Income inequality effect of government investment behavior: Comparisons based on different investment areas, different regions and different groups in China.

The research focuses on and analyses the effect of government investment on income distribution by evaluating the effects of public spending on income variation in various fields, in various regions, and at different income levels in the Chinese economy. The study found that government investment in different fields substantially decreases income inequality. Increasing housing security, medical, agriculture, forestry and other expenditures has a significant impact on improving the income inequality between rural and urban inhabitants; the impact of government investment in the western, central, and eastern regions on the reduction of income variation is decreasing successively, with emphasis on government investment in the western and central regions. The effects of government investment on the decline of the income distribution are twofold: first, it influences the amount of low- and middle-income groups; second, it has an impact on the reduction of high-income organizations; however, the impact on the income equality of high-income and low-income organizations is not considerable. In investment, the study demonstrates that income inequality can be reduced without negatively affecting the financial status of higher-income individuals. It is significant to value providing adequate housing security for low-income populations as a critical policy implication. This study, utilizing novel indicators, contributes to the current body of research on the impact of fiscal policy in addressing income inequality in China.

Public R&D Projects-Based Investment and Collaboration Framework for an Overarching South Korean National Strategy of Personalized Medicine.

Since the South Korean government designated personalized medicine (PM) as a national strategic task in 2016, it has spared no investment to achieve its goals, which were recently accelerated by the COVID-19 pandemic. This study analyzed investment trends in 17 regions and eight technology clusters related to PM, consisting of 5727 public R&D projects worth USD 148.5 million, from 2015 to 2020. We also illustrated the level of investment for different PM-related technology clusters in each region; various research organizations explicitly verified comparable innovation capabilities for all eight technology fields in 17 regions, showing individual differences in technology areas per region. Our framework provided information to allow implementation of two goals: administering successful PM and improving regional equality in public health and healthcare according to technical and organizational levels. This study empirically demonstrates that it can provide a precise overarching innovation scheme with regional, technical, and organizational dimensions to establish collaboration among different stakeholders, thereby creating a foundation for an overarching national PM strategy.

Roadmap for carbon neutrality: the mediating role of clean energy development-related investments.

Recently, the Japanese government has announced the national objective of turning the economy of Japan carbon-neutral by 2050. This declaration has therefore enhanced the imperativeness of replacing the use of unclean energy with cleaner alternatives so that the carbon-neutrality agenda can be attained in due course. Against this backdrop, this study aims to assess whether enhancing government investments in research and development for developing clean energy can help Japan curb its carbon dioxide emission figures. In addition, the analysis also controls for the environmental effects of clean electricity output, economic growth, international trade, financial globalization, and urbanization on Japan's carbon dioxide emission figures. The cointegration test results confirm long-run relationships between all these variables. Besides, the regression results showed that scaling-up research and development-related investments for clean energy development reduces carbon dioxide emissions only in the long run. Similar emission-inhibiting impacts are also evidenced to be associated with greater output of clean energy-fired electricity. Moreover, it is also observed that higher clean energy development-related investments play a mediating role in amplifying the carbon dioxide emission-reducing effects of clean electricity generation in the long run. In addition, economic growth is seen to dampen environmental quality by triggering higher emissions of carbon dioxide both in the short and long run. Simultaneously, enhancing openness to international trade and greater urbanization is found to boost the carbon dioxide emission figures of Japan. However, an influx of foreign direct investments is not observed to influence carbon dioxide emissions in Japan, neither in the short run nor in the long run. Accordingly, concerning the achievement of carbon neutrality goal by 2050, these findings emphasize the importance of boosting clean energy development-related investments, increasing clean electricity output, greening economic activities, reducing the trade of unclean commodities, adopting environmentally sustainable urbanization policies, and facilitating the influx of clean foreign direct investments within the Japanese economy.

Cataract prevalence following a nationwide policy to shorten wait time for cataract surgery.

