IDEAS home Printed from https://ideas.repec.org/p/ags/hwwadp/26142.html
   My bibliography  Save this paper

Are Reforms From a Centrally Planned to a Market System Bad for Health?

Author

Listed:
  • Suhrcke, Marc

Abstract

Alerted by the dramatic mortality increase in Russia after the onset of transition, and inspired by Sen (1997) to interpret mortality as an indicator of economic performance, mortality data is used as the benchmark, by which to judge the success or failure of transition in Central and Eastern Europe. In particular, it is examined whether reforms from a centrally planned to a market system did have a detrimental effect on health during transition, as it has allegedly been the case in Russia. Controlling for other determinants of health such as GDP growth and health provision, the hypothesis that reforms are bad for health cannot be supported. Instead, good reforms do have a beneficial effect, quite independently of GDP growth. In the 23 countries examined for the period 1989-96, health provision can only account for the development of infant, child and female mortality rates, but not for adult male mortality, which seems to be largely due to stress-related phenomena, that are generally considered to be quite unrelated to health care provision. Further, in contrast to the growth in transition-literature, there seems to be no trade-off between short-term costs and long-term benefits of reform. Good reform directly translates into better health. Several mechanisms are discussed to shed light on the link between good reform and good health. A particularly worrying trend with potentially wide-ranging long-term implications for the CEECs' development paths derives from the observation of a substantial degree of divergence in health status across the region, given the important role of health in determining future growth prospects. Alarmiert durch den dramatischen Anstieg der Sterblichkeitsrate in Russland in den ersten Jahren der Transformation und basierend auf Sen's (1997) Idee, Sterblichkeit als Indikator ökonomischer Performance zu interpretieren, verwenden wir Sterblichkeitsraten als Maßstab zur Evaluierung von Erfolg oder Mißerfolg der Transformation in Mittel- und Osteuropa. Insbesondere wird untersucht, ob die strukturellen Reformen von der Plan- zur Marktwirtschaft eine negative Auswirkung auf den Gesundheitsstatus hatten, wie das Negativ-Beispiel Russland suggeriert. Wenn für andere Determinanten der Gesundheitsentwicklung kontrolliert wird- wie z.B. die Wachstumsraten des Bruttosozialproduktes und die Bereitstellung von Gesundheitsdiensten, zeigt sich, dass diese Hypothese nicht aufrechterhalten werden kann. Im Gegenteil, eine "gute" Reformpolitik verrringert die Sterblichkeitsraten relativ unabhängig vom BSP-Wachstum. In den 23 untersuchten Ländern für den Zeitraum 1989-1996 kann die Bereitstellung an Gesundheitsdiensten nur die Entwicklung der Kinder- und Frauensterblichkeit erklären, nicht jedoch die der erwachsenen Männer. Letztere scheint in der Tat eher von stress-induzierten Phänomenen verursacht worden zu sein, die grundsätzlich als vergleichsweise unabhängig von Gesundheitsdiensten gilt. Darüber hinaus zeigt sich im Gegensatz zur Literatur über Wachstum in der Transformation, daß es keinen trade-off zwischen kurzfristigen Kosten und langfristigem Nutzen der Reform zu geben scheint: Gute Reformen führen unmittelbar zu einem verbesserten Gesundheitsstatus. Einige Mechanismen werden diskutiert, die für diesen Zusammenhang verantwortlich sein könnten. Aufgrund der erheblichen Bedeutung der Gesundheit als Bestandteil des Humankapitals ergibt sich ein besonders besorgniserregender Trend mit potentiell weitreichenden Konsequenzen für die Entwicklungsperspektiven der MOEs aus der Beobachtung zunehmender Divergenz der Sterblichleitsraten innerhalb der Region.

Suggested Citation

  • Suhrcke, Marc, 2000. "Are Reforms From a Centrally Planned to a Market System Bad for Health?," Discussion Paper Series 26142, Hamburg Institute of International Economics.
  • Handle: RePEc:ags:hwwadp:26142
    DOI: 10.22004/ag.econ.26142
    as

    Download full text from publisher

    File URL: https://ageconsearch.umn.edu/record/26142/files/dp000105.pdf
    Download Restriction: no

