Measuring third world security expenditure: A research note

There is growing evidence that important amounts of security expenditure may not enter the budgets or the national accounts of many developing countries. This article outlines five of the most common mechanisms used by governments to obscure their security-related outlays: double bookkeeping, use of extra-budgetary accounts, highly aggregated budget categories, military assistance and governmental manipulation of foreign exchange. Delineating those countries which have used these — or other — mechanisms is difficult but some examples do exist and are used here to illustrate how countries have hidden security-related expenditure from public scrutiny.     

中国地方政府公共卫生支出行为实证分析

公共卫生支出属于财政支出的重要组成部分。合理界定公共卫生支出占财政支出的比重是公共财政体制的重要内容。文章对2004-2010年间全国31省、市、自治区面板数据进行实证分析研究了影响地方财政公共卫生支出的因素及效应。研究表明:人口规模、经济发展水平、城市化程度和与财政公共卫生支出之间存在一定的相关性。财政分权对公共卫生支出具有很小的负面影响,政府规模的膨胀程度、人口结构与财政公共卫生支出并没有必然的因果关系。     

医疗支出、健康人力资本与企业出口扩张

医疗支出作为影响健康人力资本形成的基础因素,在后疫情时代,对企业构筑出口竞争优势和提高出口发展规模有着重要的作用,尤其对中小微企业出口发展影响深远。在此背景下,文章以中国私营企业调查数据库为基础,对医疗支出与企业出口之间的因果关系展开系统检验。理论上,健康人力资本是组成企业人力资本的重要模块,医疗支出的增加能够影响企业健康人力资本的形成,进而对企业出口产生积极作用。实证研究发现,医疗支出发展能够产生显著的出口促进效应,提高企业的出口规模,但这一作用就不同样本分类存在着异质性。机制检验表明,文章从人口死亡率、营养健康程度等多个维度对健康人力资本进行衡量后,医疗支出水平的提高能够改善企业健康人力资本的积累,增强企业出口的竞争优势,进而促进企业的出口发展。此外,文章在考虑计量模型设定、行业样本选取、宏观环境冲击、医疗支出构成等多方面的稳健性检验,并通过PSM分析、安慰剂检验、控制函数法来解决潜在的内生性问题后,医疗支出对企业出口的积极作用依然成立。文章研究是卫生经济学和国际贸易领域的一次有益融合,相关结论为支持我国卫生医疗和对外贸易发展政策的有效性,提供了来自现实的有力证据。     

持续灾难性卫生支出测度、城乡差异与医疗保险阻断效应评估

以往文献对持续灾难性卫生支出天然属性的研究匮乏,导致相对贫困治理和医疗保障政策长远靶向目标规划缺失。文章将家庭医疗支出连年增加,重复发生灾难性卫生支出的过程定义为持续灾难性卫生支出,并在此基础上构建反映持续灾难性卫生支出发生率、发生深度以及发生时间等指数综合刻画持续灾难性卫生支出程度,利用中国微观数据（CFPS）进行动态测度和城乡分解,最后实证分析基本医疗保险对城乡家庭持续灾难性卫生支出的政策效果。研究发现,家庭持续灾难性卫生支出发生具有较强黏性,持续时间越长,摆脱难度越大,且农村持续灾难性卫生支出程度高于城镇,但城乡差距随持续时间逐渐缩小;与此同时,基本医疗保险能够显著阻断持续灾难性卫生支出,但阻断效应呈现较大的城乡差异,农村基本医疗保险在当期的阻断效应更明显,而长期来看城镇基本医疗保险的阻断效应则更强。文章结论为我国相对贫困治理和医疗保险制度优化提供了实证参考。     

