Public-Private Mix of Health Expenditure: A Political Economy Approach and A Quantitative Exercise
This paper constructs a simple overlapping generations model to examine how the choice of public and private health expenditure is affected by preferences and economic factors under majority voting. In the model,agents with heterogeneous income decide how much to consume, save, and invest in private health care, and vote for the income tax to be used to finance public health. Agents survival probabilities are endogenously determined by a CES composite of public and private health expenditure. For the two special cases that public and private health are complements or perfect substitutes, we show that the voting equilibrium is unique and locally stable. For the general case, we calibrate the model to Canadian data to conduct a quantitative analysis.Our results suggest that the public-private mix of health expenditure is quite sensitive to the degree of substitutability between private and public health and the relative e¤ectiveness of public and private health. Using a sample of advanced democratic countries, we further infer these two parameters and construct the shares of public health in total health expenditure for each country, and find that the predicted values match the data quite well.
|Date of creation:||2012|
|Date of revision:|
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- Mariacristina De Nardi & Eric French & John Bailey Jones, 2009.
"Why do the elderly save? the role of medical expenses,"
Working Paper Series
WP-09-02, Federal Reserve Bank of Chicago.
- Mariacristina De Nardi & Eric French & John B. Jones, 2010. "Why Do the Elderly Save? The Role of Medical Expenses," Journal of Political Economy, University of Chicago Press, vol. 118(1), pages 39-75, 02.
- Mariacristina De Nardi & Eric French & John Bailey Jones, 2009. "Why do the Elderly Save? The Role of Medical Expenses," NBER Working Papers 15149, National Bureau of Economic Research, Inc.
- Gouveia, Miguel, 1997.
" Majority Rule and the Public Provision of a Private Good,"
Springer, vol. 93(3-4), pages 221-44, December.
- Miguel Gouveia, 1997. "Majority rule and the public provision of a private good," Public Choice, Springer, vol. 93(3), pages 221-244, December.
- Sebnem Kalemli-Ozcan, 2002.
"Does the Mortality Decline Promote Economic Growth?,"
- Kalemli-Ozcan, Sebnem, 2002. " Does the Mortality Decline Promote Economic Growth?," Journal of Economic Growth, Springer, vol. 7(4), pages 411-39, December.
- 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.
- Gruber, Jonathan & Simon, Kosali, 2008. "Crowd-out 10 years later: Have recent public insurance expansions crowded out private health insurance?," Journal of Health Economics, Elsevier, vol. 27(2), pages 201-217, March.
- Aisa, Rosa & Pueyo, Fernando, 2006. "Government health spending and growth in a model of endogenous longevity," Economics Letters, Elsevier, vol. 90(2), pages 249-253, February.
- Robert E. Hall & Charles I. Jones, 2007. "The Value of Life and the Rise in Health Spending," The Quarterly Journal of Economics, Oxford University Press, vol. 122(1), pages 39-72.
- Jose-Victor Rios-Rull & Per Krusell, 1999.
"On the Size of U.S. Government: Political Economy in the Neoclassical Growth Model,"
American Economic Review,
American Economic Association, vol. 89(5), pages 1156-1181, December.
- Per Krusell & Jose-Victor Rios-Rull, 1997. "On the size of U.S. government: political economy in the neoclassical growth model," Staff Report 234, Federal Reserve Bank of Minneapolis.
- Propper, Carol, 2000. "The demand for private health care in the UK," Journal of Health Economics, Elsevier, vol. 19(6), pages 855-876, November.
- Kennelly, Brendan & O'Shea, Eamon & Garvey, Eoghan, 2003. "Social capital, life expectancy and mortality: a cross-national examination," Social Science & Medicine, Elsevier, vol. 56(12), pages 2367-2377, June.
- Shankha Chakraborty, 2002.
"Endogenous Lifetime and Economic Growth,"
University of Oregon Economics Department Working Papers
2002-03, University of Oregon Economics Department, revised 26 Jan 2002.
