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Public Employment and Political Pressure: The Case of French Hospitals

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  • Clark, Andrew E.

    (Paris School of Economics)

  • Milcent, Carine

    (Paris School of Economics)

Abstract

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 (NFP) or private hospitals, even controlling for a number of measures of hospital output. NFP hospitals serve as a benchmark, being very similar to Public hospitals, but without political influence on their hiring. Public-hospital employment is positively correlated with the local unemployment rate, whereas no such relationship is found in other 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.

Suggested Citation

  • Clark, Andrew E. & Milcent, Carine, 2010. "Public Employment and Political Pressure: The Case of French Hospitals," IZA Discussion Papers 4994, Institute of Labor Economics (IZA).
  • Handle: RePEc:iza:izadps:dp4994
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    1. repec:dau:papers:123456789/12066 is not listed on IDEAS
    2. Clark, Andrew E. & Milcent, Carine, 2018. "Ownership and hospital behaviour: Employment and local unemployment," Social Science & Medicine, Elsevier, vol. 202(C), pages 151-161.
    3. Brice Fabre, 2018. "The Impact of Local Income Inequality on Public Goods and Taxation: Evidence from French Municipalities," PSE Working Papers halshs-01721825, HAL.
    4. Dormont, Brigitte & Milcent, Carine, 2012. "Ownership and Hospital Productivity," CEPREMAP Working Papers (Docweb) 1205, CEPREMAP.
    5. Andrew E. Clark & Carine Milcent, 2015. "Hospital Employment and Local Unemployment: Evidence from French Health Reforms," Working Papers halshs-01183454, HAL.
    6. Dalton, Christina Marsh & Warren, Patrick L., 2016. "Cost versus control: Understanding ownership through outsourcing in hospitals," Journal of Health Economics, Elsevier, vol. 48(C), pages 1-15.
    7. Jaaidane, Touria & Larribeau, Sophie & Leprince, Matthieu, 2020. "The Determinants of French Municipal Labor Demand," CEPREMAP Working Papers (Docweb) 2003, CEPREMAP.
    8. Saad Zbiri & Patrick Rozenberg & François Goffinet & Carine Milcent, 2018. "Cesarean delivery rate and staffing levels of the maternity unit," PLOS ONE, Public Library of Science, vol. 13(11), pages 1-14, November.
    9. Drenik, Andres & Perez-Truglia, Ricardo, 2018. "Sympathy for the diligent and the demand for workfare," Journal of Economic Behavior & Organization, Elsevier, vol. 153(C), pages 77-102.
    10. Lasse Aaskoven, 2016. "Fiscal Transparency, Elections and Public Employment: Evidence from the OECD," Economics and Politics, Wiley Blackwell, vol. 28(3), pages 317-341, November.
    11. Bertoli, Paola & Grembi, Veronica, 2021. "The political cycle of road traffic accidents," Journal of Health Economics, Elsevier, vol. 76(C).
    12. Carine Milcent & Brigitte Dormont, 2017. "Ownership and Hospital Productivity
      [Productivité et l’efficacité des hôpitaux publics et privés]
      ," PSE Working Papers hal-01521269, HAL.
    13. Brice Fabre, 2018. "The Impact of Local Income Inequality on Public Goods and Taxation: Evidence from French Municipalities," Working Papers halshs-01721825, HAL.
    14. Rossella Verzulli & Gianluca Fiorentini & Matteo Lippi Bruni & Cristina Ugolini, 2017. "Price Changes in Regulated Healthcare Markets: Do Public Hospitals Respond and How?," Health Economics, John Wiley & Sons, Ltd., vol. 26(11), pages 1429-1446, November.
    15. Takaku, Reo & Bessho, Shun-ichiro, 2018. "Political cycles in physician employment: A case of Japanese local public hospitals," Social Science & Medicine, Elsevier, vol. 216(C), pages 97-106.
    16. John William Hatfield & Fuhito Kojima & Yusuke Narita, 2011. "Promoting School Competition Through School Choice: A Market Design Approach," Working Papers 2011-018, Human Capital and Economic Opportunity Working Group.
    17. Carine Milcent & Saad Zbiri, 2022. "Supplementary private health insurance: The impact of physician financial incentives on medical practice," Health Economics, John Wiley & Sons, Ltd., vol. 31(1), pages 57-72, January.

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    More about this item

    Keywords

    unemployment; hospitals; public employment; political preferences;
    All these keywords.

    JEL classification:

    • D21 - Microeconomics - - Production and Organizations - - - Firm Behavior: Theory
    • D72 - Microeconomics - - Analysis of Collective Decision-Making - - - Political Processes: Rent-seeking, Lobbying, Elections, Legislatures, and Voting Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J21 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Labor Force and Employment, Size, and Structure

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