Unbalanced growth and health care expenditure

Baumol's model of unbalanced growth implies that health care expenditure (HCE) is driven by wage increases in excess of productivity growth. However, it remains unclear whether the HCE in developing countries is affected by the same factor. This paper tests this hypothesis by using China provincial panel data. We show that HCE grows more rapidly if economy‐wide wage growth exceeds productivity growth in China. The results are robust to the use of housing price as an instrumental variable for the economy‐wide nominal wage and the inclusion of real GDP growth, demographic structure, government deficit, pollution emissions and health sector quality as control variables. Furthermore, our findings show that Baumol's cost disease plays a more important role in the less economically developed western regions in which the rural–urban migration is less pronounced.     

Robust determinants of health care expenditure growth

Our aim is to disclose robust explanatory variables for health care expenditure (HCE) growth by introducing to this field of research a method that is especially well suited for situations of ‘model uncertainty’: the Extreme Bounds Analysis (EBA). We analyse data for 33 OECD countries over the period 1970–2010 and include – as far as it is statistically feasible – all macroeconomic and institutional determinants of HCE growth in the EBA that have been suggested in the literature. Furthermore, we analyse to what extent outliers in the data influence the results. Our results confirm earlier findings that GDP growth and a variable representing Baumol’s ‘cost disease’ theory emerge as robust and statistically significant determinants of HCE growth. Depending on whether or not outliers are excluded, we find up to six additional robust drivers: the growth in expenditure on health administration, the change in the share of inpatient expenditure in total health expenditure, the (lagged) government share in GDP, the change in the insurance coverage ratio, the growth in land traffic fatalities and the growth in the population share undergoing renal dialysis.     

Impact of remittances on household health care expenditure: Evidence from the Nepal Living Standards Survey

This paper examines the effect of remittance inflows on health care expenditure in Nepal using the Nepal Living Standards Survey 2010–2011. Using the recursive three‐stage least square regression method, the propensity score matching method, and the Oaxaca–Blinder decomposition method, we find a positive and significant effect of remittances on health care expenditure. In particular, our analysis shows a 0.099% increase in health care expenditure for every 1% increase in overall remittances. This effect increases to 0.189% for earned remittances (remittances received from a household member). We also find that remittance‐receiving households with at least one migrant family member have different health care spending behavior than those with no migrant members.     

Testing cointegration between health care expenditure and GDP in Japan with the presence of a regime shift

Using quarterly data from 1994 through 2013, this article is the first to use the Hansen and Seo (2002) tests to examine the long-term relationship between real per-capita GDP (PGDP) and real per-capita health care expenditure (PHCE) in Japan with threshold effects. We detect the presence of a threshold cointegrating relationship between the two variables. In addition, we find that error correction adjustments are significantly conducted only through PGDP in a typical regime, whereas both PGDP and PHCE drive the adjustments in the extreme regime. We find that the extreme regime occurred mainly after Q4 2008, implying that the policy introducing the late-stage medical care system for the elderly in April 2008, which expanded the ratio of personal expenses for the elderly, may be effective for attaining a long-run equilibrium between PGDP and PHCE.     

美国医疗保健模式及其改革

由于倡导自由市场经济的文化和社会背景,美国是唯一没有实行全国统一的医疗保障制度的发达国家。本文对美国医疗保险制度、美国医院的管理运行机制、美国医疗保险付费方式的沿革进行了系统的介绍,并梳理了美国医疗保健管理模式的特点与问题,结合奥巴马政府医疗保健改革要点,对我国医疗保健体系改革提出了几点建议。     

Effects of health insurance on labour supply: evidence from the health care fund for the poor in Vietnam

The expansion of health insurance in emerging countries raises concerns about the unintended negative effects of health insurance on labour supply. This article examines the labour supply effects of the Health Care Fund for the Poor (HCFP) in Vietnam in terms of the number of work hours per month and labour force participation (the probability of employment). Employing various matching methods combined with a Difference-in-Differences approach on the Vietnam Household Living Standard Surveys 2002–2006, we show that the HCFP, which aims to provide poor people and disadvantaged minority groups with free health insurance, has a negative effect on labour supply. This is manifested in both the average number of hours worked per month and the probability of employment, suggesting the income effect of the HCFP. Interestingly, the effects are mainly driven by the non-poor recipients living in rural areas, raising the question of the targeting strategy of the programme.     

