影响社会资本参与公立医院公私合作项目的主要因素分析

Analysis of main influencing factors for social capital to play in public-private partnership projects in public hospitals

分析了社会资本通过公私合作（public-private partnership，PPP）项目＂进军＂公立医院面临的亟待解决的问题：公立医院的公益性、非营利性和政治敏感性决定了社会资本无法从公立医院的核心业务中直接获利，增加了PPP模式的设计难度；项目中各方的具体利益诉求不一致，有可能导致零和博弈的局面出现；社会资本的投资回报渠道少，回收周期长，需要设计新的盈利模式；社会资本方承担的融资风险普遍偏高，会增加地方政府的隐形债务风险；政府对于社会资本进入公立医院的财政补贴、税收优惠、融资等方面的优惠政策尚没有明确的规定。这些都在一定程度上抑制了社会资本的＂冲动＂，需要加以解决。

Analyzed in this paper are difficult roadblocks for social capital to＂break into＂public hospital by way of public-private partnership （PPP） projects. To name a few, the public welfare nature and non-profit nature, and sensitive political issues of public hospitals among other factors prevent such capital from directly making profit from the core businesses of these hospitals, hence almost impossible to design a feasible PPP model. Conflicting interest demands among stakeholders might make it a zero-sum game. New profit sources need to be created to cover such problems as insufficient returns on investment and long payback period. The financing risk exposure of social capital, which tends to be high, would push up the hidden debt risks shouldered by local government in question. In addition, there are not yet clear policies for social capital in terms of fiscal subsidy, tax preference and financing. All of these have curbed the＂impulse＂of social capital to a certain extent, pending better solutions.