Fairness And Efficiency Of Public Expenditure On Health

In recent years, some realistic problems,such as the frequent erupt of public health emergencies, for example, SARS and bird flu, and the divergence of the level of public health service between urban and rural areas, are all closely associated with the fairness and the efficiency of public health expenditure. The estimate of the fairness of public health expenditure is greatly beneficial to the reduction of the disparity between different areas, the solution of problems of agriculture, the improvement of the status of inferior social groups and the advocation of social justice. The study of the efficiency of public health expenditure can help us increase the allocative efficiency and technical efficiency. The dissertation is devoted to the topic of public health expenditure. The author draws a basic evaluation of the effect of public health expenditure by analyzing the fairness and efficiency of public health expenditure in China, and puts forward proposals for policy from the view of public finance and the medical system reform.According to the fiscal theories of public expenditure, the analysis of public health expenditure develops as the following thoughts: Why does the government afford public health expenditure? Is the size and structure of public health expenditure reasonable or not? This is the basic evaluation of public health expenditure in China. Is the allocation for public health expenditure fair or not? What is the efficiency of public health expenditure like? This is the core content of the evaluation of the results of public health expenditure. The main structure of the dissertation is as follows:The first part is the introduction. It puts forward to the issues discussed in the entire dissertation and focuses on the fairness and the efficiency of public health expenditure in China on the basis of research achievements.In the meantime, the main contents of the whole paper are also summarized in this part.In chapter one, the dissertation introduces the concepts related to public health and public health expenditure and analyzes the basis of theories why the government intervene the area of public health expenditure. At the same time, the dissertation analyzes the size and structure of public health expenditure in China in the mass and generalizes the current situation of public health expenditure in China, which lays an essential foundation for breakthough point and study methods of the whole dissertation.In chapter two. two principles that evaluate the fairness of allocation for public health expenditure have been developed. Based on the empirical analysis of the use and the obtainment of health services and the health condition of urban and rural residents, the dissertation comes to a conclusion that the allocation for public health expenditure is unfair. Then the causes of unfairness of public health expenditure have been analyzed. This part concludes that the main causes are the difference of economic development between different regions, the flaws existed in public health expenditure system and the imperfection of public heath fiscal intergovernmental grant system.In chapter three, the allocative efficiency and technical efficiency has been analyzed.This part comes to a conclusion that the efficiency of public health expenditure is low. Finally, the reasons why the public health expenditure is low efficient have been analyzed. It is concluded that the reasons are insufficient size of public health expenditure, inappropriate structure of the expenditure, unfairness of the expenditure, flaws in the relevant management system, and flaws in the budget management system.In chapter four, based on the previous analysis, the main conclusions of the dissertation are generalized that the allocation for public health expenditure is unfair and the efficiency of public health expenditure should be increased. Then the part puts forward the ideas of how to solve the problems through a series of reforming measures, which includes: defining the governments' responsibilities; establishing the size and structure of public health expenditure appropriately; improving the intergovernmental grant system; increasing public health expenditure to rural area; reforming the budget system and the medical and health system.