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Fiscal Decentralization, Chinese Style: Good for Health Outcomes?

  • Jütting, Johannes P.
  • Uchimura, Hiroko

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 with 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://econstor.eu/bitstream/10419/19872/1/Juetting.pdf
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Paper provided by Verein für Socialpolitik, Research Committee Development Economics in its series Proceedings of the German Development Economics Conference, Göttingen 2007 with number 16.

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Date of creation: 2007
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Handle: RePEc:zbw:gdec07:6539
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  1. 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.
  2. 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.
  3. Jorge Martinez-Vazquez & Baoyun Qiao & Shuilin Wang & Heng-fu Zou, 2008. "Expenditure Assignments in China: Challenges and Policy Options, Public Finance," CEMA Working Papers 329, China Economics and Management Academy, Central University of Finance and Economics.
  4. International Monetary Fund, 2004. "Toward More Effective Redistribution; Reform Options for Intergovernmental Transfers in China," IMF Working Papers 04/98, International Monetary Fund.
  5. Tochkov, Kiril, 2007. "Interregional transfers and the smoothing of provincial expenditure in China," China Economic Review, Elsevier, vol. 18(1), pages 54-65.
  6. Jin, Jing & Zou, Heng-fu, 2005. "Fiscal decentralization, revenue and expenditure assignments, and growth in China," Journal of Asian Economics, Elsevier, vol. 16(6), pages 1047-1064, December.
  7. Xiaobo Zhang & Ravi Kanbur, 2004. "Spatial Inequality in Education and Health Care in China," Working Papers 159, Institute for Social and Economic Change, Bangalore.
  8. Pranab Bardhan, 2002. "Decentralization of Governance and Development," Journal of Economic Perspectives, American Economic Association, vol. 16(4), pages 185-205, Fall.
  9. Charles M. Tiebout, 1956. "A Pure Theory of Local Expenditures," Journal of Political Economy, University of Chicago Press, vol. 64, pages 416.
  10. Bird, Richard M., 1993. "Threading the Fiscal Labyrinth: Some Issues in Fiscal Decentralization," National Tax Journal, National Tax Association, vol. 46(2), pages 207-27, June.
  11. de Mello, Luiz Jr, 2000. "Fiscal Decentralization and Intergovernmental Fiscal Relations: A Cross-Country Analysis," World Development, Elsevier, vol. 28(2), pages 365-380, February.
  12. Zhang, Xiaobo, 2006. "Fiscal Decentralization and Political Centralization in China: Implications for Growth and Inequality," Working Paper Series RP2006/93, World Institute for Development Economic Research (UNU-WIDER).
  13. Robalino, David A. & Picazo, Oscar F. & Voetberg, Albertus, 2001. "Does fiscal decentralization improve health outcomes? - evidence from a cross-country analysis," Policy Research Working Paper Series 2565, The World Bank.
  14. Era Dabla-Norris, 2005. "Issues in Intergovernmental Fiscal Relations in China," IMF Working Papers 05/30, International Monetary Fund.
  15. Hehui Jin & Yingyi Qian & Barry Weingast, 1999. "Regional Decentralization and Fiscal Incentives: Federalism, Chinese Style," Working Papers 99013, Stanford University, Department of Economics.
  16. Oates, Wallace E, 1985. "Searching for Leviathan: An Empirical Study," American Economic Review, American Economic Association, vol. 75(4), pages 748-57, September.
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