| Summary: | 碩士 === 世新大學 === 行政管理學研究所(含博、碩專班) === 93 === Global budget of national health insurance is belonging to the common resources. From the theory of rational choice, the common-pool resources problem appears in advance resulted from achieving a global payment regulation. Among of the conflicts, the primary cause is due to the collective actions of the resource users. This thesis focuses on the analysis of failure for self-governance of the hospitals. The objective of this thesis is to understand the regulation of global payment. Meanwhile, what is the hospital strategy in principle of competition and cooperation? In addition, we also offer the corrective way to global budget. The analysis principle is based on the game theory, in combination of deeply analysis and discussion for this subject.
The analysis and conclusion are stated as follows it is difficult to manager the global budget of common pool resource neither by government or group of hospitals nor by the free market mechanism to allocate efficiently to the common-pool resources. It is necessary to establish a co-operation platform by both group of hospitals and National Health Insurance Bureau, and maintain a de-centralized principle and delegation to the local regions.
Research findings are summarized: First, the optimal decision made by hospital’s management is fully in compliance with the policy of National Health Insurance. Second, the cooperation problem analyzed with game theory is associated with conflict of allocative quota, i.e. one earns more and directly affects others benefits. Besides, a conflict of resources application, that is, the non-contract signed hospitals are more advantageous than the contract-signed hospitals. Third, in order to maintain good health care, hospitals cannot refuse any patients who need the health service. Bad examples like limitation of patients’ care, refusing non-profit health care as well as delaying health care, those are nothing to do with game theory or financial topics.
From government strategy and analysis of game theory, the meaning of hospitals is the group ownership for local global budget. Identically, they are all sharing with the common resources. Due to the game is a periodical cycle; we would like to keep the common resource with efficiency and fair moving in terms of co-management of global budget.
My recommendation, concerning the local global budget, the group of hospitals should pay attention to the following aspects: forcing to co-operation management, improving global budget, establishing understanding and truth between hospitals and National Health Insurance Bureau, and finally enlarging global budget.
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