Medical services the governmental regulation of the market to make research

Brian Shaffer Missing Ohio State Medical Student

Although government of the each country in reality served the market to undertake the compasses of degree is made differring to medical services, but the controversy that academic group stems from the market and governmental action and whether to need to market of medical services compasses make still exist certain difference. The necessity that makes presence about regulation of government of market of medical services basically has two kinds of theory, namely public interest regulation makes theory and plan of special interest group formulate theory.

Regulation of 1. public interest makes theory should think the government is the Maecenas of public interest theoretically, use compasses make policy correct market deviation to have rationality, compasses make a likelihood enhance social welfare, its theory foundation is market malfunction. Because medical services the characteristic of the market, this domain puts in extensive market malfunction:

(1) in market of medical services communal taste a problem

Feierdesitan thinks to serve in medical services sanitation there is one part to have communal article property in the product, still have the communal article that comparatives to although not be firm sense,go up partly, but because its are had stronger exterior sex, have the quality of accurate communal product, cannot press " who is benefited, who partakes " the principle undertakes compensating.

(2) fair problem

Medical Protection is regarded to live the one part of authority, all countryman acquires this right should equally, and without giving thought to their life state or economic position how, the action of mechanism of pure support market achieves fairness hard. WHO is in 1996 proposal " health and the fair sex that sanitation serves " in emphasize, fairness is meant live the allocation of the opportunity should direct with needing to be, is not to depend on social prerogative, every society member all has equal opportunity to obtain medical services when need, achieve live basically standard. Keernai, Weng Sheng and also emphasize fair sex problem be in particularly medical services field is more main, because the life health of medical services and people is direct relevant.

(3) information asymmetry quality

The information asymmetry that A collect basically studies to medical services both sides of supply and demand the uncertainty of gender and Medical Protection. What medical services a technology is professional gift with complexity medical establishment and doctor advantage position, the doctor waits for a circumstance to understand more clearly to the patient‘s illness and remedial program, understand how to provide a service more for the patient in order to obtain monetary reward of high specified number; Medical establishment hopes floriferous money treats the patient more likewise in order to increase income. The patient is in position of news inferior position relatively, the service quality that the price level that to illness, possible cure the method, person that anticipate result, other service is offerred raises, different medical establishment, different doctor offers and its difference do not understand, can rely on medical services to serve the person that offer to make a decision only, to recover at an early date, to dare not slighting for square requirement. May generate supply from this lead demand problem. Supply is revulsive demand is academic but restrospect to Xie En and Luo Mo, their discovery is short-term inside the bed of every 1000 people of common hospital is counted and existence positive involves a concern between number of be in hospital of every 1000 people. This observes rule of the Luo Mo that be called or Luo Mo is affected, namely " should create a new hospital bed only, will use it with respect to somebody " . Because information distributings in the asymmetry between both sides of doctors and patients,Evan puts forward on this foundation, demand of medical services is a kind of demand that just be guided by supply and decides. He thinks, because medical services market presence forestall and serious information asymmetry problem, the market supply demand relations on traditional sense does not apply to this special market, emphasize overly commercializing in this domain what often bring about resource configuration is inefficient.

(4) problem of market presence forestall serves in medical services

The medical services that different hospital provides has differential sex, beyond the price that consumer serves besides attention medical services, the service variety that the situation that still can pay close attention to a hospital, time cost that from oneself living area heads for each hospital place to cost, hospital offers, quality and technical level. And the demand flexibility of product of medical services is low, tell from this meaning, market of medical services can regard as have forestall sex. Some economist think, the concentration of the market is spent taller, the price that medical services is higher.

The competition that the market that public interest regulation makes theory think medical services a field is out of order to adopt certain form not easily gets corrective, ought to aggrandizement is made to the governmental regulation of market of medical services. Laifule emphasizes the information asymmetry between doctors and patients can reducing medical services to serve quality, it is right that the medical services that thinks a country is carried out compulsively serves lowermost quality standard to be able to be regarded the effective response that gets the high cost of quality information to make. Because Lai of black Wei · breaths out the theory of supply and demand that serves the market to be able to press a standard to medical services especially to move express to suspect, if consumer demand suffers the effect of feeder greatly,think, so resource of the consumption that market strength can‘t restrain medical services of the price, limitation possibly to serve, implementation is best configuration, if supply is revulsive,advocate a demand is market of medical services main problem, so compasses make should make choice of a policy. Formulate theory according to public interest regulation, compasses make can come true " public interest " target: The configuration with more effective resource of fair, citizen‘s better healthy state, medical services.

