Fiscal shenanigans, targeted federal health care funds, and patient mortality

• 成果类型: Article
• 署名作者: Baicker, K; Staiger, D
• 署名单位: Dartmouth College; National Bureau of Economic Research
• 刊物名称: QUARTERLY JOURNAL OF ECONOMICS
• ISSN/ISSBN: 0033-5533
• DOI: 10.1162/qjec.2005.120.1.345
• 发表日期: 2005
• 页码: 345-386
• 关键词: MEDICAID DISPROPORTIONATE SHARE; SCHOOL-FINANCE REFORM; education

摘要

We explore the effectiveness of matching grants when lower levels of government can expropriate some of the funds for other uses. Using data on the Medicaid Disproportionate Share program, we identify states that were most able to expropriate funds. Payments to public hospitals in these states were systematically diverted and had no significant impact on patient mortality. Payments that were not expropriated were associated with significant declines in patient mortality. Overall, subsidies were an effective mechanism for improving outcomes for the poor, but the impact was limited by the ability of state and local governments to divert the targeted funds.