【I】，Research background：

     In 2018, China's human Development Index ranking rose to 86th.Among them, China's per capita gnI based on purchasing power parity reached 15,270 US dollars, and the average life expectancy increased to 76.4 years (UNDP,2018).With the improvement of civilization, the health demand and consumption expenditure of residents in medical care are increasing day by day；

     According to figures released by the National Bureau of Statistics, the total expenditure on health increased from 11 billion yuan in 1978 to 5.1599 trillion yuan in 2017, with an average annual growth rate of 17.1 percent and its share in GDP rising from 3.0 percent to 6.2 percent.From 2014 to 2017, the average annual growth rate of per capita consumption on medical care was 12.3 percent, much higher than the average annual growth rate of per capita consumption expenditure of 8.5 percent, and its proportion also increased from 6.9 percent in 2013 to 7.9 percent in 2017.In 2017, there were 7.14 million beds for elderly care services, an increase of 87% from 2012 (National Bureau of Statistics,2018)；

    In the face of people's increasing demand for health, developing health industry is a realistic choice to improve the quality and efficiency of economic development，In this context, China timely introduced the "healthy China 2030" planning outline of a programmatic document, proposed to rise for the national "healthy China" strategy, their quest to establish a system of complete and health industry in optimizing the structure of the system, form a group with strong innovation capacity and international competitiveness of large enterprises, make the pillar type health industry become a national strategic industry，In the outline of the plan, medical institutions, fitness and leisure sports industry and pharmaceutical industry are the main parts of the development of health industry, and put forward the goal of integrating health with pension, tourism, the Internet, fitness and leisure, and food to foster new industries, new forms of business, and new models；

    At present, the industry has no objection to the direction of developing the health industry, but there are different views on what is the health industry and how to develop the health industry.For example, the outline of "Healthy China 2030" plan clearly proposes that the total scale of "health service industry" will exceed 8 trillion yuan in 2020 and 16 trillion yuan in 2030，However, there is no specific guidance for the overall scale of the health industry.This shows that even under the framework of "healthy China", the industry is still unable to make an accurate judgment on the boundary and development trend of the health industry；

     Goal of the traditional health industry is to meet people's basic health needs, but with the improvement of civilization, people's demand for health products and services continues to grow, and presents multi-level, diversified and personalized characteristics，traditional health industry emphasizes the government's "bottom" role, and the non-basic diversified health needs need to play the role of market mechanism to increase the supply of health products and services，Big health industry, which corresponds to people's different dimensions of health needs, is centered on health needs, and the combination between industries is getting closer and closer, and the boundary is becoming more and more blurred.Its operation law is different from the traditional health industry, which requires us to deeply understand the connotation, extension and basic attribute of this economic activity.In order to make up for the existing research shortage, the research mainly focuses on the following three aspects:

    (1) Define the big health industry and give the basic concept;

    (2) Explain the attributes of the big health industry, especially the relationship between industrial characteristics and industrial development;

    (3) Sort out specific industries and product types of big health industry, and measure the scale of big health industry；

【II】，A review of the literature on the health industry：

     According to the Outline of the healthy China 2030 Plan, health is an inevitable requirement for promoting all-round human development and a basic condition for economic and social development.In the world, there are narrow and broad understandings of health industry. In China, there are different definitions such as "medical and health service industry", "health service industry" and so on；

In the narrow sense, health industry generally refers to the sum of the economic system to provide patients with prevention, treatment, rehabilitation and other services, which corresponds to China's medical and health service industry. The health industry defined in this definition includes five subordinate industries: health care suppliers, medical equipment, medical supplies, biotechnology and pharmaceutical，Term "medical and health service industry" is also used in China in a narrow sense. It refers to the collection of health-related activities directly serving people based on medical and health knowledge and technology, with the main purpose of maintaining and promoting human health or preventing health deterioration.It can be divided into therapeutic services, rehabilitation services, long-term care services, supportive services, retail of drugs and medical supplies, preventive services, etc；

     Broad definition of health industry includes both narrow content and economic activities that provide health care products and services to healthy people.Up to now, there is no consistent statistical caliber of big health industry in the world，It is generally believed that the big health industry is an industrial system related to physical and mental health, including organic agriculture, organic food industry, health products industry, sports and fitness industry, tourism, wholesale, retail and leasing services of products directly related to health, etc.There are also studies that health industry involves both health industry and health business, so health business is also a part of the general health industry；

