IDEAS home Printed from https://ideas.repec.org/a/eee/jhecon/v28y2009i6p1071-1080.html
   My bibliography  Save this article

Equity in health care finance in Palestine: The triple effects revealed

Author

Listed:
  • Abu-Zaineh, Mohammad
  • Mataria, Awad
  • Luchini, Stéphane
  • Moatti, Jean-Paul

Abstract

This paper presents an application of the Urban and Lambert "upgraded-AJL Decomposition" approach that was designed to deal with the problem of close-income equals in equity analysis, and as applied to the area of health care finance. Contrary to most previous studies, vertical and horizontal inequities and the triple effects of inter-groups, intra-group and entire-group reranking of various financing schemes are estimated, with statistical significance calculated using the bootstrap method. Application is made on the three financing schemes present in the case of the Occupied Palestinian Territory. Results demonstrate the relative importance of the three forms of reranking in determining overall inequality. The paper offers policy recommendations to limit the existing inequalities in the system and to enhance the capacity of the governmental insurance scheme.

Suggested Citation

  • Abu-Zaineh, Mohammad & Mataria, Awad & Luchini, Stéphane & Moatti, Jean-Paul, 2009. "Equity in health care finance in Palestine: The triple effects revealed," Journal of Health Economics, Elsevier, vol. 28(6), pages 1071-1080, December.
    • Handle: RePEc:eee:jhecon:v:28:y:2009:i:6:p:1071-1080
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0167-6296(09)00099-X
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. van de Ven, Justin & Creedy, John & Lambert, Peter J, 2001. "Close Equals and Calculation of the Vertical, Horizontal and Reranking Effects of Taxation," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 63(3), pages 381-394, July.
    2. Davidson, Russell & Flachaire, Emmanuel, 2007. "Asymptotic and bootstrap inference for inequality and poverty measures," Journal of Econometrics, Elsevier, vol. 141(1), pages 141-166, November.
    3. Cowell, F.A., 2000. "Measurement of inequality," Handbook of Income Distribution, in: A.B. Atkinson & F. Bourguignon (ed.), Handbook of Income Distribution, edition 1, volume 1, chapter 2, pages 87-166, Elsevier.
    4. Cisse, Boubou & Luchini, Stephane & Moatti, Jean Paul, 2007. "Progressivity and horizontal equity in health care finance and delivery: What about Africa?," Health Policy, Elsevier, vol. 80(1), pages 51-68, January.
    5. Ivica Urban & Peter J. Lambert, 2008. "Redistribution, Horizontal Inequity, and Reranking," Public Finance Review, , vol. 36(5), pages 563-587, September.
    6. Adam Wagstaff, 2002. "Reflections on and alternatives to WHO's fairness of financial contribution index," Health Economics, John Wiley & Sons, Ltd., vol. 11(2), pages 103-115, March.
    7. Klavus, Jan, 2001. "Statistical inference of progressivity dominance: an application to health care financing distributions," Journal of Health Economics, Elsevier, vol. 20(3), pages 363-377, May.
    8. Justin Van De Ven & John Creedy & Peter J. Lambert, 2001. "Close Equals and Calculation of the Vertical, Horizontal and Reranking Effects of Taxation," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 63(3), pages 381-394, July.
    9. 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.
    10. Abu-Zaineh, Mohammad & Mataria, Awad & Luchini, Stéphane & Moatti, Jean-Paul, 2008. "Equity in health care financing in Palestine: The value-added of the disaggregate approach," Social Science & Medicine, Elsevier, vol. 66(11), pages 2308-2320, June.
    11. Aronson, J. Richard & Lambert, Peter J., 1994. "Decomposing the Gini Coefficient to Reveal the Vertical, Horizontal, and Reranking Effects of Income Taxation," National Tax Journal, National Tax Association, vol. 47(2), pages 273-94, June.
    12. Jean-Yves Duclos & Abdelkrim Araar, 2006. "Poverty and Equity," Economic Studies in Inequality, Social Exclusion, and Well-Being, Springer, number 978-0-387-33318-2, Fall.
    13. 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.
    14. Lerman, Robert I. & Yitzhaki, Shlomo, 1989. "Improving the accuracy of estimates of Gini coefficients," Journal of Econometrics, Elsevier, vol. 42(1), pages 43-47, September.
