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Public employment and political pressure: The case of French hospitals

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  • Clark, Andrew E.
  • Milcent, Carine

Abstract

This paper uses an unusual administrative dataset covering the universe of French hospitals to consider hospital employment: this is consistently higher in public hospitals than in not-for-profit (NFP) or private hospitals, even controlling for a number of measures of hospital output. NFP hospitals serve as a benchmark, being very similar to public hospitals, but without political influence on their hiring. Public-hospital employment is positively correlated with the local unemployment rate, whereas no such relationship is found in other hospitals. This is consistent with public hospitals providing employment in depressed areas. We appeal to the Political Science literature and calculate local political allegiance, using expert evaluations on various parties’ political positions and local election results. The relationship between public-hospital employment and local unemployment is stronger the more left-wing the local municipality. This latter result holds especially when electoral races are tight, consistent with a concern for re-election.

Suggested Citation

  • Clark, Andrew E. & Milcent, Carine, 2011. "Public employment and political pressure: The case of French hospitals," Journal of Health Economics, Elsevier, vol. 30(5), pages 1103-1112.
  • Handle: RePEc:eee:jhecon:v:30:y:2011:i:5:p:1103-1112 DOI: 10.1016/j.jhealeco.2011.07.007
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    1. Haskel, Jonathan & Sanchis, Amparo, 1995. "Privatisation and X-Inefficiency: A Bargaining Approach," Journal of Industrial Economics, Wiley Blackwell, vol. 43(3), pages 301-321, September.
    2. J. David Brown & John S. Earle & Almos Telegdy, 2006. "The Productivity Effects of Privatization: Longitudinal Estimates from Hungary, Romania, Russia, and Ukraine," Journal of Political Economy, University of Chicago Press, vol. 114(1), pages 61-99, February.
    3. Simon Luechinger & Stephan Meier & Alois Stutzer, 2010. "Why Does Unemployment Hurt the Employed?: Evidence from the Life Satisfaction Gap Between the Public and the Private Sector," Journal of Human Resources, University of Wisconsin Press, vol. 45(4), pages 998-1045.
    4. Melly, Blaise & Puhani, Patrick A., 2008. "Privatization and Changes in the Wage Structure: Evidence from Firm Personnel Records," IZA Discussion Papers 3760, Institute for the Study of Labor (IZA).
    5. David G. Blanchflower & Andrew J. Oswald, 1995. "The Wage Curve," MIT Press Books, The MIT Press, edition 1, volume 1, number 026202375x, January.
    6. Alesina, Alberto & Baqir, Reza & Easterly, William, 2000. "Redistributive Public Employment," Journal of Urban Economics, Elsevier, vol. 48(2), pages 219-241, September.
    7. Matthieu Chemin & Etienne Wasmer, 2009. "Using Alsace-Moselle Local Laws to Build a Difference-in-Differences Estimation Strategy of the Employment Effects of the 35-Hour Workweek Regulation in France," Journal of Labor Economics, University of Chicago Press, vol. 27(4), pages 487-524, October.
    8. William M. Gentry & John Penrod, 2000. "The Tax Benefits of Not-for-Profit Hospitals," NBER Chapters,in: The Changing Hospital Industry: Comparing For-Profit and Not-for-Profit Institutions, pages 285-324 National Bureau of Economic Research, Inc.
    9. Levitt, Steven D, 1997. "Using Electoral Cycles in Police Hiring to Estimate the Effect of Police on Crime," American Economic Review, American Economic Association, vol. 87(3), pages 270-290, June.
    10. Hervé Leleu & Benoît Dervaux, 1997. "Comparaison des différentes mesures d'efficacité technique : une application aux centres hospitaliers français," Économie et Prévision, Programme National Persée, vol. 129(3), pages 101-119.
    11. Lien, Hsien-Ming & Chou, Shin-Yi & Liu, Jin-Tan, 2008. "Hospital ownership and performance: Evidence from stroke and cardiac treatment in Taiwan," Journal of Health Economics, Elsevier, vol. 27(5), pages 1208-1223, September.
    12. Ana Lamo & Javier J. Pérez & Ludger Schuknecht, 2013. "The cyclicality of consumption, wages and employment of the public sector in the euro area," Applied Economics, Taylor & Francis Journals, vol. 45(12), pages 1551-1569, April.
    13. Albert Alesina & Stephan Danninger & Massimo Rostagno, 2001. "Redistribution Through Public Employment: The Case of Italy," IMF Staff Papers, Palgrave Macmillan, vol. 48(3), pages 1-2.
    14. Caroline M. Hoxby, 2007. "Does Competition Among Public Schools Benefit Students and Taxpayers? Reply," American Economic Review, American Economic Association, vol. 97(5), pages 2038-2055, December.
    15. Gregory, Robert G. & Borland, Jeff, 1999. "Recent developments in public sector labor markets," Handbook of Labor Economics,in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 3, chapter 53, pages 3573-3630 Elsevier.
    16. Jesse Rothstein, 2007. "Does Competition Among Public Schools Benefit Students and Taxpayers? Comment," American Economic Review, American Economic Association, vol. 97(5), pages 2026-2037, December.
    17. David Meltzer & Jeanette Chung & Anirban Basu, 2002. "Does Competition under Medicare Prospective Payment Selectively Reduce Expenditures on High-Cost Patients?," RAND Journal of Economics, The RAND Corporation, vol. 33(3), pages 447-468, Autumn.
    18. Anna Öster & Jonas Agell, 2007. "Crime and Unemployment in Turbulent Times," Journal of the European Economic Association, MIT Press, vol. 5(4), pages 752-775, June.
    19. Coelho, Cesar & Veiga, Francisco Jose & Veiga, Linda G., 2006. "Political business cycles in local employment: Evidence from Portugal," Economics Letters, Elsevier, vol. 93(1), pages 82-87, October.
    20. Philip Keefer & Stephen Knack, 2007. "Boondoggles, Rent-Seeking, and Political Checks and Balances: Public Investment under Unaccountable Governments," The Review of Economics and Statistics, MIT Press, vol. 89(3), pages 566-572, August.
    21. Frank A. Sloan & Donald H. Taylor & Chris Conover, 2000. "Hospital Conversions Is the Purchase Price Too Low?," NBER Chapters,in: The Changing Hospital Industry: Comparing For-Profit and Not-for-Profit Institutions, pages 13-44 National Bureau of Economic Research, Inc.
    22. Barton H. Hamilton & Vivian H. Hamilton, 1997. "Estimating surgical volume-outcome relationships applying survival models: accounting for frailty and hospital fixed effects," Health Economics, John Wiley & Sons, Ltd., vol. 6(4), pages 383-395.
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    Citations

