| With the rapid development of China's economy and the continuous progress of society,health issues have become the focus of attention of the state and society.“Healthy China 2030” planning outline puts forward: promoting the construction of a healthy China is an important foundation for building a moderately prosperous society in an all-round way and basically realizing socialist modernization,and is a national strategy for comprehensively improving the health quality of the Chinese nation and realizing the coordinated development of people's health and economic society.General Secretary Xi Jinping pointed out clearly in the nineteen major reports of the Communist Party of China: “Implementing the healthy China strategy,we need to improve the national health policy and provide the people with a full range of full cycle health services.We should give priority to prevention,carry out patriotic health campaign,advocate a healthy and civilized lifestyle,and prevent and control major diseases.” The“Opinions of the State Council on the Implementation of the Healthy China Action”once again clearly pointed out that smoking,excessive drinking,lack of exercise,unreasonable diet and other risk behaviors are relatively common,resulting in increasingly prominent disease problems.We should focus on the major diseases and prominent problems that affect people's health at present and in the future,implement the medium and long-term action of disease prevention and health promotion,and improve the system system of implementing prevention first in the whole society.China's public health management needs to shift from the current “heavy medical” post diagnosis and treatment to the “prevention” risk behavior in advance.At present,there are still big hidden dangers in the field of public health in China.Many health risk behaviors,such as smoking,drinking,suicide,unhealthy sexual behavior and epidemic spread,will still pose a threat to the health of Chinese residents.The formulation and intervention of appropriate fiscal policies can effectively reduce the health costs that risk behaviors may bring and produce objective health effects,which will help to improve the overall health level and the quality of life of residents in China.According to this research background,this paper mainly evaluates the health effect of fiscal policy from the perspective of risk behavior,trying to solve the following problems: first,in the face of the impact of risk behavior,whether the effect of fiscal policy can be confirmed in theory;second,how large-scale expected benefits will be generated by using fiscal policy to intervene in risk behavior,and whether it is in line with the principle of costbenefit;third,whether the effect of fiscal policy can be confirmed in theory Whether it is effective to implement fiscal policy to curb the personal and social harm caused by risk behavior.In the normative research,based on the development of health economics theory,this paper defines the concept and literature review based on three dimensions of risk behavior,fiscal policy and health effect,and reviews the classic models,theoretical models and policies.First of all,the paper defines the core concepts and reviews the existing research at home and abroad.Secondly,on the basis of reviewing the theoretical model of health,a theoretical model is established from the perspective of individual utility at the micro level and multi department at the macro level.Under the guidance of dynamic optimization,Hamilton equation is solved and the steady-state optimal solution of multi department behavior decision model is fitted,It proves that the risk behavior is harmful to the utility at the individual level and threatens the economic growth at the macro level,and deduces that the fiscal policy is significantly effective in restraining the personal and social negative effects caused by the risk behavior,which lays a theoretical foundation for the following empirical research.Finally,the development context of public health policy and medical and health financial policy since the founding of the People's Republic of China is summarized.In the part of empirical research,based on the background of risk behavior impact,this paper estimates the potential benefits of fiscal policy intervention on smoking behavior and drinking behavior.In terms of smoking behavior,this paper selects tobacco sales volume as the core index,uses the panel data of prefecture level cities from 2011 to 2014,selects simultaneous equations and three-stage least squares method to estimate the endogenous problems,and estimates the potential policy benefits of smoking behavior.It is found that the direct and indirect health losses caused by smoking behavior are huge,and the potential income scale of fiscal policy intervention on smoking behavior has reached 100 billion yuan.In terms of drinking behavior,this paper selects the amount of alcohol consumption per capita as the core explanatory variable,selects the panel data at the district and county level,uses the two-stage least square method to solve the endogenous problem,confirms the health hazards of drinking behavior and estimates the potential health benefits of fiscal policy.The results show that drinking behavior has a significant negative impact on public health.The cost of life loss,medical cost and potential social labor loss caused by drinking is more than 220 billion yuan,which means that the intervention of financial policy on drinking behavior has objective potential benefits.On this basis,this paper further evaluates the health effects of fiscal expenditure,tax reform and fiscal decentralization on HIV / AIDS transmission,suicide and epidemic outbreak.Specifically,for the risk behavior of AIDS transmission,this paper selects provincial panel data and two-way fixed effect model to evaluate the effect of financial expenditure and maternal and child barrier expenditure on the incidence and mortality of AIDS.The results show that public health expenditure can significantly reduce the incidence rate and mortality rate of AIDS,and suppress the negative effects of AIDS on individuals and society.The