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

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  • Brändle, Thomas
  • Colombier, Carsten
Abstract
A better understanding of the determinants of public health care expenditures is key to designing effective health policies. We integrate supply and demand-side determinants, factors from political economy and health policy reforms into an empirical analysis of the highly decentralized Swiss health care system. We compile a novel data set of the cantonal health care expenditure in Switzerland spanning the period 1970 - 2012. Using 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 and mandatory fiscal referenda, do not appear to limit public health care expenditure growth.

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  • Brändle, Thomas & Colombier, Carsten, 2015. "What drives public health care expenditure growth? Evidence from Swiss cantons, 1970-2012," FiFo Discussion Papers - Finanzwissenschaftliche Diskussionsbeiträge 15-2, University of Cologne, FiFo Institute for Public Economics.
    • Handle: RePEc:zbw:uoccpe:152
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    6. 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.
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    11. 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.
    12. 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.
    13. Braendle, Thomas & Colombier, Carsten, 2017. "Healthcare expenditure projections up to 2045," MPRA Paper 104737, University Library of Munich, Germany.
    14. Eggli, Yves & Stadelmann, Pierre & Piaget-Rossel, Romain & Marti, Joachim, 2019. "Heterogeneity in The drivers of health expenditures financed by health insurance in a fragmented health system: The case of Switzerland," Health Policy, Elsevier, vol. 123(12), pages 1275-1281.
    15. 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.
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    17. 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.
    18. 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.
    19. 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.
    20. 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.
    21. 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.
    22. 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.

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    More about this item

    Keywords

    Public health care expenditure; Panel data; Fiscal rules; Political selection;
    All these keywords.

    JEL classification:

    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • D72 - Microeconomics - - Analysis of Collective Decision-Making - - - Political Processes: Rent-seeking, Lobbying, Elections, Legislatures, and Voting Behavior
    • 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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