Health Financing: Does Governance Quality Matter?

Authors

1 Department of Economics, University of Medical Sciences and Technology, Khartoum, Sudan

2 Department of Economics, Universiti Putra Malaysia, Selangor, Malaysia

Abstract

Abstract





T





his paper contributes to the existing literature by examining the determinants of health financing in 177 developed and developing countries. The study introduces the variables of government effectiveness and control of corruption to capture the impact of governance quality on different mechanisms of health financing. Utilisng panel data analysis, namely system-GMM estimators, to obtain unbiased estimates, the results indicate that public and private health financing do not follow the same pattern. In addition, the GDP per capita and total government expenditure is crucial factors that affect health financing in both developed and developing countries. External aid tends to reduce public health financing, especially when it is received by a country with low governance quality. Interestingly, a high level of government effectiveness and control of corruption are found to be very influential in stimulating public health financing and helping to reduce private health financing in developed countries. However, the low amounts of health financing in developing countries are attributable to the low quality of governance, which increases out-of-pocket health financing.
 

Keywords


References

Arellano, M., & Bond, S. (1991). Some Tests of Specification for Panel Data: Monte Carlo Evidence and an Application to Employment Equations. The Review of Economic Studies, 58(2), 277-297.

Arellano, M., & Bover, O. (1995). Another Look at the Instrumental Variable Estimation of Error-Components Models. Journal of Econometrics, 68(1), 29-51.

Baltagi, B. H. (2008). Econometric Analysis of Panel Data. West Sussex: John Wiley & Sons Ltd.

Baltagi, B. H., & Moscone, F. (2010). Health Care Expenditure and Income in the OECD Reconsidered: Evidence from Panel Data. Economic Modelling, 27(4), 804-811.

Besstremyannaya, G. E. (2009). Increased Public Financing and Health Care Outcomes in Russia. Transition Studies Review, 16(3), 723-734.

Blundell, R., & Bond, S. (1998). Initial Conditions and Moment Restrictions in Dynamic Panel Data Models. Journal of Econometrics, 87(1), 115-143.

Clemente, J., Marcuello, C., Montañés, A., & Pueyo, F. (2004). On the International Stability of Health Care Expenditure Functions: Are Government and Private Functions Similar? Journal of Health Economics, 23(3), 589-613.

Farag, M., Stanley, A. K. N., Hodgkin, D., Gaumer, G., & Erbil, C. (2013). Health Expenditures, Health Outcomes and the Role of Good Governance. International Journal of Health Care Finance and Economics, 13(1), 33-52.

 

 

Galama, T. (2011). A Contribution to Health Capital Theory (WR-831). Retrieved from

http://www.rand.org/content/dam/rand/pubs/working_papers/2011/RAND_WR831.pdf.

Getzen, T. E. (2000). Health Care Is an Individual Necessity and a National Luxury: Applying Multilevel Decision Models to the Analysis of Health Care Expenditures. Journal of Health Economics, 19(2), 259-270.

Grossman, M. (1972). On the Concept of Health Capital and the Demand for Health. The Journal of Political Economy, 80(2), 223-255.

Hartwig, J. (2008). What Drives Health Care Expenditure? Baumol’s Model of “Unbalanced Growth” Revisited. Journal of Health Economics, 27(3), 603-623.

Leiter, A. M., & Theurl, E. (2012). The Convergence of Health Care Financing Structures: Empirical Evidence from OECD-Countries. The European Journal of Health Economics, 13(1), 7-18.

Liang, L. L., & Mirelman, A. J. (2014). Why Do Some Countries Spend More for Health? An Assessment of Sociopolitical Determinants and International Aid for Government Health Expenditures. Social Science & Medicine, 114, 161-168.

Lu, C., Schneider, M. T., Gubbins, P., Leach-Kemon, K., Jamison, D., & Murray, C. J. L. (2010). Public Financing of Health in Developing Countries: a Cross-National Systematic Analysis. Lancet, 375(9723), 1375-1387.

Newhouse, J. P. (1977). Medical Care Expenditure: A Cross-National Survey. Journal of Human Resources, 12, 115-125.

Nickell, S. (1981). Biases in Dynamic Models with Fixed Effects. Econometrica49(6), 1417-1426.

 

 

Phillips, P. C., & Sul, D. (2007). Bias in Dynamic Panel Estimation with Fixed Effects, Incidental Trends and Cross Section Dependence. Journal of Econometrics137(1), 162-188.

Potrafke, N. (2010). The Growth of Public Health Expenditures in OECD Countries: Do Government Ideology and Electoral Motives Matter? Journal of Health Economics, 29(6), 797-810.

Rajkumar, A. S., & Swaroop, V. (2008). Public Spending and Outcomes: Does Governance Matter? Journal of Development Economics, 86(1), 96-111.

Resolution W. H. A. (2005). Sustainable Health Financing, Universal Coverage and Social Health Insurance. Fifty-Eighth World Health Assembly, Retrieved from

http://apps.who.int/gb/ebwha/pdf_files/WHA58-REC1/english/A58_2005_REC1-en.pdf.

Sirag, A., Mohamed Nor, N., Adamu, P., & Thinng, W. B. K. (2016). Public Health Spending and GDP Per Capita in Malaysia: Does Lucas Critique Apply? Malaysian Journal of Economic Studies, 53(2), 211–226.

WGI. (2015). The World Governance Indicators. Retrieved from

http://info.worldbank.org/governance/wgi/index.aspx#doc.

WHO. (2010). The World Health Report: Health Systems Financing: the Path to Universal Coverage. Retrieved from

http://www.who.int/healthsystems/topics/financing/healthreport/whr_background/en/.

Xu, K., Saksena, P., & Holly, A. (2011). The Determinants of Health Expenditure : A Country-Level Panel Data Analysis. Retrieved from

http://www.who.int/health_financing/documents/report_en_11_deter-he.pdf?ua=1.