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An Evaluation of the 1997 Fiscal Decentralization Reform in Mexico: The Case of the Health Sector

Author

Listed:
  • André Martínez
  • Carolina Rodríguez-Zamora

Abstract

This paper studies the impact of the health decentralization of funds and responsibilities that took place in Mexico in 1997 on state level health outcomes. It renders two main results. First, the magnitude of transfers from the federal government to states failed to take into account state-specific needs; instead, transfers were mainly determined by the pre-reform health expenditures of the federal government in each state. Second, decentralization did not boost the advances in health outcomes already achieved under the centralized health sector regime. We conclude by discussing plausible reasons for the disappointing impact of decentralization on health outcomes.

Suggested Citation

  • André Martínez & Carolina Rodríguez-Zamora, 2011. "An Evaluation of the 1997 Fiscal Decentralization Reform in Mexico: The Case of the Health Sector," Working Papers 2011-16, Banco de México.
  • Handle: RePEc:bdm:wpaper:2011-16
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    File URL: http://www.banxico.org.mx/publicaciones-y-discursos/publicaciones/documentos-de-investigacion/banxico/%7B8F05C150-9933-2733-3BF4-2C33A4B3B9C4%7D.pdf
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    References listed on IDEAS

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    1. Soares, Rodrigo R., 2007. "Health and the evolution of welfare across Brazilian municipalities," Journal of Development Economics, Elsevier, vol. 84(2), pages 590-608, November.
    2. Robalino, David A. & Picazo, Oscar F. & Voetberg, Albertus, 2001. "Does fiscal decentralization improve health outcomes? - evidence from a cross-country analysis," Policy Research Working Paper Series 2565, The World Bank.
    3. Soto, Victoria Eugenia & Farfan, Maria Isabel & Lorant, Vincent, 2012. "Fiscal decentralisation and infant mortality rate: The Colombian case," Social Science & Medicine, Elsevier, vol. 74(9), pages 1426-1434.
    4. Weingast, Barry R., 2009. "Second generation fiscal federalism: The implications of fiscal incentives," Journal of Urban Economics, Elsevier, vol. 65(3), pages 279-293, May.
    5. D. Cantarero & Marta Pascual, 2007. "Analysing the impact of fiscal decentralization on health outcomes: empirical evidence from Spain," Applied Economics Letters, Taylor & Francis Journals, vol. 15(2), pages 109-111.
    6. John Akin & Paul Hutchinson & Koleman Strumpf, 2005. "Decentralisation and government provision of public goods: The public health sector in Uganda," Journal of Development Studies, Taylor & Francis Journals, vol. 41(8), pages 1417-1443.
    7. Dolores Jimenez Rubio, 2011. "The impact of decentralization of health services on health outcomes: evidence from Canada," Applied Economics, Taylor & Francis Journals, vol. 43(26), pages 3907-3917.
    8. Luca Crivelli & Massimo Filippini & Ilaria Mosca, 2006. "Federalism and regional health care expenditures: an empirical analysis for the Swiss cantons," Health Economics, John Wiley & Sons, Ltd., vol. 15(5), pages 535-541.
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    Cited by:

    1. Jorge Martinez-Vazquez & Santiago Lago-Peñas & Agnese Sacchi, 2017. "The Impact Of Fiscal Decentralization: A Survey," Journal of Economic Surveys, Wiley Blackwell, vol. 31(4), pages 1095-1129, September.

    More about this item

    Keywords

    Fiscal decentralization; federalism; health.;

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare

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