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。基于动态的社会契约理论,公立医院问题的根本出路在于社会托管,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。 The bottleneck of China’s reform of the health care system lies in the orientation of the reform of public hospitals under the “double failure” of the market and the government. Based on the dynamic social contract theory, the fundamental solution to the problem of public hospitals lies in social custody, that is, the social management functions of the third sector are used to make up for the deficiencies of the market and the government. Specifically, the specific official non-governmental organizations should assume the custodial responsibilities.