SARS triggered a public health issue of fiscal spending.docx

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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