    File URL: https://libkey.io/10.22004/ag.econ.26142?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Lant Pritchett & Lawrence H. Summers, 1996. "Wealthier is Healthier," Journal of Human Resources, University of Wisconsin Press, vol. 31(4), pages 841-868.
    2. John Strauss & Duncan Thomas, 1998. "Health, Nutrition, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 36(2), pages 766-817, June.
    3. Michael Grossman, 1972. "The Demand for Health: A Theoretical and Empirical Investigation," NBER Books, National Bureau of Economic Research, Inc, number gros72-1.
    4. Germano Mwabu, 1996. "Health Effects of Market-Based Reforms in Developing Countries," WIDER Working Paper Series wp-1996-120, World Institute for Development Economic Research (UNU-WIDER).
    5. International Monetary Fund, 1998. "Recovery and Growth in Transition Economies 1990–97: A Stylized Regression Analysis," IMF Working Papers 1998/141, International Monetary Fund.
    6. John Robst & Glenn Graham, 1997. "Access to health care and current health status: do physicians matter?," Applied Economics Letters, Taylor & Francis Journals, vol. 4(1), pages 45-48.
    7. Desai, Meghnad, 1994. "The Measurement Problem in Economics," Scottish Journal of Political Economy, Scottish Economic Society, vol. 41(1), pages 34-42, February.
    8. de Melo, Martha & Denizer, Cevdet & Gelb, Alan & Tenev, Stoyan, 1997. "Circumstance and choice : the role of initial conditions and policies in transition economies," Policy Research Working Paper Series 1866, The World Bank.
    9. Parkin, David, 1989. "Comparing Health Service Efficiency Across Countries," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 5(1), pages 75-88, Spring.
    10. Marque-Luisa Miringoff & Marc Miringoff & Sandra Opdycke, 1996. "The Growing Gap between Standard Economic Indicators and the Nation’s Social Health," Challenge, Taylor & Francis Journals, vol. 39(4), pages 17-22, July.
    11. Mr. Mark A Horton, 1996. "Health and Education Expenditures in Russia, the Baltic States, and the Other Countries of the Former Soviet Union," IMF Working Papers 1996/126, International Monetary Fund.
    12. Paul Brenton & Daniel Gros & Guy Vanadille, 1997. "Output decline and recovery in the transiton economies: causes and social consequences1," The Economics of Transition, The European Bank for Reconstruction and Development, vol. 5(1), pages 113-130, May.
    13. Xavier X. Sala-i-Martin, 1997. "I Just Ran Four Million Regressions," NBER Working Papers 6252, National Bureau of Economic Research, Inc.
    14. Dewatripont, M & Roland, G, 1992. "The Virtues of Gradualism and Legitimacy in the Transition to a Market Economy," Economic Journal, Royal Economic Society, vol. 102(411), pages 291-300, March.
    15. Filmer, Deon & Pritchett, Lant, 1997. "Child mortality and public spending on health : how much does money matter?," Policy Research Working Paper Series 1864, The World Bank.
    16. Filmer, Deon & Hammer, Jeffrey & Pritchett, Lant, 1998. "Health policy in poor countries : weak links in the chain," Policy Research Working Paper Series 1874, The World Bank.
    17. Sen, Amartya, 1998. "Mortality as an Indicator of Economic Success and Failure," Economic Journal, Royal Economic Society, vol. 108(446), pages 1-25, January.
    18. UNICEF Innocenti Research Centre. MONEE project, 1998. "Education for All?," Papers remore98/3, Regional Monitoring Report.
    19. Sala-i-Martin, Xavier, 1997. "I Just Ran Two Million Regressions," American Economic Review, American Economic Association, vol. 87(2), pages 178-183, May.
    20. Mwabu, G., 1996. "Health Effects of Market-Based Reforms in Developing Countries," Research Paper 120, World Institute for Development Economics Research.
    21. Joseph Eyer & Peter Sterling, 1977. "Stress-Related Mortality and Social Organization," Review of Radical Political Economics, Union for Radical Political Economics, vol. 9(1), pages 1-44, April.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Patrick Hamm & David Stuckler & Lawrence King, 2006. "Mass Privatization and the Postcommunist Mortality Crisis," Working Papers wp118, Political Economy Research Institute, University of Massachusetts at Amherst.
    2. David Stuckler & Lawrence P. King, 2007. "Social Costs of Mass Privatization," William Davidson Institute Working Papers Series wp890, William Davidson Institute at the University of Michigan.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Baldacci, Emanuele & Clements, Benedict & Gupta, Sanjeev & Cui, Qiang, 2008. "Social Spending, Human Capital, and Growth in Developing Countries," World Development, Elsevier, vol. 36(8), pages 1317-1341, August.
