Strengthening Local Governance in Health Financing in China: A Text-Mining Analysis of Policy Changes between 2009 and 2020

In the last two decades, developing countries have increasingly engaged in improving the governance of their health systems and promoting policy design to strengthen their health governance capacity. Although many well-designed national policy strategies have been promulgated, obstacles to policy implementation and compliance among localities may undermine these efforts, particularly in decentralized health systems. Studies on health governance have rarely adopted a central-local analysis to investigate in detail local governments’ distinct experiences, orientations, and dynamics in implementing the same national policy initiative. This study examines the policy orientations of prefectural governments in strengthening governance in health financing in China, which has transitioned from emphasizing the approach of fiscal resource input to that of marketization promotion and cost-containment regulation enforcement at the national level since 2009. Employing text-mining methodologies, we analyzed health policy documents issued by multi-level governments after 2009. The analysis revealed three salient findings. First, compared to higher-level authorities, prefectural governments generally opted to use fiscal resource input over marketization promotion and cost-containment regulation enforcement between 2009 and 2020. Second, policy choices of prefectural governments varied considerably in terms of enforcing cost-containment regulations during the same period. Third, the extent of the prefectural government’s orientation toward marketization promotion or cost-containment regulation enforcement was not only determined by the top-down orders of higher-level authorities but was also incentivized by the government’s fiscal dependency and the policy orientations of peer governments. These findings contribute to the health governance literature by providing an overview of local discretion in policy choices, and the political and fiscal dynamics of local policy orientations in promoting health governance in a decentralized health system.

Realisasi Zakat Sebagai Sumber Pendapatan Asli Daerah di Propinsi Aceh

Original Regional Revenue (PAD) originating from zakat actually has great potential to be utilized by the regions if it is managed properly and optimally. This new fiscal resource can help solve regional problems such as poverty and unemployment. This study aims to see concretely how the management of zakat as PAD and tries to explore what factors are the obstacles to managing Zakat as PAD by Baitulmal Aceh based on Qanun Number 10 of 2018. In-depth interviews were conducted with 15 informants in Baitulmal Aceh who were selected using the method purposive sampling. While the data analysis uses the Miles and Huberman interactive model. The results show that there are different views in responding to the implementation of zakat as PAD. The first response is supportive because it is in accordance with the specificities of Aceh Province as regulated in Act no. 11 of 2006 concerning the Government of Aceh. Another response was refused because it could be burdensome for Muslims if two obligations were to pay at once to pay taxes and zakat. The zakat policy as PAD itself still creates multiple interpretations so that it becomes an obstacle in its implementation. Apart from the facts in the field that shows the contribution of zakat in local revenue is still relatively small. (Pendapatan Asli Daerah (PAD) bersumber dari zakat sejatinya memiliki potensi besar untuk dimanfaatkan oleh daerah jika dikelola secara baik dan optimal. Sumber fiskal baru ini dapat membantu menyelesaikan permasalahan daerah seperti kemiskinan dan pengangguran. Studi ini bertujuan melihat secara konkret bagaimana pengelolaan zakat sebagai PAD dan berusaha mengeksplorasi faktor apa saja yang menjadi kendala pengelolaan Zakat sebagai PAD oleh Baitulmal Aceh berdasarkan Qanun Nomor 10 Tahun 2018. In-depth Interview dilakukan terhadap 15 orang informan di Baitulmal Aceh yang dipilih menggunakan metode purposive sampling. Sedangkan analisis data menggunakan model interaktif Miles and Huberman. Hasil menunjukkan ada perbedaan pandangan dalam merespon implementasi zakat sebagai PAD. Tanggapan pertama mendukung karena sesuai dengan kekhususan Provinsi Aceh yang diatur dalam Undang-Undang No. 11 Tahun 2006 Tentang Pemerintahan Aceh. Tanggapan lainnya menolak karena dapat memberatkan umat Islam jika dibebankan dua kewajiban sekaligus untuk membayar pajak dan zakat. Kebijakan zakat sebagai PAD sendiri masih menimbulkan multi tafsir sehingga menjadi kendala dalam pelaksanaannya. Selain fakta lapangan yang menunjukkan kontribusi zakat dalam pendapatan asli daerah masih relative kecil.)

The regional consequences of authoritarian power-sharing: Politburo representation and fiscal redistribution in China

Much political economy research examines how higher-level political representation of the constituent jurisdictions affects resource redistribution among the lower-level units in democracies, but little work has probed the redistributive consequences of regional political representation under dictatorship. This study investigates the effect of membership for provincial officials in the Politburo of the single-ruling Chinese Communist Party (CCP) on fiscal resource flows between the central government and provincial governments in reform-era China. I find robust evidence that the provinces overseen by CCP Politburo members tended to remit more budgetary revenues to the center but did not receive larger central budgetary subsidies. This is consistent with a territorial logic of authoritarian power-sharing in single-party states, which suggests that the regionally selective presence at a collective ruling-party decision-making forum for subnational officials aims at tighter political control to help induce greater policy compliance from below.

PERMASALAHAN DAN KONSEKUENSI DESENTRALISASI FISKAL

In local autonomy implementation, there are various decentralization processes. One of them is decentralization in fiscal sector. Fiscal decentralization relates to local authority using their own fiscal resource which is supported by financial balance between central and local government. Some problems which is estimated will emerge in fiscal decentralization process is a natural thing for local government which have authority to manage their own household affairs. In addition to emerged problems, there are some decisive factor which is calculated as the something determining the success of decentralization process. Decentralization can also give varying implications toward inter-region development activity.

Trends in Regional Inequalities in Pakistan: Evidence Since 1998

Periodic research and documentation of the extent and nature of inter-regional and intra-regional inequalities is a pre-requisite for formulating cost effective interventions for the promotion of spatially balanced and sustainable development. These interventions can be in the shape of increased fiscal resource transfers and/or fiscal incentives to the private sector for promoting investments in lagging regions. The analysis of inter-regional and intra-regional consumption and non-consumption inequalities in this paper are a preliminary attempt at assessing their status.