Analysis of the distributional impact of out-of-pocket health payments: Evidence from a public health insurance program for the poor in Mexico
Abstract
Abstract Many governments have health programs focused on improving health among the poor and these have an impact on out-of-pocket health payments made by individuals. Therefore, one of the objectives of these programs is to reach the poorest and reduce their out-of-pocket expenditure. In this paper we propose the distributional poverty impact approach to measure the poverty impact of out-of-pocket health payments of different health financing policies. This approach is comparable to the impoverishment methodology proposed by Wagstaff and van Doorslaer (2003) that compares poverty indices before and after out-of-pocket health payments. In order to escape the specification of a particular poverty index, we use the marginal dominance approach that uses non-intersecting curves and can rank poverty reducing health financing policies. We present an empirical application of the out-of-pocket health payments for an innovative social financing policy implemented in Mexico named Seguro Popular. The paper finds evidence that Seguro Popular program has a better distributional poverty impact when families face illness when compared to other poverty reducing policies. The empirical dominance approach uses data from Mexico in 2006 and considers international poverty standards of $2 per person per day.Download Info
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Bibliographic Info
Article provided by Elsevier in its journal Journal of Health Economics.
Volume (Year): 30 (2011)
Issue (Month): 4 (July)
Pages: 707-718
Contact details of provider:
Web page: http://www.elsevier.com/locate/inca/505560
Related research
Keywords: Out-of-pocket payments Poverty Distributional impact marginal dominance;References
References listed on IDEASPlease report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Shlomo Yitzhaki & Joel Slemrod, 1987.
"Welfare Dominance: An Application to Commodity Taxation,"
NBER Working Papers
2451, National Bureau of Economic Research, Inc.
- Yitzhaki, Shlomo & Slemrod, Joel, 1991. "Welfare Dominance: An Application to Commodity Taxation," American Economic Review, American Economic Association, vol. 81(3), pages 480-96, June.
- Besley, Timothy J & Kanbur, S M Ravi, 1988. "Food Subsidies and Poverty Alleviation," Economic Journal, Royal Economic Society, vol. 98(392), pages 701-19, September.
- Duclos, Jean-Yves & Makdissi, Paul, 2003.
"Restricted and Unrestricted Dominance for Welfare, Inequality and Poverty Orderings,"
Cahiers de recherche
0303, CIRPEE.
- Jean-Yves Duclos & Paul Makdissi, 2004. "Restricted and Unrestricted Dominance for Welfare, Inequality, and Poverty Orderings," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 6(1), pages 145-164, 02.
- Duclos, Jean-Yves & Makdissi, Paul, 2000. "Restricted and Unrestricted Dominance for Welfare, Inequality and Poverty Orderings," Cahiers de recherche 0001, Université Laval - Département d'économique.
- Ahmad, Ehtisham & Stern, Nicholas, 1984. "The theory of reform and indian indirect taxes," Journal of Public Economics, Elsevier, vol. 25(3), pages 259-298, December.
- Foster, James & Greer, Joel & Thorbecke, Erik, 1984. "A Class of Decomposable Poverty Measures," Econometrica, Econometric Society, vol. 52(3), pages 761-66, May.
- Duclos, Jean-Yves & Makdissi, Paul & Wodon, Quentin, 2005.
"Poverty-dominant program reforms: the role of targeting and allocation rules,"
Journal of Development Economics,
Elsevier, vol. 77(1), pages 53-73, June.
- Paul Makdissi & Quentin Wodon & Jean-Yves Duclos, 2002. "Poverty-dominant program reforms: the role of targeting and allocation rules," Cahiers de recherche 02-11, Departement d'Economique de la Faculte d'administration à l'Universite de Sherbrooke, revised 2004.
- Duclos, Jean-Yves & Makdissi, Paul & Wodon, Quentin, 2002.
"Poverty-Reducing Tax Reforms with Heterogeneous Agents,"
Cahiers de recherche
0202, Université Laval - Département d'économique.
- Jean-Yves Duclos & Paul Makdissi & Quentin Wodon, 2005. "Poverty-Reducing Tax Reforms with Heterogeneous Agents," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 7(1), pages 107-116, 02.
- Paul Makdissi & Jean-Yves Duclos & Quentin Wodon, 2002. "Poverty-Reducing Tax Reforms with Heterogeneous Agents," Cahiers de recherche 02-09, Departement d'Economique de la Faculte d'administration à l'Universite de Sherbrooke, revised 2003.
- Duclos, Jean-Yves & Makdissi, Paul & Wodon, Quentin, 2003. "Poverty-Reducing Tax Reforms with Heterogeneous Agents," Cahiers de recherche 0313, CIRPEE.
