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Fiscal Decentralization, Chinese Style: Good for Health Outcomes?

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  • Uchimura, Hiroko
  • Jutting, Johannes
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    Abstract

    This study analyzes the effect of fiscal decentralization on health outcomes in China using a panel data set with nationwide county-level data. We find that counties in more fiscal decentralized provinces have lower infant mortality rates compared to those counties in which the provincial government retains the main spending authority, if certain conditions are met. Spending responsibilities at the local level need to be matched with county government's own fiscal capacity. For those local governments that have only limited revenues, their ability to spend on local public goods such as health care depends crucially upon intergovernmental transfers. The findings of this study thereby support the common assertion that fiscal decentralization can indeed lead to more efficient production of local public goods, but also highlights the necessary conditions to make this happen.

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    File URL: http://ir.ide.go.jp/dspace/bitstream/2344/600/3/ARRIDE_Discussion_No.111_uchimura.pdf
    File Function: First version, 2007
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    Bibliographic Info

    Paper provided by Institute of Developing Economies, Japan External Trade Organization(JETRO) in its series IDE Discussion Papers with number 111.

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    Date of creation: Jul 2007
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    Publication status: Published in IDE Discussion Paper. No. 111. 2007.7
    Handle: RePEc:jet:dpaper:dpaper111

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    Related research

    Keywords: Fiscal decentralization; Health outcomes; China; Fiscal policy; Decentralization; Local government; Public health;

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    1. Jing Jin & Heng-fu Zou, 2004. "Fiscal decentralization, revenue and expenditure assignments, and growth in China," CEMA Working Papers 169, China Economics and Management Academy, Central University of Finance and Economics.
    2. Zhang, Xiaobo & Kanbur, Ravi, 2005. "Spatial inequality in education and health care in China," China Economic Review, Elsevier, vol. 16(2), pages 189-204.
    3. Emanuele Baldacci & Maria Teresa Guin-Siu & Luiz De Mello, 2003. "More on the effectiveness of public spending on health care and education: a covariance structure model," Journal of International Development, John Wiley & Sons, Ltd., vol. 15(6), pages 709-725.
    4. Filmer, Deon & Pritchett, Lant, 1999. "The impact of public spending on health: does money matter?," Social Science & Medicine, Elsevier, vol. 49(10), pages 1309-1323, November.
    5. Jin, Hehui & Qian, Yingyi & Weingast, Barry R., 2005. "Regional decentralization and fiscal incentives: Federalism, Chinese style," Journal of Public Economics, Elsevier, vol. 89(9-10), pages 1719-1742, September.
    6. Pranab Bardhan, 2002. "Decentralization of Governance and Development," Journal of Economic Perspectives, American Economic Association, vol. 16(4), pages 185-205, Fall.
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