Asymmetric Effect of Income on the Healthcare Expenditure in Türkiye

Abstract

This paper examines the dynamics between income and health spending in Türkiye from 1988 to 2020, employing autoregressive distributed lag (ARDL) and nonlinear ARDL (NARDL) methodologies. One of the key findings of this study is the presence of an asymmetric relationship between variations in income and overall healthcare expenditure. This means that changes in income levels do not have uniform effects on health expenditure, and the direction of these effects depends on whether income is rising or falling. Interestingly, the research reveals that both increases and decreases in income lead to a rise in total health expenditure. However, the impact of income declines on health expenditure is more pronounced. In other words, when people experience a decrease in income, they tend to allocate a larger portion of their reduced resources to health-related expenses. This highlights the significant financial strain that income reductions can place on individuals and households when it comes to healthcare costs. This pattern of asymmetric effects also extends to government or compulsory health expenditures. When income falls, the government's role in funding health expenses becomes more prominent, as individuals rely more on public healthcare services during economic downturns. Furthermore, the study sheds light on the intriguing relationship between income shifts and voluntary or out-of-pocket health expenses. Positive income shifts are found to be associated with a reduction in voluntary health expenditure. This suggests that as people experience an improvement in their financial situation, they may opt for less costly or more efficient healthcare services, leading to a decrease in out-of-pocket expenses. Conversely, when income levels decrease, individuals may find themselves with limited options, potentially resorting to more expensive private healthcare services or bearing a greater burden of out-of-pocket expenses. This finding underscores the financial vulnerability that can accompany negative income shifts.