- McAvinchey, Ian D & Yannopoulos, Andreas, 1994. "A Cost Function Approach to the Choice between Private and Public Acute Health Care Provision," Scottish Journal of Political Economy, Scottish Economic Society, vol. 41(2), pages 194-211, May.
- Bhattacharya, Joydeep & Qiao, Xue, 2005. "Public and Private Expenditures on Health in a Growth Model," Staff General Research Papers 12378, Iowa State University, Department of Economics.
- Ferrie, Joseph & Rolf, Karen, 2011. "Socioeconomic status in childhood and health after age 70: A new longitudinal analysis for the U.S., 1895–2005," Explorations in Economic History, Elsevier, vol. 48(4), pages 445-460.
- Rangan Gupta & Cobus Vermeulen, 2010.
"Private and Public Health Expenditures in an Endogenous Growth Model with Inflation Targeting,"
201001, University of Pretoria, Department of Economics.
- Rangan Gupta & Cobus Vermeulen, 2010. "Private and Public Health Expenditures in an Endogenous Growth Model with Inflation Targeting," Annals of Economics and Finance, Society for AEF, vol. 11(1), pages 139-153, May.
- Ben J. Heijdra & Laurie S. M. Reijnders, 2009.
"Economic Growth and Longevity Risk with Adverse Selection,"
CESifo Working Paper Series
2898, CESifo Group Munich.
- Ben Heijdra & Laurie Reijnders, 2013. "Economic Growth and Longevity Risk with Adverse Selection," De Economist, Springer, vol. 161(1), pages 69-97, March.
- Gerdtham, Ulf-G. & Sogaard, Jes & Andersson, Fredrik & Jonsson, Bengt, 1992. "An econometric analysis of health care expenditure: A cross-section study of the OECD countries," Journal of Health Economics, Elsevier, vol. 11(1), pages 63-84, May.
- Jonathan Gruber & Kosali Simon, 2007. "Crowd-Out Ten Years Later: Have Recent Public Insurance Expansions Crowded Out Private Health Insurance?," NBER Working Papers 12858, National Bureau of Economic Research, Inc.
- Hitiris, Theo & Posnett, John, 1992. "The determinants and effects of health expenditure in developed countries," Journal of Health Economics, Elsevier, vol. 11(2), pages 173-181, August.
- Shankha Chakraborty & Mausumi Das, 2004.
"Mortality, Human Capital and Persistent Inequality,"
Econometric Society 2004 North American Summer Meetings
100, Econometric Society.
- Shankha Chakraborty & Mausumi Das, 2005. "Mortality, Human Capital and Persistent Inequality," Journal of Economic Growth, Springer, vol. 10(2), pages 159-192, 06.
- Mausumi Das & Shankha Chakraborty, 2010. "Mortality, Human Capital and Persistent Inequality," Working Papers id:2365, eSocialSciences.
- Shankha Chakraborty & Mausumi Das, 2003. "Mortality, Human Capital and Persistent Inequality," University of Oregon Economics Department Working Papers 2003-11, University of Oregon Economics Department.
- Shankha Chakraborty & Mausumi Das, 2003. "Mortality, Human Capital and Persistent Inequality," Working papers 119, Centre for Development Economics, Delhi School of Economics.
- Meltzer, Allan H & Richard, Scott F, 1981. "A Rational Theory of the Size of Government," Journal of Political Economy, University of Chicago Press, vol. 89(5), pages 914-27, October.
- Mueller,Dennis C., 2003. "Public Choice III," Cambridge Books, Cambridge University Press, number 9780521894753.
- Osang, Thomas & Sarkar, Jayanta, 2008. "Endogenous mortality, human capital and economic growth," Journal of Macroeconomics, Elsevier, vol. 30(4), pages 1423-1445, December.
- Epple, Dennis & Romano, Richard E, 1996. "Public Provision of Private Goods," Journal of Political Economy, University of Chicago Press, vol. 104(1), pages 57-84, February.
