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Cyclical Patterns in Government Health Expenditures Between 1995 and 2010


  • Edit V. Velenyi
  • Marc F. Smitz


The 2008-09 global economic crises have shown that no country is immune to external challenges. When policy controls are missing or not used efficiently, crises can reverse progress even in advanced economies. This unexpected outcome has increased concerns about the ability of governments in developing countries to manage downturns. The question is whether current and future crises will reinforce the procyclical responses or whether these governments will be able to escape the procyclical trap. In the fiscal domain, countercyclical trends in developing countries are promising. Over the last decade, about a third of the developing world has been able to escape the procyclicality trap. Yet, little is known about the evidence on the cyclical patterns of government health spending. This descriptive analysis, which covers 183 countries between 1995 and 2010, provides empirical evidence on the cyclicality of government health expenditures, using panel data from a global macro database, the fiscal health database. The objective is to propose user-friendly diagnostic approaches in this area that can be easily replicated and updated to inform technical discussions and policy making

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  • Edit V. Velenyi & Marc F. Smitz, 2014. "Cyclical Patterns in Government Health Expenditures Between 1995 and 2010," Health, Nutrition and Population (HNP) Discussion Paper Series 87885, The World Bank.
  • Handle: RePEc:wbk:hnpdps:87885

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    References listed on IDEAS

    1. Frankel, Jeffrey A. & Vegh, Carlos A. & Vuletin, Guillermo, 2013. "On graduation from fiscal procyclicality," Journal of Development Economics, Elsevier, vol. 100(1), pages 32-47.
    2. Mendoza, Enrique G, 1995. "The Terms of Trade, the Real Exchange Rate, and Economic Fluctuations," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 36(1), pages 101-137, February.
    3. Hartwig, Jochen, 2008. "What drives health care expenditure?--Baumol's model of 'unbalanced growth' revisited," Journal of Health Economics, Elsevier, vol. 27(3), pages 603-623, May.
    4. Marianne Baxter & Robert G. King, 1999. "Measuring Business Cycles: Approximate Band-Pass Filters For Economic Time Series," The Review of Economics and Statistics, MIT Press, vol. 81(4), pages 575-593, November.
    5. Dora Benedek & Ernesto Crivelli & Sanjeev Gupta & Priscilla Muthoora, 2014. "Foreign Aid and Revenue: Still a Crowding-Out Effect?," FinanzArchiv: Public Finance Analysis, Mohr Siebeck, Tübingen, vol. 70(1), pages 67-96, March.
    6. Miguel Braun & Luciano di Gresia, 2003. "Towards Effective Social Insurance in Latin America: The Importance of Countercyclical Fiscal Policy," Research Department Publications 4333, Inter-American Development Bank, Research Department.
    7. Julia Darby & Jacques Melitz, 2008. "Social spending and automatic stabilizers in the OECD," Economic Policy, CEPR;CES;MSH, vol. 23, pages 715-756, October.
    8. Schlicht, Ekkehart, 2004. "Estimating the Smoothing Parameter in the So-Called Hodrick-Prescott Filter," Discussion Papers in Economics 304, University of Munich, Department of Economics.
    9. Arthur F. Burns & Wesley C. Mitchell, 1946. "Measuring Business Cycles," NBER Books, National Bureau of Economic Research, Inc, number burn46-1, June.
    10. Morten O. Ravn & Harald Uhlig, 2002. "On adjusting the Hodrick-Prescott filter for the frequency of observations," The Review of Economics and Statistics, MIT Press, vol. 84(2), pages 371-375.
    11. Alderman, Harold & Haque, Trina, 2006. "Countercyclical safety nets for the poor and vulnerable," Food Policy, Elsevier, vol. 31(4), pages 372-383, August.
    12. Olivier Blanchard & Roberto Perotti, 2002. "An Empirical Characterization of the Dynamic Effects of Changes in Government Spending and Taxes on Output," The Quarterly Journal of Economics, Oxford University Press, vol. 117(4), pages 1329-1368.
    13. Ronald Mendoza & Nicholas Rees, 2009. "Infant Mortality During Economic Downturns and Recovery," Working papers 0904, UNICEF,Division of Policy and Strategy.
    14. Skoufias, Emmanuel & Tiwari, Sailesh & Zaman, Hassan, 2011. "Can we rely on cash transfers to protect dietary diversity during food crises ? estimates from Indonesia," Policy Research Working Paper Series 5548, The World Bank.
    15. Barros, Pedro Pita, 2012. "Health policy reform in tough times: The case of Portugal," Health Policy, Elsevier, vol. 106(1), pages 17-22.
    16. Bhalotra, Sonia, 2010. "Fatal fluctuations? Cyclicality in infant mortality in India," Journal of Development Economics, Elsevier, vol. 93(1), pages 7-19, September.
    17. Pablo Gottret & George Schieber, 2006. "Health Financing Revisited : A Practitioner's Guide," World Bank Publications, The World Bank, number 7094, June.
    18. Abbas, Faisal & Hiemenz, Ulrich, 2011. "Determinants of Public Health expenditures in Pakistan," Discussion Papers 118422, University of Bonn, Center for Development Research (ZEF).
    19. Schady, Norbert & Smitz, Marc-Francois, 2010. "Aggregate economic shocks and infant mortality: New evidence for middle-income countries," Economics Letters, Elsevier, vol. 108(2), pages 145-148, August.
    20. Maureen Lewis & Marijn Verhoeven, 2010. "Financial Crises and Social Spending : The Impact of the 2008-2009 Crisis," World Bank Other Operational Studies 12965, The World Bank.
    21. Nina T Budina & Andrea Schaechter & Anke Weber & Tidiane Kinda, 2012. "Fiscal Rules in Response to the Crisis; Toward the "Next-Generation" Rules: A New Dataset," IMF Working Papers 12/187, International Monetary Fund.
    22. Agenor, Pierre-Richard & McDermott, C John & Prasad, Eswar S, 2000. "Macroeconomic Fluctuations in Developing Countries: Some Stylized Facts," World Bank Economic Review, World Bank Group, vol. 14(2), pages 251-285, May.
    23. Rachel Male, 2010. "Developing Country Business Cycles: Revisiting the Stylised Facts," Working Papers 664, Queen Mary University of London, School of Economics and Finance.
    24. Lisa Fleisher & Adam Leive & George Schieber, 2013. "Taking Stock of Fiscal Health: Trends in Global, Regional, and Country Level Health Financing," Health, Nutrition and Population (HNP) Discussion Paper Series 87994, The World Bank.
    25. Gené-Badia, Joan & Gallo, Pedro & Hernández-Quevedo, Cristina & García-Armesto, Sandra, 2012. "Spanish health care cuts: Penny wise and pound foolish?," Health Policy, Elsevier, vol. 106(1), pages 23-28.
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    Cited by:

