对医疗机构分类管理政策的回顾与反思

The Retrospect and Reflection of Hospital Classification Regulation Policy

通过回顾与分析医疗机构分类管理政策出台的背景,指出该政策出台的必然性。同时,指出卫生行政部门自身的权限决定了它主持制定的分类管理政策无法解决公立医疗机构改革的诸多关键性问题。分析了该政策实施效果不佳的原因是由于与该政策配套的营利性医疗机构税收政策和工商登记要求不尽合理。而导致目前该政策进退两难的原因则是由于该政策赋予工商和税务这两个部门在营利性医疗机构经济监管中较大的权限,使部门利益已经形成,卫生部门在与上述部门协调修改有关规定时难度极大,包括医疗机构管理体制改革在内的所有事业单位改革,仅仅依靠各行业主管部门无法取得突破性进展,国务院必须加强有关部门的协调,必须对事业单位改革做出全盘性的规划。

By reviewing and analyzing the backgrounds of constituting the policy of hospital classification regulation, the thesis points out that to some extent, the emergence of the policy is inevitable. The direct reasons why the policy＇s implementation is now in a cleft stick are the following two： first, the tax treatment for the for-profit hospital is unreasonable, and second, the requirement that for-profit hospital should register in the Administration for Industry and Commerce （AIC） is unnecessary. But both revising the tax treatment and abolishing the above requirement are beyond the MOH＇s authority. The policy＇s failure proves again that public organization＇s reform, including the reform of public hospital＇s administration system, could not break through without other ministries＇ powerful cooperation. The State Council should strengthen the coordination between various ministries and establish the across-the-board plan for public organization reform.