IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v23y2014i2p225-240.html
   My bibliography  Save this article

Health Care And Ideology: A Reconsideration Of Political Determinants Of Public Healthcare Funding In The Oecd

Author

Listed:
  • Helmut Herwartz
  • Bernd Theilen

Abstract

In this article, we examined if partisan ideology and electoral motives influence public healthcare expenditure (HCE) in countries of the Organization for Economic Cooperation and Development. We distinguished between the effects on the growth of the expenditures and its adjustment to violations of a long‐run equilibrium linking HCE with macroeconomic and demographic trends. Regarding the influence of partisan ideology, we found that if governments are sufficiently long in power, right‐wing governments spend less on public health than their left‐wing counterparts. Furthermore, if a right‐wing party governs without coalition partners, it responds more strongly to deviations from the long‐run HCE equilibrium than left‐wing governments. With regard to electoral motives, we found that health expenditure increases in years of elections. Independent of their partisan ideology, single‐party (minority) governments induce higher (lower) growth of public HCE. Each of these political factors by its own may increase (decrease) HCE growth by approximately one percentage point. Given an average annual growth of HCE of approximately 4.1%, political factors turn out to be important determinants of trends in public HCE. Copyright © 2013 John Wiley & Sons, Ltd.

Suggested Citation

  • Helmut Herwartz & Bernd Theilen, 2014. "Health Care And Ideology: A Reconsideration Of Political Determinants Of Public Healthcare Funding In The Oecd," Health Economics, John Wiley & Sons, Ltd., vol. 23(2), pages 225-240, February.
    • Handle: RePEc:wly:hlthec:v:23:y:2014:i:2:p:225-240
    DOI: 10.1002/hec.2917
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.2917
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.2917?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Hartwig, Jochen, 2008. "What drives health care expenditure?--Baumol's model of 'unbalanced growth' revisited," Journal of Health Economics, Elsevier, vol. 27(3), pages 603-623, May.
    2. Potrafke, Niklas, 2010. "The growth of public health expenditures in OECD countries: Do government ideology and electoral motives matter?," Journal of Health Economics, Elsevier, vol. 29(6), pages 797-810, December.
    3. Hansen, Paul & King, Alan, 1998. "Health care expenditure and GDP: panel data unit root test results--comment," Journal of Health Economics, Elsevier, vol. 17(3), pages 377-381, June.
    4. Hibbs, Douglas A., 1977. "Political Parties and Macroeconomic Policy," American Political Science Review, Cambridge University Press, vol. 71(4), pages 1467-1487, December.
    5. McCoskey, Suzanne K. & Selden, Thomas M., 1998. "Health care expenditures and GDP: panel data unit root test results," Journal of Health Economics, Elsevier, vol. 17(3), pages 369-376, June.
    6. Gerdtham, Ulf-G. & Lothgren, Mickael, 2000. "On stationarity and cointegration of international health expenditure and GDP," Journal of Health Economics, Elsevier, vol. 19(4), pages 461-475, July.
    7. Pesaran, M. Hashem & Smith, Ron, 1995. "Estimating long-run relationships from dynamic heterogeneous panels," Journal of Econometrics, Elsevier, vol. 68(1), pages 79-113, July.
    8. Ulf‐G. Gerdtham, 1992. "Pooling international health care expenditure data," Health Economics, John Wiley & Sons, Ltd., vol. 1(4), pages 217-231, December.
    9. Johansen, Soren, 1992. "Cointegration in partial systems and the efficiency of single-equation analysis," Journal of Econometrics, Elsevier, vol. 52(3), pages 389-402, June.
    10. Romer, Thomas, 1975. "Individual welfare, majority voting, and the properties of a linear income tax," Journal of Public Economics, Elsevier, vol. 4(2), pages 163-185, February.
    11. Kenneth Rogoff & Anne Sibert, 1988. "Elections and Macroeconomic Policy Cycles," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 55(1), pages 1-16.
    12. Stock, James H & Watson, Mark W, 1993. "A Simple Estimator of Cointegrating Vectors in Higher Order Integrated Systems," Econometrica, Econometric Society, vol. 61(4), pages 783-820, July.
    13. Hitiris, Theo & Posnett, John, 1992. "The determinants and effects of health expenditure in developed countries," Journal of Health Economics, Elsevier, vol. 11(2), pages 173-181, August.
