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1、SARStriggeredapublichealthissueoffiscalspendingSAKStriggeredapublichealthissueoffiscalspendingBeginsattheendof2002andin2003,aftertheSpringFestivalinGuangdongandotherareasalarge-scaleoutbreakofSARSepidemiconChinasgovernmentisaseveretest.InthefightagainstSRSintheprocessofgovernmentfootthebillthedecisi
2、on-making,thatis,toprovidefinancialguaranteesbytheGovernmentinthecrisisplayedareassuring,rapidtreatmentoftheeffectontheeffectivecontroloftheepidemichasplayedanindispensablerole.So,fromafinancialperspective,wecanforthisgovernmentpaycostsandbenefitsofanaccountbalance,analysisofChinasSARScrisis,thefina
3、ncialexpendituretobringthefieldofthinking.ResponsetoSARScrisis,thefinancialexpenditures(totalcostofthecrisis)-Centralandlocalfinancialemergenciesthathaveoccurredinemergencyspendingevenaftervariousefforts,theepidemichasbeeneffectivelycontrolled,butthefinancesarealsopaidahugecosttodothis,thecentraland
4、localgovernmentsinrespondingtothisincidentinTunisiaFatincidentsexpenditureexceededthecostofanypreviousStateCounci1ofsuddenpublichealthincidentstoestablishemergencyresponsemechanismtotherequirementsofspecialfundsallocated310millionyuanforthefirstphaseofemergencyresponsemechanismsforfundingtheconstruc
5、tionofthefirstdate,asofMay14,theCentralandlocalgovernmentstocombatSARS,atotalof12.6billionfunds,morethanthreeyearsfron1999to2001thesumofdisasterreliefexpenditures.scanbeseenfromtheabovedata,thecentralandlocalgovernmentsintheSARScrisis,emergenciesexpenditureisenormous.Inourcountrysbudgetarrangementst
6、odealwithsuddenincidentsbudgetexpenditureshastwosubjects:First,thecentralfinanceandlocalfinancialreservefund,andsecond,includedinthepensionandsocialwelfarereliefpaymentsunderthedisasterreliefexpenditures.Chinascentralgovernmentbudgetfor2003,arrangedthegeneralreservefundof10billion,thisspent2billion(
7、notincludingtheofficialfromthecentraltolocalSARSpreventionandtreatmentforthetransferofexpenses),belongstothelargesteverone-timeexpenditureoftime.Atal1levelsoflocalgovernmentexpenditureisaboutmorethan80billionyuanovertheextentofeconomicconditionsandtheepidemicvary.-Taxreductionandexemptionofthefeewai
8、verformoffiscalexpendituresinceMay9,thecentralandlocalgovernmentsissuedaseriesoftaxreliefpoliciesandmeasures,whichalsoconstitutealargetaxexpenditureandfinancialoffee-basedexpenditures,areductioninrevenuethisyear,thenumberofreality,accordingtolastyearsfinancialchargesandtaxrevenueestimates,thespendin
9、gbillionsofdollarsadozen,oramount.Asfollows:May9,theStateCouncildecidedtoMay1,2003unti1September30,2003,foragreaterimpactbySARSdining,hotels,entertainment,civilaviation,tourism,roadpassengertransport,waterwaypassengertransport,taxi,etc.thereductioninadministrativeservicefees,and15governmentalfunds.T
10、hese15funds,theincomeofthecentralpartofal1thefree:arelocalrevenue,thespecificreductionratebythelocalGovernment.May11,theStateCouncildecidedtobeadirectimpactontheepidemicmoreprominentpartoftheindustryintheMay1,2003toSeptember30periodtoimplementpreferentialtaxationpolicies.Ofcivi1aviationandtourism,pa
11、ssengertransportoperationsshal1beexemptedfrombusinesstax,urbanmaintenanceandconstructiontax,educationfee.Inaddition,theprovinces,autonomousregionsandmunicipalitiesaccordingtothelocalepidemicandtheimpactonrelatedindustriestheactualsituationofproductionandoperationoftheimplementationofpreferentialtaxp
12、oliciesareasfollows:Forthecateringindustry,hotelindustry,reduction,exemption,orstrictattentiontobusinesstax,urbanmaintenanceandconstructiontax,educationexpensesattached.Personalincomctaxexemptionfortaxidriversorreducethelevyquota.Fortaxicompaniesandreductionofurbanpublictransportcompanies,exemptedor
