)人(ren)的(de)消(xiao)費(fei)行(xing)為(wei)。共(gong)付(fu)保(bao)險(xian)對(dui)醫(yi)療(liao)服(fu)務(wu)需(xu)求(qiu)者(zhe)的(de)影(ying)響(xiang)程(cheng)度(du)取(qu)決(jue)於(yu)共(gong)付(fu)率(lv)(醫療保險機構支付醫療費用的比例)的高低。共付率(Co-insurancerate)較(jiao)低(di)時(shi),患(huan)者(zhe)自(zi)付(fu)的(de)比(bi)例(li)就(jiu)會(hui)增(zeng)加(jia),因(yin)此(ci),將(jiang)會(hui)抑(yi)製(zhi)病(bing)人(ren)的(de)正(zheng)常(chang)需(xu)求(qiu),尤(you)其(qi)對(dui)於(yu)收(shou)入(ru)較(jiao)低(di)的(de)病(bing)人(ren),由(you)於(yu)無(wu)力(li)支(zhi)付(fu)所(suo)應(ying)共(gong)付(fu)的(de)那(na)部(bu)分(fen)醫(yi)療(liao)費(fei)用(yong)而(er)影(ying)響(xiang)到(dao)他(ta)們(men)的(de)健(jian)康(kang)。但(dan)如(ru)果(guo)共(gong)付(fu)率(lv)較(jiao)高(gao),則(ze)會(hui)使(shi)病(bing)人(ren)的(de)費(fei)用(yong)意(yi)識(shi)降(jiang)低(di),醫(yi)療(liao)保(bao)險(xian)機(ji)構(gou)通(tong)過(guo)需(xu)方(fang)對(dui)醫(yi)療(liao)費(fei)用(yong)的(de)控(kong)製(zhi)力(li)度(du)也(ye)會(hui)降(jiang)低(di)。
(3)限額保險(limited insurance):限額保險指為病人的醫療費用的補償設立一個最高金額限製(maximum liability limit),或最大服務量限製,超出部分由病人自付,即通常所說的"封頂"。這(zhe)種(zhong)方(fang)式(shi)限(xian)製(zhi)了(le)醫(yi)療(liao)服(fu)務(wu)提(ti)供(gong)者(zhe)提(ti)供(gong)高(gao)額(e)或(huo)過(guo)度(du)的(de)醫(yi)療(liao)服(fu)務(wu),降(jiang)低(di)了(le)醫(yi)療(liao)保(bao)險(xian)成(cheng)本(ben),但(dan)對(dui)於(yu)患(huan)大(da)病(bing)而(er)又(you)無(wu)力(li)支(zhi)付(fu)的(de)病(bing)人(ren)來(lai)說(shuo),則(ze)將(jiang)會(hui)影(ying)響(xiang)到(dao)他(ta)們(men)的(de)健(jian)康(kang)。
(4)混合保險(mixed insurance):混合保險是將各種費用支付方式結合起來使用的一種醫療保險形式。當在疾病發生概率較高、醫療服務需求量較大、qiemeibiyiliaofeiyongyibandouzaiqifuxianyishangshi,kecaiyongkouchubaoxiandexingshi,yijianshaoyiliaobaoxiandechengben。ruzaiqifuxianzhifengdingxianzhijiandebufencaiyonggongfubaoxiandexingshiyizengqiangxufangdefeiyongyishi,jianshao"道德損害"(moral hazard),降低醫療費用及保險成本,又可通過患者對醫療服務的選擇(優質低價)來提高醫療服務的提供效率;在封頂線以上部分設立巨額保險,以達到風險分攤的目的。
6.醫療服務的供給
醫療保險的需求受醫療服務的價格、種類、yiliaofeiyongshuipingyijiyiliaofuwutigongzhedefuwutaiduhezhiliangdeyingxiang。suizheyiliaofuwujiagejiyiliaoxiaofeishuipingdetigao,yiliaozhichuzaishourenzhongsuozhandebizhongbuduanzengda,renmenduiyiliaobaoxiandexuqiujiuhuigengjiapoqie。ruguoyiliaofuwudezhongleijizhiliangbunengmanzurenmenduiyiliaofuwudexuqiu,jishicanjialeyiliaobaoxian,yebunenggouhuoderenmensuoxuyaode、滿意的醫療服務,那麼就會影響人們對醫療保險的需求。
7.醫療保健製度
