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Health Care Expenditures, Public Administration and the Business Cycle


  • François Béland
  • Co-director Solidage


Claims of the unsustainability of Medicare abound and have been fuelled by the consequences of the 2008-09 economic recession. The looming question for Canadian public health care services is "How will public administrations in Canada sustain their health care expenditures during the next few years, given the pressure from debt recovery and the new federal payment transfer for health care?” To examine these issues, variations from 1989 to 2009 in Canadian public administration health care expenditures (HCE) are compared with variations in GDP, in public administration revenue, their expenditures on items other than health care, transfer payments for health from the federal government to provinces, and debt charges. Since the turn of the millennium, Canadian public administrations have increased HCE in constant dollars in context of: 1) decreasing share of public revenue and expenditures in terms of GDP; 2) constant share (70%), since 1996, of expenditures for items other than health care on total expenditures ; 3) parallel trends, with a 3 year lag, for GDP and expenditures for services covered by Medicare; 4) constant share of total HCE in terms of public administration total revenues from 2003 to 2007; 5) constant share of federal transfers for health on provincial public administration expenditures for total health care and for Medicare; and 6) reverse trends for share of HCE and debt charges. Given this context, the rhetoric of apocalyptic share of HCE on public administration budget is having a boost, while increases in this share has more to do with the factors included in the denominator rather than with those in the numerator.

Suggested Citation

  • François Béland & Co-director Solidage, 2012. "Health Care Expenditures, Public Administration and the Business Cycle," Social and Economic Dimensions of an Aging Population Research Papers 297, McMaster University.
  • Handle: RePEc:mcm:sedapp:297

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    References listed on IDEAS

    1. Di Matteo, Livio, 2000. "The determinants of the public-private mix in Canadian health care expenditures: 1975-1996," Health Policy, Elsevier, vol. 52(2), pages 87-112, June.
    2. Claude Montmarquette & Virginie Giroux & Joanne Castonguay, 2005. "Pour un financement durable de la santé au Québec," CIRANO Burgundy Reports 2005rb-08, CIRANO.
    3. repec:clh:resear:v:2:y:2009:i:2 is not listed on IDEAS
    4. Livio Di Matteo, 2010. "The sustainability of public health expenditures: evidence from the Canadian federation," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(6), pages 569-584, December.
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    More about this item


    Healthcare expenditures; public administration; sustainability; federal transfers; debt charges;

    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
    • H83 - Public Economics - - Miscellaneous Issues - - - Public Administration
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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