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Do Political Factors Matter for Health Care Expenditure? A Comparative Study of Swiss Cantons

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  • Vatter, Adrian
  • Rüefli, Christian

Abstract

This study presents an empirical investigation of differences in health care expenditure between the 26 federal entities of Switzerland in the 1990s. So far, demand and supply-related factors have dominated the debate, while political determinants have largely been neglected. Here, they will be assessed together with the usual indicators on the basis of a cross-sectional analysis of both public and private health care spending. It will be shown that no approach represents the whole truth, but each one a grain of it. Demand for health care is clearly a function of socio-economic factors. On the supply side, it is mainly the number of practitioners and the overall level of provision that drive costs. Finally, from the political factors, general state interventionism is decisive – though only so far as public spending is concerned.

Suggested Citation

  • Vatter, Adrian & Rüefli, Christian, 2003. "Do Political Factors Matter for Health Care Expenditure? A Comparative Study of Swiss Cantons," Journal of Public Policy, Cambridge University Press, vol. 23(3), pages 301-323, September.
    • Handle: RePEc:cup:jnlpup:v:23:y:2003:i:03:p:301-323_00
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    Cited by:

    1. Alexander Karmann & Felix Roesel, 2017. "Hospital Policy and Productivity – Evidence from German States," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1548-1565, December.
    2. Fritz Sager & Yvan Rielle, 2013. "Sorting through the garbage can: under what conditions do governments adopt policy programs?," Policy Sciences, Springer;Society of Policy Sciences, vol. 46(1), pages 1-21, March.
    3. Braendle, Thomas & Colombier, Carsten, 2016. "What drives public health care expenditure growth? Evidence from Swiss cantons, 1970–2012," Health Policy, Elsevier, vol. 120(9), pages 1051-1060.
    4. Eggli, Yves & Stadelmann, Pierre & Piaget-Rossel, Romain & Marti, Joachim, 2019. "Heterogeneity in The drivers of health expenditures financed by health insurance in a fragmented health system: The case of Switzerland," Health Policy, Elsevier, vol. 123(12), pages 1275-1281.
    5. Li-Lin Liang & Andrew J Mirelman, 2014. "Why Do Some Countries Spend More for Health? An Assessment of Sociopolitical Determinants and International Aid for Government Health Expenditures," Health, Nutrition and Population (HNP) Discussion Paper Series 88182, The World Bank.
    6. Fritz Sager, 2009. "Governance and Coercion," Political Studies, Political Studies Association, vol. 57(3), pages 537-558, October.
    7. Martin Gregor & Michael L. Smith, 2013. "Civic initiatives in the context of legal uncertainty," Journal of Theoretical Politics, , vol. 25(1), pages 36-62, January.
    8. Silvia Fedeli, 2012. "The impact of GDP on health care expenditure: the case of Italy (1982-2009)," Working Papers in Public Economics 153, University of Rome La Sapienza, Department of Economics and Law.
    9. Fatulescu, Puiu, 2011. "Cheltuielile Publice în domeniul Sănătății- principalii factori care le influențează [Public Health Systems Expenditures and the main factors that drives them]," MPRA Paper 37191, University Library of Munich, Germany.
    10. Colombier, Carsten & Braendle, Thomas, 2022. "Healthcare expenditure projections up to 2050: ageing and the COVID-19 crisis," MPRA Paper 120659, University Library of Munich, Germany.
    11. Liang, Li-Lin & Mirelman, Andrew 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, Elsevier, vol. 114(C), pages 161-168.
    12. Boris Kaiser, Christian Schmid, 2013. "Does Physician Dispensing Increase Drug Expenditures?," Diskussionsschriften credresearchpaper02, Universitaet Bern, Departement Volkswirtschaft - CRED.
    13. Joan Costa‐Font & Marin Gemmill & Gloria Rubert, 2011. "Biases in the healthcare luxury good hypothesis?: a meta‐regression analysis," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 174(1), pages 95-107, January.
    14. Boris Kaiser & Christian Schmid, 2016. "Does Physician Dispensing Increase Drug Expenditures? Empirical Evidence from Switzerland," Health Economics, John Wiley & Sons, Ltd., vol. 25(1), pages 71-90, January.
    15. Alessandra Cepparulo & Luisa Giuriato, 2022. "The residential healthcare for the elderly in Italy: some considerations for post-COVID-19 policies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(4), pages 671-685, June.
    16. Maurus Rischatsch & Maria Trottmann & Peter Zweifel, 2013. "Generic substitution, financial interests, and imperfect agency," International Journal of Health Economics and Management, Springer, vol. 13(2), pages 115-138, June.
    17. Oliver Reich & Cornelia Weins & Claudia Schusterschitz & Magdalena Thöni, 2012. "Exploring the disparities of regional health care expenditures in Switzerland: some empirical evidence," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(2), pages 193-202, April.
    18. Carsten Colombier & Thomas Braendle, 2018. "Healthcare expenditure and fiscal sustainability: evidence from Switzerland," Public Sector Economics, Institute of Public Finance, vol. 42(3), pages 279-301.
    19. Luca Crivelli & Massimo Filippini & Ilaria Mosca, 2006. "Federalism and regional health care expenditures: an empirical analysis for the Swiss cantons," Health Economics, John Wiley & Sons, Ltd., vol. 15(5), pages 535-541, May.
    20. David Prieto & Santiago Lago-Peñas, 2012. "Decomposing the determinants of health care expenditure: the case of Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(1), pages 19-27, February.
    21. Kaufmann, Cornel & Schmid, Christian & Boes, Stefan, 2017. "Health insurance subsidies and deductible choice: Evidence from regional variation in subsidy schemes," Journal of Health Economics, Elsevier, vol. 55(C), pages 262-273.
    22. Héctor Bellido & Lorena Olmos & Juan Antonio Román-Aso, 2019. "Do political factors influence public health expenditures? Evidence pre- and post-great recession," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 455-474, April.
    23. Braendle, Thomas & Colombier, Carsten, 2017. "Healthcare expenditure projections up to 2045," MPRA Paper 104737, University Library of Munich, Germany.

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