第一种选择:移交当地政府。虽然国家出台相应政策扶持,地方政府可以选择性接管,但政府接管并非完全有利无弊。实际上,政府接管至少有两大弊端:一是政府财政支出总额的有限性。2005年底,我国卫生人员635万人,如果按人均年工资2万元计算,一年需要1270亿元的工资开支,中央和地方的卫生财政支出在2004年为832亿元人民币,之前2003年为756亿元,2002年为618亿元,由于核定补贴人员基数多年未变,因此,在此背景下,估计我国公立医院一年中至少需要创收数百亿元来支付工资,如果仅依赖政府财政,这些工资都成问题,更别提医院发展资金了。 The first option: transfer to the local government. Although the state has introduced corresponding policy support, local governments can selectively take over, but the government’s takeover is not entirely conducive to the pros and cons. In fact, the government took over at least two major drawbacks: First, the government’s total financial expenditure is limited. At the end of 2005, there were 6.35 million health workers in China. If the per capita annual wage is calculated as 20,000 yuan, a total of 127 billion yuan in wages will be needed each year. Central and local health expenditures in 2004 amounted to 83.2 billion yuan in 2004, compared with 2003. In 2006, it was estimated that the public hospitals in China would need to generate tens of billions of yuan to pay salaries in the course of a year, if only relying on government finances. These wages have become a problem, not to mention the hospital’s development funds.