医疗卫生财政支出对经济增长贡献的时空差异-基于1997-2012年30个省级地区面板数据分析

文章基于1997-2012年30个省级地区数据构建固定效应模型，选用“医疗卫生财政支出决算额”测算医疗卫生财政支出水平，研究分析医疗卫生财政支出对经济增长贡献的时间、空间差异及原因。结果显示：医疗卫生财政支出对经济增长存在明显时空差异，空间上表现为西部地区医疗卫生财政支出的贡献度最高，东部次之，中部最低，时间上呈现出“由低到高，日趋平稳”的变化趋势。政府应明确自身职能责任，通过加大西部地区医疗卫生财政支出力度，提高财政支出效率等途径，整合全社会卫生资源，完善医疗卫生资源分配机制。     

Budget Structure and Pollution Control： A Cross-country Analysis and Implications for China

In the published literature, the differences in environmental performance across countries are typically explained using the Environmental Kuznets Curve. The Environmental Kuznets Curve states that pollution initially increases with economic growth. Once GDP per capita reaches a certain level, the relationship reverses. In the present paper, we provide an alternative hypothesis, where budget structure plays an important role in explaining the variations in pollution across the world.＂ the lower the business-related taxes as a share of total tax revenue, the higher the property tax in total tax revenue and the higher the ratio of public health expenditure in total expenditure, then the stronger the incentive of pollution control and the lower the pollution level. Our empirical findings reveal that the budget structure does have an important impact on pollution control. The policy implication of this research is that effective control of environmental pollution requires changes in tax structure and expenditure assignment. This research has important policy implications for China ＂s tax system reform and pollution control efforts.     

Estimating the future health care cost of population aging in South Africa

ABSTRACT

This paper analyses the relationship between health care expenditure and population aging in South Africa using yearly data from 1983 to 2015. Empirical evidence from an Autoregressive Distributed Lag approach to cointegration indicates that old dependency and life expectancy are major drivers of public health expenditure in South Africa besides the income. Particularly, when structural breaks are controlled for, income exhibits a long-term elasticity with respect to health spending greater than unity; suggesting that South African public health care has become a luxury good over time. Interestingly, South African public health spending is found to be responsive to demographic development only in the long run. This is consistent with the micro evidence that health expenditure increases with individual age with significant impacts in the long term. Finally, using economic and demographic projections statistics, we find that public health expenditure could roughly double in the next fifteen years ceteris paribus.     

Does financial development contribute to the achievement of the “Zero Hunger” goal in Africa?

This study examines the effects of financial development on undernourishment with panel data from 40 African countries. We show that financial development in all its dimensions reduces undernourishment. In addition, financial development, financial institutions, the financial market, and financial market depth reduce child stunting. We also identify education, health expenditure, access to electricity, and control of corruption as the main transmission channels through which financial development reduces undernourishment. These results have important implications for the achievement of the “Zero Hunger” goal in Africa and for improving child nutrition.     

财政支出结构的优化路径:以改善民生为基调

近年来虽然我国的财政支出结构不断优化,经济事务支出占财政支出的比重持续下降,与此同时财政用于教育、社会保障、医疗卫生和住房保障等民生领域的支出相应增加,但与世界其他国家的财政支出结构相比较,我国财政用于教育、医疗卫生、社会保障、住房保障等民生领域方面的支出仍然偏少。因此,为更好地保障和改善民生,必须优化财政支出结构,把压缩的公共服务支出和减少竞争性领域投资后增加的财政资金的一定比例用于民生领域,加大对民生的投入力度。     

Fiscal decentralization and local expenditure policy in China

Since the tax-sharing reform in 1994, the Chinese fiscal system has exhibited a marked vertical fiscal imbalance—a mismatch between expenditure and revenue assignments—at the local levels, which may cause the common-pool problem in local governments' behavior. Using a large fiscal dataset at the county level from 1997 to 2006, this paper studies the effects of fiscal decentralization on local expenditure policy and analyzes how the vertical fiscal imbalance shapes these effects. The estimation results show that expenditure decentralization increases government spending and leads to a fund allocation with a larger weight on capital construction and smaller weights on education and administration. In contrast, revenue decentralization has little influence on local government expenditures. We show that the differences in the effects of expenditure and revenue decentralization can be attributed to the distortionary effects caused by the vertical fiscal imbalance and, thus, offer support to the importance of the common-pool problem at the county level of China's fiscal system.     

