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Health care reform: Separating insurance from income redistribution

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  • Breyer, Friedrich
  • Haufler, Andreas

Abstract

Most systems of health care financing in EU member states currently include elements of income redistribution. The paper analyzes the effects of shifting income redistribution entirely to the tax system, while confining public health systems to their insurance role. We argue that this reform could create two types of efficiency gains. On the expenditure side, it would allow to offer insured persons an improved menu of choices - for example through co-payment schemes - that would help to reduce the gap between the social costs of health care and the perceived private costs. On the revenue side, social security contributions represent a specific type of wage taxation that may imply a shadow price of public funds above that of the general tax system. --

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Bibliographic Info

Paper provided by University of Konstanz, Department of Economics in its series Discussion Papers, Series 1 with number 296.

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Date of creation: 1999
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Handle: RePEc:zbw:kondp1:296

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  1. Pauly, Mark V, 1974. "Overinsurance and Public Provision of Insurance: The Roles of Moral Hazard and Adverse Selection," The Quarterly Journal of Economics, MIT Press, vol. 88(1), pages 44-62, February.
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  3. CREMER, Helmuth & PESTIEAU, Pierre, 1995. "Redistributive Taxation and Social Insurance," CORE Discussion Papers 1995054, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
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  7. Peter Sørensen, 1994. "From the global income tax to the dual income tax: Recent tax reforms in the Nordic countries," International Tax and Public Finance, Springer, vol. 1(1), pages 57-79, February.
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  10. Sijbren Cnossen, 1999. "Taxing Capital Income in the Nordic Countries: A Model for the European Union?," FinanzArchiv: Public Finance Analysis, Mohr Siebeck, Tübingen, vol. 56(1), pages 18-50, March.
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  12. 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.
  13. Atkinson, A. B. & Stiglitz, J. E., 1976. "The design of tax structure: Direct versus indirect taxation," Journal of Public Economics, Elsevier, vol. 6(1-2), pages 55-75.
  14. Davide Fiaschi, 1996. "Fiscal policies and growth," Working Papers 261, Dipartimento Scienze Economiche, Universita' di Bologna.
  15. Jacob Frenkel & Assaf Razin, 1996. "Fiscal Policies and Growth in the World Economy," MIT Press Books, The MIT Press, edition 3, volume 1, number 0262561042, December.
  16. Jean-Charles Rochet, 1991. "Incentives, Redistribution and Social Insurance," The Geneva Risk and Insurance Review, Palgrave Macmillan, vol. 16(2), pages 143-165, December.
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