公共衛生支出、人力資本與內生成長

Abstract

文獻上有許多學者提出嬰幼兒死亡率的下降會使得經濟體系的出生率下 降，這些文獻中，部分將嬰幼兒死亡率直接視為外生參數，而部分文獻認 為嬰幼兒死亡率會因為景氣改善而下降。然而，我們從歷史的經驗卻觀察 到，嬰兒死亡率的下降起因於公共衛生的改善，也就是說，當公共衛生改 善後，嬰兒死亡率減少，出生率會經歷第一次的大幅下降，接下來隨著景 氣改善，養育小孩的成本變高，嬰兒死亡率才會有第二次的下降。換句話 說，政府對於公共衛生的投入，透過嬰幼兒死亡率的下降使得出生率下 降，在經濟發展的初期是個不可忽視的角色。本研究的目的，嘗試加入政 府的公共衛生支出於人力資本內生成長模型中，討論在內生生育率下，經 濟得以起飛並可帶來長期的經濟成長。本研究的貢獻有二，第一：傳統成 長理論文獻大多忽略了政府公共衛生支出對於嬰幼兒死亡率與生育率的 影響，尤其是經濟成長初期。第二：既有文獻探討政府的角色和經濟成長 之間的關聯大部分都是透過基礎建設的支出影響私部門的生產，進而造成 內生成長。本研究將提供一個新的角度去探討政府支出和內生成長的關係。

Many scholars have found that the fall of infant mortality will make the declining birth rates. In the literature, some treat infant mortality as exogenous parameters directly, and the other line of the literature has infant mortality move with the business cycles over time. However, from the historical experience we observed that the decline of the infant mortality rate is mainly due to the improvement of the public health, that is, when the public health improves, infant mortality rate will decline and so is the fertility rate. Then as the economy booming the infant mortality will have the second decline, and with the increase of the cost of raising a child fertility rate will further drop and trigger the investment in human capital, which is conducive to long run growth of the economy. In other words, the government’s public health expenditure in the early stages of the economic development, through the decline of infant mortality that reduces birth rates, plays an important role for the subsequent economic growth. The purpose of this study intends to incorporate the government`s public health spending into human capital-driven endogenous growth model, to discuss how an economy may take off and sustain its long-term growth. The contribution of this study has two, the first: traditional growth theory mostly ignore the literature of government public health spending on infant mortality and fertility decision. Second, most of literatures view the role of government expenditure on infrastructure to help economic development. This research provides a new perspective to discuss how government spending may lead to endogenous growth.