Advanced Search
MyIDEAS: Login to save this article or follow this journal

The political economy of austerity and healthcare: Cross-national analysis of expenditure changes in 27 European nations 1995–2011

Contents:

Author Info

  • Reeves, Aaron
  • McKee, Martin
  • Basu, Sanjay
  • Stuckler, David
Registered author(s):

    Abstract

    Why have patterns of healthcare spending varied during the Great Recession? Using cross-national, harmonised data for 27 EU countries from 1995 to 2011, we evaluated political, economic, and health system determinants of recent changes to healthcare expenditure. Data from EuroStat, the IMF, and World Bank (2013 editions) were evaluated using multivariate random- and fixed-effects models, correcting for pre-existing time-trends. Reductions in government health expenditure were not significantly associated with magnitude of economic recessions (annual change in GDP, p=0.31, or cumulative decline, p=0.40 or debt crises (measured by public debt as a percentage of GDP, p=0.38 or per capita, p=0.83)). Nor did ideology of governing parties have an effect. In contrast, each $100 reduction in tax revenue was associated with a $2.72 drop in health spending (95% CI: $1.03–4.41). IMF borrowers were significantly more likely to reduce healthcare budgets than non-IMF borrowers (OR=3.88, 95% CI: 1.95 –7.74), even after correcting for potential confounding by indication. Exposure to lending from international financial institutions, tax revenue falls, and decisions to implement cuts correlate more closely than underlying economic conditions or orientation of political parties with healthcare expenditure change in EU member states.

    Download Info

    If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
    File URL: http://www.sciencedirect.com/science/article/pii/S0168851013003059
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.

    Bibliographic Info

    Article provided by Elsevier in its journal Health Policy.

    Volume (Year): 115 (2014)
    Issue (Month): 1 ()
    Pages: 1-8

    as in new window
    Handle: RePEc:eee:hepoli:v:115:y:2014:i:1:p:1-8

    Contact details of provider:
    Web page: http://www.elsevier.com/locate/healthpol

    Related research

    Keywords: Political economy; Austerity; Recession; IMF; Healthcare;

    References

    References listed on IDEAS
    Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
    as in new window
    1. Andrea Pescatori & Daniel Leigh & Jaime Guajardo & Pete Devries, 2011. "A New Action-Based Dataset of Fiscal Consolidation," IMF Working Papers 11/128, International Monetary Fund.
    2. Kim, Il-Ho & Muntaner, Carles & Khang, Young-Ho & Paek, Domyung & Cho, Sung-Il, 2006. "The relationship between nonstandard working and mental health in a representative sample of the South Korean population," Social Science & Medicine, Elsevier, vol. 63(3), pages 566-574, August.
    3. Griliches, Zvi, 1974. "Errors in Variables and Other Unobservables," Econometrica, Econometric Society, vol. 42(6), pages 971-98, November.
    4. Zvi Griliches & Jerry A. Hausman, 1984. "Errors in Variables in Panel Data," NBER Technical Working Papers 0037, National Bureau of Economic Research, Inc.
    5. Carmen M. Reinhart & Kenneth S. Rogoff, 2010. "Growth in a Time of Debt," NBER Working Papers 15639, National Bureau of Economic Research, Inc.
    6. Beck, T.H.L. & Clarke, G. & Groff, A. & Keefer , P. & Walsh, P., 2001. "New tools in comparative political economy: The database of political institutions," Open Access publications from Tilburg University urn:nbn:nl:ui:12-3125517, Tilburg University.
    7. Reinhart, Carmen M. & Rogoff, Kenneth S., 2010. "Growth in a Time of Debt," Scholarly Articles 11129154, Harvard University Department of Economics.
    8. Fergusson, David M. & John Horwood, L. & Woodward, Lianne J., 2001. "Unemployment and psychosocial adjustment in young adults: causation or selection?," Social Science & Medicine, Elsevier, vol. 53(3), pages 305-320, August.
    9. Antonio Spilimbergo & Martin Schindler & Steven A. Symansky, 2009. "Fiscal Multipliers," IMF Staff Position Notes 2009/11, International Monetary Fund.
    10. Przeworski, Adam & Vreeland, James Raymond, 2000. "The effect of IMF programs on economic growth," Journal of Development Economics, Elsevier, vol. 62(2), pages 385-421, August.
    11. Conor Keegan & Steve Thomas & Charles Normand & Conceição Portela, 2013. "Measuring recession severity and its impact on healthcare expenditure," International Journal of Health Care Finance and Economics, Springer, vol. 13(2), pages 139-155, June.
    12. Axel Dreher & Jan-Egbert Sturm & James Raymond Vreeland, 2007. "Development Aid and International Politics: Does membership on the UN Security Council influence World Bank decisions?," KOF Working papers 07-171, KOF Swiss Economic Institute, ETH Zurich.
    13. Burgard, Sarah A. & Brand, Jennie E. & House, James S., 2009. "Perceived job insecurity and worker health in the United States," Social Science & Medicine, Elsevier, vol. 69(5), pages 777-785, September.
    14. James Vreeland, 2006. "IMF program compliance: Aggregate index versus policy specific research strategies," The Review of International Organizations, Springer, vol. 1(4), pages 359-378, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Lists

    This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

    Statistics

    Access and download statistics

    Corrections

    When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:115:y:2014:i:1:p:1-8. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Zhang, Lei) or () The email address of this maintainer does not seem to be valid anymore. Please ask to update the entry or send us the correct address.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If references are entirely missing, you can add them using this form.

    If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.