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Public Healthcare Financing during Counterinsurgency Efforts: Evidence from Colombia

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  • Samuel Lordemus
  • Noemi Kreif
  • Rodrigo Moreno‐Serra

Abstract

How do government counterinsurgency efforts affect local public health financing during civil conflicts? We investigate this question in the context of the protracted conflict in Colombia. Using data on antinarcotics operations and health transfers from the central government to municipal governments, we employ both panel estimations and an instrumental variable to address concerns of endogeneity. We first show evidence of a government discretionary power over the allocation of health transfers. We do not find evidence that counterinsurgency operations causally affect health transfers to municipalities. Our results rule out political alignment between mayors and the national governing party as an intermediary factor that could influence the flow of fiscal transfers in municipalities exposed to the conflict.

Suggested Citation

  • Samuel Lordemus & Noemi Kreif & Rodrigo Moreno‐Serra, 2024. "Public Healthcare Financing during Counterinsurgency Efforts: Evidence from Colombia," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 86(5), pages 1230-1259, October.
    • Handle: RePEc:bla:obuest:v:86:y:2024:i:5:p:1230-1259
    DOI: 10.1111/obes.12603
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    1. Gupta, Sanjeev & Clements, Benedict & Bhattacharya, Rina & Chakravarti, Shamit, 2004. "Fiscal consequences of armed conflict and terrorism in low- and middle-income countries," European Journal of Political Economy, Elsevier, vol. 20(2), pages 403-421, June.
    2. Ernesto Calvo & Maria Victoria Murillo, 2004. "Who Delivers? Partisan Clients in the Argentine Electoral Market," American Journal of Political Science, John Wiley & Sons, vol. 48(4), pages 742-757, October.
    3. Eric Werker & Faisal Z. Ahmed & Charles Cohen, 2009. "How Is Foreign Aid Spent? Evidence from a Natural Experiment," American Economic Journal: Macroeconomics, American Economic Association, vol. 1(2), pages 225-244, July.
    4. Brutti, Zelda & Sánchez Torres, Fabio, 2022. "Turning around teacher quality in Latin America: Renewed confidence and lessons from Colombia," Economic Analysis and Policy, Elsevier, vol. 73(C), pages 62-93.
    5. Emily Oster, 2019. "Unobservable Selection and Coefficient Stability: Theory and Evidence," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 37(2), pages 187-204, April.
    6. MacKinnon, James G. & Nielsen, Morten Ørregaard & Webb, Matthew D., 2023. "Cluster-robust inference: A guide to empirical practice," Journal of Econometrics, Elsevier, vol. 232(2), pages 272-299.
    7. Uchimura, Hiroko & Jütting, Johannes P., 2009. "Fiscal Decentralization, Chinese Style: Good for Health Outcomes?," World Development, Elsevier, vol. 37(12), pages 1926-1934, December.
    8. Terza, Joseph V. & Basu, Anirban & Rathouz, Paul J., 2008. "Two-stage residual inclusion estimation: Addressing endogeneity in health econometric modeling," Journal of Health Economics, Elsevier, vol. 27(3), pages 531-543, May.
    9. Daniel Mejía & Pascual Restrepo & Sandra V. Rozo, 2017. "On the Effects of Enforcement on Illegal Markets: Evidence from a Quasi-Experiment in Colombia," The World Bank Economic Review, World Bank, vol. 31(2), pages 570-594.
    10. Jacob N. Shapiro & Oliver Vanden Eynde, 2023. "Fiscal Incentives for Conflict: Evidence from India's Red Corridor," The Review of Economics and Statistics, MIT Press, vol. 105(1), pages 217-225, January.
    11. Ch, Rafael & Shapiro, Jacob & Steele, Abbey & Vargas, Juan F., 2018. "Endogenous Taxation in Ongoing Internal Conflict: The Case of Colombia," American Political Science Review, Cambridge University Press, vol. 112(4), pages 996-1015, November.
    12. Emilie Caldeira, 2012. "Does the System of Allocation of Intergovernmental Transfers in Senegal Eliminate Politically Motivated Targeting?," Journal of African Economies, Centre for the Study of African Economies, vol. 21(2), pages 167-191, March.
