IDEAS home Printed from https://ideas.repec.org/a/spr/jqecon/v16y2018i3d10.1007_s40953-017-0105-4.html
   My bibliography  Save this article

Health Policy Changes and Its Effect on Equity in Healthcare Financing in India

Author

Listed:
  • Swadhin Mondal

    (Institute for Studies in Industrial Development (ISID)
    University of Nizwa)

Abstract

Reduction of catastrophic healthcare payments, horizontal inequity, and progressivity of out-of-pocket spending (OOPS) are three crucial issues in healthcare financing. In many countries, these issues have been addressed through health sector reforms. This study examines the effect of health policy changes on equity of financing among households by using four successive rounds of national sample survey data on consumer expenditure in India. The horizontal and vertical equity of healthcare payment was measured by Wagstaff and AJL (Aronson, Johnson and Lambert) decomposition method of redistributive effect. The study shows that out-of-pocket expenditure declined during 1993 and 2009, but increased suddenly during 2009 and 2012 for lower income group. It has been also seen that the value of fairness of financial contribution index declined overtime. This means that healthcare payment structure produce less equity in out-of-pocket payment. Value of Kakwani index increased during 1993–1994 and 2004–2005, but suddenly decreased by 92% between 2004–2005 and 2009–2010, and then increased. This implies that the healthcare payment structure was more progressive during this period but became less progressive later on. This means that poor income group is sending higher share of income compared to high income groups. The government-sponsored health programmes may increase the utilization of health care services but not produce higher equity in OOPS on health.

Suggested Citation

  • 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.
    • Handle: RePEc:spr:jqecon:v:16:y:2018:i:3:d:10.1007_s40953-017-0105-4
    DOI: 10.1007/s40953-017-0105-4
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s40953-017-0105-4
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s40953-017-0105-4?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    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. World Bank, 2017. "World Development Indicators 2017," World Bank Publications - Books, The World Bank Group, number 26447, December.
    2. 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.
    3. 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.
    4. Wagstaff, Adam & Yu, Shengchao, 2007. "Do health sector reforms have their intended impacts?: The World Bank's Health VIII project in Gansu province, China," Journal of Health Economics, Elsevier, vol. 26(3), pages 505-535, May.
    5. Government of India, 2017. "National Health Policy 2017," Working Papers id:11664, eSocialSciences.
    6. Swadhin Mondal & Henry Lucas & David Peters & Barun Kanjilal, 2014. "Catastrophic out-of-pocket payment for healthcare and implications for household coping strategies: evidence from West Bengal, India," Economics Bulletin, AccessEcon, vol. 34(2), pages 1303-1316.
    7. 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.
    8. 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.
    9. World Bank, 2014. "World Development Indicators 2014," World Bank Publications - Books, The World Bank Group, number 18237, December.
    10. David H. Peters & Abdo S. Yazbeck & Rashmi R. Sharma & G. N. V. Ramana & Lant H. Pritchett & Adam Wagstaff, 2002. "Better Health Systems for India's Poor : Findings, Analysis, and Options," World Bank Publications - Books, The World Bank Group, number 14080, December.
    11. Owen O'Donnell & Eddy van Doorslaer & Ravi P. Rannan-Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Deni Harbianto & Charu C. Garg & Piya Hanvoravongchai & Mohammed N. Huq & Anup Karan & Gabriel M., 2007. "The Incidence of Public Spending on Healthcare: Comparative Evidence from Asia," The World Bank Economic Review, World Bank, vol. 21(1), pages 93-123.
    12. 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.
    Full references (including those not matched with items on IDEAS)

    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, 2009. "Equity in health care finance in Palestine: The triple effects revealed," Journal of Health Economics, Elsevier, vol. 28(6), pages 1071-1080, December.
    2. 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.
    3. 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.
    4. 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.
    5. 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.
    6. J. Richard Aronson & Peter J. Lambert & Donald R. Trippeer, 1999. "Estimates of the Changing Equity Characteristics of the U.S. Income Tax with International Conjectures," Public Finance Review, , vol. 27(2), pages 138-159, March.
    7. Ivica Urban & Peter J. Lambert, 2008. "Redistribution, Horizontal Inequity, and Reranking," Public Finance Review, , vol. 36(5), pages 563-587, September.
    8. 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.
    9. 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.
    10. Swadhin Mondal, 2015. "Health Policy Changes and Their Impact on Equity in Health Financing in India," Working Papers id:6661, eSocialSciences.
    11. Justin van de Ven & Nicolas Hérault, 2019. "The evolution of tax implicit value judgements, redistribution and income inequality in the UK: 1968 to 2015," Working Papers 498, ECINEQ, Society for the Study of Economic Inequality.
    12. 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.
    13. Liu Baihui, 2017. "Redistributive Effect of Taxes and Transfers: Evidence from China," Journal of Tax Reform, Graduate School of Economics and Management, Ural Federal University, vol. 3(1), pages 43-51.
    14. Mitja Cok & Ivica Urban, 2007. "Distribution of Income and Taxes in Slovenia and Croatia," Post-Communist Economies, Taylor & Francis Journals, vol. 19(3), pages 299-316.
    15. Duclos, Jean-Yves & Jalbert, Vincent & Araar, Abdelkrim, 2000. "Classical Horizontal Inequity and Reranking: an Integrated Approach," Cahiers de recherche 0002, Université Laval - Département d'économique.
    16. Wagstaff, Adam & van Doorslaer, Eddy & van der Burg, Hattem & Calonge, Samuel & Christiansen, Terkel & Citoni, Guido & Gerdtham, Ulf-G. & Gerfin, Michael & Gross, Lorna & Hakinnen, Unto, 1999. "Redistributive effect, progressivity and differential tax treatment: Personal income taxes in twelve OECD countries," Journal of Public Economics, Elsevier, vol. 72(1), pages 73-98, April.
    17. Achille VERNIZZI, 2009. "Playing with the Hadamard product in decomposing Gini, concentration, redistribution and re-ranking indexes," Departmental Working Papers 2009-50, Department of Economics, Management and Quantitative Methods at Università degli Studi di Milano.
    18. Lars Osberg, 2017. "On the Limitations of Some Current Usages of the Gini Index," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 63(3), pages 574-584, September.
    19. Peter J. Lambert, 2004. "Income Taxation and Equity," Working Papers 2004/4, Institut d'Economia de Barcelona (IEB).
    20. 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.

    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:spr:jqecon:v:16:y:2018:i:3:d:10.1007_s40953-017-0105-4. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    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.