Health Care Equity and COVID-19: Assessing the Relative Effectiveness of Egalitarian Governance and Health System Capacity on the COVID-19 Pandemic
30 Pages Posted: 16 Jun 2020
Date Written: June 16, 2020
Scholars of public health typically focus on societal equity for explaining public health outcomes. Indeed, the COVID-19 pandemic has led to a spate of studies showing a tight connection between inequitable access to health, welfare services, and adverse outcomes from the pandemic. Others have argued that democratic governments have generally failed relative to more autocratic ones, simply because autocrats can make the hard choices required for stemming the spread of viruses. We address this question a bit differently by asking if more “egalitarian” forms of democracy matter, given that they should contain more equitable health access and the societal infrastructure, such as social capital and trust for achieving a broader collective good. Our results suggest that more equitable access to health care does indeed increase testing rates and lower the death rate. Broader egalitarian processes, measured as egalitarian democracy, however, show the opposite effects, suggesting that factors associated with capacity to reach and treat matter more than broader societal factors associated with egalitarian governance. The results are robust to alternative testing procedures, including the application of instrumental variable technique for addressing endogeneity concern.
Keywords: COVID-19, pandemic, healthcare access, egalitarian democracy, public health
JEL Classification: I1, I11, I14, I18
Suggested Citation: Suggested Citation