13、deferrablesalestax,urbanmaintenanceandconstructiontax,educationfee.BeforeandaftertheStateDepartmentspoliciessupportingvariouspartsoftheotherpolicieshavegraduallybeenintroduced.IncludingBeijing,Shanghai,GuangdongandHangzhou,thepolicyismoretypical,includingfirst-1inehealthcareworkersandtaxiindustry,pe
14、rsonalincometaxexemption:onhotels,restaurants,businessservicespartofthetouristnatureofadministrativefeesandoperatingfeewaiver;raisingtheexporttaxrebatesubsidyratio;increasefinancialsupportformedicalreserveforce;tocashflowdifficultiesofthetourism,catering,entertainmentSMEloanguaranteeforshort-termliq
15、uiditysupport;adjustedtransportation,tourism,entertainmenttaxfees,adozentaxpreferentialpolicies.-Asthemacro-economicslowdown(GDPgrowthrateofdecrease)causedbyhiddenfinancialexpenditureprojections,accordingtoeconomists,Chinasmacro-economicslowdowningrowthisdetermined.Optimisticallyspeaking,wi11drop0.2
16、-0.5percentagepoints,pessimisticalIyspeaking,maydecrease12percentagepoints.Judgingfromthecurrentsituation,althoughthefirstfourmonthsthisyear,Chinastaxrevenueincreasedby30%,reaching727billionyuan,afigureequivalentto1.89trillionyuanlastyearstotaltaxrevenueof38.46%.Butthefirst-quarterrevenuehasgrownrap
17、idlyandeconomicgrowth,taxcutswouldbeoffsetbydecline.AccordingtotheStateAdministrationofTaxationestimatesthattheimpactofeconomicslowdown,taxrevenuethisyearmaybereducedby300billionyuan(U.S.industrywillbe11efitfromthetaxrevenuegrowthanddamagetotheindustrytoreducethetaxrevenuetakenintoaccount).Otherfina
18、ncialcharges,andfundswillnaturallyslowdownasthepaceofeconomicgrowthanddeciine,al1ofwhichbroughtaboutthecurrentSARScrisis,thehiddenfinancialexpenditure,whichisanotasmallnumber.ChinasfiscalexpenditureonpublichealthanalysisofthesituationtotalhealthexpenditureistheWorldHealthOrganization(WHO)tomeasureth
19、etotalinvestmentingeneralhealthindicators.Itincludesthegovernmentbudgetpubichealthwasdeciining.Thedecade1991-2000,Chinastotalhealthcostsfromthetotalamountofthepresentyearbyyeargrowthtrend.Nevertheless,fromtheinternationalcomparison,Chinaspercapitahealthexpenditureintheworldrankingof191countriesin141
20、,stilllowlevel.Thetotalcostofhealth,thegovernmentbudget,totalexpenditureonhealthhasalsoincreasedyearbyyear,from1991s20.23billionyuanto70.95billionyuantoincreasein2000,itaccountsfortheproportionoftotalhealthexpendilurehasdeclined,from22.8%in1991to2000to14.9%,residentsofpersonalhygieneexpenditureinthe
21、pastdecadeshowrapidgrowthmomentumin1991accountedfor38.3%oftotalhealthexpenditurein2000increasedto60.6%.11canbeseenthatchangesinthecostofChinastotalhealththesituationisadirectreflectionofChinashealthinsurancesystemreform,thatis,theplannedeconomyeraofthepubliclyfundedhealthcaresystemhasbeencompletelyb
22、roken,ourpopulationstartedtobecomeamajorburdenforhumanhealthexpenditure.However,theSARScrisis,Youjiusaquestion,thatwhilegovernmentspendingonhealthwillnolongerbeaburden,butthegovernmentpublichealthspendingisenough?-Fromthepublichealthservicesforthehealthfundsindicators,itsfinancialexpenditureasapropo
23、rtionofthedecliningtrend:Governmentfundingforpublichealthservicesisincreasingthetotalfunding,butitisinthenationalfinancialexpenditureasaproportionofthedecliningtrendfrom2.36%in1996to2000,1.71%.ThisisevidentfromonesidetoreflectthoseinChinaexpenditureonpublichealthservices,thegrowthrateofGDPgrowthandt
24、heratioisveryinconsistent,atleastthereisnoguaranteetheconsistencyoftrends.Thisistheinternationaleconomicdevelopment,increaseinvestmentinpublichealthatthesametimedifferentfromthecommonpractice.Aseriousshortageoffinancepublichealthexpenditures.Tnthisregard,itseemsthatcanhelpustoidentifytheSRScrisis.Ch
