Research On The Influence Of Fiscal Expenditure Policies On The Supply Of Basic Elderly Care Services

Fiscal expenditure policy is an important means to ensure the supply of basic elderly care services.China has gradually entered a population aging society since 1999,with fast pace in population aging in recent years.Population aging has not only caused a series of economic and social contradictions and problems,but also affected the completion of the 14th Five-Year Plan(2021-2025),the objectives of future economic and social development,and the progress of building a modern powerful socialist country.The acceleration of population aging brings the following three challenges to China’s socioeconomic development.Firstly,population aging leads to the demographic imbalance,resulting in the lack of effective labor supply during the process of economic development.The disproportionality of dependency ratio also brings much more financial and psychological pressure to the employment groups,which will inevitably affect the quantity and quality of social labor supply,total labor productivity of the whole society,as well as the speed and quality of economic growth.Secondly,the tendency of population aging has led to the demand for basic elder care services to proliferate.However,the current supply scales of resources for elder care services are a far cry from meeting the rapid increases in elder care demands,resulting in the contradiction between the increasing direct demands and insufficient effective supplies of basic elder care services.If this conflict cannot be resolved as soon as possible,the substantial elderly group will not spend their twilight years comfortably,resulting in a negative impact on social stability.Finally,most elderly groups are classified as the lower-middle-class income groups in the personal income distribution system,while they are more vulnerable to infectious disease with poor self-care ability.These makes they need more financial supports in their later-life,which will inevitably form the contradiction between the increase of elderly care services demand and insufficient supply.The government should provide more basic elder care services,which is an important way to solve this conflict.Not only provide financial supports and free provisions of basic elder care services for three-no elderly,but also give government assistance for those who are low-income and disabled.The aging population problem and the increasing effective demand for basic elderly care services will definitely continue to improve the pressure on government finance.The Ministry of Civil Affairs proposed that China will improve the basic elderly care service system during the 14th Five-Year Plan period.Thus,under the existing financial expenditure structure,how to increase the financial resources supplies for basic elderly services is not only a major economic and social issue,but also a critical issue for improving people’s livelihood.Therefore,the research on this issue has important practical significance.Most of the existing research literatures regarding the financial supply of basic elderly care services focus on the division of responsibilities between the government and other suppliers,the research on the supply mode,the financial expenditure scale and so on.Those studies provide useful references for this paper,but there are still some limitations.Firstly,it is lack of research results in respective of fiscal expenditure policy tools.Secondly,it is lack of the effects of influence mechanism on indirect impacts.Finally,it is lack of heterogeneity quantitative analysis depth regarding the effects of the fiscal expenditure policy on the basic elderly care services supply.Based on the above limitations,this paper analyzes the following three aspects under the basic concepts and related theories.Firstly,it chooses three fiscal expenditure policies that direct financial investment,government purchase services and financial subsidies to analyze.Secondly,it examines these fiscal expenditure policies from the theoretical and empirical levels.It analyzes the direct and indirect transmission effects of the above three fiscal expenditure policies on the supply of basic elderly care services through the suppliers’ probabilities,the ownership structure bias of basic elderly care services resources and the purchasing power of vulnerable elderly groups.Finally,it empirically tests the influence mechanism of fiscal expenditure policy on the basic elderly care services supply through the mediating effects test model based on the sample data of 31 provinces,cities and autonomous regions in China from 2011 to 2020.It also analyzes the heterogeneity of the whole samples according to the degree of aging population and the level of economic development.The main conclusions drawn from this study are as follows.Firstly,by examining the fiscal expenditure policy and the reality of basic elderly service supply,it is found that the scale of basic elderly service supply is improving year by year but the resource allocation tends to be in the provinces with higher economic development level.The inefficiency of financial direct investment in basic elderly service supply is the main issue.The government purchase of basic elderly services has the problems of the relevant institutional system remaining to be improved and unbalanced configuration among regions.The coverage rate of financial subsidies for basic elderly services is low,the implementation effect does not meet expectations,and the configuration is unbalanced between regions.Secondly,the increase of fiscal direct investment can improve the profitability of the basic elderly service supply side and thus significantly increase the scale of basic elderly service supply.The results of group estimation for different aging regions show that the effect of fiscal direct investment on basic elderly service supply is more significant in the high aging group.The group estimation results for different economic development regions show that the effect of fiscal direct investment on basic elderly service supply is more significant in the eastern region.Thirdly,by attracting social capital to join the basic elderly service supply,the government purchase of elderly service increases the proportion of private resources in the ownership structure,while decreasing the proportion of public resources,thus achieving the purpose of improving the efficiency of basic elderly service supply.The estimation results of different aging groups show that government purchase of services promotes the efficiency of basic elderly care service supply in both low and high aging groups,with the effect of low aging group being more obvious.The estimation results for different economic development regions show that the effect of government purchase of elderly care services to promote the efficiency of basic elderly care service supply is significant in both eastern and mid-western regions,with the effect of the eastern region being more apparent.Fourthly,financial subsidies have a positive effect on the equity of basic elderly service supply by improving the purchasing power of the elderly group.The effect of financial subsidies on the demand side of basic elderly services to promote the equity of basic elderly services supply is higher than that of subsidies on the supply side.The results of the interaction effects of aging,economic development level and financial subsidies show that aging promotes the effect of financial subsidies on basic elderly service supply,while economic development level inhibits the effect of financial subsidies on basic elderly service supply.The heterogeneity analysis shows that the effect of financial subsidies on the purchasing power of disadvantaged elderly groups and the supply of basic elderly services is more significant in the regions with deeper aging and in the central and western regions with lower economic development levels.Compared with previous studies,this paper has three innovations.First of all,it enhances perspective directions.The mostly existing studies on the fiscal expenditure policy of basic elderly services focus on supply mode,which is not good at accurately clarifying the functions of fiscal expenditure policy in the supply of basic elderly care services.Thus,this paper mainly discusses the impact of different fiscal expenditure policies on the basic elderly care services.Secondly,it expands the research content.The existing literature focuses on the analysis of the direct impact of fiscal expenditure policy on the supply of basic old-age services,which is not conducive to clarifying the mechanism of fiscal expenditure policy on the supply of basic old-age services.In view of this,this paper not only decomposes the transmission mechanism of fiscal expenditure policy affecting the supply of basic old-age services into the profitability of the supplier of basic old-age services and the purchasing power of vulnerable elderly groups from the theoretical level,but also tests the direct and indirect transmission effects of three fiscal expenditure policy means affecting the supply of basic old-age services through these three mechanisms from the empirical level,thus making a useful supplement to the existing research.Finally,it improves the research methods.The existing literatures generally use qualitative method and direct path to analyze the effect of fiscal expenditure policy on the basic elderly care services,resulting on the accuracy of the analysis.This paper empirically examines effects of fiscal expenditure policies on the direct and indirect mechanisms of the supply of basic elderly care services by using the mediating effect test model.Meanwhile,it combines these two aspects into a unified analytical framework.Moreover,it carries out relevant endogenous tests,robust tests and heterogeneity analysis.Therefore,this paper tests and analyze the interaction effects between the two indicators regarding aging population and economic developments and fiscal expenditure policy.It not only provides a new method to comprehensively measure the effects of fiscal expenditure policy on the basic elderly care services supply,but also analyze in depth the effects of the mechanism of fiscal expenditure policy on the basic elderly care services supply.