     Based on domestic and foreign studies, the big health industry can be divided into the following three categories:

     (1) Based on the division of three industries, planting, processing, manufacturing and service related to health are all included in the connotation of health industry.Big health industry is a general term for all economic activities that meet physical, mental and environmental health needs;

     (2) Based on the upstream and downstream relationship of the industry, the economic activities before, during and after medical treatment are divided as the basis;

     (3) From the perspective of service types, the health industry is divided into medical and non-medical services, and further divided on this basis；

     On the basis of industry definition and division, some scholars have calculated the scale of health industry.Total medical and health expenditure refers to the total amount of funds consumed by the whole society for medical and health services. This concept has international comparability and is usually used to evaluate the market size of the health industry in a narrow sense；In 2017, total health spending as a share of GDP was about 17.2% in the US, 9.7% in the UK, 10.7% in Japan, and 11.5% in Canada (CIHI,2017;The OECD, 2018).According to the 2017 Statistical Bulletin on The Development of China's Health services, China spent 5.2 trillion yuan on health care in 2017, accounting for 6.2% of ITS GDP, of which government spending on health accounted for 30%, social spending for 41% and private spending for 29%；

     Total health spending is based on consumption versus the health industry.Experts estimate the health industry based on production.In 2010, the output value of the health industry in the narrow sense of the United States was about 3.5 trillion DOLLARS, directly contributing 8.8% to GDP and employing more than 16 million people, accounting for about 10% of the total employed population (Wang Chan et al.,2014).，In 2016, the market size of China's health service industry was about 5.6 trillion yuan, equivalent to about 7% of GDP, including pharmaceutical industry 2.8 trillion yuan, health care industry 1.8 trillion yuan, medical industry 0.5 trillion yuan, health products 0.26 trillion yuan, and health management service industry 0.15 trillion yuan (Qianzhan Industry Research Institute,2017).Some studies predict that the market size of China's health industry will reach 10 trillion yuan in 2020；

    The above research on the big health industry mainly has the following shortcomings:

     (1) The definition of big health industry only starts from industrial activities and market behaviors, while industrial activities cannot meet all social health needs, so the extension of big health industry needs to be appropriately expanded；

     (2) the research content not form a big health industry theory framework of system, some scholars research related to specific industries, respectively, but the lack of the research findings of the correlation between industry, market structure, competition pattern, performance evaluation and space layout of the research is not enough, big health industry the new formats and the trend of industrial convergence has not been deeply explored；

    (3) There are many theoretical discussions, but there is a lack of unified standards in practice.For example, the economic scale and industrial structure of the big health industry have not been calculated in the national economic accounting system, so the status of the big health industry in the national economy cannot be answered；

【III】，Definition of big health industry：

     (1) connotation of big health industry: Industrial activities are the core:

     The big health industry is an industrial activity in essence, and gaining profits through market operation is its essential attribute.An industry is a collection of businesses that provide products and services to meet similar needs.With the continuous development of social economy and the continuous improvement of living standards, people are constantly generating new demands in production and life, and emerging industries are constantly emerging and developing.The health industry comes into being under the background of people's increasing health demand；

    Health needs of the new age must be met primarily through the market.Health products and services can be divided into public health products, quasi-public health products and private health products according to their characteristics.Different types of product requirements correspond to different providers，Entering a new stage of development, a large part of the new products and services emerging after the upgrading of health consumption correspond to differentiated, personalized and high-end needs, which cannot be met by the traditional public health industry.To develop new health industry, innovate health service model and expand the scope of health industry is to meet the new needs of the people；  

      The era of "Internet plus", the big health industry is bound to absorb modern information management technologies such as the Internet, big data and mobile Internet, and rapidly develop into new industries, new formats and new models driven by the new technological revolution. The big health industry will become a new economic growth point.The economic activities of the big health industry involve all sectors of the national economy and form a whole industrial chain containing three industrial activities；

    At present, the health industry in many developed countries has grown into the pillar industry of national economy and played a strong driving role in economic growth.Therefore, the essence of big health industry is industrial activity, and the pursuit of value increment and profitability through market operation is the basis of this industry.Based on this, promoting the development of big health industry needs to take the market as the main body, and continuously provide high-quality health products and services for the people through optimal allocation of resources；

    (2) Extension of big health industry: The combination of public welfare and industry:

     Big health industry is not an industry in the general sense. Although it is an industrial activity in essence, many products and services provided by this industrial activity have strong positive externalities. Products and services with positive externalities cannot achieve the optimal allocation of resources completely depending on the market, so the government needs to play an active role；

