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Subnational Health Spending and Soft Budget Constraints in OECD Countries

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Author Info

  • Ernesto Crivelli
  • Adam Leive
  • Thomas Stratmann

Abstract

Government spending on health has grown as a percent of GDP over the last 40 years in industrialized countries. Widespread decentralization of healthcare systems has often accompanied this increase in spending. In this paper, we explore the effect of soft budget constraints on subnational health spending in a sample of OECD countries. We find countries where subnational governments rely primarily on central government financing and enjoy large borrowing autonomy have higher healthcare spending than those with more restrictions on subnational government borrowing.

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Bibliographic Info

Paper provided by International Monetary Fund in its series IMF Working Papers with number 10/147.

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Length: 26
Date of creation: 01 Jun 2010
Date of revision:
Handle: RePEc:imf:imfwpa:10/147

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Related research

Keywords: Health care; Government expenditures; Borrowing; OECD; health spending; budget constraints; public health; health expenditure; healthcare spending; public health spending; vertical fiscal imbalance; health expenditure per capita; public spending; fiscal discipline; vertical fiscal imbalances; fiscal performance; fiscal federalism; public finance; healthcare expenditures; debt service; hard budget constraints; health sector; health expenditure share; health data; fiscal decentralization; budget allocation; government spending; fiscal behavior; fiscal policy; fiscal affairs; fiscal rules; health economics; fiscal affairs department; health policy; level of indebtedness; intergovernmental fiscal; fiscal misbehavior; expenditure levels; fiscal deficits; health insurance; health care expenditure; intergovernmental transfers; fiscal reforms; hospital sector; fiscal indiscipline; health care finance; fiscal decisions; government revenue; public health services; determinants of health; fiscal institutions; health insurance program; financial responsibilities; health care spending; provision of care; fiscal transfers; health system; public health insurance; health share; fiscal adjustment; fiscal relations; comparisons of health expenditure; health affairs; intergovernmental fiscal relations; increase in health spending; negative spillovers; health expenditures; hospital services; municipal fiscal adjustment; medicare;

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References

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  1. Gerdtham, Ulf-G. & Jonsson, Bengt, 2000. "International comparisons of health expenditure: Theory, data and econometric analysis," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 1, pages 11-53 Elsevier.
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Cited by:
  1. Eyraud, Luc & Lusinyan, Lusine, 2013. "Vertical fiscal imbalances and fiscal performance in advanced economies," Journal of Monetary Economics, Elsevier, vol. 60(5), pages 571-587.
  2. Luc Eyraud & Lusine Lusinyan, 2011. "Decentralizing Spending More Than Revenue," IMF Working Papers 11/226, International Monetary Fund.
  3. Karima Saleh, 2012. "World Bank study : A Health Sector in Transition to Universal Coverage in Ghana," World Bank Other Operational Studies 2728, The World Bank.
  4. Bernard F. Couttolenc, 2012. "Decentralization and Governance in the Ghana Health Sector," World Bank Publications, The World Bank, number 9376, October.

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