公立医院公益性问题研究

A Study of Public Welfare in Public Hospitals

近年来,公众之所以会对"公立医院是否具有公益性"产生疑问,是源于社会上对"公立医院收费使它们丧失了公益性"的批评,而这种批评又混淆了公立医院提供医疗服务应不应当收费和医疗费用最终应当由谁支付这两个不同的问题。因此,文章在综合各种公益性概念并对公益性给出一个确切定义的基础上,分别梳理了目前国际上医疗费用筹措与医疗服务提供的几种主要方式,分析各自的优缺点,指出了增加公共医疗支付的必要性。文章最后提出,目前我国一些城市试行的"按病种付费"的体制,可望根据实际情况进行改进以后在更大的范围内推广。

In recent years, the public have questioned public welfare in public hospitals, due to public hospitals charging patients for treatment. Such criticism has also led to questions about whether public hospitals should charge for their medical services and who should pay for medical expenses. Based on the review of different concepts of public welfare, this paper defines and analyzes the main ways health care costs are financed and medical services are provided internationally and their advantages and disadvantages. This paper then points out the necessity of increasing public health care payments and that the system of paying based on the type of illness, which is implemented in some cities in China, can be improved in accordance with the actual situation and rolled out on a larger scale.