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。

Medical Expenditure,Health Human Capital and Firm's Export Expansion

As a basic factor that affects the formation of health human capital,medical expenditure plays an important role in building export competitive advantages and increasing the scale of export development,which has a profound impact on the export development of small,medium and micro firms in particular.Based on this,this article uses the Chinese Private Enterprise Survey database as a basis to conduct a systematic examination of the causal relationship between medical expenditures and firms'export.Theoretically,health human capital is an important module that constitutes firm's human capital.The increase in medical expenditures can affect the formation of firm's health human capital,which in turn has a positive effect on the firm's exports.Specifically,medical expenditure can affect the accumulation of health human capital,optimize the labor structure owned by firms,improve the production efficiency brought by unit labor input,and increase the health human capital owned by firms.After the firm increases medical expenditure,it can add basic medical equipment in the working environment,improve the health protection of employees in terms of medical hard resources,and reduce the impact of external health shocks on employees of the company.At the same time,the medical expenditure can also reduce the medical burden faced by employees,improve the availability of medical services and medical knowledge cognition ability of employees,and have an impact on the health level of employees in terms of medical soft resources,thereby optimizing the structure and quality of the existing labor force of the firms,which can improve the health of employees,improve individual labor efficiency and working hours,and effectively disperse the adverse impact of disease risk shocks on employee health and labor supply.Further,the accumulation of health human capital of firms promotes the improvement of the overall human capital quality,and finally promotes the firms to exert its export competitive advantages and expand the scale of external exports.Empirical testing found that the development of medical expenditure can produce a significant export promotion effect and increase firms'export scales,but this effect is heterogeneous for different sample classifications.The mechanism test shows that after measuring health human capital from multiple dimensions such as population mortality and nutritional health,the improvement of the level of medical expenditure can improve the accumulation of health human capital of the firm,enhance the competitive advantage of the firms'export,and then promote the development of the export.In addition,this article considers the robustness test of measurement model setting,industry sample selection,macro-environmental shock,medical expenditure composition,etc.,and solves the potential endogenous problems through PSM analysis,placebo test,and control function method.Then,the positive effect of medical expenditure on firm's export is still robust.The research in this article is a beneficial integration of health economics and international trade,and it provides strong practical evidence to support the development policy of China's health care and the growth of international trade.