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Health Care Reform: Separating Insurance from Income Redistribution

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Author Info
Friedrich Breyer
Andreas Haufler

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Abstract

Most systems of health care financing in EU member states currentlyinclude elements of income redistribution. The paper analyzesthe effects of shifting this kind of redistribution to the taxsystem and argues that this reform could create two types ofefficiency gains. On the expenditure side, it would facilitatethe adoption of more incentive-compatible insurance contracts,for example through the introduction of copayment schemes. Onthe revenue side, income redistribution through the general taxsystem is likely to imply a shadow price of public funds thatis lower than if redistribution is carried out through wage-basedinsurance contributions. Copyright Kluwer Academic Publishers 2000

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File URL: http://hdl.handle.net/10.1023/A:1008773103834
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Publisher Info
Article provided by Springer in its journal International Tax and Public Finance.

Volume (Year): 7 (2000)
Issue (Month): 4 (August)
Pages: 445-461
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Handle: RePEc:kap:itaxpf:v:7:y:2000:i:4:p:445-461

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Web page: http://www.springerlink.com/link.asp?id=102915

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Related research
Keywords: health care finance; income redistribution;

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References listed on IDEAS
Please 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.:
  1. Hans-Werner Sinn, 1996. "Social Insurance, Incentives and Risk Taking," CESifo Working Paper Series CESifo Working Paper No. , CESifo Group Munich.
    Other versions:
  2. Atkinson, A. B. & Stiglitz, J. E., 1976. "The design of tax structure: Direct versus indirect taxation," Journal of Public Economics, Elsevier, vol. 6(1-2), pages 55-75. [Downloadable!] (restricted)
  3. Peter Sørensen, 1994. "From the global income tax to the dual income tax: Recent tax reforms in the Nordic countries," International Tax and Public Finance, Springer, vol. 1(1), pages 57-79, February. [Downloadable!] (restricted)
  4. Richard J. Arnott & Joseph E. Stiglitz, 1986. "Moral Hazard and Optimal Commodity Taxation," NBER Working Papers 1154, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
  5. Pauly, Mark V, 1974. "Overinsurance and Public Provision of Insurance: The Roles of Moral Hazard and Adverse Selection," The Quarterly Journal of Economics, MIT Press, vol. 88(1), pages 44-62, February. [Downloadable!] (restricted)
  6. Atkinson, A B & Sandmo, A, 1980. "Welfare Implications of the Taxation of Savings," Economic Journal, Royal Economic Society, vol. 90(359), pages 529-49, September. [Downloadable!] (restricted)
  7. Petretto, Alessandro, 1999. "Optimal social health insurance with supplementary private insurance," Journal of Health Economics, Elsevier, vol. 18(6), pages 727-745, December. [Downloadable!] (restricted)
  8. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-77, June. [Downloadable!] (restricted)
  9. Sijbren Cnossen, 1999. "Taxing Capital Income in the Nordic Countries: A Model for the European Union?," FinanzArchiv: Public Finance Analysis, Mohr Siebeck, Tübingen, vol. 56(1), pages 18-, March.
  10. Helmuth Cremer & Pierre Pestieau, 1996. "Redistributive taxation and social insurance," International Tax and Public Finance, Springer, vol. 3(3), pages 281-295, July. [Downloadable!] (restricted)
  11. Erkki Koskela & Ronnie Schoeb, 1998. "Why Governments should Tax Mobile Capital in the Presence of Unemployment," CESifo Working Paper Series CESifo Working Paper No. , CESifo Group Munich. [Downloadable!]
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  12. Deaton, Angus, 1979. "Optimally uniform commodity taxes," Economics Letters, Elsevier, vol. 2(4), pages 357-361. [Downloadable!] (restricted)
  13. Blomqvist, Ake & Horn, Henrik, 1984. "Public health insurance and optimal income taxation," Journal of Public Economics, Elsevier, vol. 24(3), pages 353-371, August. [Downloadable!] (restricted)
  14. 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. [Downloadable!] (restricted)
  15. Cochrane, John H, 1995. "Time-Consistent Health Insurance," Journal of Political Economy, University of Chicago Press, vol. 103(3), pages 445-73, June. [Downloadable!] (restricted)
Full references

Cited by:
(explanations, Please 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.)

  1. Ivonne Honekamp & Daniel Possenriede, 2008. "Redistributive effects in public health care financing," The European Journal of Health Economics, Springer, vol. 9(4), pages 405-416, November. [Downloadable!] (restricted)
  2. Mathias Kifmann, 2002. "Die Finanzierung der Gesetzlichen Krankenversicherung durch Kopfbeiträge aus verfassungsökonomischer Sicht," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 71(4), pages 505-512.
  3. Marcelin Joanis & David Boisclair & Claude Montmarquette, 2004. "La santé au Québec : des options pour financer la croissance," CIRANO Project Reports 2004rp-04, CIRANO. [Downloadable!]
  4. Haufler, Andreas, 2004. "Welche Vorteile bringt eine Pauschalprämie für die Finanzierung des Gesundheitswesens? Einige einfache Äquivalenzresultate," Discussion Papers in Economics 440, University of Munich, Department of Economics. [Downloadable!]
  5. Jacob, Johanna & Lundin, Douglas, 2001. "A Median Voter Model of Health Insurance with Ex Post Moral Hazard," Working Paper Series 2001:7, Uppsala University, Department of Economics. [Downloadable!]
  6. Friedrich Breyer, 2001. "Income Redistribution and the Political Economy of Social Health Insurance : Comparing Germany and Switzerland," Discussion Papers of DIW Berlin 253, DIW Berlin, German Institute for Economic Research. [Downloadable!]
  7. Wolfgang Buchholz & Birgit Edener & Markus Grabka & Klaus-Dirk Henke & Monika Huber & Hermann Ribhegge & Andreas Ryll & Hans-Jürgen Wagener & Gert G. Wagner, 2001. "Wettbewerb aller Krankenversicherungen kann Qualität verbessern und Kosten des Gesundheitswesens senken," Discussion Papers of DIW Berlin 247, DIW Berlin, German Institute for Economic Research. [Downloadable!]
  8. Laura Levaggi & Rosella Levaggi, 2009. "Welfare properties of restrictions to health care services based on cost effectiveness," Working Papers 0902, University of Brescia, Department of Economics. [Downloadable!]
  9. Anne Emblem, 2002. "Redistribution at the Hospital," International Tax and Public Finance, Springer, vol. 9(4), pages 367-378, August. [Downloadable!] (restricted)
  10. Mathias Kifmann, 2005. "Health insurance in a democracy: Why is it public and why are premiums income related?," Public Choice, Springer, vol. 124(3), pages 283-308, September. [Downloadable!] (restricted)
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