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Can Regional Decentralisation Shift Health Care Preferences?

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  • Costa-Font, Joan

    (London School of Economics)

  • Ferrer-i-Carbonell, Ada

    (CSIC Institute of Public Goods and Policies (IPP))

Abstract

Uniform health care delivered by a mainstream public insurer – such as the National Health Service (NHS), seldom satisfies heterogeneous demands for care, and some unsatisfied share of the population either use private health care, or purchase private insurance (PHI). One potential mechanism to partially satisfy heterogeneous preferences for health care, and discourage the use of private health care, is regional health care decentralisation. We find robust estimates suggesting that the development of regional health services shifted both perceptions of, and preferences for, using the NHS, making it more likely individuals would use public health care and, consequently, reducing the uptake of PHI. These results are heterogeneous by income, education, and age groups; and are robust to placebo and other robustness and falsification checks.

Suggested Citation

  • Costa-Font, Joan & Ferrer-i-Carbonell, Ada, 2017. "Can Regional Decentralisation Shift Health Care Preferences?," IZA Discussion Papers 11180, Institute of Labor Economics (IZA).
    • Handle: RePEc:iza:izadps:dp11180
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    Cited by:

    1. Judit Vall Castelló & Joan Costa-Font & Gilberto Turati & Dolores Jiménez-Rubio & Pilar García-Gómez, 2019. "Health Economics: Service Provision in Decentralised Healthcare Systems / Economía de la salud: prestación de servicios en sistemas de salud descentralizados / Economia de la salut: prestació de serve," IEB Reports ieb_report_1_2019, Institut d'Economia de Barcelona (IEB).
    2. Bertoli, Paola & Grembi, Veronica & Llaneza Hesse, Catalina & Vall Castelló, Judit, 2020. "The effect of budget cuts on C-section rates and birth outcomes: Evidence from Spain," Social Science & Medicine, Elsevier, vol. 265(C).

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    More about this item

    Keywords

    National Health Service (NHS); political decentralization; use of private health care; private health insurance; health system satisfaction; demand for private health care;
    All these keywords.

    JEL classification:

    • H7 - Public Economics - - State and Local Government; Intergovernmental Relations
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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