Study On The Supply Behavior Of Health Service By Local Government

Based on the first generation and the second generation of fiscal decentralization theory,combined with the essential characteristics of medical and health services as public goods and the special conditions of our country,this paper follows the proposal that the supply behavior of local governments on medical and health services,Problems,make assumptions,empirical tests,problem-solving research path,under the special system of China to study the supply of local government health care.The article first reviews the existing research literature.From the point of view of public goods,this article summarizes the development course of the fiscal decentralization theory from the first generation to the second generation,and takes the hypothesis of the economic man in the second generation of financial theory as the most basic theoretical basis for the full text analysis.On the basis of theory,the article gives an overview of China’s fiscal and political system as well as its health system and its main characteristics.In the continuous improvement of social and economic systems,our country has formed a special dual incentive system of economic decentralization and political centralization,which has a profound impact on the decision-making of the local government in the supply of medical and health services.Based on the theoretical analysis and current situation analysis,the paper analyzes several mechanisms that may affect the supply behavior of health care services in local governments in China from a qualitative point of view.From a theoretical point of view,the medical and health service itself has a positive externalities.From the perspective of profit-cost analysis,local governments can not reach the desired level on the overall level of medical and health service supply.On the other hand,due to the " Voting " and " voting with their feet " and other absence mechanisms,making the local government’s supply of health care services in the structure may also deviate from the real needs of the people.Judging from the actual situation in China,there is a certain irrationality in the division of financial rights in the medical and health field.Over the decentralization of fiscal power and expenditure,local governments have the helplessness of providing medical and health services.At the same time,the performance indicators of health care are not included in the direct examination system promoted by officials.They may also lead to the enthusiasm of local governments in the supply of medical and health services is not high,eventually resulting in the inefficient supply of medical and health services.In order to verify the hypothesis in qualitative analysis,the article establishes the game model on the hypothesis that the government is a rational economic man,and studies the action decision-making of local governments in the supply of medical and health services from the perspective of the interaction of behavior decision-making among the regional governments Combined with the actual situation in our country to explain the model.On this basis,the essay also establishes a spatial econometric model,which validates the qualitative assumptions of the impact mechanism presented in the previous section and simulates and validates the behavioral preferences of local governments in the supply of health care services.The empirical results show that at present the decentralization system in our country has a negative effect on the supply of medical and health services.The higher the degree of decentralization,the less the local governments tend to provide medical and health services.Under the dual incentive system,local governments report great vigilance to areas with similar levels of economic development and generally "hitchhiking" psychologically in areas of similar geography.In addition,the model also reflects other behavioral preferences of some local governments,such as the intertemporal relevance of current health care investments and past healthcare investment expenditures.Finally,based on the results of all theoretical analysis and empirical analysis,the article makes corresponding policy suggestions on improving the supply efficiency of public health supplies to local governments from the background of fiscal decentralization in China.