公费医疗改革现状分析

一．改革的背景及进程 公费医疗始于1952年,是国家通过卫生部门为国家工作人员提供免费医疗及预防服务的一项社会保障制度,全部资金由财政负担,个人无须付费。随着社会主义市场体制的确立和国有企业改革的不断深化,这种制度的弊端愈发明显。一组公开数据显示,2009年,北京市人均医疗卫生费用为4179．87元,平均个人负担比例为26．2％,而2010年北京市公费医疗实际支出26．2亿元,比2009年增长6．27％,以北京市享受公费医疗的22万人数来计算,人均医疗费用超1．1万元。     

财经资讯

2004年我国城市低保人数达2200万人。新华网北京2月9日消息,截至2004年12月底．全国城市低保对象总人数为2200．8万人,各级财政累计支出低保金172．9亿元,其中中央财政支出102亿元。低保对象月人均领取低保金65元,比去年底提高了7元。     

筑牢民生保障的最后一道防线——宁波市加快新型社会救助体系建设步伐

数字是枯燥的，但可以浓缩发展的轨迹。 新型社会救助体系建设，我市已走过了15年的春秋。2010年，全市城市低保对象有8527户13302人，支出低保资金5436．42万元；农村低保对象有41238户60195人，支出低保资金12445．08万元，每一位纳入新型社会救助体系的群众均得到资金支持、结对助困、医疗、教育等各类救助。     

城乡居民低保标准测算方法的创新研究

文章基于现实情况,对传统的马丁法进行调整与改进。改进后的马丁法由调整后的食物贫困线、调整后的商品贫困线和服务贫困线三部分构成。分别测算出居民为维持基本生活需要所必须的食物消费支出、商品消费支出和服务消费支出。文章借鉴了传统马丁法的优势,同时将修正的恩格尔系数和服务消费支出纳入到计算中,并对传统马丁法中复杂的商品贫困线测算方法做了改进和简化,使其与现实情况更为相符。随后,文章给出了北京市合适的城乡低保标准,并根据掌握的数据资料,对我国现行各地之间低保标准的相关性进行分析。     

透视居民服务消费 推动第三产业发展——从居民服务性消费的变化看铜陵市第三产业结构

今年1—10月份铜陵市居民人均服务性消费支出为1884．4元，同比增长37．39％，比消费性支出的增幅高出15．1个百分点。服务性消费支出占消费性支出的比重也逐年提高，2004年为23.94％，2005年达24．65％，今年1—10月份达27．71％，服务性消费支出在整个居民生活消费的重要地位日益显现。教育、饮食、通信、交通、文化娱乐是服务性消费支出中的主流，据调查资料显示，1—10月份铜陵市居民教育费用、饮食服务、通信服务、交通服务和文化娱乐服务和分别占服务性消费支出的25．25％、24．01％、20．29％、15．19％、12．49％。其变化特点如下：     

老龄化对中国医疗费用的影响——城乡差异的视角

本文利用2002-2008年中国的省级面板数据重点研究了老龄化对城乡医疗费用影响的差异,结果发现:首先,老龄化与实际人均医疗支出呈显著正相关性,且老龄化的实际人均医疗支出弹性为0.268,在实际人均医疗支出变化中的贡献率为3.9％;其次,城乡老龄化与医疗支出的关系存在城乡差异,城镇老龄化程度的提高显著增加医疗支出(支出弹性为0.207),而农村老龄化程度的提高不会增加医疗支出,甚至会导致自费医疗支出下降.本文的政策含义是:政府在控制医疗费用快速增长的同时,需要考虑未来城乡融合、城乡医疗服务差异缩小情况下农村老年人口医疗服务需求的释放,即存在农村老龄化将会引致医疗费用快速增长的可能性.     

