ABSTRACT
Public hospitals are as old as the republic, and many of these institutions are facing a crisis in financing that will affect their future. Crisis, particularly financial crisis, is not a new experience for public hospitals, but the current crisis may prove more damaging than many in the past. Hospital ownership falls into three broad types: public, voluntary and proprietary. The diversity of public hospitals and the roles they played in their communities was an issue addressed by the Commission on Public General Hospitals, established in 1976 by the Hospital Research and Educational Trust. Historically hospitals and physicians have been paid by methods that provided no incentive for efficiency and, indeed, often provided incentives for delivering ever more specialized and expensive services. Many public hospitals are financially subsidized to some extent by the government that controls them. A successful hospital must have management and leadership skills that are directed at influencing governmental policy and negotiating favorable agreements with other organizations.
