The Paradox of Health Financing in Morocco: An Exploratory Analysis using a VAR Model (2000-2022)

Despite a spectacular expansion of its insurance coverage, Morocco faces a persistent paradox: the share of out-of-pocket (OOP) expenditures in health financing remains high, standing at around 43% in 2022. This article aims to explore the macroeconomic dynamics of this paradox by analyzing the interactions between public health spending, OOP, and total health expenditure. To do this, a Vector Autoregressive (VAR) model is applied to time series from the World Bank and WHO covering the period 2000–2022. The results do not reveal statistically significant Granger causality between changes in public spending and those in OOP. The impulse response function analysis, while showing a negative response of OOP to a public spending shock, confirms the lack of statistical significance. The variance decomposition highlights a strong inertia, with over 71% of OOP fluctuations explained by their own past dynamics. These findings suggest that the relationship between public financing efforts and the alleviation of the household burden is neither direct nor automatic at the aggregate level. The study concludes on the limitations of macroeconomic analysis in capturing this complex phenomenon and underscores the imperative need to resort to micro-econometric analyses to identify the real determinants of financial risk at the household level.