Soutenabilité de la dette publique et financement de la santé au Maroc : une analyse macro-fiscale par un modèle ARDL

Abstract

Achieving Universal Health Coverage (UHC) is structurally constrained by public finance sustainability requirements. This paper assesses whether low public health spending and heavy reliance on out-of-pocket payments (OOP) enable the Moroccan state to ensure debt sustainability. Using a sample covering 2000-2024, we estimate an augmented fiscal reaction function with an ARDL-ECM model. The results reject Bohn’s sustainability hypothesis in the long run: neither debt, nor health spending, nor OOP significantly affect the primary balance. In the short run, a rapid automatic adjustment is at work (error correction term of -0.7). Health austerity does not, therefore, constitute an effective fiscal consolidation tool; on the contrary, it risks weakening human capital and potential growth. These findings call for increased public investment in health and a reduction in OOP to reconcile equity and macroeconomic viability.