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What drives public health care expenditure growth? Evidence from Swiss cantons, 1970–2012

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  • Braendle, Thomas
  • Colombier, Carsten
Abstract
A better understanding of the determinants of public health care expenditures is key to designing effective health policies. We integrate demand and supply-side determinants and factors from political economy into an empirical analysis of the highly decentralized Swiss health care system and control for major health care finance reforms. We compile a novel data set of the cantonal health care expenditure in Switzerland, which currently amounts to about one fifth of total health care expenditure. We analyze the period 1970–2012 and use dynamic panel estimation methods. We find that per capita income, the unemployment rate and the share of foreigners are positively related to public health care expenditure growth. With regard to political economy aspects, public health care expenditures increase with the share of women elected to parliament. However, institutional restrictions for politicians, such as fiscal rules, do not appear to limit public health care expenditure growth.

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  • Braendle, Thomas & Colombier, Carsten, 2016. "What drives public health care expenditure growth? Evidence from Swiss cantons, 1970–2012," Health Policy, Elsevier, vol. 120(9), pages 1051-1060.
    • Handle: RePEc:eee:hepoli:v:120:y:2016:i:9:p:1051-1060
    DOI: 10.1016/j.healthpol.2016.07.009
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    2. Yuhang Zheng & Zhehao Huang & Tianpei Jiang, 2020. "Will the Economic Recession Inhibit the Out-of-Pocket Payment Willingness for Health Care?," IJERPH, MDPI, vol. 17(3), pages 1-16, January.
    3. Elena Puerto-Casasasnovas & Jorge Galiana-Richart & María Paola Mastrantonio-Ramos & Francisco López-Muñoz & Alfredo Rocafort-Nicolau, 2023. "Direct and Indirect Management Models in Public Health in the Framework of Mental Health," IJERPH, MDPI, vol. 20(3), pages 1-11, January.
    4. Potrafke, Niklas & Roesel, Felix, 2020. "The urban–rural gap in healthcare infrastructure: does government ideology matter?," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 54(3), pages 340-351.
    5. Rezwanul Hasan Rana & Khorshed Alam & Jeff Gow, 2021. "Financial development and health expenditure nexus: A global perspective," International Journal of Finance & Economics, John Wiley & Sons, Ltd., vol. 26(1), pages 1050-1063, January.
    6. Zeynep Ceylan & Abdulkadir Atalan, 2021. "Estimation of healthcare expenditure per capita of Turkey using artificial intelligence techniques with genetic algorithm‐based feature selection," Journal of Forecasting, John Wiley & Sons, Ltd., vol. 40(2), pages 279-290, March.
    7. Adeel Saleem & Ghulam Sarwar & Jahanzaib Sultan & Zulfiqar Ali, 2022. "Determinants of Public Healthcare Investment: Cointegration and Causality Evidence from Pakistan," Journal of Economic Impact, Science Impact Publishers, vol. 4(2), pages 01-13.
    8. Thomas Braendle & Alois Stutzer, 2017. "Voters and Representatives: How Should Representatives Be Selected?," CREMA Working Paper Series 2017-05, Center for Research in Economics, Management and the Arts (CREMA).
    9. Eriksen, Steffen & Wiese, Rasmus, 2019. "Policy induced increases in private healthcare financing provide short-term relief of total healthcare expenditure growth: Evidence from OECD countries," European Journal of Political Economy, Elsevier, vol. 59(C), pages 71-82.
    10. Elena Puerto-Casasnovas & Jorge Galiana-Richart & Maria Paola Mastrantonio-Ramos & Francisco López-Muñoz & Alfredo Rocafort-Nicolau, 2023. "Determinants of Public Health Personnel Spending in Spain," IJERPH, MDPI, vol. 20(5), pages 1-14, February.
    11. Carsten Colombier & Thomas Braendle, 2018. "Healthcare expenditure and fiscal sustainability: evidence from Switzerland," Public Sector Economics, Institute of Public Finance, vol. 42(3), pages 279-301.
    12. Lopreite, Milena & Zhu, Zhen, 2020. "The effects of ageing population on health expenditure and economic growth in China: A Bayesian-VAR approach," Social Science & Medicine, Elsevier, vol. 265(C).
    13. Chiachi Bonnie Lee & Chen-Mao Liao & Li-Hsin Peng & Chih-Ming Lin, 2019. "Economic fluctuations and cardiovascular diseases: A multiple-input time series analysis," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-19, August.
    14. Viera Ivanková & Rastislav Kotulič & Jaroslav Gonos & Martin Rigelský, 2019. "Health Care Financing Systems and Their Effectiveness: An Empirical Study of OECD Countries," IJERPH, MDPI, vol. 16(20), pages 1-22, October.
    15. Carsten Colombier, 2018. "Population ageing in healthcare – a minor issue? Evidence from Switzerland," Applied Economics, Taylor & Francis Journals, vol. 50(15), pages 1746-1760, March.
    16. Chakrabarty, Himadri Shekhar & Roy, Rudra Prosad, 2021. "Pandemic uncertainties and fiscal procyclicality: A dynamic non-linear approach," International Review of Economics & Finance, Elsevier, vol. 72(C), pages 664-671.
    17. Rosella Levaggi & Francesco Menoncin, 2017. "Would less regional income distribution justify the present call for devolution?," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 24(5), pages 780-799, September.
    18. Beata Gavurova & Samer Khouri & Viliam Kovac & Michaela Ferkova, 2020. "Exploration of Influence of Socioeconomic Determinants on Mortality in the European Union," IJERPH, MDPI, vol. 17(13), pages 1-21, June.
    19. Kaya, Ilker & Kaya, Ozgur, 2020. "Foreign aid, institutional quality and government fiscal behavior in emerging economies: An empirical investigation," The Quarterly Review of Economics and Finance, Elsevier, vol. 76(C), pages 59-67.
    20. Byaro, Mwoya & Kinyondo, Abel & Michello, Charles & Musonda, Patrick, 2018. "Determinants of Public Health Expenditure Growth in Tanzania: An Application of Bayesian Model," African Journal of Economic Review, African Journal of Economic Review, vol. 6(1), January.
    21. Héctor Bellido & Lorena Olmos & Juan Antonio Román-Aso, 2019. "Do political factors influence public health expenditures? Evidence pre- and post-great recession," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 455-474, April.
    22. Braendle, Thomas & Colombier, Carsten, 2017. "Healthcare expenditure projections up to 2045," MPRA Paper 104737, University Library of Munich, Germany.

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    More about this item

    Keywords

    Health expenditures; Government financing; Public hospitals; Statistical data analysis;
    All these keywords.

    JEL classification:

    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • C72 - Mathematical and Quantitative Methods - - Game Theory and Bargaining Theory - - - Noncooperative Games
    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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