    13. Thiemo Fetzer, 2020. "Can Workfare Programs Moderate Conflict? Evidence from India," Journal of the European Economic Association, European Economic Association, vol. 18(6), pages 3337-3375.
    14. Ahmed, Faisal Z., 2016. "Does Foreign Aid Harm Political Rights? Evidence from U.S. Aid," Quarterly Journal of Political Science, now publishers, vol. 11(2), pages 183-217, July.
    15. Rodrigo Ad~ao & Michal Koles'ar & Eduardo Morales, 2018. "Shift-Share Designs: Theory and Inference," Papers 1806.07928, arXiv.org, revised Aug 2019.
    16. Teresa Molina, 2020. "Health Seeking amid Violence: Evidence from the Philippines," Economic Development and Cultural Change, University of Chicago Press, vol. 69(1), pages 173-212.
    17. Mejia, Daniel & Restrepo, Pascual, 2016. "The economics of the war on illegal drug production and trafficking," Journal of Economic Behavior & Organization, Elsevier, vol. 126(PA), pages 255-275.
    18. Timothy Besley & Torsten Persson, 2008. "Wars and State Capacity," Journal of the European Economic Association, MIT Press, vol. 6(2-3), pages 522-530, 04-05.
    19. Melissa Dell, 2015. "Trafficking Networks and the Mexican Drug War," American Economic Review, American Economic Association, vol. 105(6), pages 1738-1779, June.
    20. Joseph V. Terza, 2017. "Two-stage residual inclusion estimation: A practitioners guide to Stata implementation," Stata Journal, StataCorp LP, vol. 17(4), pages 916-938, December.
    21. Giancarlo Buitrago & Rodrigo Moreno-Serra, 2021. "Conflict violence reduction and pregnancy outcomes: A regression discontinuity design in Colombia," PLOS Medicine, Public Library of Science, vol. 18(7), pages 1-19, July.
    22. Acuna, Julio & Balza, Lenin H. & Gomez-Parra, Nicolas, 2024. "From wells to wealth? Government transfers and human capital," Journal of Development Economics, Elsevier, vol. 166(C).
    23. Adriana Camacho, 2008. "Stress and Birth Weight: Evidence from Terrorist Attacks," American Economic Review, American Economic Association, vol. 98(2), pages 511-515, May.
    24. Rodrigo Adão & Michal Kolesár & Eduardo Morales, 2019. "Shift-Share Designs: Theory and Inference," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(4), pages 1949-2010.
    25. Kreif, Noémi & Mirelman, Andrew & Suhrcke, Marc & Buitrago, Giancarlo & Moreno-Serra, Rodrigo, 2022. "The impact of civil conflict on child health: Evidence from Colombia," Economics & Human Biology, Elsevier, vol. 44(C).
    26. Colella, Fabrizio & Lalive, Rafael & Sakalli, Seyhun Orcan & Thoenig, Mathias, 2019. "Inference with Arbitrary Clustering," IZA Discussion Papers 12584, Institute of Labor Economics (IZA).
    27. Eli Berman & Jacob N. Shapiro & Joseph H. Felter, 2011. "Can Hearts and Minds Be Bought? The Economics of Counterinsurgency in Iraq," Journal of Political Economy, University of Chicago Press, vol. 119(4), pages 766-819.
    28. Daron Acemoglu & James A. Robinson & Rafael J. Santos, 2013. "The Monopoly Of Violence: Evidence From Colombia," Journal of the European Economic Association, European Economic Association, vol. 11, pages 5-44, January.
    29. Camacho, Adriana & Mejía, Daniel, 2017. "The health consequences of aerial spraying illicit crops: The case of Colombia," Journal of Health Economics, Elsevier, vol. 54(C), pages 147-160.
    30. Nathan Nunn & Nancy Qian, 2014. "US Food Aid and Civil Conflict," American Economic Review, American Economic Association, vol. 104(6), pages 1630-1666, June.
    31. Jairo Núnez Méndez & Juan Gonzalo Zapata & Carlos Castaneda & Sandra Milena Fonseca & Ramírez, Jaime, 2012. "La sostenibilidad financiera del Sistema de Salud Colombiano - Dinámica del gasto y principales retos de cara al futuro," Libros Fedesarrollo 9899, Fedesarrollo.
    32. Abay Asfaw* & Klaus Frohberg & KS James & Johannes Jütting, 2007. "Fiscal decentralization and infant mortality: empirical evidence from r ural India," Journal of Developing Areas, Tennessee State University, College of Business, vol. 41(1), pages 17-35, September.
