Research On The Financial Expenditure For The Rural Health Care-From The Perspective Of Public Finance

Health care is one of the public goods,the governments has been responsible for the provision to the public.Before the system transition,in spite of the economics developing at a lower level,the financial revenue was poor and the public expenpiture for the health care was fewer, depend on the collective economy and the right policies of health care, the rural health care have made a very great progress .however, since the system transition ,after the implement of the household contract responsibility system and the economic system of marketing reform, the development of the rural health care was made in difficulity.The resources of health care are imblanced between in the city and countryside and interlocal ,so the rural public health situation is deteriorating .It has been very difficulity for the people to obtain the health care.There are many factors to lead to the difficulity of rural health care development, especially for the reformed of Financial management system ,and the financial expenditure responsibility of the rural health care for the intergovernments.Along with the reformed ,the responsibility of fiancial expenditure for the rural health care gradually to the low-end governments.At present,it has been the local government's duty to the financial sustained. Now the are some problems in the fields:Firstly,the governments had not been recongnized its duty,relying on the markets to supply some public goods ,during the market-oriented reform.Such as the structure of financial expenditure,the proportion of invested in the competive economic area is the largest,but for the health care and other social srevice areas is very lowly, the expenditure rose slowly.The government's budget to the health care guadually reduced ,the amount of rual health care government budget was insufficient.Secondly,not only the responsibility of fiancial expenditure for the rural health care has been assumed by the local governments ,during on the fiscal responsibility system stages and dividing-taxes system stages,but also every level governments only subsidy to its owner health care institutions.When the transfer payment system are not perfect,the per capita amount of fiancial expenditure are different.Also in the dual-economy ,financial expenditure largely cost in the city, so it had been made the eastern,central and western regions,rural and urban areas an obvious gap for the health care ,and in the rural the structure is imblance.Thirdly,due to the governments are not clearly recongnized the attributes of medical and health care srevices,the budget way for the medical and public health are same ,namely balance allocation.So the public health and epidemic prevention institutions lack of funds,resulting in them pursuit profits income,and lack of the immunization momentum.Finally the health care allocation's are ineffiecntly,various infectious disease and endemic diseases rate upward, matenral and children health care level are lower,the gap between urban and rural areas are obviously,the psysical health level of the rural population are decline,health care expense are rising.It was one of targets to make the equalization of basic public services for the building a harmonious society and reforming the public finance system .At the 17th national congress of the communist party of China's report proposed to establish a basic health care system,enhance the whole people's health level ,strengthen the government's responsibility and financial sustained.Therefore,governments at all levels should intensify the rural health care financial expenditure,and defined the responsibility between governments and markrt, high-end and low-end levels of governments in the health care fields,adjusting the structure of financial expenditure on the rural health field, innovatived the use way of allocation,improved the efficiency of the funds. Eventually everyone will have access to basic medical and health.