中国财政分权对健康的影响  

The Impact of China's Fiscal Decentralization on Health Outcomes

作　　者：彭浩然[1] 吴木銮[2] 孟醒[1] 

机构地区：[1]中山大学岭南学院 [2]香港教育学院亚洲及政策研究学系

出　　处：《财贸经济》2013年第11期33-44,共12页Finance & Trade Economics

基　　金：国家社科基金重点项目"中国社会医疗保险制度整合的效果评价"(批准号:13AGL011);中山大学经济研究所基地建设经费的资助

摘　　要：健康水平是衡量一个国家经济社会发展的重要指标。迄今为止,究竟财政分权如何影响健康还存在很大的争议,且极少有针对中国的研究。本文选取人口死亡率作为反映健康水平的指标,并通过构造省内财政分权指标,利用1995-2009年的省级面板数据,实证检验中国财政分权对健康的影响。本文的主要发现是:无论是从收入还是支出方面考察,中国财政分权都不利于健康水平的提高;省份的财政依存度会部分抵消财政分权对健康的不利影响;此外,省级政府对地方政府的财政转移支付能够促进健康水平的提升,但这种积极作用会随着财政支出分权程度的提高而减弱。最后,本文利用多层委托代理理论和中国式"利维坦假设"对研究发现进行合理解释,并提出相关政策建议。Health status is an important indicator of measuring the level of one country＇s economic and social development. There has been a huge controversy over the impact of fiscal decentralization on health outcome. Though there is increasing research in this area in the English literature, few studies investigate the Chinese experience. Using mortality as health indicator and constructing provincial fiscal decentralization indicators, this paper investigates the impact of fiscal decentralization on health status drawing on China＇s provincial panel dataset from 1995 to 2009. The main findings include.. （1）China＇s fiscal decentralization doesn＇t lead to positive health outcome, no matter from the aspect of revenue decentralization or expenditure decentralization. （2） The degree of fiscal dependence of province partly offsets the adverse effect of fiscal decentralization on health outcome. （3）The intergovernmental transfers from provincial governments to sub-provincial governments improve health outcome, but this positive effect decreases with the improvement of the degree of expenditure decentralization. Finally, this paper offers some explanations for the main findings according to Three-tier principal-supervisor-agent theory and Leviathan hypothesis in the Chinese context and generates some policy implications.

关 键 词：财政分权 健康 财政收入 财政支出 

分 类 号：F812.4[经济管理—财政学]