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The Impact of Immigration on Public and Out-of-Pocket Health Expenditure in OECD Countries

Author

Listed:
  • Rezwanul Hasan Rana

    (University of Southern Queensland)

  • Khorshed Alam

    (University of Southern Queensland)

  • Jeff Gow

    (University of KwaZulu-Natal)

Abstract

This paper examined the impact of the inflow of new immigrants on public and out-of-pocket health expenditure in 33 Organisation for Economic Cooperation and Developments (OECD) countries over the period of 2000–2015. Dynamic panel data analysis is carried out using the one-step system ‘Generalised Method of Moments’ and the instrumental variable (IV) estimation approach whilst controlling for potential endogeneity. The inflow of new immigrants is modelled as a determinant of health expenditure. The results are robust to both static and dynamic models. The results show that an increasing inflow of immigrants is significantly related to out-of-pocket, but, surprisingly, not with public health expenditure. Moreover, the findings are similar for countries that primarily have publicly funded healthcare systems or those more dominated by private financing of healthcare. It can be concluded that new immigrants do not seek publicly funded healthcare at least at the initial years of their relocation and that their arrival does not trigger a significant rise in public healthcare expenditure in the OECD countries.

Suggested Citation

  • Rezwanul Hasan Rana & Khorshed Alam & Jeff Gow, 2020. "The Impact of Immigration on Public and Out-of-Pocket Health Expenditure in OECD Countries," Journal of International Migration and Integration, Springer, vol. 21(2), pages 485-508, June.
  • Handle: RePEc:spr:joimai:v:21:y:2020:i:2:d:10.1007_s12134-019-00667-y
    DOI: 10.1007/s12134-019-00667-y
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    as
    1. José-Ignacio Antón & Rafael Muñoz de Bustillo, 2010. "Health care utilisation and immigration in Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(5), pages 487-498, October.
    2. Giuntella, Osea & Nicodemo, Catia & Vargas-Silva, Carlos, 2018. "The effects of immigration on NHS waiting times," Journal of Health Economics, Elsevier, vol. 58(C), pages 123-143.
    3. Kukenova, Madina & Monteiro, Jose-Antonio, 2008. "Spatial Dynamic Panel Model and System GMM: A Monte Carlo Investigation," MPRA Paper 11569, University Library of Munich, Germany, revised Nov 2008.
    4. Rama Pal, 2012. "Measuring incidence of catastrophic out-of-pocket health expenditure: with application to India," International Journal of Health Economics and Management, Springer, vol. 12(1), pages 63-85, March.
    5. Kleibergen, Frank & Paap, Richard, 2006. "Generalized reduced rank tests using the singular value decomposition," Journal of Econometrics, Elsevier, vol. 133(1), pages 97-126, July.
    6. Badi H. Baltagi & Raffaele Lagravinese & Francesco Moscone & Elisa Tosetti, 2017. "Health Care Expenditure and Income: A Global Perspective," Health Economics, John Wiley & Sons, Ltd., vol. 26(7), pages 863-874, July.
    7. Ang, James B., 2011. "Financial development, liberalization and technological deepening," European Economic Review, Elsevier, vol. 55(5), pages 688-701, June.
    8. Maurice J. G. Bun & Frank Windmeijer, 2010. "The weak instrument problem of the system GMM estimator in dynamic panel data models," Econometrics Journal, Royal Economic Society, vol. 13(1), pages 95-126, February.
    9. Thomas K. Bauer & Astrid Kunze, 2004. "The demand for high-skilled workers and immigration policy," Brussels Economic Review, ULB -- Universite Libre de Bruxelles, vol. 47(1), pages 77-88.
    10. Christopher F Baum & Mark E. Schaffer & Steven Stillman, 2007. "Enhanced routines for instrumental variables/GMM estimation and testing," CERT Discussion Papers 0706, Centre for Economic Reform and Transformation, Heriot Watt University.
