Title: How political ideology of government affects health system efficiency. Evidence from parliamentary democracies

Authors: Nino Kokashvili; Youjun Shin

Addresses: University of Tartu, Lossi 36-129, 51003 Tartu, Estonia ' University of Tartu, Lossi 36-129, 51003 Tartu, Estonia

Abstract: What role does the government ideological composition play in health policy formation and outcomes? According to the conventional view, left-oriented governments are more likely to increase health spending. However, the impact of government ideology on health policy payoff is still a question for discussion. This paper examines how the ideological differences of ruling parties influence the efficiency of health systems. We use four stage data envelopment analysis (DEA), a non-parametric approach, to measure the health efficiency of 31 OECD countries for the period of 2001-2016. Based on the results from a panel tobit regression model, we show that while left-wing governments tend to increase public health spending, the efficiency of health systems is higher under ideologically balanced and/or right-wing governments.

Keywords: government ideology; public health; data envelopment analysis; DEA; data envelope analysis; tobit regression; health expenditure; efficiency; health policy.

DOI: 10.1504/IJPP.2020.113717

International Journal of Public Policy, 2020 Vol.15 No.5/6, pp.380 - 410

Accepted: 30 May 2020
Published online: 19 Mar 2021 *

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