The Companion Pandemic to COVID-19: The Use of Informal Practices to Access Public Healthcare Services in the European Union.

Objectives: The objective of this paper is to evaluate the use of informal payments and personal connections to gain preferential access to public health services during the COVID-19 pandemic and to propose effective policy measures for tackling this phenomenon. Methods: Using data from 25,744 patients in the European Union, six different scenarios are analyzed in relation to making informal payments and/or relying on personal connections to access public healthcare services. To evaluate the propensity to engage in informal practices in healthcare, probit regressions with sample selection and predicted probabilities are used. Robustness checks are also performed to test the reliability of the findings. Results: For each scenario, a statistically significant association is revealed between the propensity to make informal payments and/or rely on personal connections and the asymmetry between the formal rules and the patients' personal norms and trust in public authorities. Conclusion: To tackle informal practices in healthcare, policy measures are required to reduce the asymmetry between the formal rules and personal norms by raising trust in public authorities.

The Companion Pandemic to COVID-19: The Use of Informal Practices to Access Public Healthcare Services in the European Union

Objectives: The objective of this paper is to evaluate the use of informal payments and personal connections to gain preferential access to public health services during the COVID-19 pandemic and to propose effective policy measures for tackling this phenomenon. Methods: Using data from 25,744 patients in the European Union, six different scenarios are analyzed in relation to making informal payments and/or relying on personal connections to access public healthcare services. To evaluate the propensity to engage in informal practices in healthcare, probit regressions with sample selection and predicted probabilities are used. Robustness checks are also performed to test the reliability of the findings. Results: For each scenario, a statistically significant association is revealed between the propensity to make informal payments and/or rely on personal connections and the asymmetry between the formal rules and the patients’ personal norms and trust in public authorities. Conclusion: To tackle informal practices in healthcare, policy measures are required to reduce the asymmetry between the formal rules and personal norms by raising trust in public authorities.

The coronavirus pandemic, short-term employment support schemes and undeclared work: Some lessons from Europe

Purpose: The temporary enforced closure of businesses in response to the coronavirus pandemic has resulted in governments in Europe and beyond offering short-term financial support to the businesses and workers affected. The purpose of this paper is to evaluate a group of workers unable to benefit from the short-term job retention schemes and support to the self-employed made available by governments, namely, those whose paid work is comprised wholly of undeclared work, and how this could be addressed. Design/methodology/approach: To identify those whose paid work is entirely undeclared, a Eurobarometer survey of undeclared work in Europe is reported conducted in September 2019, just prior to the pandemic, and involving 27,565 face-to-face interviews in 28 European countries. Findings: The finding is that the paid work of one in every 132 European citizens is comprised wholly of undeclared work, and these workers are concentrated in non-essential businesses and activities severely affected by the lockdown. These workers whose paid work is comprised wholly of undeclared work are significantly more likely to be widowed or divorced/separated, living in households with three or more adults, without children and most of the time have financial difficulties in making ends meet. Practical implications: Given that businesses and workers in the undeclared economy are largely unable to work under lockdown, it is argued that providing access to short-term financial support, through a regularisation initiative based on voluntary disclosure, would not only provide the income support these workers need but also bring them out of the shadows and put them on the radar of the state authorities, thus transforming undeclared work into declared work. Originality/value: This paper shows how in the current or repeat lockdowns, the short-term financial support made available by governments can be used to transform undeclared work into declared work. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Exploring the Demand-Side of the Informal Economy during the COVID-19 Restrictions: Lessons from Iași, Romania

Little attention has been paid to why consumers choose to purchase goods and services from the informal economy. Similarly, few studies have been conducted on consumer behaviour in relation to informal markets during the COVID-19 pandemic. The aim of the article is to evaluate, for the first time, whether the COVID-19 pandemic influenced consumer behaviour in relation to the informal economy. Qualitative evidence collected in Iași, Romania, is reported. The finding is that the most important motives for purchasing goods and services from the informal economy are related to social ends, such as supporting local businesses, maintaining relationships with others, and enhancing sustainable development. The novel finding of this research is that community exchange in the form of mutual aid and reciprocity is not activated only for friends, neighbours, kin or work colleagues but also for local businesses facing financial difficulties. The customers are displaying solidarity and empathy for their situation. As such, this article adds to previous findings indicating that the motivation of lower cost is not the universal rationale for purchasing from the informal economy as many consumers choose to make purchases from informal market driven by social rationales. The paper ends by discussing the policy implications of the findings.

Fiscal stimulus packages to COVID-19: The role of informality.

