公益性视角的公立医院融资困境及应对策略

The Financing Difficulties and Coping Strategies for the Public Hospitals from the Perspective of Public Welfare

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-oriented financing support, but the contradiction between the nonprofit nature of public hospitals and the profitability nature of capital made the process of public hospital financing into a dilemma. Through the analysis of the connotation of public welfare in public hospitals and cases 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 dividends that belong to the government into continued investment in public hospitals to support the realization of public welfare; fourth, com- bined with the local government iinancial resources based on differentiated financing model.