财政省直管县体制与基本公共服务均等化——以居民医保整合为例

Fiscal Impacts on the Equalization of Basic Public Services——A Study Based on the Integration of Urban and Rural Social Medical Schemes

本文以城乡居民基本医疗保险的自发整合为例,考察财政省直管县体制在推进基本公共服务均等化中的作用。使用242个地级以上城市数据,(广义)有序Logit回归的结果表明:辖区内财政省直管县比重越高的城市越倾向于避免整合,这在"强市-弱县"城市和"弱市-强县"城市更为突出。我们还验证了其作用机制,在于阻碍市县之间关于整合成本分担共识的达成。此外,财政收入能力影响整合的模式选择(一档或两档),但对是否整合的影响不显著。

In this paper we examine the fiscal effects on the equalization of basic public services, taking the example of the integration of urban and rural social medical schemes. Using nationwide city-level data and employing(generalized) ordered Logit model, we find that: although fiscal expenditure did affect the integration level, it was the fiscal system arrangement that played a major part in the integration decision. Cities with more province-governing counties were more likely to avoid the integration. This tendency was more clear in cities with "strong city-weak county" as well as " weak city-strong county" combinations. We then discuss the mechanism.