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Federalism and regional health care expenditures: an empirical analysis for the Swiss cantons

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  • Luca Crivelli
  • Massimo Filippini
  • Ilaria Mosca

    (Faculty of Economics, University of Lugano (USI), Lugano, Switzerland)

Abstract

Switzerland (7.2 million inhabitants) is a federal state composed of 26 cantons. The autonomy of cantons and a particular health insurance system create strong heterogeneity in terms of regulation and organisation of health care services. In this study we use a single-equation approach to model the per capita cantonal expenditures on health care services and postulate that per capita health expenditures depend on some economic, demographic and structural factors. The empirical analysis demonstrates that a larger share of old people tends to increase health costs and that physicians paid on a fee-for-service basis swell expenditures, thus highlighting a possible phenomenon of supply-induced demand. Copyright © 2005 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.1072
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Bibliographic Info

Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 15 (2006)
Issue (Month): 5 ()
Pages: 535-541

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Handle: RePEc:wly:hlthec:v:15:y:2006:i:5:p:535-541

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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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  1. Frey, Bruno S, 1994. "Direct Democracy: Politico-economic Lessons from Swiss Experience," American Economic Review, American Economic Association, vol. 84(2), pages 338-42, May.
  2. Amemiya, Takeshi & MaCurdy, Thomas E, 1986. "Instrumental-Variable Estimation of an Error-Components Model," Econometrica, Econometric Society, vol. 54(4), pages 869-80, July.
  3. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-77, June.
  4. Wagstaff, Adam & van Doorslaer, Eddy & van der Burg, Hattem & Calonge, Samuel & Christiansen, Terkel & Citoni, Guido & Gerdtham, Ulf-G & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "Equity in the finance of health care: some further international comparisons1," Journal of Health Economics, Elsevier, vol. 18(3), pages 263-290, June.
  5. Bruno S. Frey & Alois Stutzer, . "Happiness, Economy and Institutions," IEW - Working Papers 015, Institute for Empirical Research in Economics - University of Zurich.
  6. McGuire, Thomas G., 2000. "Physician agency," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 9, pages 461-536 Elsevier.
  7. Peter Zweifel & Stefan Felder & Markus Meiers, 1999. "Ageing of population and health care expenditure: a red herring?," Health Economics, John Wiley & Sons, Ltd., vol. 8(6), pages 485-496.
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Citations

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Cited by:
  1. Luthi, Eva & Schmidheiny, Kurt, 2011. "The Effect of Agglomeration Size on Local Taxes," CEPR Discussion Papers 8344, C.E.P.R. Discussion Papers.
  2. Oliver Reich & Cornelia Weins & Claudia Schusterschitz & Magdalena Thöni, 2012. "Exploring the disparities of regional health care expenditures in Switzerland: some empirical evidence," The European Journal of Health Economics, Springer, vol. 13(2), pages 193-202, April.
  3. David Prieto & Santiago Lago-Peñas, 2012. "Decomposing the determinants of health care expenditure: the case of Spain," The European Journal of Health Economics, Springer, vol. 13(1), pages 19-27, February.
  4. Massimiliano Piacenza & Gilberto Turati, 2010. "Does fiscal discipline towards sub-national governments affect citizens’ well-being? evidence on health," Working Papers 2010/56, Institut d'Economia de Barcelona (IEB).
  5. Okma, Kieke G.H. & Crivelli, Luca, 2013. "Swiss and Dutch “consumer-driven health care”: Ideal model or reality?," Health Policy, Elsevier, vol. 109(2), pages 105-112.
  6. Moscone, Francesco & Knapp, Martin & Tosetti, Elisa, 2007. "Mental health expenditure in England: A spatial panel approach," Journal of Health Economics, Elsevier, vol. 26(4), pages 842-864, July.
  7. Masayoshi Hayashi, 2011. "The effects of medical factors on transfer deficits in Public Assistance in Japan: a quantile regression analysis," International Journal of Health Care Finance and Economics, Springer, vol. 11(4), pages 287-307, December.
  8. Joan Costa-i-Font & Marin Gemmill & Gloria Rubert, 2009. "Re-visiting the health care luxury good hypothesis: aggregation, precision, and publication biases?," LSE Research Online Documents on Economics 25303, London School of Economics and Political Science, LSE Library.
  9. Luca Crivelli & Paola Salari, 2012. "Fiscal federalism and income redistribution through healthcare financing: An empirical analysis for the Swiss cantons," CEPRA working paper 1204, USI Università della Svizzera italiana.
  10. Lagravinese, Raffaele & Paradiso, Massimo, 2012. "Corruption and health expenditure in Italy," MPRA Paper 43215, University Library of Munich, Germany.
  11. Jochen Hartwig & Jan-Egbert Sturm, 2012. "An outlier-robust extreme bounds analysis of the determinants of health-care expenditure growth," KOF Working papers 12-307, KOF Swiss Economic Institute, ETH Zurich.
  12. Andree Ehlert & Dirk Oberschachtsiek & Stefan Prawda, 2013. "Cost Containment and Managed Care: Evidence from German Macro Data," Working Paper Series in Economics 284, University of Lüneburg, Institute of Economics.
  13. Ehtisham Ahmad & Giorgio Brosio & Vito Tanzi, 2008. "Local Service Provision in Selected Oecd Countries," IMF Working Papers 08/67, International Monetary Fund.
  14. Di Matteo, Livio, 2014. "Physician numbers as a driver of provincial government health spending in Canadian health policy," Health Policy, Elsevier, vol. 115(1), pages 18-35.
  15. Boris Kaiser & Christian Schmid, 2013. "Does Physician Dispensing Increase Drug Expenditures?," Diskussionsschriften dp1303, Universitaet Bern, Departement Volkswirtschaft.
  16. Ehtisham Ahmad & Giorgio Brosio, 2009. "Decentralization and local service provision: what do we know?," LSE Research Online Documents on Economics 38347, London School of Economics and Political Science, LSE Library.
  17. André Martínez & Carolina Rodríguez-Zamora, 2011. "An Evaluation of the 1997 Fiscal Decentralization Reform in Mexico: The Case of the Health Sector," Working Papers 2011-16, Banco de México.
  18. Giardina, Emilio & Cavalieri, Marina & Guccio, Calogero & Mazza, Isidoro, 2009. "Federalism, Party Competition and Budget Outcome: Empirical Findings on Regional Health Expenditure in Italy," MPRA Paper 16437, University Library of Munich, Germany.
  19. Hai Zhong, 2010. "The impact of decentralization of health care administration on equity in health and health care in Canada," International Journal of Health Care Finance and Economics, Springer, vol. 10(3), pages 219-237, September.

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