政府公共卫生投入的经济效应--基于农村居民消费的检验

The Economic Effect of Government Investment in Public Health:A Rural Consumption Test

公共卫生投入对居民消费的影响是不确定的。但2003年后,在中国各级政府持续加大农村地区公共卫生投入的同时,中国农村居民的消费收入比保持较高水平,并明显高于城镇居民。基于中国家庭追踪调查(CFPS)微观数据库,并利用工具变量估计等方法,实证检验中国政府公共卫生投入对农村居民不同类型消费(非医疗消费和医疗消费)的影响,研究发现:参加新农合、到达医疗机构时间的缩短与农村居民的非医疗消费具有显著的正向关联,这在风险厌恶度较低(预防性储蓄动机较弱)的家庭中更明显;参加新农合与农村居民的医疗消费也具有显著的正向关联,这种作用会随着家庭医疗消费偏好的下降(家庭平均健康水平的提高)而减弱。这表明,中国政府的农村公共卫生投入,在刺激农村居民非医疗消费的增长的同时,并未以减少农村居民的医疗消费为代价。

The impact of public health inputs on household consumption is uncertain.After 2003,however,as Chinese governments at all levels continued to increase investments in public health in rural areas,the ratio of the consumption of rural residents to their incomes has been relatively high,and significantly higher than that of urban residents.Using the China Family Panel Studies(CFPS)micro-level database and the instrumental variables estimates methodology,we conducted an empirical test of the effect of the Chinese government’s investment in public health on different types of rural consumption(medical and non-medical).Our findings show that participation in the New Rural Cooperative Medical System and the shorter time required for accessing health care providers have a significant positive correlation with non-medical rural consumption.This is particularly obvious in families with lower risk aversion(who have less motivation for precautionary saving).Participation in the New Rural Cooperative Medical System also has a significant positive correlation with rural residents’medical consumption,but this weakens as the household’s preference for medical consumption falls(average household health rises).This shows that while the Chinese government’s investment in rural public health stimulates the growth of non-medical rural consumption,this does not occur at the expense of rural medical consumption.