全民医疗保险与公立医院中的政府投入:德国经验的启示

发布时间：2019-07-26 07:29

【摘要】：在德国的所有医院,包括公立医院,日常运营靠保险,基本建设靠政府,被称为"二元筹资原则"。在政府投入不足的情况下,公立医院从其他来源寻求资本投资,也实属正常。在全民医疗保障体系之下,不仅公立医院而且相当一部分私立非营利性医院的日常运营收入都来自医保机构的支付。即便是以个体户身份独立执业的家庭医生,其主要收入来源也是来自医保机构的支付。中国医疗界人士在抱怨公立医院中"政府投入不足"的时候,常常无视公立医疗保险的支付,而有关统计年鉴中记录的"政府投入"也不包括政府对公立医院的资本投资。德国的经验启示我们,在实现了全民医疗保障并且医疗保障水平较高的发达国家,公立医院的日常运营收入主要来自公共医疗保障体系的支付,而它们的资本投资来源多样化,其中政府投入仅仅是一部分。这是正常的,也是我们应该学习的。
[Abstract]:In Germany, all hospitals, including public hospitals, rely on insurance for day-to-day operation and government for capital construction, known as the principle of dual financing. In the case of insufficient government investment, it is normal for public hospitals to seek capital investment from other sources. Under the universal health care system, not only public hospitals but also a considerable number of private non-profit hospitals receive daily operating income from health care institutions. Even self-employed family doctors, whose main source of income comes from payments from health care institutions. When Chinese medical professionals complain about "insufficient government investment" in public hospitals, they often ignore the payment of public health insurance, and the "government investment" recorded in the statistical yearbook does not include government capital investment in public hospitals. The experience of Germany enlightens us that in developed countries that have realized universal health care and a high level of medical security, the daily operating income of public hospitals mainly comes from the payment of public health care system, and their sources of capital investment are diversified, in which government investment is only a part of it. This is normal, and that is what we should learn.
【作者单位】：北京大学政府管理学院;
【分类号】：F845.16;R197.1

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