“十二五”医改规划提出，2015年，非公立医疗机构床位数和服务量达到总量的20%左右。近日召开的国务院常务会议强调，要在七大领域尽快推出一批引导民间投资参与的重点项目，其中包括卫生领域。随着落实民间投资“新36条”实施细则的公布，医疗服务业正在逐步放开对社会资本的限制，社会资本办医的环境正在改善。眼下，社会资本办医遇到哪些困难？需要破除哪些政策障碍？怎样才能健康发展？从今天起，本版将推出连续报道“社会办医调查”，敬请关注。

“1025”Reform plans to put forward，In 2015,，The public medical institutions bedspace and services in about 20% of the total。Recently the state council executive meeting held emphasized，In seven areas out as soon as possible a batch of guiding non-governmental investment in key projects，Including health field。Along with the implementation of private investment“Article 36 new”Publication of the detailed rules for the implementation，Medical service is gradually open to the limitation of the social capital，Social capital to do medical environment is improving。the，Social capital to do medical meet what difficulty？Need to break what policy barriers？How to healthy development？From this day onwards，This version will launch continuous reports“Social do medical investigation”，Please pay close attention to。

　　——编 者

- knitting is

　　1. 营利与非营利区别在于分不分红，非营利性的医院所得全部用于医院的发展。我国民营医院大部分都是营利的，主要是因为我国缺乏非营利性医院成长的政策环境

1. Profit and non-profit difference between points don't share out bonus，Non-profit hospital income all used for the development of the hospital。Our country civilian battalion hospital most of them are profit-making，Mainly because our country lack of non-profit hospital growth policy environment

　　6月26日，首家台资独资医疗机构、台湾联新国际医疗集团在大陆地区的旗舰医院——上海禾新医院开业。此前，我国医疗领域已有外资合资医院，但是股权份额受到限制。2010年12月，国办发布的《关于进一步鼓励和引导社会资本举办医疗机构意见》(简称“58号文”)明确规定，逐步取消对境外资本的股权比例限制，并开始试点。政策调整后，这家医疗集团马上申请将原有的合资医院转为独资医院。

June 26,，The first wholly Taiwan medical institutions、Taiwan union new international medical group in mainland flagship hospital -- Shanghai grass new hospital opening。after，Chinese medical field for foreign joint venture hospital，But equity share limited。In December of 2010，Released map《On further encourage and guide the social capital held opinion of medical institutions》(Referred to as“Article 58,”)Specific provision，Gradually cancel on foreign capital equity ratio limit，And began to pilot。Policy adjusted，The medical group apply now will the original joint venture hospital to sole the hospital。

　　联新国际医疗集团总执行长、禾新医院院长张焕祯在大陆地区工作多年，他看好这个市场。他说：“更大的市场在大陆，比如，上海缺少提供高端服务的医疗机构，所以开办禾新医院。虽然刚开始可能比较艰难，但是凭着在大陆多年的经营经验，半年过后应该会有口碑。”下一步，该集团还会开拓儿童医疗市场。“家长带着儿童去公立医院看一次病，每次也要四五百元，所以市场不成问题。”他说。

United new international medical treatment group total CEO、Grass new hospital dean ZhangHuanZhen in mainland area for many years，He believed the market。He said：“Larger market in the mainland，For example，Shanghai to provide high-end service of medical institutions，So open grass new hospital。Although may start out comparison difficult，But with many years of operating experience in mainland China，After half a year should have public praise。”The next step，The group will also develop children's health market。“Parents with children go to public hospital see a disease，Every time also to - yuan，So the market is not a problem。”He said。

　　目前，“58号文”对民间资本进入医疗领域的“松绑效应”逐步显现。但是，高水平、大规模的连锁非公立医院还是少，其中非营利性质的更少。

At present，“Article 58,”The folk capital into medical field“Relax effect”Gradually appear。but，High level、Large-scale chain non public hospitals or less，The non-profit nature of the less。

　　张焕祯同时也是国务院医改专家咨询委员会委员。他认为，目前大陆地区好的民营医院还没出现，只是一些小规模的、只想赚钱的生意人开办的民营医院。他指出，40年前，台湾公立医院占有95%的营业额，现在占总数25%的公立医院仅占有30%的营业额。虽然75%的医院是非公立医院，但是其中大部分都是非营利性的。

ZhangHuanZhen also cure of the state council changes a expert consultation committee。He thinks，At present the mainland good private hospitals haven't appeared，Only a small scale、Just want to make money businessman open private hospital。He pointed out that，40 years ago，Taiwan occupies 95% of the turnover of public hospital，Now 25% of public hospital only occupies 30% of the turnover。Although 75% of hospital is a public hospital，But most of them are nonprofit。