    15. Raquel Andres & Samuel Calonge, 2005. "Inference on Income Inequality and Tax Progressivity Indices: U-Statistics and Bootstrap Methods," Working Papers 09, ECINEQ, Society for the Study of Economic Inequality.
    16. Mills, Jeffrey A & Zandvakili, Sourushe, 1997. "Statistical Inference via Bootstrapping for Measures of Inequality," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 12(2), pages 133-150, March-Apr.
    17. Aronson, J. Richard & Lambert, Peter J., 1994. "Decomposing the Gini Coefficient to Reveal the Vertical, Horizontal, and Reranking Effects of Income Taxation," National Tax Journal, National Tax Association;National Tax Journal, vol. 47(2), pages 273-294, June.
    18. Ravallion, Martin & Chen, Shaohua, 1997. "What Can New Survey Data Tell Us about Recent Changes in Distribution and Poverty?," The World Bank Economic Review, World Bank, vol. 11(2), pages 357-382, May.
    19. Kinam Kim & Peter J. Lambert, 2009. "Redistributive Effect of U.S. Taxes and Public Transfers, 1994-2004," Public Finance Review, , vol. 37(1), pages 3-26, January.
    20. Juster, F Thomas & Stafford, Frank P, 1991. "The Allocation of Time: Empirical Findings, Behavioral Models, and Problems of Measurement," Journal of Economic Literature, American Economic Association, vol. 29(2), pages 471-522, June.
    21. Jenkins, Stephen, 1988. "Calculating Income Distribution Indices From Micro-Data," National Tax Journal, National Tax Association;National Tax Journal, vol. 41(1), pages 139-142, March.
    22. Jenkins, Stephen, 1988. "Calculating Income Distribution Indices from Micro-Data," National Tax Journal, National Tax Association, vol. 41(1), pages 139-42, March.
    23. 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 262-270, March.
    24. Mataria, Awad & Giacaman, Rita & Khatib, Rana & Moatti, Jean-Paul, 2006. "Impoverishment and patients' "willingness" and "ability" to pay for improving the quality of health care in Palestine: An assessment using the contingent valuation method," Health Policy, Elsevier, vol. 75(3), pages 312-328, February.
    25. Xander Koolman & Eddy van Doorslaer, 2004. "On the interpretation of a concentration index of inequality," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 649-656, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Mohammad Abu-Zaineh & Habiba Romdhane & Bruno Ventelou & Jean-Paul Moatti & Arfa Chokri, 2013. "Appraising financial protection in health: the case of Tunisia," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 73-93, March.
    2. Khaled Makhloufi & Bruno Ventelou & Mohammad Abu-Zaineh, 2015. "Have health insurance reforms in Tunisia attained their intended objectives?," International Journal of Health Economics and Management, Springer, vol. 15(1), pages 29-51, March.
    3. Awad Mataria & Firas Raad & Mohammad Abu-Zaineh & Cam Donaldson, 2010. "Catastrophic healthcare payments and impoverishment in the occupied Palestinian territory," Applied Health Economics and Health Policy, Springer, vol. 8(6), pages 393-405, November.
    4. Rasha Khatib & Awad Mataria, 2010. "Equity in Health Care in The Occupied Palestinian Territory: A Benefit Incidence Analysis," Working Papers 564, Economic Research Forum, revised 11 Jan 2010.
    5. Mulenga, Arnold & Ataguba, John Ele-Ojo, 2017. "Assessing income redistributive effect of health financing in Zambia," Social Science & Medicine, Elsevier, vol. 189(C), pages 1-10.
    6. John E. Ataguba & Hyacinth E. Ichoku & Chijioke O. Nwosu & James Akazili, 2020. "An Alternative Approach to Decomposing the Redistributive Effect of Health Financing Between and Within Groups Using the Gini Index: The Case of Out-of-Pocket Payments in Nigeria," Applied Health Economics and Health Policy, Springer, vol. 18(6), pages 747-757, December.
    7. Abu-Zaineh, Mohammad & Mataria, Awad & Moatti, Jean-Paul & Ventelou, Bruno, 2011. "Measuring and decomposing socioeconomic inequality in healthcare delivery: A microsimulation approach with application to the Palestinian conflict-affected fragile setting," Social Science & Medicine, Elsevier, vol. 72(2), pages 133-141, January.
    8. John E. Ataguba, 2021. "The Impact of Financing Health Services on Income Inequality in an Unequal Society: The Case of South Africa," Applied Health Economics and Health Policy, Springer, vol. 19(5), pages 721-733, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Abu-Zaineh, Mohammad & Mataria, Awad & Luchini, Stéphane & Moatti, Jean-Paul, 2008. "Equity in health care financing in Palestine: The value-added of the disaggregate approach," Social Science & Medicine, Elsevier, vol. 66(11), pages 2308-2320, June.
