Spending In China Research Articles

The impact of mental and physical multimorbidity on healthcare utilization and health spending in China: A nationwide longitudinal population-based study.

In China, little evidence exists on the effect of mental and physical multimorbidity on individuals and the health system. This study aims to examine the prevalence of mental-physical multimorbidity and its impact on health service utilization and health expenditures. We conducted a panel study using two waves of data (in 2011 and 2015) from the China Health and Retirement Longitudinal Study, including 10,181 participants aged 45 years and older. Generalized linear regression models were used to assess the association of multimorbidity with total health expenditure and out-of-pocket expenditure (OOPE) on outpatient and inpatient care. Random-effects logistic regression models were used to examine the impact of multimorbidity on outpatient visits, admission to hospital and incidence of catastrophic health expenditure (CHE). Overall, 3210 participants (31.53% of 10,181) had mental-physical multimorbidity in 2015 in China. Compared to patients with a single physical disease, individuals with physical-mental multimorbidity had over 150% of the increase in the number of outpatient visits and days of hospitalization. The percentage change of OOPE for outpatient and inpatient care was 156.8% and 163.6%, respectively. Mental-physical multimorbidity was associated with an increased likelihood of experiencing CHE (OR = 2.205, 95% CI = 2.048, 2.051). Multimorbidity, particularly mental-physical multimorbidity, is associated with higher levels of health service use and a greater financial burden to individuals in China. Healthcare system needs to shift from single-disease models to new financing and service delivery models to more effectively manage mental-physical multimorbidity.

Guns and Butter in China: How Chinese Citizens Respond to Military Spending

AbstractMilitaries are sustained by public money that is diverted away from other domestic ends. How the public react to the “guns-versus-butter” trade-off is thus an important question in understanding the microfoundations of Chinese military power. However, there are few studies on public attitudes towards military spending in China, whose rising power has been a grave concern to many policymakers around the world. We fielded a national online survey to investigate the nature of public support for military spending in China. We find that Chinese citizens support military spending in the abstract, but their support diminishes when considered alongside other domestic spending priorities. We also find that public support for military spending coexists surprisingly with anti-war sentiments and a significant strain of isolationism. In addition, while the conventional wisdom suggests that nationalism moves a state towards bellicosity and war, we find that Chinese citizens with a stronger sense of national pride report stronger anti-war sentiments than other citizens.

What Drives Health-Care Spending in China? A Nationwide Decomposition Analysis

In this study, we explore the geographic variation in health-care spending and its driving factors in China, using a nationwide and claim-level sample of inpatients ensured under the urban basic medical insurance schemes in 2010. We show geographic variation in health-care spending is substantial in China and is significantly larger than Medicare spending in the US. The substantial geographic variation is primarily driven by the quantity variation. We also discuss the potential correlates of the quantity of health care at the city level. The findings imply possible allocation inefficiency in China’s current urban health-care system.

БЮДЖЕТНОЕ ФИНАНСИРОВАНИЕ СОЦИАЛЬНО-КУЛЬТУРНОЙ СФЕРЫ РОССИИ И КИТАЯ: СРАВНИТЕЛЬНЫЙ АСПЕКТ

The article analyzes the indicators of the budgetary financing of the sociocultural sphere in 2008–2017 based on the official statistical reports by Russian and Chinese authorities. Within the framework of structural analysis of budget expenditures in both countries, the priority of these areas for the expanded budget of the Russian Federation has been identified, whereas the sociocultural block is given only a small share in the structure of the state budget expenditures of the People’s Republic of China. The analysis of the dynamics of the budgetary spending on social and cultural events during the studied period showed a significant increase in such spending in China, with a slowdown in growth in Russia. Special attention was paid to the analysis of expenditures on the sociocultural block in the GDP volume. It was found that the Russian spending on sociocultural events in the GDP volume was gradually approaching the numbers in developed countries. This corresponds to the global trends in the leading countries characterized by increased expenditures on social protection due to the influence of factors such as the aging of the population, declining birth rates, and increasing unemployment. It is emphasized that China’s spending on sociocultural events in the GDP volume is significantly inferior to the indicators of the world’s leading economies and is aimed more at financing education, which is justified by the conditions of the “catching-up” stage. The author concludes that modern threats and challenges determine the need to adjust priorities and volumes of the state funding of sociocultural activities in China and Russia.

