本文分析了中国的财政分权和政治集权之下,地方政府忽视卫生支出的原因。基于1996—2006年省级数据发现,省级对地级政府的省内支出分权有助于增加卫生支出在财政总支出中的比重,但省级和地级财政自主性都会减少卫生支出。我们还验证了政治集权对于卫生支出的影响。通过对比卫生和教育支出后发现,中央对卫生支出的忽视是地方减少卫生支出的一大原因,有关省委书记、省长和常务副省长的年龄与工作经历对卫生支出的影响也验证了这点。本文对于理解地方政府在卫生支出的激励和行为具有重要理论和现实意义。 This article analyzes the reasons why local governments neglected health expenditure under China’s fiscal decentralization and political centralization. Based on provincial data from 1996 to 2006, provincial-level decentralization of provincial expenditures on local governments helps to increase the share of health expenditure in total fiscal expenditures, but provincial and prefectural fiscal autonomy will reduce health expenditures. We also verify the impact of political centralization on health spending. By comparing the expenditures on health and education, we find that the central government’s neglect of health expenditure is one of the major reasons for the local government to reduce expenditure on health. The influence of the age and work experience of the provincial party secretary, provincial governor and executive vice governor on health expenditure is also verified this point. This article has important theoretical and practical significance for understanding the incentive and behavior of local governments in health expenditure.