    14. Alberto Alesina, 1987. "Macroeconomic Policy in a Two-Party System as a Repeated Game," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 102(3), pages 651-678.
    15. Cameron, David R., 1978. "The Expansion of the Public Economy: A Comparative Analysis," American Political Science Review, Cambridge University Press, vol. 72(4), pages 1243-1261, December.
    16. Helmut Herwartz & Bernd Theilen, 2003. "The determinants of health care expenditure: testing pooling restrictions in small samples," Health Economics, John Wiley & Sons, Ltd., vol. 12(2), pages 113-124, February.
    17. Alberto Alesina & Nouriel Roubini & Gerald D. Cohen, 1997. "Political Cycles and the Macroeconomy," MIT Press Books, The MIT Press, edition 1, volume 1, number 0262510944, December.
    18. Alberto Alesina & Alex Cukierman, 1990. "The Politics of Ambiguity," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 105(4), pages 829-850.
    19. Rogoff, Kenneth, 1990. "Equilibrium Political Budget Cycles," American Economic Review, American Economic Association, vol. 80(1), pages 21-36, March.
    20. Gallant, A Ronald & Rossi, Peter E & Tauchen, George, 1993. "Nonlinear Dynamic Structures," Econometrica, Econometric Society, vol. 61(4), pages 871-907, July.
    21. Hansen, Paul & King, Alan, 1996. "The determinants of health care expenditure: A cointegration approach," Journal of Health Economics, Elsevier, vol. 15(1), pages 127-137, February.
    22. De Donder, Philippe & Hindriks, Jean, 2007. "Equilibrium social insurance with policy-motivated parties," European Journal of Political Economy, Elsevier, vol. 23(3), pages 624-640, September.
    23. Helmut Herwartz & Bernd Theilen, 2010. "The determinants of health‐care expenditure: new results from semiparametric estimation," Health Economics, John Wiley & Sons, Ltd., vol. 19(8), pages 964-978, August.
    24. Bénédicte Vidaillet & V. d'Estaintot & P. Abécassis, 2005. "Introduction," Post-Print hal-00287137, HAL.
    25. Yianos Kontopoulos & Roberto Perotti, 1999. "Government Fragmentation and Fiscal Policy Outcomes: Evidence from OECD Countries," NBER Chapters, in: Fiscal Institutions and Fiscal Performance, pages 81-102, National Bureau of Economic Research, Inc.
    26. Gerdtham, Ulf-G. & Sogaard, Jes & Andersson, Fredrik & Jonsson, Bengt, 1992. "An econometric analysis of health care expenditure: A cross-section study of the OECD countries," Journal of Health Economics, Elsevier, vol. 11(1), pages 63-84, May.
    27. Niklas Potrafke, 2009. "Did globalization restrict partisan politics? An empirical evaluation of social expenditures in a panel of OECD countries," Public Choice, Springer, vol. 140(1), pages 105-124, July.
    28. Blomqvist, A. G. & Carter, R. A. L., 1997. "Is health care really a luxury?," Journal of Health Economics, Elsevier, vol. 16(2), pages 207-229, April.
    29. Cusack, Thomas R, 1997. "Partisan Politics and Public Finance: Changes in Public Spending in the Industrialized Democracies, 1955-1989," Public Choice, Springer, vol. 91(3-4), pages 375-395, June.
    30. Roberts, Kevin W. S., 1977. "Voting over income tax schedules," Journal of Public Economics, Elsevier, vol. 8(3), pages 329-340, December.
    31. Meltzer, Allan H & Richard, Scott F, 1981. "A Rational Theory of the Size of Government," Journal of Political Economy, University of Chicago Press, vol. 89(5), pages 914-927, October.
    32. Saikkonen, Pentti, 1991. "Asymptotically Efficient Estimation of Cointegration Regressions," Econometric Theory, Cambridge University Press, vol. 7(1), pages 1-21, March.
    33. Johansen, Soren, 1991. "Estimation and Hypothesis Testing of Cointegration Vectors in Gaussian Vector Autoregressive Models," Econometrica, Econometric Society, vol. 59(6), pages 1551-1580, November.
    34. Tsebelis, George, 1995. "Decision Making in Political Systems: Veto Players in Presidentialism, Parliamentarism, Multicameralism and Multipartyism," British Journal of Political Science, Cambridge University Press, vol. 25(3), pages 289-325, July.
    35. William D. Nordhaus, 1975. "The Political Business Cycle," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 42(2), pages 169-190.
    36. Kittel, Bernhard & Obinger, Herbert, 2002. "Political parties, institutions, and the dynamics of social expenditure in times of austerity," MPIfG Discussion Paper 02/1, Max Planck Institute for the Study of Societies.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Wang, Quan-Jing & Feng, Gen-Fu & Chen, Yin E. & Wen, Jun & Chang, Chun-Ping, 2019. "The impacts of government ideology on innovation: What are the main implications?," Research Policy, Elsevier, vol. 48(5), pages 1232-1247.
