Does intense electoral competition increase the government health expenditure in EAs?
Does intense electoral competition in electoral autocracies (EAs) increase the government health expenditure? Previous studies on EAs and public health expenditure focus on the presence of multiparty elections in EAs as a significant determinant on the expenditure. Most of elections in EAs often are unfair because those are for the victory of dictators; hence. multiparty elections per se do not capture well-known impact of elections, such as the electoral competition increasing health expenditure. Some EAs pay health expenditure less than others even though electoral competition is high. This paper analyzes the effect of electoral competition on the government health expenditure with the balanced panel data of 20 EAs from 2001 to 2017. There are two rival arguments on how electoral competition affect the expenditure according to previous studies; (a) a high level of electoral competition indicates a difficulty of dictatorial winning in elections. Autocrats, hence, gather various demands including health issues from voters, and can increase the government health expenditure; (b) Autocrats pursue the victory in elections. Pork and personal benefits to voters rather than programmed policies are helpful for the victory. Therefore, there is no incentive for autocrats to provide government health expenditure to voters when the level of electoral competition is high. Empirical findings demonstrate that electoral competition in EAs lead the decrease of government health expenditure. This paper concludes that electoral competition does not increase the public health expenditure; the higher level of competition in autocracies does not mean that voters can exert their power to autocrats to realize policies.