Perspectives on Health Decentralization and Interjurisdictional Competition among Local Governments in the Philippines
AbstractIt has only been in the recent years that developing countries are increasingly decentralizing the provision of health care to their local governments. This paper explores some key issues related to health decentralization in the Philippines identified in literature and in course of interviews with country officials working in the health care area. Issues of planning and budgeting of health plans, revenue and expenditure assignments in a decentralized health system are discussed. In addition, issues specific to the determinants of local government health spending are closely examined. One of the key questions closely examined is whether there are any incentives for local governments to compete through spending on health in a decentralized system. The question of spatial competition is addressed through an empirical analysis that attempts to test the presence of horizontal and vertical fiscal interactions among local governments in the Philippines using local government health expenditures data. While there is a consistent positive interaction among municipalities in health spending, the interaction of municipalities with provinces is positive but weakly significant. The positive fiscal interaction among local governments is explained as a result of potential competition for health care inputs.
Download InfoIf 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.
Bibliographic InfoPaper provided by Philippine Institute for Development Studies in its series Discussion Papers with number DP 2013-20.
Date of creation: 2013
Date of revision:
Philippines; local health care; health decentralization; fiscal competition; horizontal fiscal interaction; vertical fiscal interaction; Local Government Code of 1991;
This paper has been announced in the following NEP Reports:
- NEP-ALL-2013-07-15 (All new papers)
- NEP-CWA-2013-07-15 (Central & Western Asia)
- NEP-HEA-2013-07-15 (Health Economics)
- NEP-SEA-2013-07-15 (South East Asia)
- NEP-URE-2013-07-15 (Urban & Real Estate Economics)
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.:
- Emilie Caldeira & Martial Foucault & Grégoire Rota-Graziosi, 2010. "Decentralisation in Africa and Fiscal Competition Evidence from Benin," CIRANO Working Papers 2010s-35, CIRANO.
- Hans-Werner Sinn, 2004.
"The New Systems Competition,"
Perspektiven der Wirtschaftspolitik,
Verein für Socialpolitik, vol. 5(1), pages 23-38, 02.
- Hans-Werner Sinn, 2001. "The New Systems Competition," CESifo Working Paper Series 623, CESifo Group Munich.
- Hans-Werner Sinn, 2002. "The New Systems Competition," NBER Working Papers 8747, National Bureau of Economic Research, Inc.
- Sinn, Hans-Werner, 2004. "The new systems competition," Munich Reprints in Economics 19608, University of Munich, Department of Economics.
- Charles M. Tiebout, 1956. "A Pure Theory of Local Expenditures," Journal of Political Economy, University of Chicago Press, vol. 64, pages 416.
- Turnbull, Geoffrey K & Djoundourian, Salpie S, 1993. " Overlapping Jurisdictions: Substitutes or Complements?," Public Choice, Springer, vol. 75(3), pages 231-45, March.
- Khaleghian, Peyvand, 2003. "Decentralization and public services : the case of immunization," Policy Research Working Paper Series 2989, The World Bank.
- Bewley, Truman F, 1981. "A Critique of Tiebout's Theory of Local Public Expenditures," Econometrica, Econometric Society, vol. 49(3), pages 713-40, May.
- Revelli Federico, 2002.
"Reaction or interaction? Spatial process identification in multi-tiered government structures,"
Department of Economics and Statistics Cognetti de Martiis. Working Papers
200202, University of Turin.
- Revelli, Federico, 2003. "Reaction or interaction? Spatial process identification in multi-tiered government structures," Journal of Urban Economics, Elsevier, vol. 53(1), pages 29-53, January.
- Pranab Bardhan, 2002. "Decentralization of Governance and Development," Journal of Economic Perspectives, American Economic Association, vol. 16(4), pages 185-205, Fall.
- Rebecca J. Campbell, 2004. "Leviathan and Fiscal Illusion in Local Government Overlapping Jurisdictions," Public Choice, Springer, vol. 120(3_4), pages 301-329, 09.
- Starrett, David A, 1980. "Measuring Externalities and Second Best Distortions in the Theory of Local Public Goods," Econometrica, Econometric Society, vol. 48(3), pages 627-42, April.
- Aronsson, Thomas & Lundberg, Johan & Wikstrom, Magnus, 2000. "The impact of regional public expenditures on the local decision to spend," Regional Science and Urban Economics, Elsevier, vol. 30(2), pages 185-202, March.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Aniceto Orbeta).
If references are entirely missing, you can add them using this form.