公共财政框架下县乡财政卫生支出优先次序下降的原因分析.pdfVIP

2006 军9 月第9 期《申国卫生经济》第 25 卷(总第 283 期) 公共财政框架下县乡财政卫生支出优先次序下降的原因分析* 罔淘沙①李卫平② 摘 要 通过分析财政改革与发展的历程，阐明了财政体制正在向公共化方向迈进;通过分税制背景下县乡财 政的资金流程和收支结构分析阐明了在财力不足、转移支付制度不完善、财权与事权不对称和拉动经济发展的责任 下，县乡财政压缩对社会事业的支出成为现实条件下的必然选择。在此基础上着重分析了卫生行业的特殊性、卫生 部门和财政部门对卫生事业发展认识的不一致和卫生部门不理解财政改革基本逻辑和发展规律等是导致目前卫生支 出在社会事业支出次序下降的原因。 关键词 公共财政框架 县乡财政压力 财政卫生筹资优先次序 中图分类号: R-012 文献标识码:A 文章编号: 1003-0743(2006)09一0005-05 An Analysis on the Priority Drop off on Health Financing by Grass Root Government under the Public Finance FrameworklZHOU Hai-sha , LI Wei-ping//Chinese Heal伽 Economics ， 2006 , 25 (9) :05-09 Abstract Bascd on the historical rcview of fiscal reform and development , the more public the financc system transferred to , the more funds f1 0wed to the public sector. Limited by lacking of fiscal revenue , imperfect transfer payment system , imbalanced between the fiscal revenue and the responsibilities , the pressure of stimulating economÎc growth in the cÎrcumstance of tax distribution system , the grass root govemment had no choice but cut down the expenditure for social undertaking. Based on the above background , the characteristic of health indust町， disaccord of health service development between health sector and finance sector , ignorant the rule of fiscal reform and development caused the priority drop off on health financing by grass root govemment. Key words public finance framework , grass root fiscal pressure , health care financing by govemment , priority order First-author s address Department of Health Policy and Management , School of Public Health , Peking University , Beijing , 100083 , China 经济市场化带动了财政体制的公共化..十五末期， 建国初期，