    11. Okunade, Albert A. & Murthy, Vasudeva N. R., 2002. "Technology as a 'major driver' of health care costs: a cointegration analysis of the Newhouse conjecture," Journal of Health Economics, Elsevier, vol. 21(1), pages 147-159, January.
    12. Alberto Alesina & Johann Harnoss & Hillel Rapoport, 2021. "Immigration and the Future of the Welfare State in Europe," The ANNALS of the American Academy of Political and Social Science, , vol. 697(1), pages 120-147, September.
    13. Dreger, C. & Reimers, H.E., 2005. "Health Care Expenditures in OECD Countries: A Panel Unit Root and Cointegration Analysis," International Journal of Applied Econometrics and Quantitative Studies, Euro-American Association of Economic Development, vol. 2(2), pages 5-20.
    14. David Roodman, 2009. "A Note on the Theme of Too Many Instruments," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 71(1), pages 135-158, February.
    15. Christopher F Baum & Mark E. Schaffer & Steven Stillman, 2007. "Enhanced routines for instrumental variables/generalized method of moments estimation and testing," Stata Journal, StataCorp LP, vol. 7(4), pages 465-506, December.
    16. Sheetal K. Chand & Martin Paldam, 2004. "The economics of immigration into a Nordic welfare state - and a comparison to an immigration state and a guest worker state," Economics Working Papers 2004-4, Department of Economics and Business Economics, Aarhus University.
    17. Mohanty, S.A. & Woolhandler, S. & Himmelstein, D.U. & Pati, S. & Carrasquillo, O. & Bor, D.H., 2005. "Health care expenditures of immigrants in the United States: A nationally representative analysis," American Journal of Public Health, American Public Health Association, vol. 95(8), pages 1431-1438.
    18. Bruce Newbold, K. & Danforth, Jeff, 2003. "Health status and Canada's immigrant population," Social Science & Medicine, Elsevier, vol. 57(10), pages 1981-1995, November.
    19. Stephen Bond, 2002. "Dynamic panel data models: a guide to microdata methods and practice," CeMMAP working papers CWP09/02, Centre for Microdata Methods and Practice, Institute for Fiscal Studies.
    20. David Roodman, 2009. "How to do xtabond2: An introduction to difference and system GMM in Stata," Stata Journal, StataCorp LP, vol. 9(1), pages 86-136, March.
    21. Pia Orrenius & Madeline Zavodny, 2009. "Do immigrants work in riskier jobs?," Demography, Springer;Population Association of America (PAA), vol. 46(3), pages 535-551, August.
    22. Noel Gaston & Gulasekaran Rajaguru, 2013. "International migration and the welfare state: Asian perspectives," Journal of the Asia Pacific Economy, Taylor & Francis Journals, vol. 18(2), pages 271-289.
    23. Friedrich Breyer & Normann Lorenz & Thomas Niebel, 2015. "Health care expenditures and longevity: is there a Eubie Blake effect?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(1), pages 95-112, January.
    24. Stavrunova, Olena & Yerokhin, Oleg, 2014. "Tax incentives and the demand for private health insurance," Journal of Health Economics, Elsevier, vol. 34(C), pages 121-130.
    25. Borjas, George J, 1999. "Immigration and Welfare Magnets," Journal of Labor Economics, University of Chicago Press, vol. 17(4), pages 607-637, October.
    26. Guilhem Bascle, 2008. "Controlling for endogeneity with instrumental variables in strategic management research," Post-Print hal-00576795, HAL.
    27. Mickael Bech & Terkel Christiansen & Ehsan Khoman & Jørgen Lauridsen & Martin Weale, 2011. "Ageing and health care expenditure in EU-15," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(5), pages 469-478, October.
    28. Katharina Hauck & Xiaohui Zhang, 2016. "Heterogeneity in the Effect of Common Shocks on Healthcare Expenditure Growth," Health Economics, John Wiley & Sons, Ltd., vol. 25(9), pages 1090-1103, September.
    29. Jeffrey M Wooldridge, 2010. "Econometric Analysis of Cross Section and Panel Data," MIT Press Books, The MIT Press, edition 2, volume 1, number 0262232588, December.
    30. Okunade, Albert A. & Suraratdecha, Chutima, 2006. "The pervasiveness of pharmaceutical expenditure inertia in the OECD countries," Social Science & Medicine, Elsevier, vol. 63(1), pages 225-238, July.
