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The stimulative effect of an unconditional block grant on the decentralized provision of care

Author

Listed:
  • Mark Kattenberg

    (CPB Netherlands Bureau for Economic Policy Analysis)

  • Wouter Vermeulen

Abstract

Understanding the impact of central government grants on decentralized health care provision is of crucial importance for the design of grant systems, yet empirical evidence on the prevalence of flypaper effects in this domain is rare. Understanding the impact of central government grants on decentralized health care provision is of crucial importance for the design of grant systems, yet empirical evidence on the prevalence of flypaper effects in this domain is rare. We study the decentralization of home care in the Netherlands and exploit the gradual introduction of formula-based equalization to identify the effect of exogenous changes in an unconditional block grant on local expenditure and utilization. A one euro increase in central government grants raises local expenditure by fifty cents, while adjustments occur through the number of hours as well as through substitution between basic and more advanced types of assistance. These findings suggest that conditioning of grants is not required for the central government to retain some control over the decentralized provision of care.

Suggested Citation

  • Mark Kattenberg & Wouter Vermeulen, 2015. "The stimulative effect of an unconditional block grant on the decentralized provision of care," CPB Discussion Paper 308, CPB Netherlands Bureau for Economic Policy Analysis.
    • Handle: RePEc:cpb:discus:308
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    References listed on IDEAS

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    Cited by:

    1. Mark Kattenberg & Pieter Bakx, 2018. "Are substitute services a barrier to controlling long-term care expenditures?," CPB Discussion Paper 382.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    2. Rudy Douven & Pieter Bakx & Frederik T. Schut, 2016. "Does independent needs assessment limit supply-side moral hazard in long-term care?," CPB Discussion Paper 327.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    3. Mark Kattenberg & Pieter Bakx, 2018. "Are substitute services a barrier to controlling long-term care expenditures?," CPB Discussion Paper 382, CPB Netherlands Bureau for Economic Policy Analysis.
    4. Rudy Douven & Pieter Bakx & Frederik T. Schut, 2016. "Does independent needs assessment limit supply-side moral hazard in long-term care?," CPB Discussion Paper 327, CPB Netherlands Bureau for Economic Policy Analysis.

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    More about this item

    JEL classification:

    • H42 - Public Economics - - Publicly Provided Goods - - - Publicly Provided Private Goods
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H71 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Taxation, Subsidies, and Revenue
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare

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