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    Cited by:

    1. repec:dau:papers:123456789/12066 is not listed on IDEAS
    2. Carine Milcent & Brigitte Dormont, 2012. "Ownership and Hospital Productivity
      [Productivité et l’efficacité des hôpitaux publics et privés]
      ," Working Papers hal-01521269, HAL.
    3. Andrew E. Clark & Carine Milcent, 2015. "Hospital Employment and Local Unemployment: Evidence from French Health Reforms," PSE Working Papers halshs-01183454, HAL.
    4. Dalton, Christina Marsh & Warren, Patrick L., 2016. "Cost versus control: Understanding ownership through outsourcing in hospitals," Journal of Health Economics, Elsevier, vol. 48(C), pages 1-15.
    5. Dalton, Christina Marsh & Warren, Patrick L., 2014. "Outsourcing Intensity and Ownership: Theory and Evidence from California General Care Hospitals," MPRA Paper 61949, University Library of Munich, Germany.
    6. Carine Milcent & Brigitte Dormont, 2017. "Ownership and Hospital Productivity
      [Productivité et l’efficacité des hôpitaux publics et privés]
      ," PSE Working Papers hal-01521269, HAL.
    7. Rossella Verzulli & Gianluca Fiorentini & Matteo Lippi Bruni & Cristina Ugolini, 2017. "Price Changes in Regulated Healthcare Markets: Do Public Hospitals Respond and How?," Health Economics, John Wiley & Sons, Ltd., vol. 26(11), pages 1429-1446, November.
    8. repec:hal:wpaper:halshs-01183454 is not listed on IDEAS
    9. Andrew E. Clark & Carine Milcent, 2017. "Ownership and Hospital Behaviour: Employment and Local Unemployment," PSE Working Papers halshs-01649493, HAL.
    10. John Hatfield & Fuhito Kojima & Yusuke Narita, 2012. "Promoting School Competition Through School Choice: A Market Design Approach," Discussion Papers 12-019, Stanford Institute for Economic Policy Research.

    More about this item

    Keywords

    Hospitals; Public employment; Unemployment; Political preferences;

    JEL classification:

    • D21 - Microeconomics - - Production and Organizations - - - Firm Behavior: Theory
    • D72 - Microeconomics - - Analysis of Collective Decision-Making - - - Political Processes: Rent-seeking, Lobbying, Elections, Legislatures, and Voting Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J21 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Labor Force and Employment, Size, and Structure

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