公益性视角的公立医院融资困境及应对策略
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摘要
医疗服务需求的持续释放激发了公立医院的发展冲动,政府财政补助和医院自有资金不足背景下部分公立医院寻求市场化融资方式的支持,但是公立医院的公益性和资本的逐利性两者之间的矛盾使得公立医院融资进程陷入进退两难困境。通过对公立医院公益性内涵和PPP项目案例的分析,发现公立医院的公益性并不完全排斥资本的逐利性,资本逐利所依托的市场竞争机制也是实现公立医院公益性的前提条件。要在坚持公立医院公益性的基础上利用好市场化融资方式必须做到:第一,坚持政府在公立医院运营方向上的主导性;第二,在引进资本的同时着眼于运营机制的改革与创新;第三,将归属于政府的分红转化为对公立医院的持续性投入以支持公益性的实现;第四,结合地方政府财力采用差异化的融资模式。
The continued release of demand for medical services had stimulated the development of public hospitals. In the con-text of insufficient government financial subsidies and inadequate hospital funds, some public hospitals tended to seek market-orientedfinancing support, but the contradiction between the nonprofit nature of public hospitals and the profitability nature of capital made theprocess of public hospital financing into a dilemma. Through the analysis of the connotation of public welfare in public hospitals andcases of PPP projects, it found that nonprofit of public hospitals did not completely exclude the profitability of capital, the market com-petition mechanism that capital profit behavior relied on was a prerequisite for the realization of the public welfare nature of public hos-pitals. Taking the advantage of market-oriented financing methods on the basis of insisting on the public welfare of public hospitals,the following measures must be taken: firstly, adhere to the government's dominant position in the direction of public hospitals; second-ly, while introducing capital, it needed to focus on the reform and innovation of operational mechanisms; thirdly, convert the dividendsthat belong to the government into continued investment in public hospitals to support the realization of public welfare; fourth, com-bined with the local government financial resources based on differentiated financing model.
The continued release of demand for medical services had stimulated the development of public hospitals. In the con-text of insufficient government financial subsidies and inadequate hospital funds, some public hospitals tended to seek market-orientedfinancing support, but the contradiction between the nonprofit nature of public hospitals and the profitability nature of capital made theprocess of public hospital financing into a dilemma. Through the analysis of the connotation of public welfare in public hospitals andcases of PPP projects, it found that nonprofit of public hospitals did not completely exclude the profitability of capital, the market com-petition mechanism that capital profit behavior relied on was a prerequisite for the realization of the public welfare nature of public hos-pitals. Taking the advantage of market-oriented financing methods on the basis of insisting on the public welfare of public hospitals,the following measures must be taken: firstly, adhere to the government's dominant position in the direction of public hospitals; second-ly, while introducing capital, it needed to focus on the reform and innovation of operational mechanisms; thirdly, convert the dividendsthat belong to the government into continued investment in public hospitals to support the realization of public welfare; fourth, com-bined with the local government financial resources based on differentiated financing model.
引文
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[2]杨红梅.医疗设备融资租赁及会计处理[J].经济师,2007(5):170-171.
[3]段丁强,周靖.对医疗服务供给公益性若干认识误区的辨析[J].医学与哲学(A),2016(2):45-47.
[4]张劲文.大型交通建设项目管理集成研究[D].湖南:中南大学,2006.
[5]王秋玲.收费公路公私合作问题分析[D].陕西:长安大学,2008.
[6]邢立萍.PPP在医疗行业的应用[N].东方早报,2015-04-21(008).
[7]毕舸.不要高估外资独资医院的鲶鱼效应[N].证券时报,2014-08-28(A03).
[8]吴茜.公立医院PPP模式应用:两个案例对比[J].地方财政研究,2015(8):32-43.
[9]王波,李小琴.教育公益性与资本逐利性的冲突与共生——民办高校对社区利益公司制度的借鉴[J].高教探索,2014(1):25-29.