Fiscal Decentralization, Government Behavior And Public Health Expenditure Relationship Study

The right to health is the most basic civil rights, the basic health services for survival of the resident should not be based entirely on their ability to pay, so increasing the financial health expenditure is a responsibility which modern government can not shirk. However, China's resident health care cost is rapidly increasing in recent years, "medical care is expensive, medical treatment is difficult" issue has become a social phenomenon, which has seriously affected the enjoyment rights of basic health services for the resident. With China's rapid economic growth, China's government health expenditure in absolute terms is increasing annually, but the growth rate of government health expenditure has been lower than the growth rate of total health expenditure, government health expenditure proportion on total health expenditure decreased year by year, personal health expenditure proportion on total health expenditure sharply increase, which runs counter to the mainstream that the most of the countries in the world gradually increase the fiscal health expenditure in the period of economic growth. Therefore, studying the underlying causes of the inadequate fiscal health expenditure is very significant for the current implementation of the new health care and drug system and the building of harmonious society in China.Based on comparative analysis of the current situation of China's fiscal health expenditure to start, in the situation of controlling other variables, we pay a particular emphasis on the specific impact of fiscal decentralization and the Government Competition on the financial health expenditure and further improve the distorting effects analysis of the decentralization on the public spending structure. There are five parts in this article, the first section describes the status of China's fiscal health expenditure as well as some international comparisons, we find that there are currently the irrational structure of the government expenditure and personal expenditure on health and the irrational structure of the intergovernmental burden proportion, so which guides us to study the specific influence of fiscal decentralization and government competition. The second part reviews the theoretical basis and theoretical development of fiscal decentralization as well as empirical research at home and abroad, at the same time, we find that the current domestic research on the relationship between decentralization and the literature of public health spending is rare. In the third part, we study the internal logic of public health services and fiscal decentralization through the review of fiscal decentralization and health system evolution. In the fourth part, we establish relative basic regression models and achieve the specific impact of fiscal decentralization on the fiscal health expenditures by the stability test of deleting the sample and changing the indicators. The main conclusion and thinking is in the fifth part.We attain some conclusions by the theoretical and empirical analysis, as follows: (1) the property and powers rights of health care do not match, the higher government's fiscal health expenditure is small, while the lower levels of government is overwhelmed. (2) Fiscal decentralization promoted fiscal health expenditure in the central region and held back the fiscal health expenditure in the eastern region, the effect on the western region was uncertain (or small); In addition, the intergovernmental fiscal competition also caused a negative impact on fiscal health expenditure. (3) Because of the inherent weaknesses of the current transfer payments, the promotion of transfer payments to the fiscal health expenditure is not larger than local level revenue, and it worsened the local public health services.