Democracies Invest More in Healthcare than Dictatorships
Democracies spend more money on health than dictatorships, finds a new study in ifo Schnelldienst. “Comparing countries at the same level of economic development, democratically governed ones spend about 20 to 30 percent more on public healthcare. In contrast, there are no differences between democracies and dictatorships in private health spending,” says ifo researcher Florian Dorn. Germany actually spends more money on its healthcare system than comparable democracies.
This effect is also evident after a regime change within a country. “Following a regime change from a dictatorship to a democracy, government health spending increases by about 15 to 20 percent. In the opposite case, healthcare spending falls significantly,” Dorn says. The change in public health spending becomes evident within a short period of time after a regime change. This correlation is not evident in the case of private healthcare spending by the general public.
“Democracies not only invest more, they also have higher-quality healthcare. Promoting democratic structures and institutions appears to be a key element in strengthening the resilience of health systems,” Dorn says. He adds that democratic governments are more interested in the health and welfare of their people than dictatorships. As a result, they invest more money in public health infrastructure and are eager to reduce inequalities in access to good health services.
The study was based on data from the World Health Organization (WHO) covering public and private expenditure on healthcare in 151 countries in the period 2000–2015. The dataset used permitted an examination of the effects of political systems on healthcare spending both within countries and between them.
Further information on healthcare spending in Germany and in international comparison (in German only):
Publication
Lehren aus der Covid-19-Pandemie: Der Weg zu größerer Resilienz im deutschen Gesundheitssystem
ifo Institut, München, 2022
ifo Schnelldienst, 2022, 75, Nr. 03, 03-30
The budget composition of the government in Germany
ifo Institut, München, 2018
ifo Forschungsberichte / 95
