民間參與公共建設的迷思與現實：日本公立醫院PFI之啟示

Abstract

民間參與公共建設被視為是民營化政策的一環，是我國政府實現國際化、自由化的重要經濟發展策略。其政策目標在減輕政府財政負擔、精簡政府組織人才，以及提升公共建設的效率與服務品質，以達成促進國家社會經濟發展為最終目標，其中又以減輕政府財政負擔最為迫切。然而，該項政策推動的結果卻未如預期，部分公共建設的經營也產生嚴重虧損，使人不得不對民營化或公私協力的理論預期效益產生質疑。因此，本文以日本公立醫院為例來分析民間參與公共建設所可能產生的迷思與限制，並提出可供我國參考與借鏡之處。\\r研究結果發現，民間參與公共建設可能會在五個面向上產生限制，分別是：（1）組織文化衝突、（2）提升公共設施經營管理效率、（3）減輕政府財政負擔、（4）長期契約風險、（5）事業特質等。作者認為若要減少民間參與公共建設所產生的限制，首要之務應先釐清公共建設本身的屬性與特質，以避免後續可能引發的相關問題。

As one part of the privatization policy, funding public infrastructure projects with private capital is an important strategy of economic development of Taiwan’s government to achieve internationalization and liberalization. The goal of the strategy aims to reduce government’s financial burden, downsize talents in governmental organizations and enhance the efficiency and service quality of public infrastructure to achieve the ultimate goal of enhancing national economic and social development, especially reduce government’s financial burden. However, results for the promotion of the policy have fall short of expectations, as the operations for part of the public infrastructure is in great deficit that results in doubts over the expected effects of privatization or public-private partnerships theory. Therefore, this paper conducts a case study on PFI (private finance initiative) hospitals in Japan to analyze the myths and restrictions of funding public infrastructure projects with private capital, further offering Taiwan for further reference. Research findings indicate that funding public infrastructure projects with private capital may give rise to restrictions on five dimensions (1) The conflicts in organizational culture; (2) Enhance operations management efficiency of public infrastructure; (3) Reduce government’s financial burden; (4) Risks of long-term contracts, and (5) Business characteristics. This research suggests that clarifying the attributes and distinguishing characteristics of public infrastructure projects first will be the priority to reduce restrictions on funding public infrastructure projects with private capital, avoiding the condition that related problems may occur subsequently.