In Data We Trust? An Analysis of Indonesian Socioeconomic Survey Data

What if a popular dataset that has generated a large amount of literature has been misunderstood and has led to misleading inferences? This paper examines household expenditure data from the Indonesian National Socio-economic Survey (Susenas), which started more than 50 years ago. Appropriate use of Susenas data for policy analysis requires an understanding that the survey’s expenditure variable does not measure true out-of-pocket expenses, because it includes subsidies received by households when obtaining goods and services. We also highlight an abrupt change in the survey instrument that occurred in 2015, when the reference period for certain items was extended. For health items, this generated a change in the expenditure series that can be misinterpreted as being the result of a social health insurance reform introduced in 2014 to lower the health care burden on households. Accordingly, we propose a way to account for this artificial expenditure movement in Susenas.     

What Do OECD Countries Cut First When Faced with Fiscal Adjustments?

Following the present scale of fiscal imbalances in developed countries, significant fiscal consolidation will be inevitable in the coming years. Fiscal discipline will require cuts in government expenditure, leading to trade‐offs between different components of government expenditure. In this article, we explore the relationship between components of government expenditure and government size during the period 1970‐2007 for a sample of 25 developed countries to shed light on how fiscal discipline might influence public spending composition in the coming years. Using the Pooled Mean Group estimation we find that fiscal adjustments protect functions that have both a social and productive character, such as education and health spending. In addition, the most productive spending, that related to transport and communications, is also isolated from budgetary cuts. This result shows evidence of governments reacting to the voter's increasing realization that reducing productive expenditures harms long‐term economic growth by striking a balance between utility and economic‐growth‐enhancing expenditure.     

公共卫生支出、健康人力资本与经济增长

本文通过构建随机动态一般均衡模型（DSGE）和基于该模型的数值模拟,分析了公共卫生支出、健康人力资本和经济增长的关系。主要结论有：从长期看,扩大公共卫生支出、医疗技术革新均会带来宏观经济的繁荣和居民福利的提升;从短期看,恶性突发卫生事件的冲击将给宏观经济的波动带来显著的负面影响,但这一影响一般会在短期内得以消除。本文进一步借助中国1998～2008年的面板数据,以数据包络分析（DEA）得到的公共卫生支出投入产出效率作为健康人力资本的代理变量,进行计量分析后发现：健康人力资本对本地区和相邻地区的经济增长均有显著的促进作用;在经济增长水平较高、健康人力资本集聚的地区,健康人力资本可以更有效地促进经济增长,即存在显著的门限效应。     

Does health insurance decrease health expenditure risk in developing countries? The case of China

This article studies the impact of health insurance on individual out‐of‐pocket health expenditures in China. Using China Health and Nutrition Survey data between 1991 and 2006, we apply two‐part and sample selection models to address issues caused by censored data and selection on unobservables. We find that, although the probability of accessing health care increases with the availability of health insurance, the level of out‐of‐pocket health expenditure decreases. Our results from a selection model with instrumental variables suggest that having health insurance reduces the expected out‐of‐pocket health expenditure of an individual by 29.42% unconditionally. Meanwhile, conditional on being subjected to positive health expenditure, health insurance helps reduce out‐of‐pocket spending by 44.38%. This beneficial effect of health insurance weakens over time, which may be attributable to increases in the coinsurance rates of health insurances in China.     

Fiscal flows in Europe: The redistributive effects of the EU budget

Fiscal Flows in Europe: The Redistributive Effects of the EU Budget. — In this paper we analyze the redistributive effects of the EU budget among European countries, exploring the relationship between income and fiscal flows, both in per capita terms. Using a new data set on EU budgets from 1986 to 1998, we find that the EU budget has a redistributive effect, though only on its expenditure side. The most redistributive expenditure category is the Regional Fund, followed by the Social Fund and by the guarantee section of the EAGGF. All of them have become increasingly redistributive in time. Total budgetary revenues show only proportionality with income. As regards the net financial balance, three groups of countries are identified, given the treatment they get from the EU budget that cannot be explained by their per capita income levels.     

