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面对公立医院过度追求经济利益和扩张冲动的现状,政府虽然也采取了一系列控制措施,但是都收效甚微,表现为对公立医院的管制手段失效。我们看到的是,政府对公立医院一直是在下放权力与加强控制之间游离。现实中,政府的政策一方面是把公立医院作为事业单位来控制床位、人员编制,以控制财政经费补助的支出;而另一方面又把公立医院作为可以自我创收发展的经营单位来激励其发展新技术、新项目。由于管制者与经营者之间信息不对称,在这种激励政策的引导下,大型公立医院的经营者利用信息充分的优势,最终都能——突破管制手段,不断扩张和提高公立医院的技术构成,从而拉动了医疗费用水平的持续攀升。
In the face of excessive pursuit of economic interests and expansionary impulses in public hospitals, the government has adopted a series of control measures with little success. This shows that the government has failed to control public hospitals. What we have seen is that the government has always kept public hospitals free from the power to delegate control. In reality, on the one hand, the government’s policy is to use public hospitals as public institutions to control the bedspace and staffing so as to control the expenditures for financial subsidies. On the other hand, public hospitals are encouraged to develop their own income-generating businesses New technology, new project Due to the information asymmetry between regulators and managers, under the guidance of such incentive policies, large-scale public hospital operators can make full use of the advantages of information and eventually can break through regulatory measures and continuously expand and improve public hospital technology Constitute, thus driving the medical costs continue to rise.