公共财政视角下中国卫生支出研究

我国卫生总费用的绝对数每年都在上升,但是卫生总费用的增加主要是由于居民个人卫生支出增加所致。公共卫生支出占我国财政支出及GDP的比重较低,与其他国家相比有较大差距。我国的医疗卫生服务缺少公平性,呈现城乡二元性特征。本文通过搜集和分析历年医疗卫生相关的数据,从公共财政视角下对我国医疗卫生支出的规模和结构进行探讨,并提出了完善我国医疗卫生支出的几点思考。     

我国卫生筹资结构现状及目标政策研究

我国政府已明确提出到2017年,总体上个人卫生支出占卫生总费用的比例降低到30%以下。该文分析了我国卫生筹资结构的总体情况及地区差距,研究与总结了世界卫生组织卫生绩效先进及落后国家的规律性特点,并提出未来我国应适当提高卫生总费用占GDP的比例。该文还从"两分法"及"三分法"统计口径提出我国卫生筹资结构的中长期发展目标。考虑到我国的地区差异性,建议采取差别化的卫生筹资政策,重点提高中西部等经济欠发达地区的政府卫生支出比例,提高中央和省级政府的卫生支出水平,降低市县级政府的支出比重。     

基于ISM的我国社会物流总费用占GDP比重偏高问题分析

我国社会物流总费用占GDP比重偏高.本文提出8个主要影响因素,并构建8个主要影响因素的ISM,探讨了因素间的内在联系,明确了我国产业结构以第二产业为主导和条块分割式管理体制造成物流管理分散,整体效益较差2个因素是影响我国社会物流总费用占GDP比重偏高的根本因素,提出了降低我国社会物流总费用占GDP比重的关键在于优化产业结构,改进物流管理体制的建议     

中国药物经济学评价指南(第8稿)

引言(Introduction) 医药技术是人类维护健康的重要手段.研究表明,伴随着经济发展和收入水平的不断提高,人们消费结构中用于医疗服务开支的增长幅度最大.从全球资源配置来看,卫生总费用(TotalHealth Expenditure)占GDP比重平均在9%左右,中国目前约为5%.而且,中国的药品费用占卫生总费用的比重远高于其他国家和地区的平均水平.可以预期,中国未来的医药卫生必将越来越成为社会资源配置的主导项目,因此,如何科学评估并有效配置医药资源将是中国科学发展的重大议题.     

中国公共支出的规模与结构及其增长效应

中国公共支出的规模与结构在改革以来的时序变化特征与工业化国家明显不同。本文基于协整分析方法,对中国公共支出相关变量的长期增长效应进行分析。研究发现,实际经济增长率与公共支出的GDP占比呈反向变动关系,这显示中国公共支出政策的适应性性质;政府经济建设性支出比重增加会提高GDP增长率,而文教费和维持性支出比重与GDP增长率之间有着负的双向因果关系,这体现中国经济的粗放型增长特征。研究结果还显示,地方政府支出比重提高,经济增长率会上升,这说明通过规范化的政府间转移支付可以改善欠发达地区的公共基础设施,从而有利于中国的长期经济增长。     

推进药物经济研究确保用药经济

20世纪末以来,世界各国政府均面临医疗费用不断上涨的难题。以美国为例,2002年美国卫生总费用达到1．6万亿美元,人均医疗费用5440美元,卫生总费用占GDP的比重从1998年的13％上升到2002年的14．6％。国外研究表明,药品科技创新成本日益增大和新药价格不断攀升是医约费用不断增长的重要原因。     

我国城乡收入差距影响因素的动态计量分析

文章运用动态计量的研究方法分析了经济因素对城乡收入差距的影响因素,得出的基本结论是:在长期中,非农人口占总人口的比重是影响收入差距的最主要因素且为正向影响;在短期内,人均GDP和非农人口占总人口的比重对城乡收入差距比率的影响为反向的,第二、三产业占GDP的比重对收入差距的影响为正向,但随着时间的推移影响会越来越趋近于零;在城乡收入差距的未来预期波动中,影响收入差距的最主要因素是人均GDP,其次为非农人口占总人口的比重,且其影响越来越大,而第二、三产业占GDP的比重的影响最小。因此,要缩小城乡收入差距就要不断提高城乡居民的人均GDP、非农人口占总人口的比重和第二、三产业占GDP的比重。     