Human development and decentralization: The importance of public health expenditure

In this article, we empirically analyze the impact of central and subnational government spending on human development in a sample of 57 developed and developing countries over the period 2000–18. Specifically, we focus on the effects of health and education public expenditure on the Human Development Index (HDI) and its dimensions (life expectancy, education, and income). Applying data panel analysis, our empirical evidence shows the importance of central and subnational government health expenditure positively impacting on HDI and each of its components, while in the case of the education expenditure, this positive effect is only confirmed on the educational dimension of HDI. Our study shows how governments can stimulate human development, improving the well-being of citizens, by allocating more resources to healthcare through the different administrative levels.     

The impact of education on healthcare expenditure in China: quantity or quality

With respects to the low level of the healthcare expenditure, China has been experiencing a rapid growth of the education. This article is designed to test the education quantity and the education quality on the healthcare expenditure and conducts China’s provincial data set over the period 2001–2016. The results suggest that the education quantity has no significant effect on the healthcare expenditure, while the education quality has a positive and significant effect. Thus, it is suggested that China’s expansion on education cannot maintain the quality, and is not conducive to the improvement of human capital in education and health.     

美国金融监管改革法案及其对中国的启示

2010年7月,美国出台了意在重塑其金融监管体系、重振其金融竞争力的金融监管改革法案,这将是影响全球金融体系重构的重要变革。该法案对美国金融业和监管架构及全球金融监管改革方向都将产生深远影响。该法案对中国金融监管的启示是:应寻求金融监管与市场力量的动态平衡,在重视防范系统性金融风险的同时,构建宏观审慎监管与微观审慎监管相结合的监管体系,加强对金融消费者的保护,并以客观审慎的态度开展金融综合经营。     

New evidence on factors affecting the level and growth of US health care spending

The dual problems of high and rising medical care expenditures and substantial differences in spending across geographic regions have long plagued the US health care system. We provide new evidence to explain why some states and regions of the country spend much more on medical care than others, and why health care spending for the nation as a whole has been growing rapidly over the last several decades. To do this, we estimate a health care spending panel data model using annual data on all 50 states for the period 1993–2009. Our model includes a number of socio-economic, health care provider, lifestyle and environmental variables that past studies indicate may affect the level or growth of aggregate health care spending. We exploit the time effect component of our model to obtain an upper-bound estimate of the effect of advances in medical technology. Our findings indicate that the most important factors influencing the level of spending are availability of providers, income, excessive alcohol consumption, Medicaid coverage, HMO health plans and the proportion of the population elderly and African-American. The principal drivers of growth have been the continual introduction of new medical technologies, and the growth of providers and income.     

Health care resource utilization and burden of disease in a U.S. Medicare population with a principal diagnosis of osteoarthritis of the knee

Abstract

Aims

To assess the prevalence, health care resource utilization (HCRU), and economic burden of disease among Medicare beneficiaries with a principal diagnosis of osteoarthritis (OA) of the knee.     

US state health expenditure convergence: A revisited analysis

This paper studies the evolution of US state health expenditure for a sample that covers 1966–2014. Our results provide evidence against the existence of a single pattern of behavior of personal health care expenditure across the US states. Rather, we can observe the existence of two statistically different convergence clubs. We cannot find evidence of convergence when we disaggregate health expenditure into its three main payers: Medicare, Medicaid and private health insurance expenditure, whilst we again find evidence of convergence clubs. However, the estimated clubs for Medicaid and private health insurance expenditure are statistically different that estimated for total health expenditure. Consequently, our results offer strong evidence of heterogeneity in the evolution of US health expenditure. The analysis of the forces that drive club creation shows that economic situation and some supply-side factors are important. We can also appreciate that some healthcare outcome variables are only related to private insurance health expenditure. The other health expenditures, thus, show a certain lack of efficiency which may be due to practices that have little benefit for patient health.     

