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Health care and economic well-being: estimating equivalence scales for public health care utilization

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  • Jan Klavus

    (STAKES, National Research and Development Centre for Welfare and Health, Health Services Research Unit, Helsinki, Finland)

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    Abstract

    Inconsistency between the income concept and the needs associated with its use can yield seriously misleading welfare assessments in comparisons concerning different household types. Equivalence scales are typically estimated from expenditure data that make them compatible with welfare adjustments involving cash income. However, if the welfare analysis extends to economic benefits other than cash income, the equivalence scale must be adjusted to account for needs relevant to the particular form of benefit. This paper derives needs-based equivalence scales for public health care utilization. The scales are estimated from the health care utilization data of different services. In addition, redistributional analysis is used to investigate the effects of adopting various income concepts and allowing for health care needs in the equivalence scale. The results clearly reveal the conceptual importance of accounting for health status, household size and age in welfare comparisons concerning non-cash transfers. It is also shown that the redistributive effect of public health care is heavily dependent upon assumptions made about its scope. Copyright © 1999 John Wiley & Sons, Ltd.

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    Bibliographic Info

    Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

    Volume (Year): 8 (1999)
    Issue (Month): 7 ()
    Pages: 613-625

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    Handle: RePEc:wly:hlthec:v:8:y:1999:i:7:p:613-625

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    Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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    1. Mullahy, John, 1998. "Much ado about two: reconsidering retransformation and the two-part model in health econometrics," Journal of Health Economics, Elsevier, vol. 17(3), pages 247-281, June.
    2. Pfahler, Wilhelm, 1987. "Redistributive Effects of Tax Progressivity: Evaluating a General Class of Aggregate Measures," Public Finance = Finances publiques, , vol. 42(1), pages 1-31.
    3. van Doorslaer, Eddy & Wagstaff, Adam & Bleichrodt, Han & Calonge, Samuel & Gerdtham, Ulf-G. & Gerfin, Michael & Geurts, Jose & Gross, Lorna & Hakkinen, Unto & Leu, Robert E., 1997. "Income-related inequalities in health: some international comparisons," Journal of Health Economics, Elsevier, vol. 16(1), pages 93-112, February.
    4. Jones, Andrew & O'Donnell, Owen, 1995. "Equivalence scales and the costs of disability," Journal of Public Economics, Elsevier, vol. 56(2), pages 273-289, February.
    5. Deaton, Angus S & Ruiz-Castillo, Javier & Thomas, Duncan, 1989. "The Influence of Household Composition on Household Expenditure Patterns: Theory and Spanish Evidence," Journal of Political Economy, University of Chicago Press, vol. 97(1), pages 179-200, February.
    6. Klavus, Jan & Hakkinen, Unto, 1996. "Health care and income distribution in Finland," Health Policy, Elsevier, vol. 38(1), pages 31-43, October.
    7. Danziger, Sheldon & Taussig, Michael K, 1979. "The Income Unit and the Anatomy of Income Distribution," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 25(4), pages 365-75, December.
    8. Deaton, Angus S & Muellbauer, John, 1986. "On Measuring Child Costs: With Applications to Poor Countries," Journal of Political Economy, University of Chicago Press, vol. 94(4), pages 720-44, August.
    9. Jan Klavus, 1998. "Progressivity of health care financing : estimation and statistical inference," Finnish Economic Papers, Finnish Economic Association, vol. 11(2), pages 86-95, Autumn.
    10. van Doorslaer, Eddy & Wagstaff, Adam, 1992. "Equity in the delivery of health care: some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 389-411, December.
    11. 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.
    12. Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
    13. Lewbel, Arthur, 1989. "Household equivalence scales and welfare comparisons," Journal of Public Economics, Elsevier, vol. 39(3), pages 377-391, August.
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    Cited by:
    1. Panos Tsakloglou & Christos Koutsampelas, 2012. "The distribution of full income in Greece," DEOS Working Papers 1207, Athens University of Economics and Business.
    2. Leibbrandt, Murray & Lilenstein, Kezia & Shenker, Callie & Woolard, Ingrid, 2013. "The influence of social transfers on labour supply: A South African and international review," SALDRU Working Papers 112, Southern Africa Labour and Development Research Unit, University of Cape Town.
    3. Alari Paulus & Holly Sutherland & Panos Tsakloglou, 2010. "The distributional impact of in-kind public benefits in European countries," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 29(2), pages 243-266.
    4. Christos Koutsampelas & Panos Tsakloglou, 2013. "The distribution of full income in Greece," International Journal of Social Economics, Emerald Group Publishing, vol. 40(4), pages 311-330, April.

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