公众主导还是国家主导:1952-2006年中国财政支出增长影响因素研究

在经济发展的不同阶段,各影响因素对财政支出规模的影响程度存在着差异。实证研究表明:公众主导型理论对中国财政支出增长的解释作用弱于国家主导型理论,即财政收入和政府产出成本因素成为制约财政支出规模的主要因素;人均GDP和人口因素对财政支出规模的作用不明显,但其对与民生直接相关的文教科卫支出规模具有显著影响。随着财政支出模式和支出重点的转变,人均GDP、人口和城市化率等因素将取代目前的财政收入和政府产出成本两因素而逐渐发挥主导作用。     

我国财政科技支出存在的问题与对策建议

一是财政科技支出虽然在绝对量上增长迅速,但是相对量增长不足,财政科技支出占国家财政总支出的比重不高且增长缓慢,同时财政科技支出占GDP比重较低,这与我国建立创新型国家的战略和未来经济发展不相符合。二是R&D经费支出中政府支出所占比例仅为25%左右,相对于经济发展阶段而言,当前我国R&D经     

关于山西省居民个人现金卫生支出的思考

居民现金卫生支出占卫生总费用比重过大,会给居民带来一定经济负担,并造成因病致贫、因病返贫现象.本文利用2007-2009年山西省来源法卫生费用核算表相关数据,通过分析居民个人现金卫生支出现状并与全国其他省份进行对比,寻找与发达省份间存在差距,为降低居民现金卫生支出比重提出科学可行的政策建议.     

Robust determinants of health care expenditure growth

Our aim is to disclose robust explanatory variables for health care expenditure (HCE) growth by introducing to this field of research a method that is especially well suited for situations of ‘model uncertainty’: the Extreme Bounds Analysis (EBA). We analyse data for 33 OECD countries over the period 1970–2010 and include – as far as it is statistically feasible – all macroeconomic and institutional determinants of HCE growth in the EBA that have been suggested in the literature. Furthermore, we analyse to what extent outliers in the data influence the results. Our results confirm earlier findings that GDP growth and a variable representing Baumol’s ‘cost disease’ theory emerge as robust and statistically significant determinants of HCE growth. Depending on whether or not outliers are excluded, we find up to six additional robust drivers: the growth in expenditure on health administration, the change in the share of inpatient expenditure in total health expenditure, the (lagged) government share in GDP, the change in the insurance coverage ratio, the growth in land traffic fatalities and the growth in the population share undergoing renal dialysis.     

An empirical analysis of the relationship between economic development and population growth in China

China has experienced a dramatic demographic transition since the latter half of the twentieth century, and thus, assessing the global economic implications is an important issue. This article uses time-series data on China to estimate the determinants of gross domestic product (GDP) per capita. According to the results of the presented co-integration analysis, population has a significantly negative impact on GDP per capita, while savings rate, total factor productivity and degree of industrialization have significantly positive impacts on GDP per capita. These results suggest that the share of the working-age population relative to the total population does not have a strong influence on GDP per capita. Therefore, the contribution of the working-age population to economic growth might not be as large as previously assumed. It is also possible that an increase in savings, remarkable industrialization and rapid technological progress have all stimulated economic growth in China greatly.     

Nonlinear relationship between health care expenditure and its determinants: a panel smooth transition regression model

This paper employs a panel of 16 OECD countries over the period 1975–2009 to reexamine the health care expenditure (HCE)-income relationship by considering a lagged ratio of public expenditures on health as the transition variable in panel smooth transition regression (PSTR) models. PSTR models can capture the heterogeneity of any individual country, provide more detailed information for policy makers of an individual government, and resolve the insufficient observations problem that frequently appears in annual country-level data. Our empirical results indicate that the relationship between HCE and its determinants, including income, time (trend), and age structure variables, is nonlinear and varies with time and across countries. The time (trend) variable—a proxy for technical progress in health care—has a non-linear impact on HCE. Ignoring the variables—technological change of health care and age structure of population—will result in over-estimates of the income elasticities of HCE. Moreover, HCE behaves as a necessity good, and the income elasticity increases when the five-period lagged ratio of public expenditures on health increases. Clearly, the ratio of government financing on health plays an important role in influencing HCE.     

