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The stimulative effect of an unconditional block grant on the decentralized provision of care

Mark Kattenberg () and Wouter Vermeulen ()
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Mark Kattenberg: CPB Netherlands Bureau for Economic Policy Analysis

CPB Discussion Paper from CPB Netherlands Bureau for Economic Policy Analysis

Abstract: Understanding the impact of central government grants on decentralized health care provision is of crucial importance for the design of grant systems, yet empirical evidence on the prevalence of flypaper effects in this domain is rare. We study the decentralization of home care in the Netherlands and exploit the gradual introduction of formula-based equalization to identify the effect of exogenous changes in an unconditional block grant on local expenditure and utilization. A one euro increase in central government grants raises local expenditure by fifty cents, while adjustments occur through the number of hours as well as through substitution between basic and more advanced types of assistance. These findings suggest that conditioning of grants is not required for the central government to retain some control over the decentralized provision of care.

JEL-codes: H42 H51 H71 H75 (search for similar items in EconPapers)
New Economics Papers: this item is included in nep-pbe
Date: 2015-06
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Related works:
Working Paper: The Stimulative Effect of an Unconditional Block Grant on the Decentralized Provision of Care (2016) Downloads
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