控制医疗费用的主体与方式研究

按照财权决定事权的原则，医疗费用的司控主体取决于医疗费用的支付主体。国家、医疗保险和个人作为医疗费用的三大支付主体，其中具有代表性、集合性、专业性的医疗保险无疑是司控医疗费用的最佳主体。但是，在委托代理框架内的契约约束机制，并无法有效控制知识经济背景下医疗技术、知识、信息资本的相对垄断对医疗保险与医疗服务所产生的交易成本和医疗费用的增长。基于纵向一体化的医疗保险与医疗服务合并，可以有效规制外生的交易成本，控制医疗费用的增长，降低医疗保险的风险成本并提高医疗资源的配置效率和社会利用效率。

Studying the body and mode of controlling medical expenses

According to the principle that financial right determines execution right, the payment body of medical expenses is responsible for the control of medical expenses. As one of three important payment bodies, including national payment, social medical insurance and individual payment, social medical insurance is definitely optimum body of controlling medical expenses. However, contract mechanism under the frame of principal agency theory could not control the increase in the transaction cost and medical expenses derived from the medical technology, knowledge and relatively information monopoly under new economy. The vertical integration of medical insurance and medical services could effectively control exogenous transaction cost and medical expenses, reduce the risk cost of medical insurance and enhance medical resources allocation efficiently.