Are people in the SADC region willing to pay more tax to fund public healthcare?

ABSTRACT

For Africa to develop and achieve sustainable development, African governments have to prioritise spending on public health. However, the current spending data shows that health spending is a continuing struggle for African countries. Many researchers have the view that African governments have to collect more tax to spend enough on public healthcare. The question here is what extent people are willing to pay more tax to increase spending on public healthcare? Employing a multilevel regression model on Afrobarometer survey data, this paper examined to what extent individual and country level factors influence people’s willingness to pay more tax to increase spending on public healthcare in 12 Southern African Development Community (SADC) member states. This study found that peoples’ trust in their government is an important determinant of willingness to pay more tax, while factors such as the country’s quality of democracy, economic condition, and current per capita health expenditure have no influence.     

Human capital investment in children: An empirical study of household child education expenditure in China, 2007 and 2011

Household education expenditure is an important component of human capital investment in children. In China, the rising child education expenditure and the subsequent financial burden on families have attracted much research and policy attention in the recent years. Using 2007 and 2011 data from the Urban Household Education Surveys, our empirical study provides new evidence on the education expenditure level, ratio of expenditure to household income, and inequality in this expenditure. We also elucidate changes in China's household education expenditure and explore factors associated with such changes. From the analysis, we obtain the following findings. First, education expenditure incurred outside the school significantly contributes to increasing household education expenditure. Second, compulsory education programs are effective in curbing in-school education expenditure; however, it does not prevent the rapidly increasing education investment outside school. Third, education expenditure disproportionally increases with family income. In other words, a larger share of the income earned by lower income families is spent on children's education, compared to higher income families.     

Impacts of the COVID-19 crisis on single-person households in South Korea

Using nationally representative income and expenditure data from South Korea, we show that single-person households suffered a much greater decrease in household income and expenditure compared to multi-persons households during the COVID-19 pandemic in 2020. Negative effects on income were largest for the single-person households in ages 50—64, mostly driven by decreases in earned income rather than business income. There was no corresponding decrease in consumption expenditures, however, other than on transportation expenditure for young men. Notably, there were significant decreases in non-consumption expenditures that are related to formal and informal consumption-smoothing mechanisms, such as spending on insurances, pensions, and household transfers. Our findings highlight the disproportionately negative effects of the COVID-19 pandemic on the middle-aged single-person households. With reduced spending on consumption-smoothing mechanisms, this group is likely to be even more vulnerable to negative income shocks in the future.     

Indicators of rural inequality

There are gradations of poverty even in the poorest societies. This essay explores indicators that measure wealth differences between households in the same community. Ethnographic and other literature has been surveyed, to provide examples from major Third World areas. The most important single indicator is control of land, followed by other productive resources — capital equipment (tractors, ploughs), consumer durables, income (farm and non-farm) and livestock. Non-productive indicators include housing, consumer goods, fuel, ceremonial expenditure and diet. Methodological problems are examined, and the essay concludes with representative case studies that illustrate effective and specific use of indicators.     

Unleash the Pandora's Box: Political Turmoil and Malaria Outbreak During China's Cultural Revolution

This paper examines whether the health system disruption during the Cultural Revolution was the major factor that triggered the malaria outbreak in the early 1970s. The trend of public health expenditure shows that the health system was disrupted from 1968 to 1970. The regression results demonstrate that provinces which experienced a more severe shock to the health system had larger increases in malaria incidence in the early 1970s. The malaria outbreak is found to have negative effects on public health, implying that the health consequence of disease control disruption was not eliminated by the improvement of medical care in rural China.