Prenatal care: Mechanisms and impacts on infant health and health care utilization

We estimate that prenatal care has positive impacts on health measured at birth, shifts the distribution of future health care utilization away from inpatient care, and find that some of these impacts likely come from an informational mechanism. We also find well child visits are used in a complementary fashion with emergency department care in the production of infant health, suggesting that factors beyond barriers to access may drive the demand for emergency care. Finally, we find differential impacts of prenatal care across racial groups with evidence that the information mechanism may be particularly important for black mothers.     

The causes of government expenditure growth: A survey of the U.S. evidence

The growth of government budgets can be broken down into a-institutional and institutional components. The former component — the familiar substitution, income, and population/public goods-tax sharing effects — is estimated to contribute about two-fifths of the growth of U.S. government spending. The latter component — rent-seeking political redistributions, bureaucracy and perceptual/informational impedimentia — is important, too, but an exact imputation cannot be asserted given the state of the art in empirical public choice theory. The cross-effects on spending of the growth of regulation and tax preferences or tax expenditures, though interesting, is not pursued.     

Winners and losers from financial derivatives use: evidence from community banks

This article provides empirical evidence on how profitability of small community banks was affected by derivatives use before and after the 2008 crisis. We use an endogenous switching regressions model to estimate the sensitivity of bank profitability to risks and control for the endogenous choice to use or not to use derivatives. We then compute counterfactual effects and show how profitability would have looked without derivatives use for banks that used derivatives and how it would have looked with derivatives for banks that did not use derivatives. The results show that derivatives helped reduce the sensitivity of profitability to credit risks and improved profitability for most specialists. However, for the largest number of banks which are non-user non-specialists, devivates use would have resulted in lower return on assets had they used derivatives post 2008. Therefore, our evidence suggests that implementation of the Volcker Rule, imposing high compliance costs on community banks and, thus, discouraging hedging, may have a negative impact on profits of specialists banks but, overall, a neutral effect on profits in the community banks industry as a whole.     

金融危机中的美国服务外包

服务外包是美国经济的重要组成部分。2008年以来，受金融危机的影响，美国服务外包呈现一定的下降趋势，但同时仍然保持比较稳定的发展，在市场动荡和新一轮产业升级和调整中孕育新的发展机遇。     

Aggregate health care expenditure in the United States: evidence from cointegration tests

Unlike recent studies that are based on international cross-sectional series, this paper attempts to quantify the role of the determinants of aggregate health care expenditure per capita, using time-series data for the period of 1960–87 for the United States. The paper applies the relatively new procedures of unit root testing, cointegration and error-correction modelling. The evidence supports cointegration. Although, the results indicate that per capita income, age of the population, number of practising physicians, and public financing of health care are important determinants, the age structure of the population and number of practising physicians emerge as the major determinants of aggregate health care expenditure in the United States.     

Owner-managers and firm performance during the asian and global financial crises: evidence from Korea

We examine the performance of the Korean owner-managers during the 1997?1998 Asian financial crisis and the 2008?2009 global financial crisis to establish whether they overcome the unexpected exterior shocks better than employed managers. We find that the owner-managers record a significantly greater performance during the crises, and especially during the latter period. Moreover, our results suggest that such a tendency comes from the owner-managers’ superior investment decisions. Our paper thus highlights the role of owner-managers by studying their performance during the Korean economic crisis periods. (JEL G01, G32, G34)     

美国次级房货危机对中国房货和金融市场的影响

美国次级房贷危机已对全球股市和美国经济产生较大影响。分析美国次级房贷危机产生的背景和原因,并指出中国的抵押贷款市场存在的重大风险。我们应该以美国次级债危机为借鉴,为中国房地产市场发展和金融市场的健康发展获得一些启示,并做好风险防范措施。     

美国次级房贷危机对中国房贷和金融市场的影响

美国次级房贷危机已对全球股市和美国经济产生较大影响。分析美国次级房贷危机产生的背景和原因,并指出中国的抵押贷款市场存在的重大风险。我们应该以美国次级债危机为借鉴,为中国房地产市场发展和金融市场的健康发展获得一些启示,并做好风险防范措施。