Regulated medical fee schedule of the Japanese health care system
Regulated medical fee schedule of the Japanese health care system
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DOI：
10.1007/s10754-013-9133-6
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发表时间：
2013-12-01
期刊：
影响因子：
--
通讯作者：
Kato, Ryuta Ray
中科院分区：
文献类型：
--
作者：
Kakinaka, Makoto;Kato, Ryuta Ray
这项研究提供了一个理论框架，用来检验日本政府管制的医疗价格计划--新罗-厚州-世道--对医疗服务提供者行为的影响。特别地，我们讨论了考虑到监管者和供应商之间的信息不对称时，监管者的最优定价规则。我们的简单模型预测，与社会最优结果相比，不同的提供者要么提供不足，要么过度提供医疗投入。此外，我们的结果表明，当分配的预算减少到一定水平时，无论如何调节价格时间表，即使是次优结果也是无法实现的。虽然有限的预算规模被证明对社会福利有明显的负面影响，但我们建议，获得第二好结果的前景留给监管机构和预算分配者之间的谈判。
This study presents a theoretical framework for examining the effect of the Japanese government-regulated medical price schedule, 'Shinryo-Houshu-Seido,' on the behavior of medical providers. In particular, we discuss the optimal rule of this price schedule for the regulator, taking into account information asymmetry between the regulator and providers. Our simple model predicts that heterogeneous providers either under-provide or over-provide medical inputs in comparison with the socially optimal outcome. Moreover, our results show that when the allocated budget is reduced to a certain level, even the second-best outcome becomes unachievable, no matter how the price schedule is regulated. While the limited budget size is shown to have a clear negative effect on social welfare, we suggest that the prospect of obtaining the second-best outcome is left to negotiation between the regulator and the budget allocator.