The more that health care expenditures are financed by general taxation, the greater the discretion governments are likely to exercise when timing increases in health care expenditures. Vote-maximising governments time increases in health care expenditures to occur in economic upturns, when voters are not as aware of the required increase in taxation. In recessions, they have an incentive to sustain expenditures on health care by diverting expenditures from other public expenditure programmes that voters perceive as low priority. In this way, government pursuit of a political agenda is likely to exert a systematic influence on the cyclicality of government expenditure. Predictions are tested with reference to the cyclicality of government health expenditures, for a sample of OECD countries from 2000 to 2012.

由一般税收资助的医疗保健支出越多，当医疗保健支出的时间增加时，政府就越有可能行使自由裁量权。投票最大化政府在经济好转时增加医疗保健支出的时间，而此时选民并没有意识到所需的税收增加。在经济衰退期间，他们有动力通过从选民认为低优先级的其他公共支出计划中转移支出来维持医疗保健支出。通过这种方式，政府对政治议程的追求可能会对政府支出的周期性产生系统性影响。对 2000 年至 2012 年间经合组织国家样本的政府卫生支出周期性的预测进行了检验。