现代农村金融制度将如何建设？

“2020年农民人均纯收入比2008年翻一番”，按此测算，2020年农民人均纯收入约为8280元，年递增为5．5％。1997—2007年的10年中，笔者测算每年非农化资金在1000亿元左右，故农村贷款递增幅度仅为10．4％，比金融机构总贷款递增幅度13．3％低2．9个百分点。在十七届三中全会后，各种扶农、护农的政策措施的出台，对农村信贷需求必将有较高的增长，农村资金由非农化有可能转为增农化。按年递增15％的幅度测算，2020年，农村贷款需求可能要达到13万亿元，平均每年增加余额为8900多亿元。到时能否达到13万亿元，还要看各种现代农村金融制度功能能否健全、服务能否完善、对农村资金供给能否充分。     

我国居民医疗支出影响因素的实证分析

本文以一种新的方式使用了两部分模型方法,将医疗支出发生的过程分解为患病和治病两个子过程,利用中国健康与营养调查2000年的调查数据,研究了可能影响我国居民医疗支出的各种重要因素.回归分析结果显示:对患病影响最大的因素为所在省份、居住在城市或农村、是否有医疗保险;在给定已经患病的情况下,对治病支出影响最大的因素为病情严重程度、收入和居住地为城市或农村.最后,本文提出了一些有助于从宏观层面控制国家医疗费用和从微观层面更好地满足居民医疗需求的初步意见和建议.     

2006年来宾市需求分析

从使用角度看，GDP是全社会最终需求（包括消费需求、投资需求及净出口需求）的总和，按此计算的2006年来宾市GDP为203．46亿元，比上年增长13．9％。从最终产品的三个使用去向看，最终消费支出98．63亿元，增长11．0％；资本形成总额82．57亿元，增长30．6％；货物和服务净流出22．26亿元，下降25．8％。     

解决"看病难"问题之途径探析

所谓“看病难”，是指人们在生老病死等方面的消费支出能力不抵为这种消费所提供的服务及产品价格要求的现象。“看病难”，难在高昂的手术费用、虚高的药品价格、奢侈的器械检测费用及相关的医疗服务费用。在这贵族消费的医疗市场中，普通百姓力所不支，谈医色变，不惜抱病叹息，放弃就医。2003年第三次国家卫生服务调查主要结果显示：我国医疗服务费用增速已超过人均收入的增长，医药卫生开销成为家庭食物、教育支出后的第三大消费，更为重要的是，将近五成（48．9％）的居民生了病不去医院看病。在去看病的患中，经医生诊断该住院治疗却未住院的也达到了29．6％，这突出反映了群众“看病难、看病贵”基本状况。[第一段]     

The determinants of poverty dynamics in Indonesia: evidence from panel data

We use the ‘spell’ approach to identifying poverty and apply an ordered logit model to examine the determinants of poverty dynamics in Indonesia, categorising households as poor, transient poor (–), transient poor (+) or non-poor. Observing the National Socio-Economic Survey (Susenas) balanced-panel data sets of 2005 and 2007, we found that 28% of poor households are classified as chronically poor (that is, remaining poor in two periods) while 7% of non-poor households are vulnerable to being transient poor (–). Our estimations confirmed that the determinants of poverty dynamics in Indonesia are educational attainment, the number of household members, physical assets, employment status, health shocks, the microcredit program, access to electricity, and changes in employment sector, employment status and the number of household members. We also found that households in Java–Bali are more vulnerable to negative shocks than those outside Java–Bali.     

'The Rich Are Just Like Us, Only Richer': Poverty Functions or Consumption Functions?

The reduced form determinants of economic welfare, proxied byconsumption, are modelled using the first nationally representativehousehold survey of Uganda. It is investigated whether anythingis gained by modelling poverty rather than welfare, when povertyis measured by the poverty gap. Parameters from the tobit povertyfunction are found to be generally similar to those from consumptionfunctions, indicating that the poor receive comparable ratesof return on their assets to the non-poor. The main exceptionis that the return to labour is significantly lower for thepoor, even with many controls.     

Does Economic Growth Really Benefit the Poor? Income Distribution Dynamics and Pro-poor Growth in Indonesia

We explore the nexus between poverty, inequality, and economic growth in Indonesia between 2002 and 2012, using several pro-poor growth concepts and indices to determine whether growth in this period benefited the poor. Our regression-based decompositions of poverty into growth and redistribution components suggest that around 40% of inequality in total household expenditure in Indonesia was due to variations in expenditure by education characteristics that persisted after controlling for other factors. We find that economic growth in this period benefited households at the top of the expenditure distribution, and that a ‘trickle down’ effect saw the poor receive proportionately fewer benefits than the non-poor. If reducing poverty is one of the Indonesian government's principal objectives, then policies designed to spur growth must take into account the possible impacts of growth on inequality.     