參保前的醫療保健製度對醫療保險的需求也有很大影響。長期以來,我國城鎮實行"公費醫療"和"勞保醫療",絕jue大da部bu分fen醫yi療liao服fu務wu費fei用yong由you國guo家jia預yu算suan和he企qi業ye財cai務wu開kai支zhi,使shi人ren們men產chan生sheng了le免mian費fei就jiu醫yi的de心xin理li慣guan性xing,而er參can加jia醫yi療liao保bao險xian發fa生sheng醫yi療liao費fei用yong後hou自zi付fu的de比bi例li往wang往wang會hui有you所suo提ti高gao,因yin而er影ying響xiang了le人ren們men參can加jia醫yi療liao保bao險xian的de需xu求qiu。從cong經jing濟ji學xue的de觀guan點dian看kan,當dang替ti代dai品pin(公費、勞保醫療)的價格近乎為零時,被替代的商品(醫療保險)dexuqiuzaibeitidaidefanweineijihuweiling,yincizaigongfeiyiliaohelaobaoyiliaozhiduxia,renmenmeiyoucanjiayiliaobaoxiandebiyao,yebuhuichanshengyiliaobaoxiandeyouxiaoxuqiu。danduiyuguoqujiuyixuzifuyiliaofeiyongzhe,canjiayiliaobaoxiankeyijianqingtamendejingjifudan,yinerduiyiliaobaoxiandexuqiujiuhuijiaogao。
8.保險意識
是指人們對"醫療保險"這zhe一yi客ke觀guan事shi由you的de主zhu觀guan認ren識shi。有you疾ji病bing風feng險xian存cun在zai,且qie經jing濟ji收shou入ru已yi達da到dao一yi定ding水shui平ping,就jiu產chan生sheng了le對dui醫yi療liao保bao險xian需xu求qiu的de可ke能neng性xing,但dan從cong可ke能neng性xing變bian為wei現xian實shi性xing,需xu要yao人ren的de主zhu觀guan意yi識shi的de推tui動dong作zuo用yong。因yin此ci在zai其qi他ta條tiao件jian不bu變bian的de情qing況kuang下xia,人ren們men的de醫yi療liao保bao險xian意yi識shi越yue強qiang,對dui醫yi療liao保bao險xian的de需xu求qiu就jiu越yue大da;反之則越小。由於"免費就醫"的慣性影響,加之正在試行的社會醫療保險起點低、覆蓋麵窄,給人們帶來實惠的"示範效應"buqiang,renmenpubianquefayiliaobaoxianyishi,yineryizhileyiliaobaoxianxuqiudekuaisuzengchang。baoxianyishidelingyizhongbiaoxiangjiushibixianxintai,butongdexiaofeizheduifengxiandexingweishibutongde,daduoshuxiaofeizhedouhuibiaoxianchubixianxingwei,bixianxintaiyuezhongdexiaofeizhe,duiyiliaobaoxiandexuqiuyejiuyueda。yucixiangfan,mianduifengxianbiaoxianchumaoxianxingweidexiaofeizhejiubuhuigoumaiyiliaobaoxian。
9.其他
除上述影響因素外,還要其他很多因素均在不同程度上影響醫療保險的需求。如消費者的健康狀況、年齡、性別、職業、文化水平等。健康狀況對醫療保險需求的影響,一般來說應該是健康愈差的人,參加保險的可能性愈大;相反,可能性愈小。但一些研究結果與上述假設相反。造成這種現象的原因,一方麵是由於收人、文化水平等原因,沒有參加保險,以致小病得不到及時的治療,造成健康狀況差;另一方麵是由於保險公司把那些身體狀況極差的人排斥在保險之外。
jinguanjibingfengxiandecunzaishirenmencanjiayiliaobaoxiandezhuyaoyuanyin,danshitajinshiyizhongkeguanyinsu。wenhuachengduduiyiliaobaoxianxuqiuchanshengzhengxiangyingxiang,wenhuashuipinggaoderen,bijiaoxiangxinherongyijieshouyiliaobaoxian,duiyiliaobaoxiandexuqiuyejiuyueduo。ruguorenmenduiyiliaobaoxianmeiyourenshi,meiyoucanjiayiliaobaoxiandezhuguanyuanwang,yejiubuhuichanshengduiyiliaobaoxiandexuqiu。
多保魚