Impacts of Government Reimbursement Negotiation on Targeted Anticancer Medication Price, Volume and Spending in China

Impacts of Government Reimbursement Negotiation on Targeted Anticancer Medication Price, Volume and Spending in China

Linkages between Trade, CO2 Emissions and Healthcare Spending in China.

China has remained top among the carbon dioxide (CO2) emitting countries in the world, while it has a significant contribution to world trade after World Trade Organization (WTO) reforms in China. The dramatic increase in CO2 emissions has been witnessed. This study examines the linkages between trade openness, CO2 emissions, and healthcare expenditures in China using time series data for the period 1990–2017. The study extended a theoretical model by adding healthcare expenditures, CO2 emissions, and trade openness with some constraints. We used simultaneous equation method for the analysis, and the outcomes suggest that trade is significantly affecting the CO2 emissions in the country, resulting in an increase of healthcare expenditures. The government needs reforms and trade policy embodied green energy consumption in the industrial sector, especially in export sector industries. In addition, carbon tax may be an important tool to reduce CO2 emissions and it may compensate the healthcare spending in the country.

Effects of FDI on the Efficiency of Government Expenditure on Environmental Protection Under Fiscal Decentralization: A Spatial Econometric Analysis for China.

Most governments strive for an ecological civilization so the efficiency of government expenditure on environmental protection (EPEE) is an important issue. While it is recognized that foreign direct investment (FDI) enhances environmental protection, this investigation focuses on the effects of FDI on the efficiency of government expenditure on environmental protection under fiscal decentralization. Analysis is conducted using an output-oriented data envelopment analysis (DEA) scale return model to calculate the efficiency of environmental protection spending in China. Then, a spatial model is built to test the linkages among FDI, fiscal decentralization and the efficiency of government expenditure. The results reveal that, firstly, the efficiency of government spending has been enhanced over the last 10 years. Secondly, FDI is positively correlated with the efficiency of government environmental expenditure in terms of both quantity and quality of spending and it has a positive spillover effect. Thirdly, financial decentralization is negatively correlated with the efficiency of environmental spending, but it improves the effect of FDI. Accordingly, policy proposals are that the government should improve the supervision system for environmental spending and local governments should pursue FDI, improve the structure of FDI and use its spillover effect to enhance the efficiency of environmental expenditure.

Economic fluctuations, volatility changes and the role of government spending in China: A structural analysis

AbstractWe study the economic fluctuations in China by using a standard neoclassical general equilibrium model to provide a structural analysis. We have carefully constructed measurements for economic variables from Chinese data to be consistent with the literature. We show that the government spending behaviour plays an important role in accounting for the changes in the pattern of both absolute and relative volatilities. Although we find that a general moderation in economic fluctuations after 1978 can be largely explained by the total factor productivity (TFP) process, TFP itself cannot explain the change in the pattern of relative volatilities. We show that policy changes in government spending can account for the relative volatility divergency. Counterfactual experiments are also provided to discover the role of each factor in explaining the economic fluctuations in China.

Passing the food and agricultural R&D buck? The United States and China

The global geographical balance of food and agricultural R&D spending is shifting, characterized by a declining U.S. share and a rising middle-income-country share, propelled heavily by the rapid rise of spending in China. Based on our newly compiled data, we estimate that China now outspends the United States on both public and private food and agricultural research on a purchasing power parity basis. The public-private orientation of the research has also changed markedly, with the private sector now accounting for around two-thirds of the food and agricultural R&D spending total in both China and the United States. Our estimates indicate that China’s private sector tilts heavily towards post-farm R&D activities, whereas the U.S. private sector is split more evenly between on-farm and post-farm spending. While the intensity of Chinese investment in food and agricultural R&D (relative to agricultural GDP) is beginning to grow, it still lags well behind the food and agricultural R&D investment intensities of the United States and other higher-income Asian countries (e.g., Japan and South Korea). The development regularities we reveal in the longer-run trends are indicative of future R&D investment patterns with potentially profound long-run implications for the size, shape and accessibility of the global stocks of scientific knowledge that underpin food and agricultural sectors worldwide.

