A Study on the Fiscal Pathways for Realizing the Public Welfare Function of Public Hospitals:From"Triangular Game"to"Systemic Synergy"
Wang Qunkai
Jiang Xiaoyan
Li Wanchun
Song Junjie
Abstract：Objective:To analyze the"triangular dilemma"arising from conflicting objectives and counterproductive incentives among the finance department,medical insurance department,and public hospitals during public hospital reforms,and to explore the theoretical logic and fiscal pathways toward"systemic synergy".Methods:Based on property rights theory,incentive compatibility principles,and systemic coordination theory,a theoretical model of"dilemma analysis,role reshaping,pathway construction"was developed and analyzed through literature review and policy deduction.Results:The"triangular dilemma"stems from the government's improper fulfillment of property rights responsibilities and distorted systemic incentive structures.As both the property rights holder and"meta-governor"of the system,the finance department must transcend simple compensatory funding.Its role should be elevated through establishing a foundation for coordination via performance-based compensation,activating coordination momentum through strategic purchasing empowerment,and building coordination safeguards by constructing information platforms,thereby guiding the system toward public welfare objectives.Conclusion:Realizing the public welfare nature of public hospitals hinges on the fiscal department's transformation from"direct operator"to"system architect".Through sophisticated mechanism design,this shift will foster a community of shared destiny among the three parties-aligning objectives,complementing functions,and ensuring incentive compatibility.
Keywords：public hospitalpublic welfarefiscal departmentmedical insurance departmenttriangular game theorysystemic synergy
Publication Date：2026-03-05
Online Publishing Date：2026-04-01(First online date of this platform, not the publication date of the document)
Pages：5( 1-4,9 )