县、乡财政体制下四个代表县卫生发展分析

An Analysis on Rural Health Development under the Fiscal System at County Level and Township Level

在分析4个调查县财政体制特点的基础上,探讨了财政对不同性质卫生机构的支持情况,分析了在财政投入不足的情况下各县卫生发展的不同路径。揭示了在各县卫生发展路径各异的表象下,以县、乡财政困境导致财政对卫生投入不足为逻辑起点,卫生发展走出了一条充分利用政策空间、以市场筹资为主但是机构效率并不高的路径。指出财政对卫生投入的重要程度和当地财力呈负相关关系。提出要扭转这一卫生发展路径,在筹资方面需要重新调整各级政府对卫生发展的事权和完善转移支付制度。

The article introduced the fiscal system characteristics of the selected 4 counties and the government financing to the different health agencies and described the different path of health development in the 4 counties. Based on the positive analysis, the author inducted that lack of government financing for health sector was resulted from the distress of county level and township level＇ s fiscal system. As this logic starting point, rural health industry development walked along with the path of full use the policy, financing by market and low efficiency. And it was the negative corrective between the importance of financing by government and the local government fiscal revenue. To change this development path, the main body of financing must be changed, the health development responsibilities among all level governments should be adjusted and the transfer payment system should be improved.