health effects of the policy are confirmed.As far as suicide behavior is concerned,this paper takes the agricultural tax reform as a “quasi natural experiment”,and uses the panel data at the county level and the Difference-in-Difference estimation method(DID)of the death cause monitoring data set of Chinese residents to empirically study the impact of agricultural tax reform on the suicide of middle-aged and elderly people,and analyzes its mechanism.The results show that agricultural tax reform,as an important tax system reform,can reduce the harm of suicide and produce health effects by increasing the welfare level of rural residents and improving the behavior ability of local government.At the same time,the impact of the abolition of agricultural tax policy on the suicide behavior of middle-aged and elderly people also shows some heterogeneity characteristics: firstly,the agricultural tax exemption and reduction has inhibitory effect on the suicide of middle-aged and elderly people,with the central region being the most obvious,the western region taking the second place,and the eastern region being the weakest;secondly,compared with the urban area,the change of suicide behavior in rural areas is more sensitive to the agricultural tax reform;finally,the agricultural tax exemption policy has a negative impact on the suicide behavior of the middle-aged and elderly Men and the elderly over 65 years old are the biggest beneficiaries of the health effects of tax reform.Further analysis also shows that the former two groups of agricultural tax reform pilot areas have greater suicide inhibition effect than the third group.For epidemic control,this paper chooses the index of incidence rate and mortality of epidemics and establishes the spatial Durbin model(SDM).With the spatial econometrics paradigm,the direct effects,indirect effects and total effects of fiscal decentralization on epidemic prevention and control are systematically analyzed,and the powers and responsibilities of the central government and local governments in the process of epidemic governance are further explored.The division of expenditure responsibility.The results show that fiscal decentralization has significant spatial correlation to the incidence and mortality of epidemics.Fiscal decentralization will reduce the incidence rate of epidemics in the region and reduce the incidence rate of epidemics in the surrounding areas.On the contrary,fiscal decentralization will increase the prevalence of epidemic diseases in the region and the impact will be spilt to the surrounding areas.Comprehensive analysis of the effect of fiscal decentralization on epidemic governance shows that the total effect of fiscal decentralization on epidemic incidence rate is significantly negative,and the total effect on epidemic mortality is significantly positive.The results of heterogeneity analysis show that fiscal decentralization has better effect on the governance of chronic epidemics such as hepatitis B and AIDS in northern China,coastal areas along the border,and so on.Based on the above normative research and empirical research results,this paper puts forward the following policy recommendations:Pay attention to the health effect of public policy.First of all,we should improve the financial policy support for the prevention and control of risk behavior,strengthen the overall planning of funds,and optimize the allocation of funds.At the same time,we should expand the scope of medical and health expenditure at the grass-roots level,improve the coverage of basic medical and health service items and the applicable population in grassroots areas,so as to achieve the universality of risk behavior prevention funds.Secondly,we should increase the financial expenditure of scientific research and education on risk behavior,and strengthen scientific research support and education services.Finally,from the aspect of social security,the social and personal health hazards caused by risk behaviors are effectively guaranteed and reasonably compensated.To restrain the development of upstream and downstream industries.In order to restrain the upstream industry development of risk behavior subsidiary products,this paper suggests to adopt corresponding fiscal and tax policies for macro-control.First,the tax revenue of the subsidiary goods in the production and processing of risk behaviors should be appropriately improved.Secondly,we should increase the financial expenditure and transfer payment for the health substitutes industry of risk behavior affiliated commodities.Third,strengthen the administrative law enforcement,and crack down on the risk behaviors that may cause harm through illegal channels.In order to restrain the spread of risk behavior and the adverse harm,it is imperative to restrict downstream industry at the institutional level.First,the tax rate of risk behavior subsidiary goods should be appropriately increased in the sales process,and the enthusiasm of the sales or supply channels of the accessory products should be reduced by increasing the cost of the seller.Second,the control measures shall be taken for the publicity and advertising of risk behavior affiliated goods or services and the online publicity and distribution.Third,strictly control the import of risk behavior subsidiary goods and increase the tariff appropriately to prevent the harm of overseas bad goods and information to the health of our residents.We should publicize the hazards of risk behaviors and promote healthy lifestyle.Adhere to the “Healthy China” strategy,actively publicize the harm of health risk behavior,improve the public awareness of risk behavior,and promote a healthy lifestyle.First of all,we should pay attention to the publicity and guidance,take various forms of publicity,and strengthen the public opinion propaganda on the health hazards of risk behaviors.Secondly,we should make use of the existing mass organizations and social groups to realize the public participation and co construction and sharing of risk behavior prevention and control.Finally,actively promote a healthy lifestyle. |
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