- Kam Ki Tang & Jie Zhang, 2007. "Health, Education, And Life Cycle Savings In The Development Process," Economic Inquiry, Western Economic Association International, vol. 45(3), pages 615-630, 07.
- Joseph P. Ferrie & Karen Rolf, 2011. "Socioeconomic Status in Childhood and Health After Age 70: A New Longitudinal Analysis for the U.S., 1895-2005," NBER Working Papers 17016, National Bureau of Economic Research, Inc.
- Kelvin R. Utendorf & Rowena A. Pecchenino, 1999.
"Social security, social welfare and the aging population,"
Journal of Population Economics,
Springer, vol. 12(4), pages 607-623.
- Pecchenino, R.A., 1994. "Social Security, Social Welfare and the Aging Population," Papers 9403, Michigan State - Econometrics and Economic Theory.
- Hsu, Minchung & Lee, Junsang, 2013.
"The Provision Of Public Universal Health Insurance: Impacts On Private Insurance, Asset Holdings, And Welfare,"
Cambridge University Press, vol. 17(06), pages 1252-1280, September.
- Minchung, Hsu & Junsang, Lee, 2011. "The provision of public universal health insurance: impacts on private insurance, asset holdings and welfare," MPRA Paper 32974, University Library of Munich, Germany.
- Ettner, Susan L., 1996. "New evidence on the relationship between income and health," Journal of Health Economics, Elsevier, vol. 15(1), pages 67-85, February.
- Lakshmi K. Raut, 2003. "Long Term Effects of Preschool Investment on school Performance and Labor Market Outcome," Labor and Demography 0307002, EconWPA.
- Radhika Lahiri & Elizabeth Richardson, 2008. "Public and Private Expenditures on Health in the Presence of Inequality and Endogenous Mortality: A Political Economy Perspective," School of Economics and Finance Discussion Papers and Working Papers Series 240, School of Economics and Finance, Queensland University of Technology, revised 15 Dec 2008.
- Isabelle Joumard & Christophe André & Chantal Nicq, 2010. "Health Care Systems: Efficiency and Institutions," OECD Economics Department Working Papers 769, OECD Publishing.
- Di Matteo, Livio & Di Matteo, Rosanna, 1998. "Evidence on the determinants of Canadian provincial government health expenditures: 1965-1991," Journal of Health Economics, Elsevier, vol. 17(2), pages 211-228, April.
- Juergen Jung & Chung Tran, 2010.
"Medical Consumption over the Life Cycle: Facts from a U.S. Medical Expenditure Panel Survey,"
2010-09, Towson University, Department of Economics, revised Mar 2013.
- Juergen Jung & Chung Tran, 2010. "Medical Consumption Over the Life Cycle: Facts from a U.S. Medical Expenditure Panel Survey," Discussion Papers 2010-08, School of Economics, The University of New South Wales.
- Gerard J. van den Berg & Maarten Lindeboom & France Portrait, 2006. "Economic Conditions Early in Life and Individual Mortality," American Economic Review, American Economic Association, vol. 96(1), pages 290-302, March.
- Parkin, David & McGuire, Alistair & Yule, Brian, 1987. "Aggregate health care expenditures and national income : Is health care a luxury good?," Journal of Health Economics, Elsevier, vol. 6(2), pages 109-127, June.
- Bethencourt, Carlos & Galasso, Vincenzo, 2008. "Political complements in the welfare state: Health care and social security," Journal of Public Economics, Elsevier, vol. 92(3-4), pages 609-632, April.
- Blackburn, Keith & Cipriani, Giam Pietro, 2002. "A model of longevity, fertility and growth," Journal of Economic Dynamics and Control, Elsevier, vol. 26(2), pages 187-204, February.
- Parker, Susan W. & Wong, Rebeca, 1997. "Household income and health care expenditures in Mexico," Health Policy, Elsevier, vol. 40(3), pages 237-255, June.
- Orazio P. Attanasio & Carl Emmerson, 2003. "Mortality, Health Status, and Wealth," Journal of the European Economic Association, MIT Press, vol. 1(4), pages 821-850, 06.
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