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The Political Economy of Health Services Provision in Brazil

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  • Ahmed Mushfiq Mobarak
  • Andrew Sunil Rajkumar
  • Maureen Cropper

Abstract

We examine the impact of local politics and voter preferences on the allocation of publicly subsidized the Unified and Decentralized Health Care System (SUS) health services across 4,338 counties in Brazil. SUS clinics, doctors, and nurses (per capita) are higher in counties with a higher share of uninsured in the population and with higher per capita incomes, as is consistent with a probabilistic voting model. Political participation (i.e., the fraction of the poor who vote) and the political power of the mayor (his vote share in the last election) are associated with more visible health inputs, namely, clinics and consultation rooms, but not with more doctors and nurses.

Suggested Citation

  • Ahmed Mushfiq Mobarak & Andrew Sunil Rajkumar & Maureen Cropper, 2011. "The Political Economy of Health Services Provision in Brazil," Economic Development and Cultural Change, University of Chicago Press, vol. 59(4), pages 723-751.
  • Handle: RePEc:ucp:ecdecc:doi:10.1086/660001
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    References listed on IDEAS

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    1. Denisard C. O. Alves & Christopher D. Timmins, 2001. "Social Exclusion And the Two-Tiered Healthcare System of Brazil," Anais do XXIX Encontro Nacional de Economia [Proceedings of the 29th Brazilian Economics Meeting] 072, ANPEC - Associação Nacional dos Centros de Pós-Graduação em Economia [Brazilian Association of Graduate Programs in Economics].
    2. Kenneth Leonard & David Leonard, 2004. "The Political Economy of Improving Health Care for the Poor in Rural Africa: Institutional Solutions to the Principal-Agent Problem," Journal of Development Studies, Taylor & Francis Journals, vol. 40(4), pages 50-77.
    3. Robert P. Inman, 1988. "Federal Assistance and Local Services in the United States: The Evolution of a New," NBER Chapters,in: Fiscal Federalism: Quantitative Studies, pages 33-78 National Bureau of Economic Research, Inc.
    4. Betancourt, Roger & Gleason, Suzanne, 2000. "The Allocation of Publicly-Provided Goods to Rural Households in India: On Some Consequences of Caste, Religion and Democracy," World Development, Elsevier, vol. 28(12), pages 2169-2182, December.
    5. Zhang, Xiaobo & Fan, Shenggen & Zhang, Linxiu & Huang, Jikun, 2004. "Local governance and public goods provision in rural China," Journal of Public Economics, Elsevier, vol. 88(12), pages 2857-2871, December.
    6. Case, Anne, 2001. "Election goals and income redistribution: Recent evidence from Albania," European Economic Review, Elsevier, vol. 45(3), pages 405-423, March.
    7. Lee J. Alston & Bernardo Mueller, 2006. "Pork for Policy: Executive and Legislative Exchange in Brazil," Journal of Law, Economics, and Organization, Oxford University Press, vol. 22(1), pages 87-114, April.
    8. David Strömberg, 2004. "Radio's Impact on Public Spending," The Quarterly Journal of Economics, Oxford University Press, vol. 119(1), pages 189-221.
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    Cited by:

    1. Christine Buttorff & Antonio J. Trujillo & Fernando Ruiz & Jeannette L. Amaya, 2015. "Low rural health insurance take-up in a universal coverage system: perceptions of health insurance among the uninsured in La Guajira, Colombia," International Journal of Health Planning and Management, Wiley Blackwell, vol. 30(2), pages 98-110, April.
    2. Wells, Rebecca & Cilenti, Dorothy & Issel, L. Michele, 2015. "The political economy of a public health case management program's transition into medical homes," Social Science & Medicine, Elsevier, vol. 145(C), pages 98-106.

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