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Drivers of health care expenditure: Does Baumol's cost disease loom large?

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  • Colombier, Carsten

Abstract

According to Baumol (1993) health care epitomises Baumol's cost disease. Sectors that suffer from Baumol's cost disease are characterised by slow productivity growth due to a high labour coefficient. As a result, unit costs of these sectors rise inexorably if the respective wages increase with productivity growth of the progressive industries such as manufacturing. Thus, according to Baumol (1993) the secular rise in health-care expenditure has been unavoidable. This present paper demonstrates that health care is contracted by Baumol's cost disease, but only to a minor extent. Consequently, policy-makers have more leeway to curbever-increasing health-care expenditure than is suggested by Baumol (1993) and other authors. In addition, we test the implications of Baumol's cost disease for health care by avoiding the well-known flaws in constructing medical price indices. Therefore, the adjusted Baumol variable derived in this paper is also extremely appropriate to test the validity of Baumol's cost diseases of other service industries such as education or the live performing arts. Additionally, our analysis suggests that health care is rather a necessity than a luxury at the national level, which conflicts with macroeconomic evidence provided in the relevant literature.

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  • Colombier, Carsten, 2012. "Drivers of health care expenditure: Does Baumol's cost disease loom large?," FiFo Discussion Papers - Finanzwissenschaftliche Diskussionsbeiträge 12-5, University of Cologne, FiFo Institute for Public Economics.
  • Handle: RePEc:zbw:uoccpe:125
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    Cited by:

    1. Manabu Nose, 2017. "Estimation of drivers of public education expenditure: Baumol’s effect revisited," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 24(3), pages 512-535, June.
    2. Bradley Rossen & Akhter Faroque, 2016. "Diagnosing the Causes of Rising Health-Care Expenditure in Canada: Does Baumol's Cost Disease Loom Large?," American Journal of Health Economics, MIT Press, vol. 2(2), pages 184-212, Spring.
    3. Atanda, Akinwande & Reed, W. Robert, 2020. "Not Evidence for Baumol's Cost Disease. A replication study of Hartwig (Journal of Health Economics, 2008)," International Journal for Re-Views in Empirical Economics (IREE), ZBW - Leibniz Information Centre for Economics, vol. 4(2020-1), pages 1-10.
    4. Lars-Erik Borge & Kjetil Hatlebakk Hove & Tobias Lillekvelland & Per Tovmo, 2018. "Cost disease in defense and public administration: Baumol and politics," Public Choice, Springer, vol. 175(1), pages 1-18, April.
    5. Kaan Celebi & Jochen Hartwig & Anna Pauliina Sandqvist, 2024. "Baumol's Cost Disease in Acute vs. Long-term Care - Do the Differences Loom Large?," Chemnitz Economic Papers 062, Department of Economics, Chemnitz University of Technology.
    6. Akinwande Atanda & W. Robert Reed, 2019. "Not Evidence for Baumol’s Cost Disease," Working Papers in Economics 19/05, University of Canterbury, Department of Economics and Finance.
    7. 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.
    8. Siciliani Luigi, 2013. "The Economics of Long-Term Care," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 14(2), pages 343-375, August.
    9. Nor Aziah Abd Kadir & Nur Fakhzan Marwan & Adibah Hussin & Rosmah Nizam & Fazreena Mansor, 2022. "Long Run Analysis between Climate Change, Socio-Economic Factors and Technology on Health Expenditure in Malaysia," International Journal of Human Resource Studies, Macrothink Institute, vol. 12(2), pages 6589-6589, December.
    10. Laurie J. Bates & Rexford E. Santerre, 2015. "Does Baumol's Cost Disease Account for Nonfederal Public-Sector Cost Growth in the United States? A New Test of an Old Idea," Social Science Quarterly, Southwestern Social Science Association, vol. 96(1), pages 251-260, March.
    11. Morales Sarriera, Javier & Salvucci, Frederick P. & Zhao, Jinhua, 2018. "Worse than Baumol's disease: The implications of labor productivity, contracting out, and unionization on transit operation costs," Transport Policy, Elsevier, vol. 61(C), pages 10-16.
    12. Carsten Colombier, 2018. "Population ageing in healthcare – a minor issue? Evidence from Switzerland," Applied Economics, Taylor & Francis Journals, vol. 50(15), pages 1746-1760, March.
    13. Akinwande Atanda & Andrea Kutinova Menclova & W. Robert Reed, 2018. "Is health care infected by Baumol's cost disease? Test of a new model," Health Economics, John Wiley & Sons, Ltd., vol. 27(5), pages 832-849, May.
    14. Corlet Walker, Christine & Druckman, Angela & Jackson, Tim, 2021. "Welfare systems without economic growth: A review of the challenges and next steps for the field," Ecological Economics, Elsevier, vol. 186(C).
    15. Bates, Laurie J. & Santerre, Rexford E., 2013. "Does the U.S. health care sector suffer from Baumol's cost disease? Evidence from the 50 states," Journal of Health Economics, Elsevier, vol. 32(2), pages 386-391.
    16. Hofmarcher, Maria M. & Festl, Eva & Bishop-Tarver, Leslie, 2016. "Health sector employment growth calls for improvements in labor productivity," Health Policy, Elsevier, vol. 120(8), pages 894-902.
    17. Akinwande A. Atanda & Andrea K. Menclova & W. Robert Reed, 2016. "Is Health Care Infected by Baumol’s Cost Disease? Test of a New Model Using an OECD Dataset," Working Papers in Economics 16/04, University of Canterbury, Department of Economics and Finance.
    18. Chen, Xin & Moul, Charles C., 2014. "Disease or utopia? Testing Baumol in education," Economics Letters, Elsevier, vol. 122(2), pages 220-223.
    19. Jochen Hartwig & Jan-Egbert Sturm, 2014. "Robust determinants of health care expenditure growth," Applied Economics, Taylor & Francis Journals, vol. 46(36), pages 4455-4474, December.
    20. Anu Keshiro Toriola & Emmanuel Oladapo George & Walid Gbadebo Adebosin, 2021. "The Nexus Between Commodity Terms and National Terms of Trade of Sub-Sahara African Countries: Implication for Intersectoral Linkage," South-Eastern Europe Journal of Economics, Association of Economic Universities of South and Eastern Europe and the Black Sea Region, vol. 19(1), pages 79-98.
    21. Jamiil Jeetoo, 2020. "Healthcare Expenditure and Baumol Cost Disease in Sub-Sahara Africa," Economics Bulletin, AccessEcon, vol. 40(4), pages 2704-2716.

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    More about this item

    Keywords

    health-care expenditure; Baumol's cost disease; the macroeconomics of health care; the adjusted Baumol variable;
    All these keywords.

    JEL classification:

    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I10 - Health, Education, and Welfare - - Health - - - General

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