    2. Mulenga, Arnold & Ataguba, John Ele-Ojo, 2017. "Assessing income redistributive effect of health financing in Zambia," Social Science & Medicine, Elsevier, vol. 189(C), pages 1-10.
    3. Ivica Urban & Peter J. Lambert, 2008. "Redistribution, Horizontal Inequity, and Reranking," Public Finance Review, , vol. 36(5), pages 563-587, September.
    4. Herault, Nicolas & Jenkins, Stephen P., 2023. "Redistribution, horizontal inequity, and reranking: direct taxation in the UK, 1977–2020," LSE Research Online Documents on Economics 120996, London School of Economics and Political Science, LSE Library.
    5. Alice Sanwald & Engelbert Theurl, 2015. "Out-of-pocket payments in the Austrian healthcare system - a distributional analysis," Working Papers 2015-05, Faculty of Economics and Statistics, Universität Innsbruck.
    6. Nicolas Hérault & Stephen P. Jenkins, 2023. "Redistribution, horizontal inequity, and reranking: Direct taxation in the UK, 1977–2020," Working Papers 660, ECINEQ, Society for the Study of Economic Inequality.
    7. 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.
    8. Ivica Urban, 2009. "Kakwani decomposition of redistributive effect: Origins, critics and upgrades," Working Papers 148, ECINEQ, Society for the Study of Economic Inequality.
    9. Essama-Nssah, B., 2008. "Assessing the redistributive effect of fiscal policy," Policy Research Working Paper Series 4592, The World Bank.
    10. Jean-Paul Moatti & Bruno Ventelou, 2009. "Économie de la santé dans les pays en développement des paradigmes en mutation," Revue économique, Presses de Sciences-Po, vol. 60(2), pages 241-256.
    11. Wagstaff, Adam*Doorslaer, Eddy van, 2001. "Paying for health care : quantifying fairness, catastrophe, and impoverishment, with applications to Vietnam, 1993-98," Policy Research Working Paper Series 2715, The World Bank.
    12. Peter J. Lambert, 2004. "Income Taxation and Equity," Working Papers 2004/4, Institut d'Economia de Barcelona (IEB).
    13. Adam Wagstaff, 2002. "Reflections on and alternatives to WHO's fairness of financial contribution index," Health Economics, John Wiley & Sons, Ltd., vol. 11(2), pages 103-115, March.
    14. Swadhin Mondal, 2018. "Health Policy Changes and Its Effect on Equity in Healthcare Financing in India," Journal of Quantitative Economics, Springer;The Indian Econometric Society (TIES), vol. 16(3), pages 709-725, September.
    15. John Creedy, 2023. "Distributional Comparisons Using the Gini Inequality Measure," Australian Economic Review, The University of Melbourne, Melbourne Institute of Applied Economic and Social Research, vol. 56(4), pages 538-550, December.
    16. Bilger, Marcel, 2008. "Progressivity, horizontal inequality and reranking caused by health system financing: A decomposition analysis for Switzerland," Journal of Health Economics, Elsevier, vol. 27(6), pages 1582-1593, December.
    17. Achille VERNIZZI & Simone PELLEGRINO, 2007. "On the Aronson-Johnson-Lambert decomposition of the redistributive effect," Departmental Working Papers 2007-13, Department of Economics, Management and Quantitative Methods at Università degli Studi di Milano, revised 26 Jun 2007.
    18. Nolan, Matt, 2018. "Horizontal and Vertical Equity in the New Zealand Tax-Transfer System: 1988-2013," Working Paper Series 7657, Victoria University of Wellington, Chair in Public Finance.
    19. Härpfer, Marco & Cacace, Mirella & Rothgang, Heinz, 2009. "And fairness for all? Wie gerecht ist die Finanzierung im deutschen Gesundheitssystem? Eine Berechnung des Kakwani-Index auf Basis der EVS," Working papers of the ZeS 04/2009, University of Bremen, Centre for Social Policy Research (ZeS).
    20. William Horrace & Joseph Marchand & Timothy Smeeding, 2008. "Ranking inequality: Applications of multivariate subset selection," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 6(1), pages 5-32, March.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:jhecon:v:28:y:2009:i:6:p:1071-1080. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/inca/505560 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.