The fundamental sex resource that plan of 2. interest group makes plan of theoretical interest group control academic hypothesis government is to be able to make social welfare is between different person the coercive power of move, compasses the demand that make just is mixed supply just is rational " economic person " , they can realize effectiveness through choosing action the biggest change. This theory emphasizes special interest group forming the main effect of the process in public policy, think interest group comes through seeking governmental regulation to make promotional its interest, consequently governmental regulation makes the kill that is interest group drive, it is to be group of contented and specific interest to seek its member profit the biggest those who change need and carry out. The plan that Sidigele starts makes economic theory be provided most representative, this supply and demand that brings into political behavior economics theoretically analyses frame, effectively explained how is interest group controlled or influence government regulation is made, put forward a group to be gotten successfully compasses the possibility that make depends on its anticipate in compasses the place in making is obtained accrual organizes cost with its the balance between is compared, as a result of the consumer with numerous to the amount photograph character, the member number of an industry is less, more organize easily, and from compasses the getter in making all profit is bigger, the drive of industrial influence politics is so bigger, the compasses person that make is likely by capture of industrial group place. Peierciman expands and perfected Sidigele‘s theory, turn its model. It is in graceful model of admire Er at present, political support is the function that makes profit about interest group plan, and every interest group (generator and consumer) include different subclass group, the compasses person that make makes the choice function of its politics support is the biggest the policy that change. Beikeerdi gives politics balanced model, this model pays close attention to the competition between interest group, backer thinks compasses making basically is the welfare that uses the interest group that enhances more influential power.

Formulate theory according to interest group plan, governmental regulation is made restricted competition, increased the profit of special interest group, so this theory view is loosened cancel even compasses make, the plan that includes medical services to serve market field is made, think to pass free market mechanism to be able to realize medical services to serve the efficiency of the domain.

Theory of public interest and interest group theory had one part learned man analysis of a case of a physically strong patient running a high fever or suffering from such disorders as stasis of blood, reach different conclusion. The demonstration of Paul studies the result shows, of the number of doctor of city average per capita that can register in American medicine and practice system of licensing execute fixed number of year to have apparent negative correlativity, the public interest that this research denied medical services market government regulation to make says, card understands interest group plan to formulate theory; Geleidi also undertook examining to two kinds of hypothesis, her evidence makes clear, the compasses of service market made medical services satisfy public interest requirement on certain level, its are basic conclusion is, did not discover compasses the onefold dominant intention that make, the compasses person that make can is opposite at the same time interest group, public interest and the legislative environment that its face make response.

The existence in although theory and analysis of a case of a physically strong patient running a high fever or suffering from such disorders as stasis of blood proved medical services market government regulation,controlling a process satisfies the issue that special group profit needs, but the governmental plan that can not put forward cancel this domain according to this is made, because pure market mechanism is unwarrantable,medical services the efficiency of the domain and patient rights and interests. Market mechanism produces effect and implementation efficiency is conditional, the value that the most fundamental condition is the goods that witting place should buy customer or service and cost, oneself are made buy the decision-making, total value that gets buying goods to bear total cost. But in market of medical services, need falls to make corresponding services quickly in professional knowledge setting decision-making, the value that the patient evaluates the medical services that he enjoys to serve without enough time and also lack corresponding decision-making capacity, this brings about the kind that medical services and cost to basically be decided by feeder, the patient chooses feeder of be enslaved to be enslaved to to what medical services; In addition, the existence that tripartite pays an institution makes the patient does not bear all cost. So, the any in 3 afore-mentioned conditions cannot serve the market to be able to satisfy in medical services, market mechanism is unwarrantable the implementation of efficiency. The life health of market of service of together with medical services and people is direct and relevant, use normally " human life closes a day " will describe it, need makes the rights and interests that ensures a patient through governmental regulation. Consequently, although serve the market to whether need governmental regulation to make about medical services,return existence controversy, but in light of the characteristic that serves the market from medical services and current practice, had not achieved in this domain need compasses is made or do not cancel completely compasses the level that make, the viewpoint that the problem depends on how making public interest plan theory and interest group plan formulate theory organic union, make through designing more appropriate system framework compasses make behavior accord with public interest as far as possible, reduce compasses the possibility that makes capture, is not treat two kinds of afore-mentioned theory completely contrary.