自主治理理论视域下的公立医院改革

现有医改方案不是市场的就是政府的,而且得出的结论往往是悲观的或过于乐观的。奥斯特罗姆指出,以政府为唯一或以市场为唯一的途径解决公共事务问题,都是有问题的。本文结合理论与案例,提出通过自治组织管理公共物品的途径：我国公立医院改革的切入点是培育优秀民营医院,鼓励国际资本和慈善机构举办医疗机构,倒逼公立医院改革,实现医疗卫生服务领域的主体多元化,为多元化的自主治理创造基本条件;之后,借用市场竞争之手和政府调控之手实现和谐共治。

Public hospital reform from self-governance theory perspective

The existing health reform plan is dominated by market or government mechanism,and the conclusion is always extremely pessimistic or optimistic.Ostrom pointed out that there always existed side-effects to solve public affair problems using government or market mechanism exclusively.By combining theory and case,we introduced public goods management pathway using autonomous organization.The initiative step of public hospital reform is to foster excellent private hospitals,and encourage international and charity capital to build hospital.Competition will force public hospital to change and improve it performance.The diversity of medical health service market will contribute to multi-type self-governance.Eventually,harmonious governance will be fulfilled by market and government methods.