title: Evidence of horizontal and vertical interactions in health care spending in the Philippines.
abstract: This article examines whether within a decentralized system of health care spending, local government units in developing countries have any incentive to compete with one another. The existence of spatial competition, whether horizontal or vertical, is tested in the case of Philippines using local government health expenditures data. Results indicate that health spending is characterized by a strong positive interaction between municipalities, consistent with the existence of a horizontal fiscal interaction. However, the results provide less support for the existence of vertical externalities, with the interaction of municipalities with provinces being positive and marginally significant.
authors.affiliation: School of Business Administration, Marymount University, 1000, North Glebe Road Arlington, Virginia 22201, USA and ukelekar@marymount.edu.
authors.forename: Uma
authors.initials: U
authors.lastname: Kelekar
authors.affiliation: Philippine Institute for Development Studies, NEDA sa Makati Building, 106 Amorsolo Street, Legaspi Village 1229, Makati City, Philippines.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Llanto
mesh_terms: D003695:Delivery of Health Care / Q000191:economics*; D004465:Economic Competition / Q000706:statistics & numerical data*; D005380:Financing, Government; D009111:Local Government; D010679:Philippines; D011057:Politics
keywords: Fiscal competition; Local Government Code of 1991; health decentralization; horizontal and vertical fiscal interactions; local health care