    In theory, due to the deviation between marginal private cost and marginal social cost, marginal private net output value and marginal social net output value, the optimal state of resource allocation cannot be achieved by completely relying on market mechanism.An industry with Marshall externalities means that the market itself cannot achieve the most efficient allocation and needs government policy support to ensure the effective allocation of resources and the realization of social value，Public product theory required everyone to the consumption of public goods does not reduce the consumption of anyone on this product, the pure public product noncompetitive with consumption and income of an integral sex non-exclusive and utility of three characteristics, should be provided by the government, between pure public products and private products of quasi-public products should be provided by the government and market；

    Big health industry is characterized by strong information asymmetry, quasi-public goods, complex pricing mechanism, and typical characteristics of Marshall externalities. With the rapid development of economy and society, the public goods attribute boundary of the big health industry is changing.Just because the big health industry has obvious positive externalities, countries usually develop related industries with the support of the government and coordinate the relationship between industry and public welfare；

     China's health industry has been dominated by the government for a long time. With the promotion of market economic system reform, the scope of health industry is gradually extending, and the development of health industry is accelerating, and gradually from "public" to "market". The development of big health industry is actually a process of optimizing public health services and cultivating market health services；

     Boundary between the government and the market is clear and the division of labor is clear. Through institutional reform and innovation, the government improves public health services, removes marketable health services, introduces a large number of marketable health service institutions, gathers health industry resources, and promotes regional economic development through the development of health industry.Big health industry has a certain public welfare, the combination of public welfare and industry is the extension of big health industry；

     (3) Basic attribute of big health industry: it is an industrial activity with semi-public welfare：

    Fundamental attribute that distinguishes the big health industry from the general industry is that it has both the market attribute and the public benefit attribute. To develop this industry, the market and the government need to play a role together.Health products naturally have the nature of public welfare. If they rely entirely on the market, patients are bound to pay a high economic price，From the perspective of the whole society, the failure to meet the basic medical needs is a market failure.Market failure requires the government to organize public welfare institutions to provide public goods and services；

     Health products also have strong market attributes. Compared with the traditional medical and health industry, the big health industry no longer aims to solve people's physical and mental diseases and injuries, but expands to the growing new health needs of the people，These new health needs are diversified, personalized and high-end, involving industries no longer limited to the medical and health industry, but expanded to health services, health tourism, sports and fitness, health care, culture and entertainment and other emerging service industries.A significant portion of these health goods and services can be classified as private goods, which are competitive and exclusive and can be provided in a market-based manner；

    To be specific, the big health industry includes not only the health industry and pension industry which are market-oriented and play a leading role by market mechanism, but also the public health, medical and health undertakings and welfare undertakings which are public-service oriented and the government plays a Besides, it is inseparable from the beautiful ecological environment;

     On the basis of clearly defining the boundary between the government and the market,the government and the market will effectively connect and complement each other, the market will play a decisive role in the allocation of resources in health and old-age care related industries, and the government will provide necessary policy support in related industries to guide and encourage the entry of Social capital;Health industry and health enterprise have different emphases and are organically linked to form the national health security system.In the health industry on the operation mode of endowment health related industries in accordance with economic laws and rules of market profits, excess profits support pension utilities and healthy development of the government utility into the main body of responsibility, as quasi-public goods to provide necessary infrastructure such as security, Provide a good business environment for related industry development;

    (4) Concept of big health industry：

     Based on the above analysis of the connotation and extension mechanism, this paper puts forward the specific definition of China's big health industry: based on beautiful ecological environment, supported by health product manufacturing industry, with health service industry as the core, through industry integration to develop the whole industry chain activities to meet social health needs.The nature of the big health industry is that the public welfare activities of health play their economic functions through new industries, new forms of business and new business models；

    Big health industry includes both narrow and broad health industry discussed in existing research, and public welfare undertakings such as maintaining beautiful ecology and providing basic health services.The "big" of the big health industry is reflected in that it is a collective concept of industrial development, which not only includes the traditional health service industry with health care as the core, but also involves multiple sectors in the first, second and third industries of the national economy；

