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The political economy of public health expenditure and wait times in a public‐private mixed health care system

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  • Haizhen Mou

Abstract

This paper investigates the determinants of public health expenditure in a public‐private mixed health care system, where a longer wait time for public care is the major difference between public and private sectors. Voter preferences for health care vary according to their age and by income, and public policy choices are part of a multi‐dimensional, competitive political equilibrium. We show how equilibrium public health expenditure and wait times depend on demographics and explain why they are independent of the distributions of income and political influence. We also show that population aging may not always lead to more public health expenditure. Ce texte examine les déterminants des dépenses en santé publique dans un régime mixte public‐privé de soins de santé quand un temps d’attente plus long est la différence majeure entre les secteurs public et privé. Les préférences des électeurs dans le monde de la santé varient selon l’âge et le revenu, et les choix de politique publique sont partie d’un équilibre politique concurrentiel multidimensionnel. On montre que les dépenses en santé publique et les temps d’attente en équilibre dépendent de la démographie, et que cela explique pourquoi elles sont indépendantes de la répartition des revenus et de l’influence politique. On montre aussi que le vieillissement de la population peut ne pas toujours entraîner des dépenses en santé publique additionnelles.

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  • Haizhen Mou, 2012. "The political economy of public health expenditure and wait times in a public‐private mixed health care system," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 45(4), pages 1640-1666, November.
    • Handle: RePEc:wly:canjec:v:45:y:2012:i:4:p:1640-1666
    DOI: 10.1111/j.1540-5982.2012.01741.x
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