【作者】 杨丽；

【导师】 陈超；

【作者基本信息】 南京农业大学 ， 农业经济管理， 2013， 博士

【摘要】 消费需求相对不足已成为制约我国经济发展的关键因素。相比西方国家消费对经济增长80%的贡献率,我国消费对经济增长50%的贡献率有很大差距。2008年,国际金融危机背景下,我国实施了积极的财政政策、适度宽松的货币政策,皆在扩大内需以振兴国民经济。现实情况是,我国城乡二元结构的存在,导致农村的教育、医疗等方面公共支出不足,不仅压制了农民自身能力的释放,降低了农民的消费意愿,而且进一步影响了整个国民经济的持续发展能力。近年来我国政府加大对农村教育和医疗的公共投入,教育和医疗的公共投入是否有助于促进农村居民消费,其作用机制是什么,教育和医疗的公共投入分别对农村居民的哪一类消费支出贡献最大,有待进一步进行实证研究。本文也正是在这种背景下着手开展教育、医疗公共品供给与农村居民消费关系的研究的,并将全文分为八章。基于我国内需不足,特别是农村居民消费水平偏低的背景,第一章提出了本文研究的问题。第二章阐述了经典的、现代的消费理论并且对我国农村居民消费的研究状况、农村公共产品供给及公共支出的消费效应进行了文献综述。基于农户理性人的假说,第三章分析了我国农户跨期消费行为,在此基础上,基于预防性储蓄和人力资本的视角分析政府教育、医疗公共品供给对农村居民消费水平及消费结构的影响机制,形成本文的分析框架。第四章分析了我国政府对农村教育与医疗的投入状况,从中可以看出我国政府对农村教育、医疗公共品供给的不足,为本文进一步研究提供了现实依据。基于教育和医疗公共支出降低居民预防性储蓄的假说,第五章利用2003-2010年我国东部、中部和西部的省际面板数据,构建实证模型并估计了三大区域教育、医疗公共品供给对农村居民消费倾向的影响。从模型估计的结果来看,在东部、中部和西部地区,公共教育支出比例增加对农民消费倾向均无显著影响。可以看出,我国政府对农村教育的投入力度长期存在不足,虽然实现农村九年义务教育,但是并没有起到降低预防性储蓄的作用,农民家庭教育负担依然很重,未来不仅要加大农村教育的投入力度,而且在投入方向和效率上也要做深一步的研究。公共医疗支出比例对三个区域的消费倾向作用方向不同。首先,公共医疗支出对东部农村居民的生活消费既有替代效应,也有互补(收入)效应,互补效应大于替代效应,农民消费倾向总体上升,公共医疗支出起到降低东部农民预防性储蓄的作用。其次,中部地区公共医疗支出的增加,对农民消费产生了挤出效应,公共医疗支出比例增加使中部地区农民增加了储蓄倾向。与以往学者研究结论不同：尽管民生性公共支出(如公共教育、公共医疗、养老保险支出等)理论上有利于降低预防性储蓄,增加居民消费倾向。但是现实中,由于医疗费用投入方向、投入效率的不同,不仅不能降低预防性储蓄,还会对消费产生抑制作用。再次,公共医疗支出比例的增加对西部地区农民预防性储蓄的下降无显著影响。当前在西部农村地区,原有的医疗条件差,相关基础设施较为薄弱,医疗公共品投入的增加,没有起到降低西部地区农民预防性储蓄的作用。此外,取消农业税政策的实行切实减轻了农民的负担,有利于降低农村居民预防性储蓄,这也间接证明了公共支出辅以配套措施的重要性。基于教育和医疗公共品供给提升人力资本的视角,第六章从东部、中部和西部三个维度展开实证,探讨教育、医疗公共品供给对农村居民消费倾向的影响。研究结果表明教育性人力资本与健康资本对不同区域农村居民生活消费的影响各不相同,而家庭人均纯收入、农业税的减免、老人抚养比例等控制变量显著影响农村居民消费倾向。首先,农村居民教育性人力资本的提升有效地促进了西部地区农村居民消费倾向,但对东部和中部地区的作用不明显。具体表现为：西部地区各省农村劳动力平均教育性人力资本每提升1%,当地农村居民消费倾向将会增加0.173%,西部农村居民受教育程度低,经济基础弱,而农村劳动力平均教育性人力资本的提升,促进了当地农民外出就业的能力,有利于家庭收入水平的提升和消费倾向的增加。其次,农村居民健康资本的提升有效地促进了东部地区农村居民消费倾向,但对中部和西部地区的作用不明显。医疗公共支出投入到乡镇医院比直接投入到村卫生所更能有效地促进当地农村居民消费倾向。具体表现为东部地区各省每万人乡村人口所拥有的乡镇卫生人员数量每增加1%,当地区农村居民消费倾向将会增加0.058%。而在中部和西部地区没有通过显著性检验。这里可以解释为：我国各地区农村医疗基础普遍条件差、投入资金少、投入效率低,尤其是在中部和西部地区。根据陈东和王小霞(2010)的分析,农村医疗卫生投入效率还受到投入规模“门槛效应”的影响,因此短时间内难以达到预期的效果。而各省每千农业人口拥有的村卫生室人数的系数为负,但尚未通过统计学上的显著性检验。村级卫生室是农民基层医疗服务机构,在常见伤、病的诊治以及儿童预防保健等方面发挥了重要作用。近些年,因为政府投入很少,导致村级卫生机构医疗硬件、软件设施滞后,限制了其应有的作用,不利于农民基本医疗卫生服务需求的满足。为了更加深入细致考察教育、医疗公共品供给对农村居民消费各大类的影响程度,第七章采用QUAIDS模型求解2003-2010年27个省自治区农村居民各项生活消费品的边际预算份额,然后建立面板结构模型分析教育、医疗公共品供给对我国农村居民消费结构变化的影响效果。实证结果表明：随着收入和支出水平的提高,农村居民消费结构升级的方向是对食品、衣着和文教娱乐的消费需求不断降低,对居住、家庭设备、交通和通讯、医疗和保健以及其他商品和服务的消费需求不断提高。文教娱乐消费需求不断降低主要原因是目前农民收入的增长在很大程度上以增加劳动时间来实现的,牺牲了闲暇时间,降低了文教娱乐需求。公共教育支出比例增加引起农村家庭的教育支出增加,并挤占了其他生活开支,导致生活质量下降；同时,医疗公共投入比例对农村居民消费结构影响的程度还很小,由此可以看出,农村教育、医疗公共投入长期不足,使得农村家庭的教育、医疗支出的负担加重,导致生活质量的下降。从教育性人力资本看,教育水平的提升促使农民增加了医疗保健等享受型消费,减少了基本生存型消费(食品和衣着),有助于消费结构的升级。而由医疗投入引起的健康资本(各省村卫生人员比例和乡镇卫生人员比例)对农村居民消费结构影响的程度还很小。地区经济越发达,教育、医疗公共品供给对居民的消费结构升级作用会越明显。实证结果也体现了地区经济的差异性：东部地区教育、医疗公共品供给对农村居民消费结构的升级作用要大于中部和西部地区。此外,老人抚养比的增加促进了家庭设备及医疗保健的边际消费份额,这也反映了农村的现实情况。取消农业税减轻了农民支出负担,间接增加了农民收入,有助于提高农民生活质量、优化消费结构。根据前文的分析,第八章从加大对农村教育投入力度,减轻农村家庭教育支出负担；注重应用型人才培养,提升就业能力,增强农民消费能力；逐步完善农村公共卫生体系,减轻家庭医疗支出负担；加强对农村基层医疗机构的投入,提高农民健康资本；改革和完善农村新型养老保险体系,刺激“银发经济”发展等方面提出加快完善农村地区教育医疗公共品供给促进农民消费增长的可操作性对策和建议。更多还原

【Abstract】 In recent years, the relative lack of demand in China has become the prominent factors restricting the economic growth. Compared with the western countries consumption contribution to economic growth rate of80%, China’s consumption contribution to economic growth rate of50%has the very big disparity. In2008, under the background of international financial crisis, China implemented a proactive fiscal policy, monetary policy in order to expand domestic demand to revitalize the national economy. The reality is, the existence of China’s urban-rural dualistic structure, leads to the lack of education, health public expenditure in rural area, which not only suppresses the ability of farmers themselves, reduce a farmer’s willingness to consume, but also affects the sustainable development of the whole national economy. In recent years the Chinese government increases the public investment in education and medical care in rural area. Whether public investment in health and education will help to promote the demand of rural residents, what is its mechanism, and which kind of public investment between education and health has the largest contribution to consumption growth of rural residents need further empirical research. Under this kind of background, this paper set out to study the relationship between education, medical