25、inaspublichealthsystemunpreparedpartofthereasonwhy.-Fromhealthfundsuseof,Chinaspublichealthexpendituretopreventivehealthcareandaverysmallproportionoftheruralgrass-rootsWHOChinaspublichealthprovision,medicalinstitutionstoensurethefocusofinvestmentisfunded,althoughthetotalfundingforhealthfrom1994to199
26、7,increasedyearbyyear,butthehospitalsabovethecountylevelofoperatingexpensesexpendituresaccountedforthelargestproportionoftotalexpendilure,ifthehospitalsandthesumoftheproportionofChinesemedicinehospitalsinurban64.2%,56.5%inruralareas;forthetownship(neighborhood)hospitalsintheproportionofsubsidy,urban
27、9.6%,rural23.8%:fortheproportionofpreventivecare,urban13.2%,rural15.6%.Inotherwords,thecurrentgovernmenthealthexpenditureismainlyusedformedicalinstitutions,especiallyhospitalsabovecountylevel,andaremainlypersonnelexpenditures,whileforruralprimaryandpreventivehealthcareserviceslowerproportionofthecos
28、t.RepostedelsewhereinthepaperforfreedownloadFromthepubichealthgains,Chinasexpenditurestofocusonlyonpreventionofcommondiseasescontrol,andlackofacomprehensivediseasepreventionandepidemicresponsesystemandtheabilitytoburstBenefitfromapublichealthperspective,preventionofdiseasedespiteoursmallnumberoffina
29、ncialinvestment,Chinasdiseasepreventionandachievedgoodresults,theresidentsgraduallyincreasedlevelofhealth,infectiousdiseasemortalityhasdecreasedtosomeextent,indicatesthatChinastheefficiencyofhealthservicesisrelativelyhigh.ThisseemstotheSRScrisis,themediacoverageofthepoorperformanceofChinasdiseasepre
30、ventionandagreat-lookingstatements.So,intheendtheproblemliesinthewrong?Firstofal1,thisyearsowell,thecauseofChinasdiseasepreventionisthepreventionoflong-termeffortsincethefoundingoftheresult,manydiseaseshavehadagoodvaccine,anditsincidenceinrecentyears,beguntofall.Second,theexistingstatutorydiseasepre
31、ventionhasbeenontherighttrack,theresidentsimprovedeconomicconditionsandthepurchaseofinvestmentproducts,toincreaseimmunization,andalarge-scaleoutbreaksofinfectiousdiseasesinrecentyears,thenumberoflow,sothelowertheannualinvestmenttoensurethehealthofresidentscanalsobe.Thirdly,itisagoodfoundationhasbeen
32、achievedonthecarelessneglectofthesanitationandepidemicpreventionsystem,theconstructionandstrengtheningofepidemicprevention,itmakesthisnewemergingSARSvirusesaresorampant.ThisalsoexposedthehealthandepidemicpreventionworkinChinasshortcomingsandweaknesses,namely,raisethelevelofmedicalcaretoday,healthand
33、quarantineinfrastructureconstruction,medicalequipmentanddiseasepreventionresearchworkhasnotbeenactivelydeveloped.And,inthepublichealthepidemicpreventionsystem,weonlyattachimportancetohaveasimplediseaseprevention,lackofvigilanceofnewepidemicsandinfectiousdiseases,newtypesofdiseases,poorresearchandres
34、ponsecapacity,lackofsuddenemergencyresponsemechanism.Candrawsuchaconclusion,intheprocessofmarket-orientedreforms,Chinasfinanceinthepubichealthepidemicpreventionsystem,thepositionwas,infactweakened.Therefore,thefinancialpubichealthexpenditure,weshouldmakeanewthinking.djustthedirectionofChinasfiscalex
35、pendilureonpublichealthrecommendations-identifythegovernmentbuildinginpublichealthposition,increasetheproportionofhealthspendinginthisfiscalcrisis,sothatwerecognizethatgovernmentspendingonhealth,thepublicgoodsandquasi-thefieldofpublicgoods,shouldplayamoreimportantrole,wemustquestiontheprocessofre-un
36、derstandingofmarket-orientedreformsingovernmentfunctionsandpositioning.ForabearingonthequalityofpeoplesIivelihood,andlabor-pub1ichealthproductsinthemarkettoprovideflawed,theGovernmentshouldplayaverygoodsupportprovidedbyitspublicfunctions.Therefore,publichealthproducts,financeshouldbetheirmostsignifi