Background: Cataract is an age-related eye disease. Visual impairment from cataract can be restored by cataract surgery. In 2004 the Canadian federal government invested in a multibillion dollar wait time strategy to shorten the wait time for cataract surgery, a government-insured health service in all Canadian jurisdictions. We assessed if this nationwide policy reduced the number of Canadians waiting for cataract surgery as more individuals with cataract were free of cataract following the rapidly conducted surgery. Methods: In this cross-sectional study we analyzed data from randomly selected individuals aged ≥ 45 years responding to the Canadian Community Health Survey (CCHS) in 2000/2001, 2003, 2005, and the CCHS Healthy Aging in 2008/2009. Information on cataract was obtained from self-reported questionnaire. The age- and sex-standardized prevalence of cataract was calculated for comparisons. Results: Cataract was reported by 0.93 million Canadians in 2000/2001, 0.99 million in 2003, 1.10 million in 2005, and 1.34 million in 2008/2009. This corresponds to an age- and sex-standardized prevalence of 8.9% in 2000/2001, 9.0% in 2003, 9.5% in 2005, and 10.2% (P <0.05) in 2008/2009. The increase in age- and sex-standardized prevalence was greater in individuals without secondary school graduation than those with secondary school graduation or higher (4.3% versus 1.3%, P < 0.05) and was seen in all Canadian provinces. The largest increase was documented in a province (Saskatchewan, from 9.8% in 2000/2001 to 12.6% in 2008/2009, P < 0.05) with the longest median wait times for cataract surgery (118 days in 2008) and the lowest number of ophthalmologists per 100 000 population (1.96 versus 3.35 national average). Conclusions: The age- and sex-standardized prevalence of cataract increased 4‒5 years after the multibil- lion-dollar wait time strategy was launched in 2004. A lower threshold to diagnose cataract may be one potential reason for this finding. Further research is needed to understand the true reasons for the increase.

Governmental Investments in Hospital Infrastructure Among Regions and Its Efficiency in China: An Assessment of Building Construction.

Hospital infrastructure has been addressed as the prerequisite of healthcare delivery which intensively affects medical quality. Over the past decade, China has proposed a series of investment plans for hospital infrastructure in order to promote healthcare development in underdeveloped regions. Focusing on the construction of hospital buildings as the key component of hospital infrastructure, this study aims to examine whether the investment efficiency is lower where a government prioritizes equity and to explore what kind of geographical predispositions should be embedded in governmental investment plans for hospital infrastructures from the perspectives of both investment equity and efficiency. Relevant data from 330 governmental-invested hospital building construction projects in Sichuan province, China, from 2009 to 2018 were collected. Concentration index was used to evaluate the equity in the distribution of the investments. Tobit model was employed to explore the relationship between regional economic development and investment efficiency measured by an integrated approach of principal component analysis and data envelopment analysis. The results demonstrated a slight concentration of governmental investments in economically developed regions, while a negative association with regional economic development was identified with investment efficiency. Our study illustrated the investment efficiency was higher where a government prioritized equity and provided empirical evidences on switching governmental investment predisposition in the aspect of healthcare infrastructure construction toward less developed regions in China from the perspectives of both investment allocation equity and efficiency, which would further assist in the formulation of region-specific policies and strategies for underdeveloped regions.

Health reform and out-of-pocket payments: lessons from China.

OBJECTIVE: China's ongoing new health reform aims to reduce individual out-of-pocket (OOP) payments for healthcare services. The aim of this article is to analyse the impact of this reform and to draw policy implications. METHODS: Data are retrieved from the relevant government publications. Polynomial regression models are used to predict future health expenditures. An extensive sensitivity analysis is conducted to investigate the ratios of OOP payments to the total health expenditures (THEs) and to the disposable personal income (DPI) for 2009-11 under different scenarios of cost projections and personal income distributions. Both quantitative and qualitative analyses are carried out to draw conclusions. RESULTS: The ratios of OOP payments to THE and DPI vary significantly across scenarios tested. Only if all committed government investments and social health expenditure are realized can China's new health reform reduce both ratios and achieve its target goals. In particular, the ratio of OOP payments to DPI can also be significantly reduced by improving income distribution. Due to the complicated interplay among different cost components in health expenditures, these two ratios may not change in the same direction, indicating that both need to be examined when evaluating the reform. CONCLUSION: The new health reform in China aims to alleviate the high OOP payments for healthcare services, but it has not yet been able to reduce both OOP-to-THE and OOP-to-DPI ratios simultaneously. Major reasons include (1) inability of local governments to fulfil their responsible investments due to health finance decentralization and uneven economic development in China and (2) a serious cost inflation in health expenditures coupled with a low level of income distribution. It is suggested that the central government should bear more financial responsibility and assist local governments to fully invest, and should improve individual incomes, in particular for the poor.