From china to the world: the implications of fiscal decentralization, government debt, and public health dynamics

This research stands as the first of its kind to unravel the intricate global interplay between fiscal decentralization, government debt, and public health outcomes, transcending the confines of singular dimension studies. By employing sophisticated single and simultaneous equation models, our investigation sheds new light on how fiscal decentralization impacts government debt and public health at a global scale. The findings reveal a groundbreaking insight: fiscal decentralization is instrumental in reducing government debt across diverse economic landscapes. Furthermore, our study identifies a consistent global pattern where increased local government debt is associated with poorer health outcomes, highlighting a universal challenge where debt limits the resources allocated for health services. Challenging prevailing perceptions, our research also discovers that the mere augmentation of medical resources, such as the density of medical institutions and staff, does not guarantee improved public health outcomes universally. This key finding underscores the urgent need to reassess current health policies and advocates for a more strategic and effective allocation of medical resources globally. By elaborating the important role of prudent fiscal management, especially from the perspective of fiscal decentralization, calling for more detailed and effective health policies, and recognizing the fiscal reality of local governments, this study not only has important academic contributions, but also provides practical insights for global policy makers and health strategists. It emphasizes the interconnectedness of fiscal policy and health systems and their collective influence on the global stage.