    1. Davide La Torre & Tufail Malik & Simone Marsiglio, 2019. "Optimal Control of Prevention and Treatment in a Basic Macroeconomic-Epidemiological Model," Papers 1910.03383,
    2. Lisa Fleisher & Adam Leive & George Schieber, 2013. "Taking Stock of Fiscal Health: Trends in Global, Regional, and Country Level Health Financing," Health, Nutrition and Population (HNP) Discussion Paper Series 87994, The World Bank.
    3. Deepak Kumar Behera & Ranjan Kumar Mohanty & Umakant Dash, 2020. "Cyclicality of public health expenditure in India: role of fiscal transfer and domestic revenue mobilization," International Review of Economics, Springer;Happiness Economics and Interpersonal Relations (HEIRS), vol. 67(1), pages 87-110, March.

    More about this item


    allocation of resources; analytical capacity; Article; automatic stabilizer; automatic stabilizers; balance of payment; banking crises; Burns; BUSINESS CYCLE; business ... See More + cycles; capital flows; capital formation; capital investment; capital spending; Central Bank; central government; central government spending; checks; Country Risk; credit markets; creditworthiness; crisis countries; currency crises; data analysis; DATA AVAILABILITY; data quality; debt; debt crises; debt payments; demand for health; demand for health care; demand for services; developing countries; diagnostic tool; economic cycle; economic development; economic downturn; economic downturns; economic fluctuations; economic growth; ECONOMIC POLICIES; economic policy; ECONOMIC RISK; economic shocks; education spending; efficiency gains; exchange rate; exchange rates; expenditure growth; EXPENDITURES ON HEALTH; exporters; external borrowings; external debt; family planning; financial crises; Financial Crisis; financial flows; financial markets; financial protection; financial resources; financial risk; financial sustainability; financial variables; financing policies; fiscal adjustment; fiscal austerity; fiscal behavior; fiscal constraints; fiscal deficits; Fiscal Health; fiscal impact; fiscal institutions; fiscal policies; fiscal policy; fiscal rules; fiscal stabilization; Fiscal Statistics; fiscal targets; foreign direct investment; government budgets; government consumption; government expenditure; GOVERNMENT EXPENDITURES; government revenue; government revenues; government spending; gross domestic product; growth potential; growth rate; health budgets; health care; health care financing; health coverage; Health Database; health expenditure; HEALTH EXPENDITURES; health financing; health insurance; health insurance funds; health needs; Health Organization; health outcomes; health policies; Health Policy; health sector; health sector reform; health service; health services; health share; health spending; health status; health system; Health Systems; Health Systems Research; health targets; household income; human capital; Human Development; illness; income countries; income effects; income elasticity; income groups; income growth; interest payments; International Bank; intervention; Keynesian theories; liquidity; loan; loan repayment; local currency; local governments; low-income countries; macroeconomic environment; Monetary Fund; National Health; national income; nongovernmental organizations; Nutrition; pensions; personal income; policy formulation; policy responses; political economy; Political Risk; poverty reduction; price volatility; private sector; provision of health services; provision of water; public education; public expenditure; public expenditures; public health; public health spending; public investment; public investments; public sector; public spending; purchasing power; remittances; reserves; returns; Risk Groups; risk management; safety net; sanitation; sector budget; sector policies; sector policy; sectoral allocation; sectoral policies; SOCIAL EXPENDITURES; social insurance; social policies; social policy; social programs; social protection; social safety nets; social services; solvency; sovereign debt; tax; total spending; transparency; Trust Fund; unemployment; voluntary sector;

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