　　“营利与非营利区别在于分不分红，非营利性的医院所得全部用于医院的发展。因此，即使非营利医院是社会举办的，也丝毫不影响医疗服务的公益性质。而我国民营医院大部分都是营利的，主要是因为缺乏非营利性医院成长的政策环境。”华中科技大学同济医学院教授姚岚说。

“Profit and non-profit difference between points don't share out bonus，Non-profit hospital income all used for the development of the hospital。therefore，Even if the nonprofit hospital is held by the society，Also does not affect medical service public property。And our country civilian battalion hospital most of them are profit-making，Mainly because of the lack of non-profit hospital growth policy environment。”Central China university of science and technology, professor of tongji medical college YaoLan said。

　　她介绍，国外很多民营医院都是非营利性的，真正目的只有一个，就是为百姓提供医疗服务。投入的钱都用来支付医院的运行成本，捐赠主要用于改善服务能力、聘用更好的医生。而我国没有合理的补偿渠道，也没有社会捐赠，没有形成适合非营利机构成长的环境。

She introduces，Many foreign countries and civilian battalion hospital are nonprofit，There is only one true purpose，The people is to provide medical services。Put money to pay the hospital operation cost，Donation is mainly used to improve service ability、Hire a better doctor。And our country has no reasonable compensation channels，No social donation，No form suitable for non-profit organizations growth environment。

　　卫生部提供的一组数据显示，截至2011年底，全国民营医疗机构数为45.7万所，占全国医疗机构总数的47.9%，床位数占全国总数的9.7%。今年6月，卫生部部长陈竺在全国加快推进社会办医现场经验交流会上指出，社会办医在一定程度上还存在“小、散、乱”等问题，尚不能对公立医院形成有效竞争。民营医院规模普遍偏小，仅有12%的民营医院床位数达到100张以上，二级和二级以上民营医院仅占其总数的5.6%。

The ministry of health to provide a set of data display，By the end of 2011，The number of private medical institutions for 457000，Accounted for 47.9% of the total number of medical institutions，Bedspace accounted for 9.7% of the total。In June this year，The ministry of health minister Outlines in the national accelerate social do medical field experience sharing conference pointed out，Medical social do in a certain extent still exist“small、scattered、disorderly”problems，Is not to public hospital form effective competition。Civilian battalion hospital scale slant generally small，Only 12% of civilian battalion hospital bedspace excess of 100 copies，Level 2 and secondary above the private hospitals accounted for only 5.6% of the total。

　　武汉亚洲心脏病医院床位达到750张，是一家大规模非营利性质的专科民营医院。总经理叶红说：“公众对一家医院的认可是非常不容易的，需要一个漫长过程。医院投资者要有良好的心态，把办医院当成长远事业来做。”

Wuhan Asia heart disease hospital beds of 750 copies，Is a large-scale specialized non-profit nature of private hospital。The general manager YeGong said：“The public recognition of a hospital is very not easy，Need a long process。Hospital investors want to have a good state of mind，Do the hospital as a long-term business to do。”

　　2. 虽然评职称的政策障碍已经不存在了，但民营医院的人才依然集中在“一老一少”，即以退休和新毕业医疗卫生人员为主，缺少中青年技术骨干和学科带头人

2. Although professional evaluation policy barriers already did not exist，But private hospital still focus on talent“An old a less”，As new graduates retirement and medical personnel is given priority to，The lack of young and middle-aged technology backbone and the leader in the field

　　在医疗服务行业中，人才是最重要的因素。没有好的医生，就没有好的服务，也就不是好的医院。在一所三级医院的日常运行中，人员成本要占据医院总支出的1/3甚至更多，还没有包括各种人才培养经费。

In medical service industry，Talent is the most important factor。Did not have a good doctor，There is no good service，Also is not a good hospital。In a tertiary hospital in daily operation，Personnel cost to occupy one-third of total hospital even more，Also does not include all kinds of talents training funds。

　　多年来，非公立医疗机构的医生一直没有晋升职称的资格，造成医生的事业发展受限。“58号文”明确规定，非公立医疗机构在技术职称考评、科研课题招标及成果鉴定、临床重点学科建设、医学院校临床教学基地等方面，享有与公立医疗机构同等待遇。

For many years，The public medical institutions doctor there has been no promotion title qualifications，Cause the doctor's career development limited。“Article 58,”Specific provision，The public medical institutions in technical title appraisal、Scientific research project bidding and result evaluation、Clinical key subject construction、Medical colleges and universities clinical teaching base, etc，Enjoy the same treatment with public medical institution。

　　虽然评职称的政策障碍已经不存在了，但民营医院的人才依然集中在“一老一少”，即以退休和新毕业医疗卫生人员为主，缺少中青年技术骨干和学科带头人，缺乏梯队建设机制和长远发展战略。

Although professional evaluation policy barriers already did not exist，But private hospital still focus on talent“An old a less”，As new graduates retirement and medical personnel is given priority to，The lack of young and middle-aged technology backbone and the leader in the field，Lack of echelon construction mechanism and long-term development strategy。