    2. John Anyanwu & Andrew E. O. Erhijakpor, 2007. "Working Paper 91 - Health Expenditures and Health Outcomes in Africa," Working Paper Series 226, African Development Bank.
    3. AfDB AfDB, 2002. "Working Paper 38 - Health Development in Africa," Working Paper Series 2176, African Development Bank.
    4. AfDB AfDB, 2002. "Working Paper 38 - Health Development in Africa," Working Paper Series 2256, African Development Bank.
    5. AfDB AfDB, 2007. "Working Paper 91 - Health Expenditures and Health Outcomes in Africa," Working Paper Series 2224, African Development Bank.
    6. AfDB AfDB, 2007. "Working Paper 91 - Health Expenditures and Health Outcomes in Africa," Working Paper Series 2304, African Development Bank.
    7. David M. Cutler & Adriana Lleras-Muney & Tom Vogl, 2008. "Socioeconomic Status and Health: Dimensions and Mechanisms," NBER Working Papers 14333, National Bureau of Economic Research, Inc.
    8. Smith, Lisa C. & Haddad, Lawrence James, 1999. "Explaining child malnutrition in developing countries," FCND discussion papers 60, International Food Policy Research Institute (IFPRI).
    9. Schultz, T. Paul, 2005. "Productive Benefits of Health: Evidence from Low-Income Countries," Center Discussion Papers 28532, Yale University, Economic Growth Center.
    10. Wagner, Martin & Hlouskova, Jaroslava, 2001. "The CEEC10's Real Convergence Prospects," Transition Economics Series 20, Institute for Advanced Studies.
    11. William Easterly, 2009. "Can the West Save Africa?," Journal of Economic Literature, American Economic Association, vol. 47(2), pages 373-447, June.
    12. John Anyanwu & Andrew E. O. Erhijakpor, 2007. "Working Paper 92 - Education Expenditures and School Enrolment in Africa: Illustrations from Nigeria and Other SANE Countries," Working Paper Series 227, African Development Bank.
    13. Marwa Farag & A. Nandakumar & Stanley Wallack & Dominic Hodgkin & Gary Gaumer & Can Erbil, 2013. "Health expenditures, health outcomes and the role of good governance," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 33-52, March.
    14. J. Fidrmuc & J. Fidrmuc, 2000. "Macroeconomic Developments in Slovakia and the EU Accession Process," Working Papers ir00007, International Institute for Applied Systems Analysis.
    15. Mr. Emanuele Baldacci & Mr. Larry Q Cui & Mr. Benedict J. Clements & Mr. Sanjeev Gupta, 2004. "Social Spending, Human Capital, and Growth in Developing Countries: Implications for Achieving the MDGs," IMF Working Papers 2004/217, International Monetary Fund.
    16. Jeffrey Kouton & Rafiou R. Bétila & Moïse Lawin, 2021. "The Impact of ICT Development on Health Outcomes in Africa: Does Economic Freedom Matter?," Journal of the Knowledge Economy, Springer;Portland International Center for Management of Engineering and Technology (PICMET), vol. 12(4), pages 1830-1869, December.
    17. ATAKE, Esso - Hanam, 2014. "Financement Public des dépenses de santé et survie infantile au Togo [Public funding of health expenditure and infant survival in Togo]," MPRA Paper 59320, University Library of Munich, Germany, revised 26 Oct 2014.
    18. Gupta, Sanjeev & Verhoeven, Marijn & Tiongson, Erwin R., 2002. "The effectiveness of government spending on education and health care in developing and transition economies," European Journal of Political Economy, Elsevier, vol. 18(4), pages 717-737, November.
    19. Martin Gächter & Engelbert Theurl, 2010. "Convergence of the Health Status at the Local Level: Empirical Evidence from Austria," NRN working papers 2010-09, The Austrian Center for Labor Economics and the Analysis of the Welfare State, Johannes Kepler University Linz, Austria.
    20. Scanlan, Stephen J., 2004. "Women, Food Security, and Development in Less-Industrialized Societies: Contributions and Challenges for the New Century," World Development, Elsevier, vol. 32(11), pages 1807-1829, November.

    More about this item

    Keywords

    Health Economics and Policy;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:ags:hwwadp:26142. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: AgEcon Search (email available below). General contact details of provider: https://edirc.repec.org/data/hwwaade.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.