Saez M, Murillo C
Department of Econometrics and Statistics, University of Barcelona, Spain.
Health Econ. 1994 Jul-Aug;3(4):267-79. doi: 10.1002/hec.4730030408.
The evidence found in most studies suggests a strong positive relationship between health care expenditure and gross domestic product. However, this evidence weakens with respect to the actual value of the income elasticity. There are two possible sources of these discrepancies, the use of arbitrary deflators and specification errors. We find that health PPP cannot be taken as a 'universal' price index. The problem is that its components do not move together. Nevertheless, we derive a 'universal' health price index from a dynamic system in which its components share both short and long run co-movements. The omission of relevant explanatory variables seems to be the main cause of the discrepancies. We confirm that there exists a strong positive relationship between per capita health care expenditure and per capita GDP. However we estimate a long run income elasticity at or around unity, although it is greater than unity for the countries with lower per capita income (Spain and Ireland). The results for income elasticity are the same regardless of whether health care expenditure is converted using the GDP PPP or the 'universal' health price index. The importance of non-income variables is also confirmed, in particular the relative price of health care. We find that relative price has a strong rationing effect on the quantity of health demanded and has no effect on the expenditures.
大多数研究中发现的证据表明,医疗保健支出与国内生产总值之间存在着很强的正相关关系。然而,就收入弹性的实际值而言,这一证据的说服力有所减弱。这些差异可能有两个来源,一是使用了任意的平减指数,二是存在设定误差。我们发现,卫生购买力平价不能被视为一个“通用”的价格指数。问题在于其组成部分并非同步变动。尽管如此,我们从一个动态系统中推导出了一个“通用”的卫生价格指数,在该系统中其组成部分在短期和长期均存在共同变动。遗漏相关解释变量似乎是造成这些差异的主要原因。我们证实人均医疗保健支出与人均国内生产总值之间存在很强的正相关关系。然而,我们估计长期收入弹性约为1,不过对于人均收入较低的国家(西班牙和爱尔兰),该弹性大于1。无论医疗保健支出是使用国内生产总值购买力平价还是“通用”卫生价格指数进行换算,收入弹性的结果都是相同的。非收入变量的重要性也得到了证实,尤其是医疗保健的相对价格。我们发现相对价格对卫生需求数量具有很强的配给效应,而对支出没有影响。