　　原来，我国事业单位将医务人员以“单位人”的方式管理，加上社会保障机制缺失、学术研究平台差异等多方面原因，现有的优质医护人才主要集中在公立医院。

The original，Our country institution will medical personnel to“Unit people”Way management，Social security mechanism and missing、Academic research platform differences and so on the various reason，The existing high quality medical talents mainly concentrated in public hospital。

　　“只有在公立医院才有好的事业发展前景，所以中青年技术人才一般不会去民营医院。有人说，找不到专家，可以高薪聘请刚退休的老专家，关键是老专家做一段时间就做不下去了，因为不少民营医院逼着老专家昧着良心赚钱。”姚岚说。

“Only in public hospitals will have a good career future，So young and middle-aged technology talented person general won't go to a private hospital。Some say，Find experts，Can be employed a well-paid just retired old experts，The key is old experts do a period of time do not bottom go to，Because a lot of civilian battalion hospital make old experts mei wear conscience to make money。”YaoLan said。

　　吴作红是湖北省武汉爱尔眼科医院青光眼科主任，从中山医科大学毕业后就在该医院工作，至今已7年。他说：“现在评上职称了，也有武汉的科研课题，比以前确实好多了。爱尔很重视人才的培养，靠个人能力发展，收入比在公立医院工作的同学多一些，前景不错。”因为导师是同仁医院著名专家，吴作红有了很多参与科研课题的机会。“但是发展到了一定高度的时候，很多科研机会相对公立医院来说依然偏少，无形中限制了个人的晋升。”他说。

WuZuoGong is hubei wuhan love's eye hospital of director of division of glaucoma，After graduation from sun yat-sen university in this hospital，Has been 7 years。He said：“Now on the title，Also have wuhan research topic，Do much better than before。Love's attaches great importance to the cultivation of talents，By individual ability development，Income than in public hospital classmates some more，Prospect is good。”Because the teacher is tongren hospital famous experts，WuZuoGong have many opportunities to participate in scientific research。“But to a certain height of the time，A lot of research opportunities for relative public hospital is still too little，Virtually limits the personal promotion。”He said。

　　3. 严控公立医院床位规模的扩增，同时对公立医院开展的业务范围和高端特需服务予以限制，积极培育民营市场

3. Tight control of public hospital beds scale of amplification，At the same time in public hospitals and high-end business scope of special service to limit，Actively cultivate the private market

　　民营医院要想生存，必须错位经营发展，提供专科或高端服务。但是，由于投资医院回报期长达8—10年，免税时间普遍只有3年。在营利压力下，一些民营医院只能选择“赚快钱”模式，服务质量、效率均不高，进入恶性循环。

While the private hospitals need to want to survive，Must malposition management development，Provide college or high-end services。but，Because investment return period hospital for 8-10 years，Free time generally only 3 years。In profit under pressure，Some civilian battalion hospital can only choose“Profit in the short run”mode，Service quality、Efficiency is not high，Into the vicious circle。

　　“大型公立医院不断扩张，盖大楼、购置设备，民营医院无法与之竞争。而在医疗服务薄弱的基层、边远地区，民营医院又无利可图，难以生存。”姚岚说，从这一点看，积极引导社会办医，一方面应该营造竞争环境，另一方面还要限制公立医院的盲目扩张。

“Large public hospital expanding，Cover building、Equipment purchase，Civilian battalion hospital can't compete with。And in the medical service weak base、Remote areas，Civilian battalion hospital and unprofitable，Hard to survive。”YaoLan said，From this point of view，Actively guide social do medical，On the one hand should build competition environment，On the other hand also limit public hospital blind expansion。

　　广东省卫生厅副厅长廖新波认为，在满足当地基本医疗服务需求的前提下，严控公立医院床位规模的扩增，对公立医院开展的业务范围和高端特需服务予以限制，积极培育民营市场，同时探索监管新思路。

Guangdong provincial health bureau deputy director manifold new wave think，To meet the local basic medical service needs of the premise，Tight control of public hospital beds scale of amplification，In public hospitals and high-end business scope of special service to limit，Actively cultivate the private market，At the same time explore supervision new ideas。

　　即使当前政策不断“松绑”，但一些地方和部门仍不同程度地对社会办医存在各种歧视和偏见，在机构、技术、大型设备准入以及医保定点方面，尚没有完全落实国家政策要求。专家认为，审批政策不能做到一视同仁，实际上也是一种对民营医院的不公平，不利于其健康发展。

Even if the current policy continuously“relax”，But some localities and departments are still different degree of social do medical exists all kinds of discrimination and prejudice，In the institutions、technology、Large scale equipment access and health care in fixed point，Is still not fully implement the national policy requirements。Experts say，The examination and approval policy cannot do without discrimination，In fact is a kind of to civilian battalion hospital unfair，Against its healthy development。