Paper Two on Medical Fiscal Policy Public Financial Investment in Medical and Health Security: Effectiveness and Policy Paths Abstract: Currently, basic medical and health care is one of the areas that improves people’s livelihood.

The economic and social attributes of basic medical and health services determine that investment in their protection is an important part of people's livelihood finance.

Under the realistic constraints of government financial resources and investment scale, the effectiveness of public financial investment should become the focus of attention.

As the main mechanism for allocating medical and health resources, public finance must leverage its efforts to adjust the investment structure and implement effective policies and measures to ensure fairness and efficiency in the allocation of medical and health resources from both supply and demand aspects.

Keywords: medical and health security; public financial investment; effectiveness; policy path CLC Classification Number: FS10 Document Identification Code: A Article Number: 1000-176X(2010)01-0089-05 1. Proposition of Medical Issues

Health services can be divided into two aspects: one is public health services, such as immune prevention, infectious disease prevention and control, etc.; the other is general medical services, that is, the diagnosis and treatment of individual diseases.

No government in modern society has completely allowed market forces to solve medical and health service problems, but has intervened in the field of financing and security through public finance. The main reason is that public health services have significant external effects and scale returns.

The characteristics of incremental and public goods; while ordinary medical services have the characteristics of uncertainty, information asymmetry, moral hazard, adverse selection and possible induced consumption, leading to "market failure" and sub-optimal levels of consumption.

supply.

What is particularly important is that people generally regard receiving necessary medical and health services as a basic human right and in line with the requirements of basic social values.

This view is evidenced by public spending in most countries supporting the expansion of health care systems and the universalization of low-cost access to care for individuals.

Although government intervention can correct market failures and improve social welfare to a certain extent, there will also be intervention failures.

The "absence" of government intervention in the medical and health market during my country's transition process is one of the important factors leading to the unsuccessful reform of the medical and health system.

Therefore, in order to achieve the people's livelihood goal of providing medical care for all diseases proposed at the 17th National Congress of the Communist Party of China, the government must reasonably position and effectively play its leading role in assuming the responsibility of universal medical security.

Government intervention in the medical and health field is mainly realized through government health expenditure (that is, all public resources used by the government to carry out medical and health activities). Correspondingly, medical and health security is transformed into public financial investment.

question.

In what way should the government assume its responsibilities in the medical and health field? To what extent should it take the lead? On this issue, there are differences in views between the "government-led" and "market competition" factions in China.

In the view of the "government-led party", the government's increased investment should be invested in the medical service delivery system, control the medical service delivery system, and bear the investment in the medical sector and the salary of medical personnel, and encourage them to provide free or reduced-fee services to the public.

Basic medical and health services, thereby reducing the public’s medical burden.

In the view of market competition faction.

Government investment should be invested in the social medical insurance system, and the social medical insurance system should be organized and constructed by providing subsidies to low-income groups. At the same time, competition in the medical service provision system should be promoted to improve efficiency.

The above-mentioned view is biased in that it focuses on analyzing the scale and direction of public financial investment from the perspective of financing, while neglecting the study of the performance of the investment.

Judging from the scale of my country's government health expenditure, with the coordinated development of social economy and the transformation of government functions, the government's investment in health has increased, and the proportion of government health investment in the total health financing of the whole society has begun to rebound.

Since the late 1990s, some key indicators have been close to South Korea and ahead of India, indicating that under consistent comparisons, government health expenditures are of a certain scale.

The "China Total Health Expenditure Research Report 2006" issued by the Institute of Health Economics of the Ministry of Health shows that from 1978 to 2005, the average annual growth rate of total health expenses was 11.47%, which was slightly faster than the GDP growth rate.

From January to November 2008, the national fiscal revenue was 5.806821 billion yuan, an increase of 20.5% over the same period of the previous year; the national fiscal expenditure was 4.582534 billion yuan, an increase of 23.6%; the medical and health expenditure was 194.871 billion yuan, an increase of 37.3%.

However, while the scale of government health expenditures has expanded, my country's medical and health security has not effectively formed a fair and efficient mechanism.

Since the 1990s, the utilization efficiency and fairness of medical and health resources have been on a downward trend, which is reflected in the extraordinary rapid growth of medical expenses, unfair medical cost burdens, declining medical accessibility for low-income groups, and limited improvements in medical service levels.

, most residents have negative expectations about medical problems, and the supply of medical and health resources cannot effectively meet individual needs for medical and health care, etc.