    2. Clemens Fuest & Klaus Gründler & Niklas Potrafke & Fabian Ruthardt, 2021. "Read My Lips? Taxes and Elections," CESifo Working Paper Series 9401, CESifo.
    3. 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.
    4. repec:zbw:rwirep:0557 is not listed on IDEAS
    5. Yonghong An & Kai Zhao & Rong Zhou, 2016. "Health spending and public pension: evidence from panel data," Applied Economics, Taylor & Francis Journals, vol. 48(11), pages 987-1004, March.
    6. Potrafke, Niklas, 2020. "General or central government? Empirical evidence on political cycles in budget composition using new data for OECD countries," European Journal of Political Economy, Elsevier, vol. 63(C).
    7. Becchetti, Leonardo & Conzo, Pierluigi & Salustri, Francesco, 2017. "The impact of health expenditure on the number of chronic diseases," Health Policy, Elsevier, vol. 121(9), pages 955-962.
    8. Niklas Potrafke & Felix Roesel, 2020. "The urban–rural gap in healthcare infrastructure: does government ideology matter?," Regional Studies, Taylor & Francis Journals, vol. 54(3), pages 340-351, March.
    9. Almudena Recio-Román & Manuel Recio-Menéndez & María Victoría Román-González, 2021. "Vaccine Hesitancy and Political Populism. An Invariant Cross-European Perspective," IJERPH, MDPI, vol. 18(24), pages 1-20, December.
    10. Helmut Herwartz & Bernd Theilen, 2021. "Government ideology and fiscal consolidation: Where and when do government parties adjust public spending?," Public Choice, Springer, vol. 187(3), pages 375-401, June.
    11. Jäger, Philipp & Schmidt, Torsten, 2016. "The political economy of public investment when population is aging: A panel cointegration analysis," European Journal of Political Economy, Elsevier, vol. 43(C), pages 145-158.
    12. Almudena Recio-Román & Manuel Recio-Menéndez & María Victoria Román-González, 2022. "Political Populism, Institutional Distrust and Vaccination Uptake: A Mediation Analysis," IJERPH, MDPI, vol. 19(6), pages 1-13, March.
    13. 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.
    14. Björn Kauder & Manuela Krause & Niklas Potrafke, 2018. "Electoral cycles in MPs’ salaries: evidence from the German states," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 25(4), pages 981-1000, August.
    15. Clemente, Jesús & Lazaro, Angelina & Montanes, Antonio, 2016. "Public health expenditure in Spain: is there partisan behaviour?," MPRA Paper 69781, University Library of Munich, Germany.
    16. Takaku, Reo & Bessho, Shun-ichiro, 2018. "Political cycles in physician employment: A case of Japanese local public hospitals," Social Science & Medicine, Elsevier, vol. 216(C), pages 97-106.
    17. 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.
    18. Alexander Karmann & Felix Roesel, 2017. "Hospital Policy and Productivity – Evidence from German States," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1548-1565, December.
    19. Potrafke, Niklas, 2017. "Partisan politics: The empirical evidence from OECD panel studies," Journal of Comparative Economics, Elsevier, vol. 45(4), pages 712-750.
    20. Philipp Jäger & Torsten Schmidt, 2015. "The Political Economy of Public Investment when Population is Aging – A Panel Cointegration Analysis," Ruhr Economic Papers 0557, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    21. Abbott, Andrew & Jones, Philip, 2021. "Government response to increased demand for public services: The cyclicality of government health expenditures in the OECD," European Journal of Political Economy, Elsevier, vol. 68(C).
    22. Junming Li & Xiulan Han, 2022. "Spatiotemporal Evolution and Drivers of Total Health Expenditure across Mainland China in Recent Years," IJERPH, MDPI, vol. 20(1), pages 1-19, December.
    23. Liang, Li-Lin & Mirelman, Andrew J., 2014. "Why do some countries spend more for health? An assessment of sociopolitical determinants and international aid for government health expenditures," Social Science & Medicine, Elsevier, vol. 114(C), pages 161-168.
    24. Clemente, Jesús & Lázaro-Alquézar, Angelina & Montañés, Antonio, 2019. "Convergence in Spanish Public health expenditure: Has the decentralization process generated disparities?," Health Policy, Elsevier, vol. 123(5), pages 503-507.
