[Biweekly Symposium] No. 588: Insurance Paradox—A Hypothesis that Price for Healthcare Is Inversely Related to Self Payment Rate in the Current Insurance Regime.
Lecturer: SHENG Hong, ZHANG Lin
Commentator: HE Liping, ZHOU Honghong
Professor SHNEG Hong firstly introduced that the research in “A Theoretical Research, Performance Evaluation and Reform Plan for China’s Healthcare System” was a flagship project for Unirule Institute of Economics in 2017. In the research, the research team spotted an insurance paradox. The establishment of the insurance is to get reimbursement for the healthcare expenditure people pay. The higher you pay for your treatment or medicine, the more reimbursement you get from insurance. However, in general terms, insurance has resulted in a price increase where 75% of the medicine fee gets reimbursed, but the price in general increases as well.
Professor SHENG thought it depends on whether the cost of insurance is higher than the utility when it comes to judge whether the insurance system is good or bad.
The research proposed two reform measures, firstly, self payment rate should be raised to 100% for minor diseases(outpatients); and secondly, a payment threshold for major diseases(inpatients) should be removed.