Andras Gregor*, Manoj Sasikumar**
Edward Levavasseur: edward.levavasseur[at]univ-amu.fr
Océane Piétri: oceane.pietri[at]univ-amu.fr
Morgan Raux: morgan.raux[at]univ-amu.fr
*In this paper I provide evidence on effects of plurality and proportional electoral formula on fiscal outcomes. In Hungary different voting regimes are applied to elect the members of local councils: in places where more than 10,000 people live a variant of proportional voting system, while below a variant of plurality voting system is used. Not only the electoral formula, but the district magnitude (the number of councilmembers), varies at different population threshold. The setting allows me to apply a sharp regression discontinuity design to identify the causal effect of the electoral formula on political and fiscal outcomes, and at the same time control for variation in district magnitude. My findings show that the electoral formula directly affects the composition of municipal finances, but has no effects on their size. Moreover, the district magnitude has not got significant effects on any outcome variables. And finally there is no evidence that either the electoral formula or the district magnitude has an effect on politicians rent-extraction activity. The empirical findings on the composition of public finances are in line with the theoretical predictions of Persson and Tabellini (2000) and Lizzeri and Persico (2001).
**Economic theory predicts that intense competition among general practitioners (GP) will produce a rivalry effect resulting in reduced prescriptions of specialist care. Empirical literature on GP competition in the USA suggests a negative relationship of GPs density with hospital care, while results in the European context (UK & Norway) provide a contrasting picture of no association or positive if a significant association exists. After having examined the extent of geographical variation in GPs’ referral rates across mainland France, we investigate the relationship between the GP’s competition indexes measured in the departments and referrals to specialists, using OLS and spatial regression models controlling for several departmental level independent variables, taking into account the French context where gatekeeping policies have restricted access to certain specialities. Our results indicate that considerable geographic variation in referral rates is observed for all specialities, with direct access specialities varying more. We find that GP competition is significantly and negatively associated with referrals to Dermatology and Otorhinolaryngology indicating substitutability between primary care and these two specialties, which could hinder cooperation. The nature of GP-specialist relationships holds serious implications for the reform of gatekeeping systems.