Military Spending and the Sino-US Arms Race: An Analysis Using Bootstrap ARDL

This paper used the newest bootstrap ARDL model to explore a Sino-US arms race and the correlation between military spending and gross debt between China and the United States covering the period from 1995 to 2016. The results showed that military spending positively affected gross debt, while gross debt negatively affected military spending in China and the United States. Furthermore, from the Chinese point of view, when China’s economy was prospering, a Sino-US arms race took place by separately using interest rates and gross debt of China and the US as control variables to explore the Sino-US arms race. If logically speaking, there had been a Chinese economic recession, military spending would have been crowded out, and the Sino-US arms race may not have happened. From the perspective of the US, the US is threatened by China's rapid economic growth which triggers the United States to initiate a Sino-US arms competition.

Geographical Leadership Mobility and Policy Isomorphism: Narrowing the Regional Inequality of Social Spending in China

The link between geographical leadership mobility and policy isomorphism is rarely discussed in the extant literature. We argue that the geographical leadership mobility encourages local executives to converge their development experiences in their original working jurisdictions and their current positions. The distinct Chinese political personnel system provides an ideal environment that allows researchers to examine the isomorphic effects of geographical leadership mobility. This research builds a dataset of local social spending between 1998 and 2011 as well as a database of the leadership mobility history of provincial executives in China. Results of the spatial panel analysis (SPA) demonstrate that the geographical leadership mobility (i.e., horizontal, top‐down, and bottom‐up) of governors stimulates the regional isomorphism of provincial education and health care spending. The empirical findings affirm the effectiveness of the effort of the Chinese central government in narrowing the regional inequality of social welfare provision through the geographical mobility of local leadership.

Sex-Disaggregated Employment and Public Spending in China

This paper econometrically analyses the relationship between public spending and women's and men's urban employment in China for the period 1999–2009. Theoretically, spending on healthcare and education could increase employment growth and women's relative employment via the expansion of paid care work (increasing labour demand) and reductions in unpaid labour (increasing labour supply). To empirically test this, female, male, and relative employment growth are estimated as functions of public spending while both demand-side and supply-side factors are controlled for. Economic growth is also included in a simultaneous equation estimation. While healthcare results are mixed, education spending is positively associated with economic growth, employment growth for both women and men, and women's relative urban employment. Using economic significance calculations, I describe how well-directed public policies can promote both economic growth and long- and short-run benefits in employment equality between the sexes.

Macroeconomic effects of government spending in China

AbstractGovernment spending plays an important role in determining economic performances in China. Its macroeconomic effects are analysed in this paper. We show that government spending in China Granger‐causes output, consumption and investment booms as well as inflation, and has a multiplier larger than 1. The large multiplier effects are found not only in aggregated time‐series data but also in panel data at the provincial level. We also provide a theoretical model and Monte Carlo analysis to rationalize our empirical findings. Our theoretical and Monte Carlo analyses support the large multiplier found in China but also suggest that government spending is not necessarily a free lunch in spite of the large multiplier effects.

Depression hurts, depression costs: The medical spending attributable to depression and depressive symptoms in China.

Due to its fast economic growth and lifestyle changes, China is experiencing a rapid epidemiological transition from communicable to noncommunicable diseases (NCDs). Mental disorder such as depression is an important yet often neglected NCD and is becoming a growing cause of disability, suicides, and disease burden. This paper provides the first nationally representative estimate of the medical cost attributable to depression and depressive symptoms among the adult population in China. On the basis of the 2012 China Family Panel Studies survey, our results indicate that these mental health conditions have significant impacts on the individual medical expenditure, and they jointly contribute to 14.7% of total personal expected medical spending in China, with depression and depressive symptoms accounting for 6.9% and 7.8%, respectively. Given that patients with mental illness face multiple psychological and institutional barriers in seeking appropriate treatment, the high depression-induced medical costs may be primarily driven by the cost-shifting effect from mental health care to general health care, as mental disorders often coexist with other NCDs such as diabetes and hypertension. As an implication, our study calls for an urgent reform of China's mental health and insurance systems to remove the policy-induced obstacles for the access to mental health care resources.