    25. Brender, Agnes, 2018. "Government Ideology and Arms Exports," ILE Working Paper Series 21, University of Hamburg, Institute of Law and Economics.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Herwartz, Helmut & Theilen, Bernd, 2014. "Partisan influence on social spending under market integration, fiscal pressure and institutional change," European Journal of Political Economy, Elsevier, vol. 34(C), pages 409-424.
    2. Potrafke, Niklas, 2010. "The growth of public health expenditures in OECD countries: Do government ideology and electoral motives matter?," Journal of Health Economics, Elsevier, vol. 29(6), pages 797-810, December.
    3. Niklas Potrafke, 2012. "Political cycles and economic performance in OECD countries: empirical evidence from 1951–2006," Public Choice, Springer, vol. 150(1), pages 155-179, January.
    4. Helmut Herwartz & Bernd Theilen, 2021. "Government ideology and fiscal consolidation: Where and when do government parties adjust public spending?," Public Choice, Springer, vol. 187(3), pages 375-401, June.
    5. Niklas Potrafke, 2012. "Is German domestic social policy politically controversial?," Public Choice, Springer, vol. 153(3), pages 393-418, December.
    6. Herwartz, Helmut & Theilen, Bernd, 2017. "Ideology and redistribution through public spending," European Journal of Political Economy, Elsevier, vol. 46(C), pages 74-90.
    7. 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.
    8. Potrafke, Niklas, 2017. "Partisan politics: The empirical evidence from OECD panel studies," Journal of Comparative Economics, Elsevier, vol. 45(4), pages 712-750.
    9. César Martinelli & John Duggan, 2014. "The Political Economy of Dynamic Elections: A Survey and Some New Results," Working Papers 1403, Centro de Investigacion Economica, ITAM.
    10. Vitor Castro, 2017. "Pure, White and Deadly… Expensive: A Bitter Sweetness in Health Care Expenditure," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1644-1666, December.
    11. Hartwig, Jochen, 2008. "What drives health care expenditure?--Baumol's model of 'unbalanced growth' revisited," Journal of Health Economics, Elsevier, vol. 27(3), pages 603-623, May.
    12. Niklas Potrafke, 2011. "Does government ideology influence budget composition? Empirical evidence from OECD countries," Economics of Governance, Springer, vol. 12(2), pages 101-134, June.
    13. Christian Bjørnskov & Niklas Potrafke, 2012. "Political Ideology and Economic Freedom Across Canadian Provinces," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 38(2), pages 143-166.
    14. Helmut Herwartz & Bernd Theilen, 2003. "The determinants of health care expenditure: testing pooling restrictions in small samples," Health Economics, John Wiley & Sons, Ltd., vol. 12(2), pages 113-124, February.
    15. Jennifer Roberts, 1999. "Sensitivity of elasticity estimates for OECD health care spending: analysis of a dynamic heterogeneous data field," Health Economics, John Wiley & Sons, Ltd., vol. 8(5), pages 459-472, August.
    16. Bove, Vincenzo & Efthyvoulou, Georgios & Navas, Antonio, 2017. "Political cycles in public expenditure: butter vs guns," Journal of Comparative Economics, Elsevier, vol. 45(3), pages 582-604.
    17. Clemens Fuest & Klaus Gründler & Niklas Potrafke & Fabian Ruthardt, 2021. "Read My Lips? Taxes and Elections," EconPol Working Paper 71, ifo Institute - Leibniz Institute for Economic Research at the University of Munich.
    18. Chakroun, Mohamed, 2009. "Health care expenditure and GDP: An international panel smooth transition approach," MPRA Paper 14322, University Library of Munich, Germany.
    19. Potrafke, Niklas, 2020. "General or central government? Empirical evidence on political cycles in budget composition using new data for OECD countries," European Journal of Political Economy, Elsevier, vol. 63(C).
    20. Persson, Torsten & Tabellini, Guido, 1999. "Political economics and macroeconomic policy," Handbook of Macroeconomics, in: J. B. Taylor & M. Woodford (ed.), Handbook of Macroeconomics, edition 1, volume 1, chapter 22, pages 1397-1482, Elsevier.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:23:y:2014:i:2:p:225-240. See general information about how to correct material in RePEc.

    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 CitEc recognized a bibliographic reference but did not link an item in RePEc 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 RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

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

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.