The Political Economy of Health Services Provision and Access in Brazil

44 Pages Posted: 3 Feb 2005

See all articles by Andrew Sunil Rajkumar

Andrew Sunil Rajkumar

World Bank - Development Research Group (DECRG)

Maureen Cropper

University of Maryland - Department of Economics; Resources for the Future

Ahmed Mushfiq Mobarak

Yale School of Management; Yale University - Cowles Foundation

Date Written: September 2004

Abstract

Mobarak, Rajkumar, and Cropper examine the impact of local politics and government structure on the allocation of publicly subsidized (SUS) health services across municipios (counties) in Brazil, and on the probability that uninsured individuals who require medical attention actually receive access to those health services. Using data from the 1998 PNAD survey they demonstrate that higher per capita levels of SUS doctors, nurses, and clinic rooms increase the probability that an uninsured individual gains access to health services when he or she seeks it. The authors find that an increase in income inequality, an increase in the percentage of the population that votes, and an increase in the percentage of votes going to left-leaning candidates are each associated with higher levels of public health services. The per capita provision of doctors, nurses, and clinics is also greater in counties with a popular local leader and in counties where the county mayor and state governor are politically aligned. Administrative decentralization of health services to the county decreases provision levels and reduces access to services by the uninsured unless it is accompanied by good local governance.

This paper is a product of the Infrastructure and Environment Team, Development Research Group.

JEL Classification: O12, D72, H4

Suggested Citation

Rajkumar, Andrew Sunil and Cropper, Maureen L. and Mobarak, Ahmed Mushfiq, The Political Economy of Health Services Provision and Access in Brazil (September 2004). World Bank Policy Research Working Paper No. 3508. Available at SSRN: https://ssrn.com/abstract=660101

Andrew Sunil Rajkumar (Contact Author)

World Bank - Development Research Group (DECRG) ( email )

1818 H. Street, N.W.
MSN3-311
Washington, DC 20433
United States

Maureen L. Cropper

University of Maryland - Department of Economics ( email )

College Park, MD 20742
United States

Resources for the Future ( email )

1616 P Street, NW
Washington, DC 20036
United States

Ahmed Mushfiq Mobarak

Yale School of Management ( email )

135 Prospect Street
P.O. Box 208200
New Haven, CT 06520-8200
United States
203-432-5787 (Phone)

HOME PAGE: http://mba.yale.edu/faculty/profiles/mobarak.shtml

Yale University - Cowles Foundation

Box 208281
New Haven, CT 06520-8281
United States

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