中国公立医院社会托管:理论、实践、案例

中国医疗卫生体制改革进退维谷,其瓶颈在于市场与政府"双失灵"下的公立医院经营改革取向,创设的"社会托管"是市场失灵与政府失灵的解决途径之一。基于动态的社会契约理论,公立医院问题的重要出路在于社会托管经营,即以第三部门的社会管理职能来弥补市场与政府的缺陷,具体应由特定的官方非政府组织承担起托管责任。社会托管相关问题包括:国有产权的主导地位、社会托管的创新理念、非政府组织的社会作用、所有与经营的分类处理、公益与效率的统筹兼顾等。通过"宿迁医改"与"潞河托管"的现实案例对比,佐证了上述方案的必要性与可操作性。

Social Trusteeship of Public Hospitals in China:Theory,Practice and Case Analysis

In the development of the health care system reform in China,there are still many problems,in which the most pivotal thing is how to operate the public hospitals in the case of the" double failure" of the government and market.Based on the dynamic social contractual theories,the author brings forward the plan to actualize the social trusteeship of public hospitals and tries to make the social trusteeship by the third department to offset the failure of the government and the market,by means of enduing the especial non-governmental organizations with the responsibility for the social trusteeship of the public hospitals.The research includes these respects as follows: the dominant status of the state property,the innovation of the social trusteeship,the effect of the non-government organization,the division of the ownership and the operating right in the public hospital,the equilibrium of equity and efficiency.