Abstract
Does high defence spending limit the growth of public health investment? Using comparative data from 31 OECD countries between 1980 and 2010, we find little evidence that defence crowds out public health spending. Whether measured in terms of long-term levels or short-term changes, per capita defence and health spending positively and significantly correlate. To investigate the possibility that countries with high security needs such as Israel exhibit differing patterns, we also compare crowd-out among countries experiencing violent conflicts as well as current high military-spending countries. We observed a greater positive correlation between changes in health and defence spending among conflict-countries (r = 0.65, p < 0.01) than in non-conflict countries (r = 0.12, p = 0.01). However, similar to other high-military spending countries, Israel’s politicians reduced defence spending while increasing health expenditure during its recent recession. These analyses reveal that while Israel’s politicians have chronically underinvested in public health, there are modest steps being taken to rectify the country’s unique and avoidable crowding out of public health from its high military spending.
Highlights
Does high defence spending limit the growth of public health investment? Using comparative data from 31 OECD countries between 1980 and 2010, we find little evidence that defence crowds out public health spending
Commentary Does high defence spending limit the growth of public health investment? This notion, known as ‘crowd-out’, is theorised to apply in advanced industrialized nations [1,2]
Over the past three decades across OECD countries, there has been a significant and positive correlation between changes in defence spending and health spending (r = 0.16, p < 0.01, number of countries = 31) [4], even after adjusting for economic growth rates or using spending as a fraction of Gross Domestic Product, indicating that there is no inevitable crowding-out of public health from defence among high-income countries
Summary
Does high defence spending limit the growth of public health investment? Using comparative data from 31 OECD countries between 1980 and 2010, we find little evidence that defence crowds out public health spending. Commentary Does high defence spending limit the growth of public health investment? It is intriguing that in their paper, “Adjusting health expenditure for military spending and interest payment: Israel and the OECD countries”, Shmueli and Israeli, re-assess the priority Israel’s politicians place on public health starting with an implicit assumption that defence spending will crowd out public health investment [5].
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