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The Progressivity Of Health Care Services In Ghana

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  • Mawuli Gaddah
  • Alistair Munro

    (National Graduate Institute for Policy Studies)

Abstract

This paper examines the incidence of public health subsidies in Ghana using the Ghana Living Standards Survey. Using a combination of (uniform) benefit incidence analysis and a discrete choice model, our results give a clear evidence of progressivity with consistent ordering: postnatal and prenatal services are the most progressive, followed by clinic visits, and then hospital visits. Children health care services are more progressive than adults'. Own price and income elasticities are higher for public health care than private health care and for adults than children. Poorer households are substantially more price responsive than wealthy ones, implying that fee increases for public health care will impact negatively on equity in health care. Simulations based on an estimated nested logit model show the importance of opportunity costs in healthcare decisions and suggest that reforms that focus only on out-pocket expenses will have a limited ability to extend public healthcare to all potential users.

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Bibliographic Info

Paper provided by National Graduate Institute for Policy Studies in its series GRIPS Discussion Papers with number 11-14.

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Length: 39 pages
Date of creation: Nov 2011
Date of revision:
Handle: RePEc:ngi:dpaper:11-14

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References

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  1. Ablo, Emmanuel & Reinikka, Ritva, 1998. "Do budgets really matter? - evidence from public spending on education and health in Uganda," Policy Research Working Paper Series 1926, The World Bank.
  2. van de Walle, Dominique, 1998. "Assessing the welfare impacts of public spending," World Development, Elsevier, vol. 26(3), pages 365-379, March.
  3. Jehu-Appiah, Caroline & Aryeetey, Genevieve & Spaan, Ernst & de Hoop, Thomas & Agyepong, Irene & Baltussen, Rob, 2011. "Equity aspects of the National Health Insurance Scheme in Ghana: Who is enrolling, who is not and why?," Social Science & Medicine, Elsevier, vol. 72(2), pages 157-165, January.
  4. Lavy, V. & Quigley, J.M., 1993. "Willingness to Pay for the Quality and Intensity of Midical Care; Low- Income Households in Ghana," Papers 94, World Bank - Living Standards Measurement.
  5. Ssewanyana, Sarah & Nabyonga, Juliet O. & Kasirye, Ibrahim & Lawson, David, 2004. "Demand for Health Care Services in Uganda: Implications for Poverty Reduction," Research Series 150529, Economic Policy Research Centre (EPRC).
  6. Jorge Martinez-Vazquez, 2001. "The Impact of Budgets on the Poor: Tax and Benefit," International Center for Public Policy Working Paper Series, at AYSPS, GSU paper0110, International Center for Public Policy, Andrew Young School of Policy Studies, Georgia State University.
  7. Aaron, Henry & McGuire, Martin, 1970. "Public Goods and Income Distribution," Econometrica, Econometric Society, vol. 38(6), pages 907-20, November.
  8. repec:lje:journl:v:2:y:2007:i:2:p:27-48 is not listed on IDEAS
  9. Ahmed Nawaz Hakro & Muhammed Akram, 2007. "The Incidence of Government Expenditures on Education and Health: Microeconomic Evidence from Pakistan," Lahore Journal of Economics, Department of Economics, The Lahore School of Economics, vol. 12(2), pages 27-48, Jul-Dec.
  10. Agar Brugiavini & Noemi Pace, 2011. "Extending Health Insurance: Effects of the National Health Insurance Scheme in Ghana," RSCAS Working Papers 2011/27, European University Institute.
  11. Edward Morey & Kathleen Rossmann, 2008. "Calculating, With Income Effects, the Compensating Variation for a State Change," Environmental & Resource Economics, European Association of Environmental and Resource Economists, vol. 39(2), pages 83-90, February.
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Cited by:
  1. Olumuyiwa Adedeji & Huancheng Du & Maxwell Opoku-Afari, 2013. "Inclusive Growth," IMF Working Papers 13/139, International Monetary Fund.

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