In this paper, we use a novel cross-country dataset to investigate the relationship between the prevalence of the shadow economy and fiscal policy responses to the economic crisis induced by the pandemic. The finding is that countries with a relatively larger shadow economy before the pandemic have adopted a smaller fiscal policy package. The results are robust to different econometric specifications, including an instrumental variable estimation. This reinforces the wider literature that countries (especially those with larger shadow economies) generally follow a procyclical policy as opposed to the optimal and countercyclical one.

Institutional Determinants of Informal Payments for Health Services: An Exploratory Analysis across 117 Countries.

Healthcare accessibility and equity remain important issues, as corruption in the form of informal payments is still prevalent in many countries across the world. This study employs a panel data analysis over the 2006-2013 period to explore the role of different institutional factors in explaining the prevalence of informal payments. Covering 117 countries, our findings confirm the significant role of both formal and informal institutions. Good governance, a higher trust among individuals, and a higher commitment to tackling corruption are associated with diminishing informal payments. In addition, higher shares of private finance, such as out-of-pocket and domestic private health expenditure, are also correlated with a lower prevalence of informal payments. In policy terms, this displays how correcting institutional imperfections may be among the most efficient ways to tackle informal payments in healthcare.

The Coronavirus Pandemic and Europe's Undeclared Economy: Impacts and a Policy Proposal

The coronavirus pandemic has led to a loss of revenues for enterprises and workers due to workplace closures and restrictions on movement to 'flatten the curve'. In response, governments have made available temporary financial support to enterprises and workers affected. This paper evaluates a group currently excluded from this support, namely enterprises and workers in the undeclared economy, and a possible government policy response. To identify those involved, a 2019 Eurobarometer survey of undeclared work in Europe is reported. This reveals that one in every 132 European citizens relies wholly on undeclared earnings and the sectors and population groups involved. Given their reduced revenues and inability to access the temporary financial support, a voluntary disclosure initiative is recommended which brings undeclared enterprises and workers into the declared economy and onto the radar of state authorities by offering access to this temporary financial support if they disclose their previous undeclared work.

Informal Payments by Patients in Central and Eastern Europe during the COVID-19 Pandemic: An Institutional Perspective.

Confronted with a global pandemic, public healthcare systems are under pressure, making access to healthcare services difficult for patients. This provides fertile ground for using illegal practices such as informal payments to gain access. This paper aims to evaluate the use of informal payments by patients during the COVID-19 pandemic and the institutions that affect the prevalence of this practice. Various measurements of formal and informal institutions are here investigated, namely the acceptability of corruption, the level of trust, transparency, and performance of the healthcare system. To do so, a logistic regression of 10,859 interviews with patients conducted across 11 Central and Eastern Europe countries in October-December 2020 is employed. The finding is that there are large disparities between countries in the prevalence of informal payments, and that the practice is more likely to occur where there are poorer formal and informal institutions, namely higher acceptability of corruption, lower trust in authorities, lower perceived transparency in handling the COVID-19 pandemic, difficult access to, and poor quality of, healthcare services, and higher mortality rates due to the COVID-19 pandemic. These findings suggest that policy measures for tackling informal payments need to address the current state of the institutional environment.

The coronavirus pandemic and Europe's undeclared economy: Impacts and a policy proposal

The coronavirus pandemic has led to a loss of revenues for enterprises and workers due to workplace closures and restrictions on movement to 'flatten the curve'. In response, governments have made available temporary financial support to enterprises and workers affected. This paper evaluates a group currently excluded from this support, namely enterprises and workers in the undeclared economy, and a possible government policy response. To identify those involved, a 2019 Eurobarometer survey of undeclared work in Europe is reported. This reveals that one in every 132 European citizens relies wholly on undeclared earnings and the sectors and population groups involved. Given their reduced revenues and inability to access the temporary financial support, a voluntary disclosure initiative is recommended which brings undeclared enterprises and workers into the declared economy and onto the radar of state authorities by offering access to this temporary financial support if they disclose their previous undeclared work.

COVID-19 and undeclared work: impacts and policy responses in Europe

The Coronavirus pandemic has led to restrictions on movement and workplace closures, resulting in governments offering temporary financial support to enterprises and workers. This paper evaluates a group unable to access this financial support, namely those in the undeclared economy, and possible policy responses. To identify the service industries and workers involved, a late 2019 Eurobarometer survey of undeclared work in Europe is reported. This reveals that undeclared work is particularly prevalent in the hospitality, retail and personal services sectors and identifies the population groups over-represented. Given that this undeclared workforce is now largely unable to work, it will be argued that providing access to temporary financial support, through a voluntary disclosure initiative, would be a useful initiative not only to provide the income support these enterprises and workers need but also to bring them out of the shadows and put them on the radar of the state authorities.