1928-1937年河南县级公立医院建设的制度困境

Institutional dilemma of constructing county-level public hospitals in Henan province from 1928 to 1937

南京国民政府时期,河南省县级公立医院建设是在疫病丛生、缺医少药的省情以及政治与军事压力下展开的,其建设进程具有明显的行政命令特征。省政府经费筹措中的制度缺陷,造成医院乱象丛生;卫生技术人才选聘时的制度掣肘,加重了医院运营的艰难程度。造成制度困境的原因,一是省、县两级政府应对中的慌乱与无奈,二是制度“改进”的失当与变相的督责。反思历史可知,缺少众谋众筹的制度格局,盲目仿外、不切实际的制度移植,都将会事与愿违,付出沉重代价。

During the period of Nanjing National Government,the construction of county-level public hospitals in Henan province was carried out under the provincial conditions of epidemic disease,lack of medical services,and political and military pressures.The construction process had an obvious feature of administrative command.The system design of financing by provincial government caused the chaos of hospitals.The system of selecting health technical personnel restricted the development of hospitals,which also worsened the development of hospitals.The reasons for overstocking the regulations were as follows:first,the panic and helplessness in the response of the provincial and county-level governments while dealing with the dilemma;second,the improper and disguised supervision of the institutional“improvement”.Reflecting on the history,we can be sure that practices such as the lack of crowd-designed system structure,blind imitation of foreign path,unrealistic system transplant,will backfire.