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Keynesian hospitals? Public employment and political pressure

  • Andrew E. Clark

    (EEP-PSE - Ecole d'Économie de Paris - Paris School of Economics - Ecole d'Économie de Paris, IZA - Institute for the Study of Labor - IZA, PSE - Paris-Jourdan Sciences Economiques - CNRS : UMR8545 - École des Hautes Études en Sciences Sociales (EHESS) - École des Ponts ParisTech (ENPC) - École normale supérieure [ENS] - Paris)

  • Carine Milcent

    (EEP-PSE - Ecole d'Économie de Paris - Paris School of Economics - Ecole d'Économie de Paris, PSE - Paris-Jourdan Sciences Economiques - CNRS : UMR8545 - École des Hautes Études en Sciences Sociales (EHESS) - École des Ponts ParisTech (ENPC) - École normale supérieure [ENS] - Paris)

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 or private hospitals, even controlling for many measures of hospital output (such as the type of operations and care provided, and the bed capacity rate). Public-hospital employment is positively correlated with the local unemployment rate, whereas no relationship is found in non-Public 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.

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Paper provided by HAL in its series PSE Working Papers with number halshs-00586792.

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Date of creation: Apr 2008
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Handle: RePEc:hal:psewpa:halshs-00586792
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  1. Benoît Dervaux & Hervé Leleu, 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.
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  8. 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.
  9. 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.
  10. 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.
  11. 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, 06.
  12. Easterly, William & Baqir, Reza & Alesina, Alberto, 2000. "Redistributive Public Employment," Scholarly Articles 4553013, Harvard University Department of Economics.
  13. 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.
  14. Leibenstein, Harvey, 1969. "Organizational or Frictional Equilibria, X-Efficiency, and the Rate of Innovation," The Quarterly Journal of Economics, MIT Press, vol. 83(4), pages 600-23, November.
  15. 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.
  16. Haskel, Jonathan & Sanchis, Amparo, 1995. "Privatization and X-Inefficiency: A Bargaining Approach," CEPR Discussion Papers 1192, C.E.P.R. Discussion Papers.
  17. William N. Gentry & John R. Penrod, 1998. "The Tax Benefits of Not-for-Profit Hospitals," NBER Working Papers 6435, National Bureau of Economic Research, Inc.
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