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Can Regional Decentralisation Shift Health Care Preferences?

Author

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  • Costa-Font, Joan

    () (London School of Economics)

  • Ferrer-i-Carbonell, Ada

    () (IAE Barcelona (CSIC))

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 for the Study of Labor (IZA).
  • Handle: RePEc:iza:izadps:dp11180
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    References listed on IDEAS

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    1. Jeroen Klomp & Jakob de Haan, 2008. "Effects of Governance on Health: a Cross-National Analysis of 101 Countries," Kyklos, Wiley Blackwell, vol. 61(4), pages 599-614, November.
    2. Besley, Timothy & Hall, John & Preston, Ian, 1999. "The demand for private health insurance: do waiting lists matter?," Journal of Public Economics, Elsevier, vol. 72(2), pages 155-181, May.
    3. Guillem Lopez-Casasnovas & Joan Costa-Font & Ivan Planas, 2005. "Diversity and regional inequalities in the Spanish 'system of health care services'," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 221-235.
    4. Salmon, Pierre, 1987. "Decentralisation as an Incentive Scheme," Oxford Review of Economic Policy, Oxford University Press, vol. 3(2), pages 24-43, Summer.
    5. Iversen, Tor, 1997. "The effect of a private sector on the waiting time in a national health service," Journal of Health Economics, Elsevier, vol. 16(4), pages 381-396, August.
    6. Mireia Jofre-Bonet, 2000. "Public health care and private insurance demand: The waiting time as a link," Health Care Management Science, Springer, vol. 3(1), pages 51-71, January.
    7. Leonard, Kenneth L., 2008. "Is patient satisfaction sensitive to changes in the quality of care? An exploitation of the Hawthorne effect," Journal of Health Economics, Elsevier, vol. 27(2), pages 444-459, March.
    8. Propper, Carol, 2000. "The demand for private health care in the UK," Journal of Health Economics, Elsevier, vol. 19(6), pages 855-876, November.
    9. Timothy Besley & Masayuki Kudamatsu, 2006. "Health and Democracy," American Economic Review, American Economic Association, vol. 96(2), pages 313-318, May.
    10. Miguel Gouveia, 1997. "Majority rule and the public provision of a private good," Public Choice, Springer, vol. 93(3), pages 221-244, December.
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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;

    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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