public goods supply and consumption of rural residents, and is divided into eight chapters.Based on the lack of domestic demand, especially the low level of consumption of rural residents in the background, Chapter1puts forward the problem. Chapter2describes the classical, modern consumption theory and provides a comprehensive review on the research status of rural residents’consumption, the supply of rural public goods and the consumption effects of public expenditure.In Chapter3, based on the rational behaviour hypothesis of the famer, the thesis analysizes the intertemporal consumption behavior, and based on the previews of precautionary saving and human capital, the thesis analysizes the influence mechanism of education and medical treatment public goods supply on the consumption level and the consumption structure of rural residents, as a result, sets up theoretical analysis frame. In Chapter4the thesis has analyzed the situation of our government investment in education and health care in rural area, from which we can see the lack of the supply of education and medical treatment public goods in rural area, and provides a realistic basis for further study.Based on the hypothesis of public spending on education and health care to reduce the precautionary saving, using the provincial panel data of China’s eastern, central and Western areas from2003to2010, the thesis has built the model and estimated the impact on the propensity to consume of the rural household because of the three regional education and medical public goods supply in Chapter5.The empirical results show that, the education public goods supply has no significant influence on the propensity to consume of rural residents in the eastern, central and western regions; and medical public goods supply has obvious crowding-in effect on the rural residents’propensity to consume in the eastern region, and the complementary effect is greater than the substitution effect. Medical public goods supply has the obvious crowding-out effect on consumption in the central region. Unlike previous studies:Although the livelihood public expenditure (such as public education, public health, pension expenditure) is helpful to decrease precautionary savings and increase the propensity to consume in theory. But in reality, due to the differences of the investment direction and investment efficiency of the medical expense, not only can the livelihood public expenditure not decrease precautionary savings, but also it may inhibit the consumption. For the western region, and medical public goods supply has no significant effect on rural residents’propensity to consume. At present in the western rural areas, the original medical conditions are very poor; the infrastructure is weak, with the increasing of the medical public goods investment, the precautionary saving of the peasants in the west area is not increased. In addition, the abolition of agricultural tax policy has lightened the burden on rural residents and increased precautionary savings, and it shows the importance of the supporting measures of public expenditure.From the perspective of education and medical public goods supply improvement of human capital, the thesis analyzed the education and medical public goods supply effect on the propensity to the rural residents’ consumption from three dimensions of the eastern, central and western areas in Chapter6.The empirical results show that the influence on living consumption coming from knowledge capital and health capital caused by the input of education and medical public goods in different regions are different, and the per capita net income of household, the control variables, such as agricultural tax reduction, the elderly dependency ratio significantly affect the consumption of rural residents.First of all, the upgrading of knowledge capital of rural residents effectively promotes rural resident consumption tendency in Western China, but the effect is not obvious in the eastern and central regions. The specific results are as following:the average knowledge capital of labor force in western provinces increased by1%, the propensity to consume of rural residents will increase0.173%, The culture level of rural residents in western is low, the economic foundation is weak, and the increasing of average