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健康水平是衡量一个国家经济社会发展的重要指标。迄今为止,究竟财政分权如何影响健康还存在很大的争议,且极少有针对中国的研究。本文选取人口死亡率作为反映健康水平的指标,并通过构造省内财政分权指标,利用1995-2009年的省级面板数据,实证检验中国财政分权对健康的影响。本文的主要发现是:无论是从收入还是支出方面考察,中国财政分权都不利于健康水平的提高;省份的财政依存度会部分抵消财政分权对健康的不利影响;此外,省级政府对地方政府的财政转移支付能够促进健康水平的提升,但这种积极作用会随着财政支出分权程度的提高而减弱。最后,本文利用多层委托代理理论和中国式“利维坦假设”对研究发现进行合理解释,并提出相关政策建议。
Health level is a measure of a country’s economic and social development an important indicator. So far, there is still much controversy over how fiscal decentralization affects health, with very few studies on China. In this paper, we choose the mortality rate of population as an indicator to reflect the health level. By constructing the provincial fiscal decentralization index and using the provincial panel data from 1995 to 2009, we empirically test the health effects of fiscal decentralization in China. The main findings of this paper are as follows: Whether in terms of income or expenditure, the fiscal decentralization in China is not conducive to the improvement of the health level; the provincial financial dependence will partially offset the unfavorable impact of fiscal decentralization on health; in addition, the provincial government Local government’s fiscal transfer payment can promote the improvement of health level, but this positive effect will be weakened with the increase of fiscal expenditure decentralization. Finally, this paper makes use of multi-layer principal-agent theory and Chinese-style “Leviathan hypothesis” to reasonably explain the research findings and put forward relevant policy suggestions.