METHODOLOGICAL, THEORETICAL AND EMPIRICAL CONSIDERATIONS IN THE ANALYSIS OF THE DETERMINANTS OF AGGREGATE HEALTH CARE EXPENDITURES IN OECD

Health care now accounts for just under 10 % of national income in most developed OEeD countries. Yet, despite its importance in the overall economy, the factors that drive health care expenditure remain only imperfectly understood. This thesis shows that the determinants of health care expenditures are simply too diverse amongst different countries to be brought within a common denominator such as GDP, as it has been argued for decades. It also shows that the assumption that health care is a homogeneous good across countries is over-simplistic and arbitrary, and finds ample evidence showing that health care is not a luxury good, as widely suggested. The contribution of the thesis is on methodological, theoretical and empirical grounds. In terms of methodology, the thesis shows that there are significant flaws in several areas that influence our thinking concerning the determinants of health care expenditures and offers alternative ways of analysis and appraisal. Flaws were shown in: the relationship between health expenditure and GDP; the importance of factors such as ageing; the macroeconomic context and the burden of disease; the measurement of key variables used in empirical analysis such a