37、cantinputinperson.Budgetexpendituresinthefuture,theGovernmentshouldberapidgrowthinrecentyears,revenuecases,withgoodrevenuegrowthinfiscalrevenues,andotherpartsoftheestablishmentofalegalguaranteeofastablesourceoffundingandtheuseofmonitoringmechanisms.-Financialhealthexpenditureshouldincreasetheproport
38、ionofexpenditureonpreventivehealthcare,ourhealthcaresysteminthe2Othcentury,carriedout90yearsafterthetargetmarketintothereformofthefinancialburdentooheavytoaddresstheproblem.tthesametime,market-orientedhealthcaresystemhasalsobroughtanumberofrelatedissues.First,thehospitaisystemshouldhaveamarketregula
39、tion,hasreceivedfinancialsupportfromthegovernment(whichcanbeseenfromthefrontofthedata).Second,thelackoffinanceforinvestmentinpublichealth,resultingintheGovernmentshouldsupportthismovetowardmarket-orientedratherthandiseasepreventionsystemhasnotreceivedenoughfinancialsupportsothatthelong-termprimarypr
40、eventionandemergencymanagementinastateoflackoffunds.Third,subjecttomarket-orientedpatternofdramaticchangesinincomedistribution,theimpactofgrass-rootshealthandepidemicpreventionwork,thefocusshiftedtovarioustypesofrevenue-generatingservices,healthandepidemicpreventiondepartmentsatal1levelstousepublich
41、ealthfacilitiesprovidemarketingservicestoraisefundsandtakethepaidservicesoftheroad,Thisinevitablymakesthepublicepidemicpreventionsystembytheimpactofsectoralinterests,affectingthehealthsystemtodealwithmajordiseaseoutbreaksandemergenciesofadaptability.Thecrisis,sothatweclearlyseeinthemarketeconomytran
42、sitionprocess,theGovernmentinvestmentinpublichealthandmanagementintheabsenceandoffsidebehavior,therefore,shouldadjustgovernmentbehaviorandfiscalexpenditurestructure,increasethegovernmentindiseaseinputtopreventthecauseofreasonablepreventiveworkmanagementfortheresidentsandNationalDevelopmenttobuildafi
43、rst1ineofdefense.-Shouldbearationalallocationofemergencymedicalincidentspre-andpost-investmentrat100finputs,increasetheproportionoffiscalexpenditureinadvancetopreventInChinasfiscalexpenditureintherange,havelonghadanemergencymedicalincidentsrescuethiselement.Althoughthepreventivemeasures,toguideourlo
44、ng-termhealthofanimportantspirit,buttheemphasisonpost-treatmentofideasandtherealityformanyyearswithoutmajorepidemics,resultinginsuddenSRScrisisinourcountryspublichealthsystemwithstoodaseveretest,andleadtothecentralandlocalbudgetsatalllevelsthisyear,aone-timeexpenditureofupto100billionyuantothisyears
45、budgetfortheimplementationofgreatdifficulties.Therefore,wemustputintooperationbeforeandafterdealingwithagoodratiobetweeninputs.Beforeandafterinvestmentinapre-inputtime-consuming,andrequirethecontinuityofmulti-yearinvestmentandconstruction,sothetotalcapitalinvestmentmaybelarge,butthespecificinputsofe
46、achyearisnottoomuch.Inaddition,comparedtopre-investmentduetolackofinvestmentcausedbysubsequentincreases,harmfullevelsofincreaseandthesubsequentincreaseinreplacementcostterms,theimportanceofsuchinputsisevenmoreevident.Therefore,thepre-andpost-investmentrat100finputsandrelationships,whichdeterminethec
47、onfigurationofthispartoftheefficiencyofpublicresources,butalsotosomeextentdcterninetheemergencyresponsecapacityforcrisismanagement.Inaddition,theurgentneedtoestablishsuitableconditionsofourcountrysruralmedicalsecuritysystem,pre-buildingsystem.Otherwise,oncetherearenewepidemicsorotheroutbreaksofthedi
48、seaseintheruralareas,thatlosswillbeevenmoredevastatingandunimaginable.Therefore,increasingthefinancialstrengthofthepreventionofhealthspendingisalong-termbenefitsandshort-terminterestsoftherelationshipbetweentheshort-termeconomicgrowthandlong-termeconomicdevelopmentrelationship.Repostedelsewhereinthepaperforfreedownload
