政府医疗卫生支出结构——基于省际与国际对比

Government Health Expenditure Structure—Based on Provinces and International Comparison

摘要: 本文从医疗卫生支出结构以及我国政府与的医疗支出与其他国家的支出结构比较分别展开研究，分析我国医疗卫生支出中的结构问题。发现医疗保障支出开始在政府医疗卫生支出中占据重要地位，显示政府医疗卫生支出向需求方倾斜，政府卫生政策从供给方为主向需求方的重大转变；人均政府卫生支出各省份投入极不均衡；按全国三个区域平均分配来看，三个区域的人均政府卫生支出西部地区大于东部地区，而东部地区大于中部地区，中部地区的人均政府卫生支出水平最低。总体看中央财政收入仍占有较大比重，而中央财政医疗卫生支出的增长幅度要远低于国家财政医疗卫生支出的增长幅度。国际比较中，中国中央政府卫生支出占GDP的百分比很低，除了在中央和地方支出结构上存在负担结构失衡，在省级、市级政府以及地级、乡镇级政府负担结构上同样存在此问题。最后针对存在的问题，提出相应政策建议。

Abstract: This paper analyzes the structural problems of medical and health expenditure in China from the aspects of medical and health expenditure structure and the expenditure structure of medical expenditure between our government and other countries. It is found that medical insurance spending occupied an important position in government health expenditure at the beginning, indicating that the government health care spending tilts to the demand side, the government health policy changes from the supply side to the demand side. Per capita government health expenditure investments in provinces are very uneven. According to the three regional average distributions, per capita government health expenditure in the western region is greater than the eastern region, while the eastern region is greater than the central region, which means per capita government health expenditure of the central region is in the lowest level. Overall, the central government still accounts for a large proportion of revenue, and the central financial health expenditure growth rate is much lower than the national financial and health expenditure growth. In the international comparison, the percentage of China's central government's health expenditure as a percentage of GDP is very low. In addition to the structural imbalance in the central and local expenditure structure, this problem is also present at the provincial, municipal and prefecture-level governments. Finally, according to the existing problems, the corresponding policy recommendations are putting forward.