Suchergebnisse

Purpose
More and more statistics have repeatedly shown that as the economic development has entered the New Normal, the Chinese fiscal system has experienced tremendous changes. Although chance cannot be ruled out, much of those changes indicate trends, and they can even be said to be the result of the law of economic development. These trends and changes have repeatedly demonstrated that, as a reflection and an inevitable result of the economic developing speed shift, structural adjustment and energy conversion, the Chinese fiscal system, far from the conventional operating state, has progressed on a new path. The paper aims to discuss this issue.


Design/methodology/approach
This paper systematically analyzes several new trends and changes in the Chinese fiscal system under the New Normal. First, revenue growth has experienced a sharp downward trend, while the tax elasticity coefficient has declined rapidly. Second, fiscal expenditure has risen against the tendency, while the rigidity of expenditure has kept on increasing.


Findings
Considering the present fiscal and taxation system reform with the analysis above, it can be seen that if the reform's progress for the past two years is slower than expected – thus, preventing the effects of all aspects from a timely achievement – then, in the recent period, the agreement on the fiscal and taxation system reform will be reached and challenges entirely different from the past, including sharp slowdown in revenue growth rate, fiscal expenditure rising against trend and increases in fiscal deficit and government debts will be faced. The factors encouraging the reform are gathering gradually. The growth of the strength to push the reform forward is speeding up. And the pace of the reform in relevant areas is quickening.


Originality/value
In the face of those trends and changes, on the one hand, the authors should deeply understand and accurately grasp them through a comprehensive summary and systematic analysis. On the other hand, a series of conventional ideas, thoughts and strategies should be adjusted comprehensively and duly. Taking a train of new ideas, thoughts and strategies, the authors ought to actively adapt to and initiate a new Chinese fiscal structure under the New Normal of China's economy.

Abstract Background In 2003 the Chinese government introduced voluntary cooperative medical schemes (CMS), soon to be in place throughout rural China. Families who chose to enroll do so as a single unit and nothing is known about any differential effect of these new schemes on family members. This study evaluates the impact of one pilot CMS in Anhui Province on health care use by girls aged less than 5 years and women 65 years or older, and on the pattern and cost of prescriptions. Methods Health care records were extracted covering a 10 year period, before, during and after the pilot CMS in 4 townships, one with the intervention and 3 comparison townships without. The impact of the intervention on the age and gender distribution of patients presenting for health care and on the prescription of certain drugs was assessed by logistic regression. The cost of prescriptions before, during and after the intervention period was also assessed. Results 203,058 registration and 643,588 prescription records were identified. During the intervention there was a reduced likelihood overall that a patient was female (OR = 0.92: 95%CI 0.87 - 0.97) at the intervention site. Girls aged < 5 years had an increased likelihood of health care (OR = 1.41: 95%CI 1.23 - 1.59) during the CMS, but women ≥ 65 years were relatively disadvantaged (OR = 0.84: 95%CI 0.75 - 0.95). The use of antibiotics and systemic steroids increased disproportionately at the intervention site for patients ≥ 5 years. Prescription costs at the township hospital also increased at the intervention site, particularly for older men. Conclusions This evaluation suggests that all family members did not benefit equally from the pilot CMS and that women ≥ 65 years may be disadvantaged by the newly available reimbursements of health care costs through the CMS. It points to the need, in future evaluations, to use individuals rather than families as the unit of analysis, in order to determine whether such health care inequalities are wide-spread and persistent or are reduced in the longer term. The results also support earlier concerns about the influence of new funding resources on prescription practices and the need for regulation of for-profit prescribing.