【作者】 吕娜；

【导师】 邹薇；

【作者基本信息】 武汉大学 ， 西方经济学， 2011， 博士

【副题名】基于私人与公共健康投资的内生增长模型和实证分析

【摘要】 健康人力资本,是不同于教育人力资本的另一种人力资本形式。健康不仅是使人类生活体现价值的基本潜能之一,也对经济增长做出重要的贡献。纵观世界各国经济发展的历史进程,健康人力资本发挥着巨大的作用。健康人力资本匮乏的社会往往会遇到多种经济发展障碍,相反,经济史上一些国家巨大的经济腾飞都是以公共卫生、疾病控制和改善营养摄入等方面的重大突破为后盾。历史事实证明,健康人力资本一定程度上促进了国家经济的增长。健康人力资本积累主要依赖于来自私人的健康投资和来自政府的公共健康投资,现有的理论模型和经验研究均肯定了健康投资的重要意义,却没有区别分析私人和公共健康投资的不同效应,因此研究呈现了截然不同的结论。私人健康投资和公共健康投资行为对经济增长的影响方式存在差异,因此将任一方的健康投资代替健康总投资以此所做的理论和实证研究都是缺乏科学性的。本文将健康投资分为私人健康投资和公共健康投资,构架内生增长模型分析两者对健康人力资本积累和经济增长的效应,并进行实证分析验证理论结论。本文的理论模型是在政府支出、健康人力资本和物质资本的三部门内生增长框架下,分析私人和公共健康投资所决定的健康人力资本对经济增长的效应。家庭效用最大化的选择行为和政府的社会福利最大化的选择行为形成动态博弈,本文运用逆向归纳方法分别得到了家庭的分散均衡和政府的社会最优均衡。比较静态分析和转移动态分析表明,私人健康投资和公共健康投资对健康人力资本积累和经济增长至关重要,缺少任一方将会导致经济停止增长甚至出现负增长；在发展中国家,私人健康投资对经济增长始终具有正效应,而在发达国家私人健康投资与经济增长呈现“倒U型”关系；私人健康投资与公共健康投资之间呈现既替代又互补的关系,需要根据国家的收入水平、税率水平、已有健康人力资本存量和基础设施支出的产出贡献等因素综合判断。本文的实证分析首先采用了CHNS的微观面板数据。采用固定效应模型和随机效应模型分析了私人健康投资和公共健康投资对个体健康状况和个人收入的效应,实证结果肯定了两类健康投资对个体健康状况的正效应,以及健康水平对个人收入的正效应。实证分析还表明,健康人力资本对个人收入的贡献度高达19.3%,略高于教育人力资本。且健康人力资本不仅直接影响长期收入,还通过影响教育人力资本和物质资本间接影响长期收入。中国农村地区的健康状况一直是经济学者关注的焦点,为此本文还专门针对CHNS农村样本进行了实证分析。分析结果表明,农村居民的私人健康投资和公共健康投资对其健康水平具有非常显著的正效应,私人健康投资的效应高于总体样本,而公共健康投资的效应略低于总体样本,反映出我国农村地区公共健康投资不足的事实；农村居民的健康人力资本对收入的贡献下降到16.8%,教育对收入的贡献也有所下降。而农村样本中表现出来的健康人力资本的长期收入效应不明显。此外,为了考察不同收入水平和公共健康投资水平下,私人和公共健康投资对经济增长的影响,本文还采用了三个具有代表性国家的时间序列数据进行协整分析。对三个国家分别采取MLE协整检验的结果表明,私人和公共健康投资均对经济增长存在长期正效应,美国的私人健康投资的产出贡献最高,中国的公共健康投资的产出贡献最高,而英国的私人和公共健康投资的产出贡献均处于较低水平。利用ECM模型考察三个代表性国家健康投资对经济增长的短期效应的研究表明,不论何种收入水平的国家,私人健康投资对当期经济产出均具有显著的正效应,而公共健康投资的产出正效应均需要滞后一期方能实现。这一结论说明公共健康投资对经济增长的具有较强的潜在效应,而私人健康投资能在较短时间内获得经济收益。更多还原

【Abstract】 Health human capital, unlike education human capital, is the other form of human capital. Health is not only among the basic capabilities that gives value to human life, but make a significant contribution to economic growth as well.Health human capital has played critical role for the country in the process of economic development all over the world. Societies with a shortage of health human capital tend to experience a multiplicity of severe impediments to economic progress. Conversely, several of the great "takeoffs" in economic history were supported by important breakthroughs in public health, disease control, and improved nutritional intake. These historical facts prove that health human capital promotes the economic growth of a country to a certain extent.The accumulation of health human capital mainly depends on the investment from private and public department. Both the existing theory and empirical analysis have been proving the importance of health investment for the economic growth, but none of them made a distinction between the effect of private and public health investment on growth. Therefore, the research presented very different conclusions. The way private and public health investment influent the economic growth is different, so the theory and empirical study which regard either of them as total health investment is in lack of scientific reasoning. We analyse the effect of private and public health investment on the accumulation of health human capital and economic growth in endogenous growth model, and support the conclusions with empirical analyses.The endogenous growth model includes government expenditure, health human capital and physical capital. In the model we analyse the effect of health human capital from the investment of private and public department on economic growth. The choice behavior of household for maximum utility and government for maximum social welfare form a dynamic game. We use backward induction method to establish of decentralized equilibrium and social optimal equilibrium respectively. Comparative static analyses and transitional dynamics show that private and public health investment are essential for health human capital accumulation and growth, and lack of one of them will make economic growth stop or even appear negative growth. Private health investment always generates positive effect on economic growth in developing countries, but in the developed countries, it presents inverted U-shaped relationship with growth. Private and public health investment show both substitution and complement relationship, which depend on the income level, the tax rate, the existing stock of health human capital of the country, and contribution share of infrastructure to output.In empirical analysis we adopt CHNS microscopic panel data. With fixed effects model and random effects model, we study the effect of private and public health investment on individual health status and personal income, the empirical results affirm the positive effect of the two health investment on individual health status, and the contribution of health human capital to individual income is 19.3%, which is higher than that of education human capital. Health human capital not only affect personal income directly in long-run, but also affect long-term income indirectly through education human capital and physical capital.Scholars focus on the rural resident health status in China. Therefore we also study rural sample of CHNS specifically. Results show that both private and public health investment of rural residents play very significant positive effect on their health status improvement. The effect of private health investment is higher than the one in the whole sample, and the effect of public health investment is slightly lower than the one in the whole sample, reflecting the fact that public health invest in rural areas is not enough. The contribution share of health human capital of rural residents fall to 16.8%, and the share of education human capital is also reduced. Rural sample shows that the effect of health human capital on individual income is not obvious in long-run. In addition, in order to investigate how private and public health human capital influent economic growth among the countries with different income levels and public health investment level, this paper also adopts the three representative counties’time series datum in co-integration analysis. The MLE empirical analysis shows that, private and public health investment have a positive effect on economic growth in long-run. The contribution share of private health investment to output in USA is highest, and China has highest contribution share of public health investment to output, and the share of both private and public health investment in UK are lowest among the three. Using the ECM model, we get the short-run effects of health investment in the three countries. Regardless country’s income level, private health investment has a positive effect on current output, and the positive effect of public health investment on output will appear one year later. The results demonstrate that public health investment has strong potential positive effect on growth, and private health investment can obtained return more quickly.更多还原