Provision of a merit good by hierarchical government agencies: medications for diabetes in Argentina: Public provision in decentralized systems

Abstract

Introduction: It is important to evaluate the coverage achieved in the public drugs provision. Aim: to study the provision of a merit good where three levels of government intervene. Materials and methods: We analyze a framework of interaction between government agencies for the provision of certain merit good and a real case of drugs provision for type 2 diabetes mellitus. Results: It can be deduced from the formal framework that, for sequential decisions, the last government level, conditioned by previous decisions, supports the greatest burden of the provision. The case study reveals that the regional level provides the highest percentage of tablets, followed by the local and central levels. Discussion: Drug provision for T2DM is not assured for the share of the population without healthcare insurances, and about 22% of doses were provided voluntarily by the local level, which intervened because levels of provision of other governments proved insufficient.