Intergovernmental Fiscal Relations and Military Spending in China, 1980–2013

Based on quantitative and normative analyses, this article finds that China’s military budget in the post-Mao era benefits from the central government’s advantageous position in national revenue distribution under the 1994 tax-sharing scheme. Memoirs of political and military elites have shown that military needs were actually a major concern for the launch of tax reform, which subsequently facilitated changes in the fund allotment of the People’s Liberation Army from Deng Xiaoping’s “military shall endure” (军队要忍耐 jundui yao rennai) approach, to “self-improving, self-developing” (自我完善 自我发展 ziwo wanshan ziwo fazhan) commercialisation, and to Jiang Zemin’s “eating imperial grain” (吃皇粮 chi huangliang) reform.

Guns for Butter? Empirical Evidence from China

This study examines the causal nexus between defence spending and education expenditure in China using the bootstrap Granger full-sample causality test and sub-sample rolling window estimation. The full-sample result indicates that there is no causality between defence spending and education expenditure. By adopting a time-varying rolling window approach to revisit the dynamic causal relationships, this article identifies a negative unidirectional causality running from education expenditure to defence spending. The finding suggests that it is the education expenditure crowds out defence spending in China rather than reverse. No causality is demonstrated from defence spending to education expenditure, indicating that an increase in military spending will not crowd out expenditure on education. The results could be partly explained by that the education expenditure in China is below the requirement of corresponding economic growth, urging for more financial budget. Whereas the findings support a negative trade-off between defence and education expenditures, they refute the theory of ‘guns for butter’.

An Empirical Study on the Relationship Between Advertising Spending, Network Channel and Retail Enterprise Performance

Theoretical analysis shows that advertising spending, network channel performance is related with the retail enterprise, this article uses the data of listed companies in 2015 retail research retail business advertising spending in China and the relationship between corporate performance and the network channels opened in the retail business performance, the conclusion, found that advertising spending influence on the performance of retail enterprises under the influence of retail enterprise scale, retail enterprise scale is larger, the more advertising spending, retail enterprise performance, the better; Network channels to the opening of the negative influence to the retail business performance, but advertising spending more enterprises open network channels will promote the retail business performance. Retail enterprises should base on their own actual decision-making and should not blindly follow the trend to pay for a large number of advertising expenses and open network channels.

Consumer Technology Readiness and E-Service Quality in E-Tailing: What is the Impact on Predicting Online Purchasing?

ABSTRACTTotal online retail spending in China reached $427 billion in 2014 and is expected to surpass $1 trillion in 2018 (Chu and Wong 2015). In addition, the number of online stores in China has been rapidly increasing. The present study proposes a model based on the theoretical frameworks of technology readiness (Parasuraman et al. 2005) and e-service quality (Parasuraman and Malhotra 2005), and tested the model on consumers from China. The results indicate that consumer technology readiness positively influences the perceived efficiency, system availability, fulfillment, and privacy dimensions of e-service quality as it relates to the online retailing environment in China. Moreover, the influence of technology readiness on the intention to purchase online in the future is both direct and mediated by the dimensions of perceived e-service quality. Implications and future research suggestions are also discussed.

Infrastructure Spending in China Increases Trust in Local Government

Following the 2008/9 financial crisis, China instituted a 4 trillion RMB stimulus package that was spent mostly on infrastructure, with a particular impact at local level. The goal was to sustain economic growth and preserve social stability. We use the Asian Barometer surveys from shortly before and after the stimulus to examine its impact on public trust in government, and find a reversal of a previous downward trend and a substantial increase in trust in local government post stimulus. We consider a number of alternative explanations for this increase in trust, and conclude that the stimulus package is the most convincing explanation. Both perceptions of corruption and experience of corruption increased over the stimulus period. Given the strong negative correlation between corruption and trust, this implies that trust would have increased even further if the level of corruption had remained the same.

Taxation without representation: local fiscal response to intergovernmental transfers in China

This paper studies the effects of intergovernmental transfers on local public spending in China, an authoritarian country where local politicians are not largely accountable to residents. The identification exploits a discontinuity from the central government’s designation of National Poor Counties. We find that additional transfers to county governments increase local public spending one-for-one. We further confirm that counties receiving additional transfers do not reduce the effective tax burden borne by firms. The results echo the empirical anomaly of the flypaper effect found in developed economies under democratic governments.