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Equity of health care in Australia

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  • Lairson, David R.
  • Hindson, Paul
  • Hauquitz, Alan
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    Abstract

    This paper examines the equity characteristics of health care financing and delivery in Australia and compares its performance with recent findings on systems in Europe and the United States. Vertical equity of finance is evaluated with income and payment concentration indices derived from published survey data on taxes and expenditure by income decile. Horizontal equity of health care delivery is assessed with standardized expenditure concentration coefficients for three measures of health status and four types of health services, derived from household survey data on health care utilization, health status, income and demographics. Health cover is available to the entire population. Results show the financing system is slightly progressive despite the fact that 30% of payment comes from private sources, which are regressive. The equity index compares favorably to many European countries and is much better than the U.S. which has a regressive financing system. The Australian system fares less well in terms of equity of health care delivery. Several features favor privately insured higher income persons in use of health care and this is reflected, for some health status measures and types of service, in inequity favoring the better off. This contrasts with inequity favoring the less well off in many European countries and the U.S. This analysis provides a benchmark for monitoring the equity of the Australian system and provides information on the equity of a mixed private and public financing system that covers the entire population. This is relevant to the U.S. which is moving in this direction by extending private cover to the uninsured and to European countries that are increasing private sector involvement in health care financing.

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    File URL: http://www.sciencedirect.com/science/article/B6VBF-3YS8D9V-4C/2/8fd6b8764c093203edcc05b4085a62c5
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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 41 (1995)
    Issue (Month): 4 (August)
    Pages: 475-482

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    Handle: RePEc:eee:socmed:v:41:y:1995:i:4:p:475-482

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    Keywords: equity health care finance health care delivery;

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    Cited by:
    1. Mohammad Hajizadeh & Luke B. Connelly & James R.G. Butler & Aredshir Khosravi, 2012. "Unmet need and met unneed in health care utilisation in Iran," International Journal of Social Economics, Emerald Group Publishing, vol. 39(6), pages 400-422, May.
    2. 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.
    3. E. Xie, 2011. "Income-related inequalities of health and health care utilization," Frontiers of Economics in China, Springer, vol. 6(1), pages 131-156, March.
    4. Mohammad Hajizadeh & Hong Nghiem, 2011. "Out-of-pocket expenditures for hospital care in Iran: who is at risk of incurring catastrophic payments?," International Journal of Health Care Finance and Economics, Springer, vol. 11(4), pages 267-285, December.
    5. Hajizadeh, Mohammad & Connelly, Luke B., 2009. "Equity of health care financing in Iran," MPRA Paper 14672, University Library of Munich, Germany.
    6. McDermott, Robyn & Beaver, Carol & Zhao, Yuejen, 1997. "Outcomes-based resource allocation for indigenous health services: a model for Northern Australia?," Health Policy, Elsevier, vol. 39(1), pages 69-78, January.
    7. 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.

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