监管和自律是克服医生道德风险的主要途径,医疗领域的特殊性决定了克服医生道德风险的最根本途径在于自律而不是过度监管,政府对医疗领域的过度干预会对声誉机制产生“挤出效应”,同时也进一步强化了医生的道德风险。制度安排的关键在于改革现行“管办不分”的医疗卫生体制以及医院等级评定和医生职称评定制度,同时放松政府对医疗服务价格的控制,彻底解除卫生行政部门与公立医院的“父子关系”,以恢复医疗供方市场声誉机制。
The supervision and the self-discipline are main ways to overcome the moral hazard of doctors. But the excessive intervention to the medical domain of the government can occupy the market growth space of the reputation mechanism. Meantime,it will also strengthen the doctor's moral hazard. The reforms of the current medical and health system of "inseperation between functions of execution and those of administration", the hospital rating system and the doctor's job appraisal system, simultaneously relaxing the control of the government to the medical service price, are the ways to restore the market reputation mechanism of the medical supply-side which is distorted.