From slippery slopes to steep hills: Contrasting landscapes of economic growth and public spending for health

Abstract

Identifying ways to increase public spending on health is critical for the achievement of universal health coverage. While policymakers and donors often look at available options for increasing public spending for health in the medium-term, examining trends and drivers of past growth can help countries elucidate important lessons and to anticipate changes in the future. This note analyzes trends in inflation-adjusted per capita public spending for health vis-à-vis economic growth within and across a sample of 150 countries over the 2000-2017 period. Since 2000, per capita public spending for health across low- and middle-income countries has more than doubled. Less than one-fifth of this increase, however, resulted from a higher priority for health in government budgets. The remainder was largely due to conducive macroeconomic conditions such as economic growth and increases in total public spending. Furthermore, across most countries, a single time trend does not adequately capture the evolution either of economic growth or of per capita public spending on health. Instability in growth rates is large for both indicators, revealing distinct episodic patterns.

Keywords: Economic growth; Health care financing; National government health expenditure; Public expenditure.

Fig. 1

Caption: Per capita GDP and public spending on health, by patterns of growth, 2000–2017, Source/Notes: SOURCE: Authors' analysis using data from WHO Global Health Expenditure Database. NOTE: Y-axes are expressed in logarithmic scale.

Fig. 2

Caption: Landscape distribution of countries, 2000–2017, Source/Notes: SOURCE: Authors' analysis using data from WHO Global Health Expenditure Database. NOTE: Chart shows concentration of countries per combination of per capita GDP landscape and per capita public spending on health landscape. Larger circles indicate higher number of countries. Yellow circles indicate countries with the same landscape for both per capita GDP and per capita public spending on health. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)