- Mayshar, Joram & Yitzhaki, Shlomo, 1996. "Dalton-improving tax reform: When households differ in ability and needs," Journal of Public Economics, Elsevier, vol. 62(3), pages 399-412, November.
- Gustafsson, Bjorn & Li, Shi, 2004. "Expenditures on education and health care and poverty in rural China," China Economic Review, Elsevier, vol. 15(3), pages 292-301.
- Coady, David P. & Skoufias, Emmanuel, 2001.
"On the targeting and redistributive efficiencies of alternative transfer instruments,"
FCND discussion papers
100, International Food Policy Research Institute (IFPRI).
- David Coady & Emmanuel Skoufias, 2004. "On the Targeting and Redistributive Efficiencies of Alternative Transfer Instruments," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 50(1), pages 11-27, 03.
- Coady, David P. & Skoufias, Emmanuel, 2001. "On the targeting and redistributive efficiencies of alternative transfer instruments," FCND briefs 100, International Food Policy Research Institute (IFPRI).
- David Coady, 2006. "The Welfare Returns to Finer Targeting: The Case of The Progresa Program in Mexico," International Tax and Public Finance, Springer, vol. 13(2), pages 217-239, May.
- Pannarunothai, Supasit & Mills, Anne, 1997. "The poor pay more: Health-related inequality in Thailand," Social Science & Medicine, Elsevier, vol. 44(12), pages 1781-1790, June.
- Atkinson, Anthony B., 1970. "On the measurement of inequality," Journal of Economic Theory, Elsevier, vol. 2(3), pages 244-263, September.
- Paul Makdissi & Quentin Wodon, 2007.
"Poverty-Reducing and Welfare-Improving Marginal Public Price and Price Cap Reforms,"
Journal of Public Economic Theory,
Association for Public Economic Theory, vol. 9(4), pages 683-698, 08.
- Paul Makdissi & Quentin Wodon, 2001. "Poverty-Reducing and Welfare-Improving Marginal Public Price and Price Cap Reforms," Cahiers de recherche 04-04, Departement d'Economique de la Faculte d'administration à l'Universite de Sherbrooke, revised 2004.
- Angus Deaton & Salman Zaidi, 1999.
"Guidelines for Constructing Consumption Aggregates For Welfare Analysis,"
Working Papers
217, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
- Deaton, A. & Zaidi, S., 1999. "Guidelines for Constructing Consumption Aggregates for Welfare Analysis," Papers 192, Princeton, Woodrow Wilson School - Development Studies.
- Makdissi, Paul & Wodon, Quentin, 2002. "Consumption dominance curves: testing for the impact of indirect tax reforms on poverty," Economics Letters, Elsevier, vol. 75(2), pages 227-235, April.
- Sosa-Rubí, Sandra G. & Galárraga, Omar & Harris, Jeffrey E., 2009.
"Heterogeneous impact of the "Seguro Popular" program on the utilization of obstetrical services in Mexico, 2001-2006: A multinomial probit model with a discrete endogenous variable,"
Journal of Health Economics,
Elsevier, vol. 28(1), pages 20-34, January.
- Sandra G. Sosa-Rubi & Omar Galarraga & Jeffrey E. Harris, 2007. "Heterogeneous Impact of the "Seguro Popular" Program on the Utilization of Obstetrical Services in Mexico, 2001-2006: A Multinomial Probit Model with a Discrete Endogenous Variable," NBER Working Papers 13498, National Bureau of Economic Research, Inc.
- Obermann, Konrad & Jowett, Matthew R. & Alcantara, Maria Ofelia O. & Banzon, Eduardo P. & Bodart, Claude, 2006. "Social health insurance in a developing country: The case of the Philippines," Social Science & Medicine, Elsevier, vol. 62(12), pages 3177-3185, June.
- Feldstein, Martin S, 1972. "Distributional Equity and the Optimal Structure of Public Prices," American Economic Review, American Economic Association, vol. 62(1), pages 32-36, March.
- Juan Jose Diaz & Sudhanshu Handa, 2006. "An Assessment of Propensity Score Matching as a Nonexperimental Impact Estimator: Evidence from Mexico’s PROGRESA Program," Journal of Human Resources, University of Wisconsin Press, vol. 41(2).
Citations
Lists
This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.Statistics
Access and download statisticsCorrections
When requesting a correction, please mention this item's handle: RePEc:eee:jhecon:v:30:y:2011:i:4:p:707-718For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Wendy Shamier).
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 references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link 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 profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.

