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Progressivity, horizontal inequality and reranking caused by health system financing: A decomposition analysis for Switzerland

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  • Bilger, Marcel
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    Abstract

    This paper presents an application of the Duclos et al. [Duclos, J.-Y., Jalbert, V., Araar A., 2003. Classical horizontal inequity and reranking: an integrated approach. Research on Economic Inequality 10, 65-100] decomposition to an analysis of the 1998 Swiss health system financing. We see that in addition to measuring horizontal inequality in the classical sense, this decomposition is more efficient and flexible than earlier ones. It is also pointed out that methods involving a nonparametric estimation lead to asymptotically biased vertical and horizontal effects. A procedure to estimate this bias is given. Finally, it is shown that despite a major reform, health system financing is still very regressive and social health insurance is more regressive than direct financing.

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    Bibliographic Info

    Article provided by Elsevier in its journal Journal of Health Economics.

    Volume (Year): 27 (2008)
    Issue (Month): 6 (December)
    Pages: 1582-1593

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    Handle: RePEc:eee:jhecon:v:27:y:2008:i:6:p:1582-1593

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    Web page: http://www.elsevier.com/locate/inca/505560

    Related research

    Keywords: Health care financing Income redistribution Vertical equity Horizontal equity Reranking;

    References

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    1. Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Progressivity, horizontal equity and reranking in health care finance: a decomposition analysis for the Netherlands," Journal of Health Economics, Elsevier, vol. 16(5), pages 499-516, October.
    2. Duclos, Jean-Yves & Jalbert, Vincent & Araar, Abdelkrim, 2003. "Classical Horizontal Inequity and Reranking: an Integrating Approach," Cahiers de recherche 0306, CIRPEE.
    3. Wagstaff, Adam & van Doorslaer, Eddy & van der Burg, Hattem & Calonge, Samuel & Christiansen, Terkel & Citoni, Guido & Gerdtham, Ulf-G & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "Equity in the finance of health care: some further international comparisons1," Journal of Health Economics, Elsevier, vol. 18(3), pages 263-290, June.
    4. Jean-Yves Duclos, 2000. "Gini Indices and the Redistribution of Income," International Tax and Public Finance, Springer, vol. 7(2), pages 141-162, March.
    5. Creedy, J. & Lambert, P.J. & van de Ven, J., 2001. "Close Equals and Calculation of the Vertical, Horizontal and Reranking Effects of Taxation," Department of Economics - Working Papers Series 781, The University of Melbourne.
    6. Leu, Robert E. & Schellhorn, Martin, 2004. "The Evolution of Income-Related Inequalities in Health Care Utilization in Switzerland over Time," IZA Discussion Papers 1316, Institute for the Study of Labor (IZA).
    7. Jean-Yves Duclos & Peter J. Lambert, 2000. "A normative and statistical approach to measuring classical horizontal inequity," Canadian Journal of Economics, Canadian Economics Association, vol. 33(1), pages 87-113, February.
    8. Aronson, J Richard & Johnson, Paul & Lambert, Peter J, 1994. "Redistributive Effects and Unequal Income Tax Treatment," Economic Journal, Royal Economic Society, vol. 104(423), pages 262-70, March.
    9. Wagstaff, Adam & van Doorslaer, Eddy, 2000. "Chapter 34 Equity in health care finance and delivery," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 34, pages 1803-1862 Elsevier.
    10. Leu, Robert E. & Schellhorn, Martin, 2004. "The Evolution of Income-Related Health Inequalities in Switzerland over Time," IZA Discussion Papers 1346, Institute for the Study of Labor (IZA).
    11. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & Citoni, Guido & Di Biase, Rita & Gerdtham, Ulf-G. & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "The redistributive effect of health care finance in twelve OECD countries," Journal of Health Economics, Elsevier, vol. 18(3), pages 291-313, June.
    12. Kakwani, Nanok C, 1977. "Measurement of Tax Progressivity: An International Comparison," Economic Journal, Royal Economic Society, vol. 87(345), pages 71-80, March.
    13. Robert E. Leu & Martin Schellhorn, 2004. "The evolution of income-related inequalities in health care utilization in Switzerland over time," Diskussionsschriften dp0413, Universitaet Bern, Departement Volkswirtschaft.
    14. Wagstaff, Adam & van Doorslaer, Eddy, 1992. "Equity in the finance of health care: Some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 361-387, December.
    15. Wagstaff, Adam, 2008. "Measuring financial protection in health," Policy Research Working Paper Series 4554, The World Bank.
    16. Yaari, Menahem E., 1988. "A controversial proposal concerning inequality measurement," Journal of Economic Theory, Elsevier, vol. 44(2), pages 381-397, April.
    17. Plotnick, Robert, 1981. "A Measure of Horizontal Inequity," The Review of Economics and Statistics, MIT Press, vol. 63(2), pages 283-88, May.
    18. Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1989. "Equity in the Finance and Delivery of Health Care: Some Tentative Cross-country Comparisons," Oxford Review of Economic Policy, Oxford University Press, vol. 5(1), pages 89-112, Spring.
    19. Robert E. Leu & Martin Schellhorn, 2004. "The evolution of income-related health inequalities in Switzerland over time," Diskussionsschriften dp0414, Universitaet Bern, Departement Volkswirtschaft.
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    Cited by:
    1. Thierry Debrand & Christine Sorasith, 2010. "Bouclier sanitaire : choisir entre égalité et équité ? Une analyse à partir du modèle ARAMMIS," Working Papers DT32, IRDES institut for research and information in health economics, revised Jun 2010.
    2. Ivica Urban, 2013. "Implementation Issues in the Duclos–Jalbert–Araar Decomposition of Redistributive Effect," Public Finance Review, , vol. 41(1), pages 121-143, January.
    3. Ivica, Urban, 2011. "Duclos-Jalbert-Araar decomposition of redistributive effect: implementation issues," MPRA Paper 28068, University Library of Munich, Germany.
    4. Luca Crivelli & Paola Salari, 2012. "Fiscal federalism and income redistribution through healthcare financing: An empirical analysis for the Swiss cantons," CEPRA working paper 1204, USI Università della Svizzera italiana.
    5. Mototsugu Fukushige & Noriko Ishikawa & Satoko Maekawa, 2012. "A modified Kakwani measure for health inequality," Health Economics Review, Springer, vol. 2(1), pages 1-7, December.
    6. Cavagnero, Eleonora & Bilger, Marcel, 2010. "Equity during an economic crisis: Financing of the Argentine health system," Journal of Health Economics, Elsevier, vol. 29(4), pages 479-488, July.
    7. Amedeo Spadaro & Lucia Mangiavacchi & Ignacio Moral-Arce & Marta Adiego-Estella & Angela Blanco-Moreno, 2013. "Evaluating the redistributive impact of public health expenditure using an insurance value approach," The European Journal of Health Economics, Springer, vol. 14(5), pages 775-787, October.

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