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对医疗费用的增长以及医疗保险与医疗服务之间交易成本的控制 ,对医疗保险尤其是商业医疗保险的经营与发展至关重要。以代理成本最小化为契约基础的委托代理方式 ,并无法将跨时期的、不确定的、剩余收益、权利的对比等交易费用因素纳入均衡契约约束的框架 ,代理成本的制约机制———代理目标最优激励契约 ,亦不能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。基于交易成本经济学理论的纵向一体化策略 ,医疗保险与医疗服务的合并 ,可以对交易成本和医疗费用形成有效的制约机制。
The growth of medical costs and the control of transaction costs between medical insurance and medical services are crucial to the operation and development of health insurance, especially commercial medical insurance. It is impossible to include the transaction cost factors such as cross-term uncertainties, residual income, and rights in the framework of the contractual balance of contract and the mechanism of agency cost control. The optimal incentive contract can not effectively control the relative monopoly of medical technology, knowledge and information capital in the context of knowledge-based economy to increase transaction costs and medical expenses arising from medical insurance and medical services. Based on the vertically integrated strategy of transaction cost economics, the combination of medical insurance and medical services can form an effective restriction mechanism on transaction costs and medical expenses.