公辦民營醫院的迷失：管理學的觀點

The Puzzle of Public Hospitals Privatization: Perspective of Management

主張公立醫院民營化的理由為，公立醫院有兩大問題：欠缺效率以及營運成本高。此項觀點認為，私立醫院都是有效率的，而且營運成本低。事實上，私人醫院也有經營不善，效率低，而倒閉的。所以，這個觀點與事實不合。公立醫院的問題是管理問題，管理問題應從管理著手來解決，因此，需要深入瞭解管理問題的緣由，才能針對問題提出解決的方法。我國民營化的公立醫院以合約方式，將醫院外包給私人經營，政府握有所有權，私人取得經營權，是一種所有權與經營權分離式的經營方式，此種方法有可能有政治因素介入，使問題更複雜；而且政府難以執行監督權。欲改善公立醫院經營的缺失，有兩點可供思考，一為從管理著手，強化管理方式；一為從公共政策與公共服務方面著手，為公立醫院尋找生存的空間。

The reasons of privatization public hospitals come from the problems of public hospitals, inefficiency and high cost. Based on the perspective, private hospitals are efficiency and low cost. In fact, some private hospitals are inefficiency and poor performance and closure. Therefore, the perspective is irrelevance to fact. The problems of public hospitals are problems of management. Management problems should be solution by management. The country privatization public hospitals based on contract, government holds ownership, private holds operation. The separation of ownership and operation could bring into politic factor and worsen the problems, by the way, government is difficult to supervise. For improvement the problems of public hospitals, there are two points could consider, to improve management and to look for space existence by public service or public policy.