    In the primary industry, organic agriculture and Chinese herbal medicine planting are included;The secondary industry includes health food processing manufacturing, pharmaceutical manufacturing, health equipment manufacturing and other industries;The tertiary industry covers medical and health service industry, health product wholesale and retail industry, public facilities management industry, health management industry, health financial service industry and other industries, As well as public welfare undertakings to provide a good ecological environment and based on the combination of health care services, ecological leisure tourism.The "new" of the big health industry is reflected in the integration of industries.As the boundary of the big health industry is greatly expanded compared with the traditional health industry, the space for the integrated development of the industry is greatly expanded, which will inevitably produce new industries, new formats and new business models；

【IV】，Economic scale measurement of China's big health industry：

    (1) Composition, economic scale and structure of big health industry：

    In recent years, the society has paid more and more attention to the health industry, and there is an urgent need to calculate the scale and structure of the big health industry. In order to facilitate economic analysis and policy making, it is necessary to accurately locate the position and role of the health industry in the system of national economic accounting；

    For this reason, this article compared the "healthy China 2030" planning outline "the development of health industry" proposed "to optimize new formats, development pattern of diversity in do medical health services, actively developing fitness leisure sports industry, promote the development of pharmaceutical industry" specific requirements, and the State Council on several opinions to promote the development of health services (2013) proposed by the health servicesCategory: According to the Industry Classification of National Economy (GB/T4754 -- 2017), the industry catalogue involved in big health industry will be marked in categories, major categories, middle categories and sub-categories respectively；

     Category involves 16 industries, major involves 33 industries, middle involves 83 industries, and minor involves 172 industries.Big health industry is a collective concept of industrial development, involving many sectors in the first, second and third industries of national economy，In the primary industry, organic agriculture and Chinese herbal medicine planting are included;The secondary industry includes health food processing manufacturing, pharmaceutical manufacturing, health equipment manufacturing and other industries;The tertiary industry includes medical and health service industry, environment and public facilities management industry, health management industry, health financial service industry and so on；

     According to the GDP accounting method, the market size of the big health industry can be estimated not only from the perspective of supply but also from the perspective of demand. From the perspective of demand, the market size is relatively simple and easy to estimate. Residents' consumption expenditures such as medical care and pension can be calculated according to the household income and expenditure survey data of the National Bureau of Statistics；

     Yearbook of Chinese Household Survey released by the National Bureau of Statistics released the total consumption expenditure on medical care of Chinese residents in recent years, including two categories of consumption expenditure on medical devices and drugs and medical services，At the same time, for the industry part of public welfare spending, according to the National Bureau of Statistics released by the "central and local general public budget expenditure mainly project" in the "health and family planning spending" calculation, and social health expenditure can according to the National Bureau of Statistics released the "national total health expenses" in the "social health expenditure"；

    First, determine the proportion of the major health industry in the "input-output table" of the national economy.For example, the National Bureau of Statistics released the operation data of subdivided industries in the manufacturing industry, and we took the added value of some industries, such as pharmaceutical manufacturing and health equipment manufacturing, as part of the big health industry in the manufacturing industry；

    Then, in some industries whose proportion cannot be determined, such as the road transport industry, it is difficult to determine how much proportion serves the major health industry. We take the proportion of all major health industries in the national GDP as the benchmark and balance demand and supply according to the principle that total supply equals total demand.Twelve of the 139 industries used this approach；

    On this basis, using the average wage level of employees (workers) and other types of employment in urban units of different industries released by the National Bureau of Statistics, combined with the total labor remuneration of various industries provided by the input-output table, the number of employed persons in each industry in the input-output table can be calculated.Combined with the industry weight and input-output relationship, we can calculate the employment scale of China's big health industry；

    According to the supply estimation results, China's big health industry is widely distributed in the first, second and third industrial activities.From the three industries, the primary industry accounted for a relatively low proportion.In 2012, the added value of organic agriculture in China was about 8.58 billion yuan, accounting for 0.02 percent of the country's GDP in that year, and about 43.3 billion yuan in 2016, accounting for 0.06 percent of the country's GDP in that year；

    In 2016, the primary industry accounted for about 0.6% of the total health industry.Health care accounted for 12.4 percent of the secondary industry.In the culture, education, industry, sports and entertainment goods manufacturing industry, involving the concept of health is the sports goods manufacturing industry;In the special equipment industry, Related to the concept of health are pharmaceutical special equipment manufacturing, medical equipment and equipment manufacturing and environmental protection special equipment manufacturing;In the manufacturing of railways, ships, aerospace and other transport equipment, the concept of health is involved in the manufacturing of bicycles and disabled vehicles and off-highway recreational vehicles and spare parts;In the instrument manufacturing industry, the concept of health is related to the special instrument manufacturing industry for environmental monitoring；

