RESUMO
This paper presents further international comparisons of progressivity of health care financing systems. The paper builds on the work of Wagstaff et al. [Wagstaff, A., van Doorslaer E., et al., 1992. Equity in the finance of health care: some international comparisons, Journal of Health Economics 11, pp. 361-387] but extends it in a number of directions: we modify the methodology used there and achieve a higher degree of cross-country comparability in variable definitions; we update and extend the cross-section of countries; and we present evidence on trends in financing mixes and progressivity.
Assuntos
Política de Saúde/economia , Programas Nacionais de Saúde/economia , Justiça Social , Impostos/classificação , Comparação Transcultural , Europa (Continente) , Finlândia , Alemanha , Pesquisa sobre Serviços de Saúde , Humanos , Renda/estatística & dados numéricos , Seguro Saúde/economia , Suécia , Impostos/economia , Impostos/estatística & dados numéricosRESUMO
This paper presents evidence on income-related inequalities in self-assessed health in nine industrialized countries. Health interview survey data were used to construct concentration curves of self-assessed health, measured as a latent variable. Inequalities in health favoured the higher income groups and were statistically significant in all countries. Inequalities were particularly high in the United States and the United Kingdom. Amongst other European countries, Sweden, Finland and the former East Germany had the lowest inequality. Across countries, a strong association was found between inequalities in health and inequalities in income.
Assuntos
Alocação de Recursos para a Atenção à Saúde/economia , Nível de Saúde , Renda , Justiça Social , Países Desenvolvidos , Alocação de Recursos para a Atenção à Saúde/normas , Política de Saúde/economia , Humanos , Análise de Regressão , Autoavaliação (Psicologia)RESUMO
This paper presents the results of an eight-country comparative study of equity in the delivery of health care. Equity is taken to mean that persons in equal need of health care should be treated the same, irrespective of their income. Two methods are used to investigate inequity: an index of inequity based on standardized expenditure shares, and a regression-based test. The results suggest that inequity exists in most of the eight countries, but there is no simple one-to-one correspondence between a country's delivery system and the degree to which persons in equal need are treated the same.
Assuntos
Atenção à Saúde/economia , Acessibilidade aos Serviços de Saúde/economia , Internacionalidade , Justiça Social/economia , Comparação Transcultural , Atenção à Saúde/normas , Atenção à Saúde/estatística & dados numéricos , Europa (Continente) , Gastos em Saúde/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/normas , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Pesquisa sobre Serviços de Saúde , Renda/classificação , Seguro Saúde/economia , Seguro Saúde/normas , Seguro Saúde/estatística & dados numéricos , Modelos Econométricos , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/normas , Programas Nacionais de Saúde/estatística & dados numéricos , Análise de Regressão , Fatores Socioeconômicos , Medicina Estatal/economia , Medicina Estatal/normas , Medicina Estatal/estatística & dados numéricos , Estados UnidosRESUMO
This paper presents the results of a ten-country comparative study of health care financing systems and their progressivity characteristics. It distinguishes between the tax-financed systems of Denmark, Portugal and the U.K., the social insurance systems of France, the Netherlands and Spain, and the predominantly private systems of Switzerland and the U.S. It concludes that tax-financed systems tend to be proportional or mildly progressive, that social insurance systems are regressive and that private systems are even more regressive. Out-of-pocket payments are in most countries an especially regressive means of raising health care revenues.
