Clientelistic budget cycles: evidence from health policy in the Italian regions

Francesco Stolfi (Macquarie University) & Mark Hallerberg (Hertie School)

When elections are around the corner, incumbent governments face incentives to ramp up their redistributive spending to attract the support of voters, giving rise to so-called political budget cycles (PBCs). In their article “Clientelistic budget cycles: evidence from health policy in the Italian regions” published in the Journal of European Public Policy, Francesco Stolfi and Mark Hallerberg argue that clientelistic fiscal expansions prior to elections are more prevalent in jurisdictions with few employment opportunities offered by the private sector. Clientelistic public expenditures are a particularly promising strategy for incumbents seeking re-election in poorer jurisdictions with a large share of voters relying on jobs in the public sector to support their livelihoods. Francesco and Mark support their claim with original data on income and public health personnel spending in Italy’s 21 regions between 1989 and 2012. Their analysis shows that prior to elections regions with higher per-capita incomes were less likely to see increases in public health personnel spending than poorer regions. Francesco and Mark conclude that “[i]f we take into account the incentives of incumbents and voters in poorer societies, then clientelism becomes a powerful factor explaining differences in the extent of PBCs between countries at different levels of development.”