    Although health-related industries are widely distributed in culture, education, industry, beauty, sports and entertainment products, pharmaceutical products, special equipment, transportation equipment and instruments, the industry concentration of added value is very high, mainly concentrated in pharmaceutical products；

     Based on the Industry Classification of National Economy (GB/T4754 -- 2017), the industry attributes of the 4-bit code industry directory are divided.There are 172 industries involving the concept of health, among which 67 are completely public welfare industries, mainly distributed in environmental protection, health and public services, social work, public administration, social security and social organizations，By combining the input-output table and summing up the added value of these industries, the industrial structure of big health industry can be obtained according to the attributes of economic activities.In terms of the attributes of economic activities, market-oriented industries accounted for 69%, while public welfare undertakings accounted for 31%(see Table 4).；

      (2) Growth trends in the big health industry：

     The "Healthy China 2030" plan Outlines that the health industry has become a national pillar strategic industry.Therefore, the growth trend of the big health industry is a concern.The proportion of big health industry in GDP keeps increasing, indicating that the growth rate of big health industry is higher than the economic growth rate.However, this increase in the ratio includes inflation factors；

     Added value of the big health industry calculated at the price of the previous year can be obtained by dividing the added value of the big health industry by the consumer price index of medical care in the previous year.Divide this added value by the added value of the previous year to get the actual growth rate of the added value of the big health industry in that year；

 Based on the above understanding, the future growth trend of the big health industry can be predicted:

     (1)GDP growth rate is 6.5% from 2017 to 2020 and 5% from 2021 to 2030.Composite prices (GDP deflator) rose 2.5 percent annually;

     (2) Plan 1: the actual growth rate of added value of big health industry is 8%;

     (3) Plan 2: The actual growth rate of added value of big health industry follows and is 2.5 percentage points higher than GDP growth rate；

     Growth rate of Option 2 is 8.7 per cent in 2020, 7.7 per cent in 2025 and 6.7 per cent in 2030.In plan 1, by 2020, the added value of big health industry will reach 1.04 billion yuan, accounting for 9.9% of GDP;By 2025, the added value will reach 1.74 billion yuan, accounting for 11.1% of GDP.By 2030, the added value will reach 2.91 billion yuan, accounting for 13.1 percent of GDP，In plan 2, by 2020, the added value of big health industry will reach 1.07 billion yuan, accounting for 10.2% of GDP;By 2025, the added value will reach 1.79 billion yuan, accounting for 11.4% of GDP.By 2030, the added value will reach 2.85 billion yuan, accounting for 12.9 percent of GDP；

【V】，Conclusions and policy recommendations：

    Among the major health industries, 69 percent are market-based and 31 percent are public welfare.Therefore, it can be seen that the big health industry is not an industry in the general sense. Although its essence is an industrial activity, this industrial activity has strong positive externalities, and the optimal allocation of resources cannot be achieved solely by relying on the market. Therefore, the development idea should be followed different from that of the general industry, and the government should play an active role；To develop the big health industry, we must follow the green development concept of good ecology and positive interaction of industrial development, rely on the advantages of ecological resource endowment, make use of the development trend of Internet and big data, take health and pension as the breakthrough point, vigorously develop new business forms and new models of the big health industry, and promote the transformation and upgrading of the big health industry；

    The development of the big health industry requires both the decisive role of the market in allocating resources and the guidance and support of the government. It is necessary to deeply grasp the properties of the big health industry, innovate industrial support policies, and strengthen institutional guarantee from the following aspects:

    (1) Promote the integration of the healthy development plan and the "integration of multiple plans", organically combine the healthy development plan with the national economic and social development plan, urban and rural planning, tourism planning and other aspects, and provide policy support for development land, municipal supporting facilities, site construction and other aspects；

    (2) Improve the ecological property rights system and ecological compensation mechanism, explore the establishment of ecological product pricing mechanism and ecological environmental damage compensation mechanism;

    (3) Improve the financing system and fiscal and tax incentive mechanism, establish funds for the development of big health industries through government investment and guiding social capital, and increase credit supply to key industries；

    (4) Support big health enterprises to establish academician workstations and postdoctoral research workstations, and support the establishment of big health industry research institutes to attract high-end talents in relevant international fields;

    (5) Promote the formation of the "Internet plus big health" industrial model featuring big data, cloud computing, Internet of Things, mobile Internet and other information technologies；