Determinants of Public Expenditure on Health in India: A Panel Data Analysis at Sub-National Level

Abstract

This study explores whether political factors and fiscal capacity matter more in explaining the growth and variation in health expenditure than the state’s income in India. The findings suggest that with the widening of political participation and greater representation of diverse population groups in politics, one can see a concomitant rise in government expenditure on health, indicating state interventionism in health sector for political reasons. Government’s desire to increase health spending depends on the availability of financial resources with the states, failing which the probability of fulfilling expenditure obligations towards the sector would be low. In contrast to earlier estimates that income elasticity of health expenditure is nearly equal to or greater than one, the elasticity is found to be less than one which ranges between 0.16 and 0.59. Overall, coefficient estimates of most of these important covariates show an upward bias in terms of magnitude and precision due to the absence of unobserved control factors and of advanced robust estimation techniques.