Estimating income equity in social health insurance system
AbstractTThe paper measures horizontal equity in health care access and utilization in Japan by estimating the coefficients for income groups in a multi-part model which distinguishes between non-users of health care, the users of inpatient and outpatient care. To account for consumer unobservable characteristics, we apply a latent class approach. We address a retransformation problem of logged health care expenditure, using generalized linear models. Our sample is the 2009 data for 4,022 adult consumers (Japan Household Panel Survey). The coefficients for income groups are insignificant both in the binary choice models for inpatient/outpatient health care use, and in the models for health care expenditure. Consumers separate into two latent classes in the generalized linear model for outpatient health care expenditure. Although the results reveal horizontal equity in health care access and utilization in Japan, horizontal inequity remains in health insurance premiums and the prevalence of catastrophic coverage.
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Bibliographic InfoPaper provided by Center for Economic and Financial Research (CEFIR) in its series Working Papers with number w0172.
Length: 36 pages
Date of creation: Apr 2012
Date of revision:
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More information through EDIRC
health care demand; equity; income elasticity; generalized linear models; latent class; two-part model; four-part model; social health insurance;
Find related papers by JEL classification:
- I10 - Health, Education, and Welfare - - Health - - - General
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
- G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies
- R22 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - Household Analysis - - - Other Demand
This paper has been announced in the following NEP Reports:
- NEP-ALL-2012-04-17 (All new papers)
- NEP-HEA-2012-04-17 (Health Economics)
- NEP-IAS-2012-04-17 (Insurance Economics)
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.:
- Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1991. "Horizontal equity in the delivery of health care," Journal of Health Economics, Elsevier, vol. 10(2), pages 251-256, July.
- Culyer, A. J. & Wagstaff, Adam, 1993. "Equity and equality in health and health care," Journal of Health Economics, Elsevier, vol. 12(4), pages 431-457, December.
- Manning, Willard G., 1998. "The logged dependent variable, heteroscedasticity, and the retransformation problem," Journal of Health Economics, Elsevier, vol. 17(3), pages 283-295, June.
- 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.
- Willard G. Manning & John Mullahy, 1999.
"Estimating Log Models: To Transform or Not to Transform?,"
NBER Technical Working Papers
0246, National Bureau of Economic Research, Inc.
- Manning, Willard G. & Mullahy, John, 2001. "Estimating log models: to transform or not to transform?," Journal of Health Economics, Elsevier, vol. 20(4), pages 461-494, July.
- Blough, David K. & Madden, Carolyn W. & Hornbrook, Mark C., 1999. "Modeling risk using generalized linear models," Journal of Health Economics, Elsevier, vol. 18(2), pages 153-171, April.
- Jones, Andrew M. & Wildman, John, 2008. "Health, income and relative deprivation: Evidence from the BHPS," Journal of Health Economics, Elsevier, vol. 27(2), pages 308-324, March.
- Hurley, Jeremiah, 2000. "An overview of the normative economics of the health sector," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 2, pages 55-118 Elsevier.
- Buntin, Melinda Beeuwkes & Zaslavsky, Alan M., 2004. "Too much ado about two-part models and transformation?: Comparing methods of modeling Medicare expenditures," Journal of Health Economics, Elsevier, vol. 23(3), pages 525-542, May.
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