Export-led Growth in South Asia: A Panel Cointegration Analysis

Abstract

In this paper, we attempt to examine the export-led and manufacturing export-led growth hypothesis for four South Asian Countries; namely, India, Pakistan, Bangladesh and Sri Lanka, using Pedroni’s panel cointegration technique for the period 1980–2002. In this context we estimate growth accounting equations to investigate the impact of exports, manufacturing exports and other important physical and human capital variables on both total GDP and non-export GDP. The study finds long-run equilibrium relationship between GDP (and non-export GDP) and exports along with other variables supporting export-led growth hypothesis. The results also substantiate the existence of manufacturing export-led growth hypothesis. Further, we find that export, fixed capital formation, public expenditure on health and education have statistically significant coefficients re-emphasizing the importance of these variables for higher economic growth.     

中国财政竞争与地方公共支出结构分析

This article examines the impact of intergovernmental fiscal competition on local public expenditure in China under current performance assessment system in which GDP is a critical factor. First, we present the assignment of public goods and tax burden and the share of foreign direct investment (FDI) of 30 provinces, and we find that current fiscal competition in China has taken the form of public expenditure improvement accompanied by preferential tax policies. Second, we regress the share of FDI on different components of provincial public expenditure, and find that the share of FDI is correlated negatively with the public service, tax burden and health care service while positively with infrastructure development. Therefore, FDI-based infrastructural investment crowds out public services investment, which fails to support the view that fiscal competition improves social welfares.     

Endogenous longevity,public debt and endogenous growth

This study explores the mechanism that causes an inverted U-shaped relationship between the public debt to GDP ratio and the economic growth rate which is observed in empirical studies. We show that this relationship is caused even when the government does not introduce the golden rule of public finance, and government health care expenditure has important role in generating this relationship.     

The role of ageing in the growth of government and social welfare spending in the OECD

Government expenditure as a share of GDP in the OECD rose at an annual growth rate of 1.02% in the period between 1970 and 1997. Government spending has increased most on functions particularly demanded by elderly population: social welfare, health and defence. Ageing is the main driving force of the growth of government spending, followed by relative prices and population. However, we also find that the other age groups react to ageing, thereby preventing increases in benefits per retired persons and that institutional reforms have been successful at reducing the impact of ageing on pensions in recent years.     

人力资本与区域经济发展的计量分析

基于1990年与2000年人口普查数据,运用回归分析研究了区域人力资本指标10年间的差异及其变化趋势对地区经济发展水平变动的影响.结果表明,对人均GDP的增长率有显著影响的因素,按其影响程度由大到小依次为:平均受教育年限增长率、识字率提高率、教育投资占GDP 的比例变动和每千人医生数增长率,但它们对人均GDP影响的方向不同,这一结论不同于许多学者的总量研究结果.本文还利用因子分析进一步解释了人力资本各指标的层次结构对经济作用的影响.这对于在经济转型期深刻认识人力资本在促进区域经济发展中的作用有参考价值.     

How Important Are Scale Effects for Growth When Knowledge Is a Public Good?

In this paper, by proposing an R&D accumulation law for an economy with an expanding number of firms, I seek to reconcile the following three facts: the positive relationship between the fraction of income allocated to R&D expenditure and growth; the positive relationship between the number of firms and total factor productivity growth; and knowledge as a non‐rival and non‐excludable good. There are scale effects because of the public nature of knowledge, but the economy also grows in the absence of population growth. I find that population growth explains one‐fifth of market income growth but only one‐sixteenth of efficient income growth.     

Population ageing in healthcare – a minor issue? Evidence from Switzerland

Our study shows that population ageing is a relevant determinant of healthcare expenditure (HCE). This conclusion supports the popular, but recently strongly contested, view that the coming population ageing will threaten the fiscal sustainability of health systems. We contribute to this debate, first by estimating the determinants of Swiss HCE with outlier-robust dynamic regressions, and second, by projecting Swiss HCE based on the estimates produced and new population scenarios. Medical advances and GDP per capita also play a decisive role. Governments can mitigate HCE growth by improving the health status of the population and by stimulating cost-effective and productive medical advances.