    31. Ssozi, John & Amlani, Shirin, 2015. "The Effectiveness of Health Expenditure on the Proximate and Ultimate Goals of Healthcare in Sub-Saharan Africa," World Development, Elsevier, vol. 76(C), pages 165-179.
    32. Andrews,Donald W. K. & Stock,James H. (ed.), 2005. "Identification and Inference for Econometric Models," Cambridge Books, Cambridge University Press, number 9780521844413.
    33. Razin, Assaf & Sadka, Efraim & Swagel, Phillip, 2002. "Tax burden and migration: a political economy theory and evidence," Journal of Public Economics, Elsevier, vol. 85(2), pages 167-190, August.
    34. Nannestad, Peter, 2007. "Immigration and welfare states: A survey of 15 years of research," European Journal of Political Economy, Elsevier, vol. 23(2), pages 512-532, June.
    35. Giuntella, Osea & Mazzonna, Fabrizio, 2015. "Do immigrants improve the health of natives?," Journal of Health Economics, Elsevier, vol. 43(C), pages 140-153.
    36. Stephen R. Bond, 2002. "Dynamic panel data models: a guide to micro data methods and practice," Portuguese Economic Journal, Springer;Instituto Superior de Economia e Gestao, vol. 1(2), pages 141-162, August.
    37. Blundell, Richard & Bond, Stephen, 1998. "Initial conditions and moment restrictions in dynamic panel data models," Journal of Econometrics, Elsevier, vol. 87(1), pages 115-143, August.
    38. Vázquez, María-Luisa & Terraza-Núñez, Rebeca & Vargas, Ingrid & Rodríguez, Dolors & Lizana, Tona, 2011. "Health policies for migrant populations in three European countries: England; Italy and Spain," Health Policy, Elsevier, vol. 101(1), pages 70-78, June.
    39. Gaston, Noel & Rajaguru, Gulasekaran, 2013. "International migration and the welfare state revisited," European Journal of Political Economy, Elsevier, vol. 29(C), pages 90-101.
    40. David Roodman, 2006. "How to Do xtabond2," North American Stata Users' Group Meetings 2006 8, Stata Users Group.
    41. Ybarra, Marci & Ha, Yoonsook & Chang, Jina, 2017. "Health insurance coverage and routine health care use among children by family immigration status," Children and Youth Services Review, Elsevier, vol. 79(C), pages 97-106.
    42. Na Hou & Bo Chen, 2013. "Military Expenditure And Economic Growth In Developing Countries: Evidence From System Gmm Estimates," Defence and Peace Economics, Taylor & Francis Journals, vol. 24(3), pages 183-193, June.
    43. Vandersteegen, Tom & Marneffe, Wim & Cleemput, Irina & Vereeck, Lode, 2015. "The impact of no-fault compensation on health care expenditures: An empirical study of OECD countries," Health Policy, Elsevier, vol. 119(3), pages 367-374.
    44. Osea Giuntella, 2012. "Do immigrants squeeze natives out of bad schedules? Evidence from Italy," IZA Journal of Migration and Development, Springer;Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 1(1), pages 1-21, December.
    45. Mladovsky, Philipa, 2009. "A framework for analysing migrant health policies in Europe," Health Policy, Elsevier, vol. 93(1), pages 55-63, November.
    46. Manuel Arellano & Stephen Bond, 1991. "Some Tests of Specification for Panel Data: Monte Carlo Evidence and an Application to Employment Equations," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 58(2), pages 277-297.
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    More about this item

    Keywords

    Immigrants; Healthcare expenditure; System GMM; Instrumental variable; OECD countries;
    All these keywords.

    JEL classification:

    • C3 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables
    • C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data; Spatio-temporal Models
    • C36 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Instrumental Variables (IV) Estimation
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H40 - Public Economics - - Publicly Provided Goods - - - General
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

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