Study On The Devepment Situation And Policy Of The Social Capital In The Public Hospitals

ObjectivesTo discuss the function and influence of the social capital on the current public hospitals in China by the theoretical study and empirical study, and propose the strategies that how the social capital develops the public hospitals. The outcome of the paper is expected to provide the theoretical and political supports for the social capital in the development of the public hospitals.MethodsData resources: this paper selected 13 public hospitals in the east, middle and west areas of China for field investigation. It collected the related financing data of the hospitals and interviewed the hospital financing personals, the health administrators and the social capital investors from the bank, the financing leasing companies and so on. At the same time, it analyzed the basic information of the asset-liability and the income and expense of the government public hospitals.Research methods: (1) the theoretical study. Literature review was conducted to collect domestic and international research evidence on the social capital in the hospitals. The expert conference was held to discuss the theoretical frame; (2) the empirical study. The questionnaire was conducted to collect the basic data as well as the situation the social capital used in the hospitals; the in-depth interview was applied to collect the suggestions from the specialists such as the effects, the developing strategies for the use of the social capital in the public hospitals; SWOT analysis was used to match the opportunities, the challenges, the advantages and the weakness the various social capital models that the public hospital used.ResultsTheoretical study: the key point to construct the public private corporation public hospital financing pattern is to clear the responsibilities of the government and the market. The government's responsibilities are to increase the investment, strengthen the plan and the supervision; the market's responsibilities are to guide the public hospitals to provide highly effective service through the competitive system.Domestic references: the public hospitals introduce the social capital in various degrees whatever the government investment is. The main models include bank loan, charitable donation, financing lease and so on. In order to promote the public welfare enterprise, the foreign countries carry out the preferential policies to encourage the social capital to enter in general. At the same time, they stress that the governments have the financing decision right of the public hospitals and the hospitals have limited property processing rights. In addition, they have established the perfect legal system to clear the duties of all the quarters of the hospital financing.Political analysis: the transformation of the government compensation pattern is one of the main reasons that promote the social capital enter the public hospitals through multi channels. The release of the new medical reform program will bring the significant adjustment of the benefit pattern of the current medical system. The interest subsidy loan is the popular economic policy that the local governments carry out to encourage the hospitals to collect the social capitals. However, due to the lack of the corresponding favorable measures, it is hard to arouse the enthusiasm of the social capital investors. Empirical study: (1) hospital scales: The various local public hospitals were at the fast expansion time. The average annual growth rate of the total assets generally surpassed 10% generally, and the highest was 27.3%; (2) the social capital demand: the expansion of the hospital scales is the most primary causes that the hospitals call for fund. The insufficiency of the government investment was generally existed in the regional hospitals. The government subsidy accounts for the proportion of the hospital gross income was lowest at 1.4% and highest at 10.1%; (3) the main financing models: it Included bank loan, financing lease, foreign loan and charitable donation as well as the employee's calling for funds, commercial credit and so on; (4) the amount, use, term and repayment of the social capital: The financing amount differs from hundreds of thousands to over a billion Yuan; it was mainly used in the infrastructure construction, the equipment purchase, the wages provide as well as the drugs purchase and so on; The social capital not only had the dominant income request (interest and so on), but also had the stealth one; (5) credit appraisal: The hospitals often use the credit loan, which was trend to the big hospitals. In addition, the mortgage guarantee and the third party guarantee also appear in part hospitals; (6) risk control: the government emphasized on the approval and despised on the supervision. the hospital emphasized on the introduction of social capital and despised on the operation. They both lack the effective risk control measures; (7) the tendency: it overall presented a growth movement; (8) the problems: The financing of the public hospitals lacked the plan; the existing policy was not clear as well as the government supervision responsibility; the charitable fund had not yet fully play a role on the in medical domain.ConclusionsTo further emancipate the mind and encourage the social capital enter the public hospitals. According to the request of the new medicine reform program"to encourage and guide the social capital to develop the health industry", it is necessary to fully understanding the connotation of the requests and further emancipate the mind, transform the original mind that the social capital was conflicted with the public hospitals.To establish a public hospital fund raising mechanism that the government investment is dominant and the social capital is complementary. The government should increase the financial support and except the direct investment, it can attempt on the interest subsidy loan, stipulated fees'reduction; to strengthen the plan's function, and establish the classified resource allocation standard of the public hospitals and at the same time to control the scale of the capital investment to the hospitals.To formulate the market access policy and guide the good social capital to enter the public hospitals. To strict the admittance conditions on the social capital that enters the public hospitals; to establish the credit guarantee system. To compensate the social capital'loss for the bad bank loan of the hospitals through the risk fund; to establish a mechanism that can compensate the benefit for the social capital. The government can attract the social capital into the public welfare by establishing a compensation fund, reducing the business tax and so on. To support various social capital enter the public hospitals such as the charitable donation, bank loan, the financing lease and so on.To strengthen the hospital management and standardize the behavior when the public hospital use social capital. To clear the reasonable scale of the public hospitals and guide them to the connotative development path; to establish the decision-making and the internal financial inspection control on the public hospitals when they want to introduce the social capital.To construct the political support system and to build the good development environment that support the social capital enters the public hospitals. To perfect the policies of the financial control, fund supervision and asset management, operate the medical insurance scientifically and remodel the supervision responsibility of various departments. Under the favorable environment of the reform on the public hospitals, it should carry out benefit attempts in every way. To set up a Public hospital developing fund and call on the coordination development of the regional public hospitals; to explores other models of social capital, such as the tax-exempted bond.