knowledge capital of the rural labor force promotes the upgrading of the employment ability of local farmers and increases the level of family income and the propensity to consume.Secondly, the upgrading of the health capital of rural residents effectively increases rural resident consumption tendency in eastern region, but it is not obvious in the central and western regions. The input of medical public expenditure into the township hospitals can more effectively promote rural residents consumption propensity than directly into the village medical clinic Specific performances are as following:the township health personnel of per million rural populations in the eastern provinces increased by1%, the propensity to consume of rural residents will increase0.058%. But the significant tests weren’t passed in the central and the western regions.This can be explained as:generally the medical basis of every rural area is poor, the capital of investment is less and investment efficiency is low in our country, especially in the central and western regions. And according to the analysis from Chen Dong and Wang Xiaoxia (2010), the investment efficiency of rural health is also affected by the size of investment, called "threshold effect", and therefore within a short time it is difficult to achieve the expected effect. The coefficient of the village health clinic personnel per thousand rural population is negative, and didn’t pass the significant statistics test. Village health clinics are primary medical care organizations and play an important role in the common injury, disease diagnosis and children’health care. In recent years, because the public investment is little, resulting in the lag of village medical institutions in hardware and software facilities, limiting its role, and it is not conducive to meet the basic health service needs of rural residents.In order to more thorough and meticulous study the education and medical public goods supply influence on the consumption of various goods of rural residents, the thesis analyses the educational and medical public goods supply impact on the rural residents’ consumption structure, based on the model of QUAIDS and using the provincial panel data of27Chinese (except Beijing, Tianjin, Shanghai and Chongqing) provinces and autonomous regions across2003to2010in Chapter7.The results show that:the increasing of the public education investment proportion doesn’t improve the rural residents’consumption structure, but improve the Engel coefficient, and from the education investment results, knowledge capital optimizes and upgrades the consumption structure. Nowadays the knowledge capital increase largely comes from private family investment in education, so we can see that the government education investment result on rural residents’consumption is not satisfactory. The increase in the proportion of medical public investment has no obvious improvement of consumption structure, and from the medical investment results, the increase of the nearer village clinic staff proportion is conducive to the upgrade of the rural residents’ consumption structure. In the future the investment in village or community medical care should be strengthened to help the rural residents see doctors. To co-ordinate the urban and rural medical insurance system, and let rural residents really enjoy the national health welfare. The government’s abolishment of agricultural taxes is reducing the burden on farmers, and promotes the upgrade of rural residents’ consumption structure. From the regional perspective, compared to the Easter, the rural residents in central and western areas pay more attention to the improvement of health and living, the consumption structure has also been upgrading.Based on the previous analysis, from the fowling aspects:increasing rural education and health total supply, optimizing the supply structure of rural education and health public goods, narrowing the area differences of the rural education and medical public goods supply and improving the investment efficiency of education and medical public goods, the thesis puts forward to operable countermeasures and suggestions to accelerate the improvement of rural area education and medical public goods supply mechanism to promote rural residents consumption growth in Chapter8.更多还原