Fiscal competition in health spending among local governments in the Philippines

The Philippines is one of several Asian countries that has decentralized the provision of health care to its local governments in recent decades. In the context of decentralization, a few studies have previously examined the issue of fiscal competition among local governments in the developing world. This report presents a summary of a published study that examined the existence of inter-jurisdictional competition in health-care spending in the Philippines. The results indicate the presence of positive fiscal "spillovers" in health spending, consistent with municipalities/cities competing to outspend their neighbours. Several potential explanations forthis finding are discussed.