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Bribery in Health Care in Peru and Uganda

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Jennifer Hunt

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Abstract

In this paper, I examine the role of household income in determining who bribes and how much they bribe in health care in Peru and Uganda. I find that rich patients are more likely than other patients to bribe in public health care: doubling household consumption increases the bribery probability by 0.2-0.4 percentage points in Peru, compared to a bribery rate of 0.8%; doubling household expenditure in Uganda increases the bribery probability by 1.2 percentage points compared to a bribery rate of 17%. The income elasticity of the bribe amount cannot be precisely estimated in Peru, but is about 0.37 in Uganda. Bribes in the Ugandan public sector appear to be fees-for-service extorted from the richer patients amongst those exempted by government policy from paying the official fees. Bribes in the private sector appear to be flat-rate fees paid by patients who do not pay official fees. I do not find evidence that the public health care sector in either Peru or Uganda is able to price-discriminate less effectively than public institutions with less competition from the private sector.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 13034.

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Date of creation: Apr 2007
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Handle: RePEc:nbr:nberwo:13034

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Find related papers by JEL classification:
H4 - Public Economics - - Publicly Provided Goods
K4 - Law and Economics - - Legal Procedure, the Legal System, and Illegal Behavior
O1 - Economic Development, Technological Change, and Growth - - Economic Development

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  1. Daniel Kaufmann & Shang-Jin Wei, 1999. "Does "Grease Money" Speed Up the Wheels of Commerce?," NBER Working Papers 7093, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
  2. Maureen Lewis, 2006. "Governance and Corruption in Public Health Care Systems," Working Papers 78, Center for Global Development. [Downloadable!]
  3. Benjamin A. Olken, 2005. "Monitoring Corruption: Evidence from a Field Experiment in Indonesia," NBER Working Papers 11753, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  6. Dean Yang, 2005. "Integrity for Hire: An Analysis of a Widespread Program for Combating Customs Corruption," Working Papers 525, Research Seminar in International Economics, University of Michigan. [Downloadable!]
  7. Fisman, Raymond & Gatti, Roberta, 2002. "Decentralization and corruption: evidence across countries," Journal of Public Economics, Elsevier, vol. 83(3), pages 325-345, March. [Downloadable!] (restricted)
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  8. Treisman, Daniel, 2000. "The causes of corruption: a cross-national study," Journal of Public Economics, Elsevier, vol. 76(3), pages 399-457, June. [Downloadable!] (restricted)
  9. Mauro, Paolo, 1995. "Corruption and Growth," The Quarterly Journal of Economics, MIT Press, vol. 110(3), pages 681-712, August. [Downloadable!] (restricted)
  10. Robin Thompson & Ana Xavier, 2002. "Unofficial Payments for Acute State Hospital Care In Kazakhstan. A Model of Physician Behaviour with Price Discrimination and Vertical Service Differentiation," LICOS Discussion Papers 12402, LICOS - Centre for Institutions and Economic Performance, K.U.Leuven. [Downloadable!]
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  11. Deininger, Klaus & Mpuga, Paul, 2005. "Does Greater Accountability Improve the Quality of Public Service Delivery? Evidence from Uganda," World Development, Elsevier, vol. 33(1), pages 171-191, January. [Downloadable!] (restricted)
  12. Shang-Jin Wei, 2000. "How Taxing is Corruption on International Investors?," The Review of Economics and Statistics, MIT Press, vol. 82(1), pages 1-11, February. [Downloadable!] (restricted)
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  13. Di Tella, Rafael & Schargrodsky, Ernesto, 2003. "The Role of Wages and Auditing during a Crackdown on Corruption in the City of Buenos Aires," Journal of Law & Economics, University of Chicago Press, vol. 46(1), pages 269-92, April.
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  15. Olken, Benjamin A., 2006. "Corruption and the costs of redistribution: Micro evidence from Indonesia," Journal of Public Economics, Elsevier, vol. 90(4-5), pages 853-870, May. [Downloadable!] (restricted)
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