    33. Lyall, Jason & Blair, Graeme & Imai, Kosuke, 2013. "Explaining Support for Combatants during Wartime: A Survey Experiment in Afghanistan," American Political Science Review, Cambridge University Press, vol. 107(4), pages 679-705, November.
    34. Kirschner, Shanna A. & Finaret, Amelia B., 2021. "Conflict and health: Building on the role of infrastructure," World Development, Elsevier, vol. 146(C).
    35. Arulampalam, Wiji & Dasgupta, Sugato & Dhillon, Amrita & Dutta, Bhaskar, 2009. "Electoral goals and center-state transfers: A theoretical model and empirical evidence from India," Journal of Development Economics, Elsevier, vol. 88(1), pages 103-119, January.
    36. Patricia Justino, 2006. "On the Links between Violent Conflict and Chronic Poverty: How Much Do We Really Know?," HiCN Working Papers 18, Households in Conflict Network.
    37. Nickell, Stephen J, 1981. "Biases in Dynamic Models with Fixed Effects," Econometrica, Econometric Society, vol. 49(6), pages 1417-1426, November.
    38. Stephan Litschig & Kevin M. Morrison, 2013. "The Impact of Intergovernmental Transfers on Education Outcomes and Poverty Reduction," American Economic Journal: Applied Economics, American Economic Association, vol. 5(4), pages 206-240, October.
    39. Bertone, Maria Paola & Jowett, Matthew & Dale, Elina & Witter, Sophie, 2019. "Health financing in fragile and conflict-affected settings: What do we know, seven years on?," Social Science & Medicine, Elsevier, vol. 232(C), pages 209-219.
    40. Jairo Núñez Méndez & Juan Gonzalo Zapata & Carlos Castaneda & Sandra Milena Fonseca & Ramírez, Jaime, 2012. "La sostenibilidad financiera del Sistema de Salud Colombiano - Dinámica del gasto y principales retos de cara al futuro," INFORMES DE INVESTIGACIÓN 009899, FEDESARROLLO.
    41. Evans, David K. & Holtemeyer, Brian & Kosec, Katrina, 2019. "Cash transfers increase trust in local government," World Development, Elsevier, vol. 114(C), pages 138-155.
    42. Kruk, Margaret E. & Freedman, Lynn P. & Anglin, Grace A. & Waldman, Ronald J., 2010. "Rebuilding health systems to improve health and promote statebuilding in post-conflict countries: A theoretical framework and research agenda," Social Science & Medicine, Elsevier, vol. 70(1), pages 89-97, January.
    43. Conley, T. G., 1999. "GMM estimation with cross sectional dependence," Journal of Econometrics, Elsevier, vol. 92(1), pages 1-45, September.
    44. Bird, Richard M. & Smart, Michael, 2002. "Intergovernmental Fiscal Transfers: International Lessons for Developing Countries," World Development, Elsevier, vol. 30(6), pages 899-912, June.
    45. Wooldridge, Jeffrey M., 2014. "Quasi-maximum likelihood estimation and testing for nonlinear models with endogenous explanatory variables," Journal of Econometrics, Elsevier, vol. 182(1), pages 226-234.
    46. Benjamin Crost & Joseph Felter & Patrick Johnston, 2014. "Aid under Fire: Development Projects and Civil Conflict," American Economic Review, American Economic Association, vol. 104(6), pages 1833-1856, June.
    47. Banful, Afua Branoah, 2011. "Do formula-based intergovernmental transfer mechanisms eliminate politically motivated targeting? Evidence from Ghana," Journal of Development Economics, Elsevier, vol. 96(2), pages 380-390, November.
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    More about this item

    JEL classification:

    • D74 - Microeconomics - - Analysis of Collective Decision-Making - - - Conflict; Conflict Resolution; Alliances; Revolutions
    • F52 - International Economics - - International Relations, National Security, and International Political Economy - - - National Security; Economic Nationalism
    • 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
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration
    • O23 - Economic Development, Innovation, Technological Change, and Growth - - Development Planning and Policy - - - Fiscal and Monetary Policy in Development

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