Labour market dimensions of poverty in Indonesia

This paper focuses on labour market issues relevant to poverty alleviation. Patterns of participation, unemployment and employment are examined among the poor compared with the non-poor in general, among urban and rural households, and among various socio-demographic groups. Using data from the 2002 National Socio-Economic Survey, the paper finds that low participation in the workforce and high unemployment, while important, are less closely related to poverty status than expected, especially among spouses of household heads. However, sector of employment and underemployment are closely associated with poverty, especially for those in informal jobs in urban areas; in rural areas, the poor are heavily concentrated in agriculture. Among the poor, young people and females are more likely to be underemployed and to work in agriculture than prime-age workers. The data suggest that labour market policies that tend to protect those in formal sector employment are unlikely to reduce poverty much, if at all.     

子女教育与农户消费：基于8省微观面板数据的经验研究

本文利用来自中国8省农户的微观面板数据测算了子女教育对于农户消费的影响。经验研究的主要发现包括：1．有在校子女的农户人均消费支出比没有在校子女的农户平均要低10％左右,并且在校子女越多,农户人均消费的下降的幅度越大;2．非义务教育阶段子女教育对农户的负担明显加重,有子女上大学的农户,比其他有在校子女但未在大学的农户人均消费水平还要低14％左右;3．越是贫困的组别,子女教育对于农户消费的影响越是强烈,在收入五等分组的最低组别,1个在校子女使得其人均消费降低15％左右,而在最为富裕的两个组别则对农户消费没有显著影响。     

Agricultural Research and Urban Poverty: The Case of China

This paper develops a framework to measure the impact of agricultural research on urban poverty. Increased investments in agricultural R&D can lower food prices by increasing food production, and lower food prices benefit the urban poor because they often spend more than 60% of their income on food. Application of the framework to China shows that these food price effects are large and that the benefits for the urban poor have been about as large as the benefits for the rural poor.     

Income shocks,coping strategies,and consumption smoothing: An application to Indonesian data

Using the Indonesian Family Life Survey, this study investigates whether Indonesian farmers respond differently to income shocks (crop loss) depending on the level of their asset ownership, and whether their responses are aimed at preserving consumption levels or at accumulating assets. We consider a framework in which assets contribute directly to the income generation process. In this context, the need to accumulate assets to ensure future income may lead poor farmers to behave quite differently in terms of both their responses to shocks and their consumption decisions. Our results suggest that while non-poor farmers smooth consumption relative to income, poor households use labor supply to compensate the income loss and, on average, they save half of this extra income. These results confirm the importance of savings for poor households, and highlight a crucial role for policies that support savings or, more precisely, the accumulation of productive assets.     

Subective poverty line definitions

Summary In this paper we will deal with definitions ofsubjective poverty lines. To measure a poverty threshold value in terms of household income, which separates the poor from the non-poor, we take into account the opinions of all people in society. Three subjective methods will be discussed and compared,viz., the Leyden Poverty Line (LPL), the Subjective Poverty Line (SPL) and the Centre for Social Policy Poverty Line (CSP). In the empirical part of the paper we compute the average poverty line and a few corresponding characteristics for each definition.     

新型农村合作医疗制度的公平与受益:对760户农民家庭调查

利用我国不同区域三县760户农村居民的调查数据,从需求角度实证分析新农合的受益状况,探讨该制度的公平性的研究结果表明,贫困居民、身体健康差和疾患严重的人更多地从新农合中受益,新农合门诊补偿的公平性优于住院补偿的公平性,新农合制度存在收入再分配效应,但效果有限。     

The impact of teacher credentials on student achievement in China

Teacher quality is an important factor in improving student achievement. As such, policymakers have constructed a number of different credentials to identify high quality teachers. Unfortunately, few of the credentials used in developing countries have been validated (in terms of whether teachers holding such credentials actually improve student achievement). In this study, we employ a student-fixed effects model to estimate the impact of teacher credentials on student achievement in the context of the biggest education system in the world: China. We find that having a teacher with the highest rank (a credential based on annual assessments by local administrators) has positive impacts on student achievement relative to having a teacher who has not achieved the highest rank. We further find that teacher rank has heterogeneous impacts, benefiting economically poor students more than non-poor students. However, whether a teacher attends college or holds teaching awards does not appear to provide additional information on teacher quality (in terms of improving student achievement).