The relationship between insurance development, population, economic growth, and health expenditures in OECD countries: a panel causality analysis

Abstract This paper examines the relationship between insurance development, population, economic growth, and health expenditures for a panel of 31 OECD countries over the period 1995–2021. A dynamic panel data analysis based on cointegration, FMOLS, DOLS, VECM, and Granger causality tests is employed to suggest for the existence of a long-run relationship among variables. The long-run results show that insurance development, national income, and population exhibit positive impacts on health expenditures. The results reveal that insurance factor has larger income effects than substitution effects on health expenditures. Regarding the short-run causal relationship between the variables, the empirical results suggest that economic growth strengthens health expenditure growth, while insurance growth reduces it. In the short-run, insurance development has a crowding-out effect since it produces larger substitution effects than income effects. The results provide political implications that governments need to concern the short-run crowding-out effect of private insurance sections on health expenditures when making fiscal policies on public health expenditures.