Working Paper

Can Regional Decentralisation Shift Health Care Preferences?

Joan Costa-i-Font, Ada Ferrer-i-Carbonell
CESifo, Munich, 2017

CESifo Working Paper No. 6779

Uniform health care delivered by a mainstream public insurer - such as the National Health Service (NHS), seldom satisfies heterogeneous demands for care, and some unsatisfied share of the population either use private health care, or purchase private insurance (PHI). One potential mechanism to partially satisfy heterogeneous preferences for health care, and discourage the use of private health care, is regional health care decentralisation. We find robust estimates suggesting that the development of regional health services shifted both perceptions of, and preferences for, using the NHS, making it more likely individuals would use public health care and, consequently, reducing the uptake of PHI. These results are heterogeneous by income, education, and age groups; and are robust to placebo and other robustness and falsification checks.

CESifo Category
Public Finance
Public Choice
JEL Classification: H700, I180