IDEAS home Printed from https://ideas.repec.org/a/bla/worlde/v26y2003i10p1459-1479.html
   My bibliography  Save this article

The Distributional Impact of Health Financing in Europe: A Review

Author

Listed:
  • Diana De Graeve
  • Tom Van Ourti

Abstract

This article summarises, extends and updates previous empirical work on the distributional implications of alternative health care financing arrangements in a selection of European countries and the US. On the one hand, total health care payments are almost proportional to ability to pay in most countries. This is predominantly driven by a high reliance on public financing. On the other hand, private payments – out‐of‐pocket payments as well as private insurance premiums – are highly regressive. More extended reliance on private financing may therefore endanger the equitable nature of financing systems. In addition, private payments put a heavy burden on unfortunate households.

Suggested Citation

  • Diana De Graeve & Tom Van Ourti, 2003. "The Distributional Impact of Health Financing in Europe: A Review," The World Economy, Wiley Blackwell, vol. 26(10), pages 1459-1479, November.
    • Handle: RePEc:bla:worlde:v:26:y:2003:i:10:p:1459-1479
    DOI: 10.1111/j.1467-9701.2003.00582.x
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/j.1467-9701.2003.00582.x
    Download Restriction: no
    File URL: https://libkey.io/10.1111/j.1467-9701.2003.00582.x?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Carine Van De Voorde & Eddy Van Doorslaer & Erik Schokkaert, 2001. "Effects of cost sharing on physician utilization under favourable conditions for supplier‐induced demand," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 457-471, July.
    2. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-277, June.
    3. Klavus, Jan, 2001. "Statistical inference of progressivity dominance: an application to health care financing distributions," Journal of Health Economics, Elsevier, vol. 20(3), pages 363-377, May.
    4. repec:pri:cheawb:case_paxson_economic_status_paper is not listed on IDEAS
    5. Kunst, A.E. & Mackenbach, J.P., 1994. "The size of mortality differences associated with educational level in nine industrialized countries," American Journal of Public Health, American Public Health Association, vol. 84(6), pages 932-937.
    6. Anne Case & Darren Lubotsky & Christina Paxson, 2002. "Economic Status and Health in Childhood: The Origins of the Gradient," American Economic Review, American Economic Association, vol. 92(5), pages 1308-1334, December.
    7. Deaton, Angus S & Paxson, Christina H, 1998. "Aging and Inequality in Income and Health," American Economic Review, American Economic Association, vol. 88(2), pages 248-253, May.
    8. repec:pri:cheawb:case_paxson_economic_status_paper.pdf is not listed on IDEAS
    9. Kakwani, Nanok C, 1977. "Measurement of Tax Progressivity: An International Comparison," Economic Journal, Royal Economic Society, vol. 87(345), pages 71-80, March.
    10. Adam Wagstaff & Eddy van Doorslaer, 2003. "Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993–1998," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 921-933, November.
    11. 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.
    12. 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.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. FLEURBAEY, Marc & SCHOKKAERT, Erik, 2011. "Equity in health and health care," LIDAM Discussion Papers CORE 2011026, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    2. Erik Schokkaert & Carine Van de Voorde, 2005. "Health care reform in Belgium," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 25-39, September.
    3. Erik Schokkaert & Jonas Steel & Carine Van de Voorde, 2017. "Out-of-Pocket Payments and Subjective Unmet Need of Healthcare," Applied Health Economics and Health Policy, Springer, vol. 15(5), pages 545-555, October.
    4. Amedeo Spadaro & Lucia Mangiavacchi & Ignacio Moral-Arce & Marta Adiego-Estella & Angela Blanco-Moreno, 2013. "Evaluating the redistributive impact of public health expenditure using an insurance value approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(5), pages 775-787, October.
    5. Jinkook Lee, 2010. "Data sets on pensions and health: Data collection and sharing for policy design," International Social Security Review, John Wiley & Sons, vol. 63(3‐4), pages 197-222, July.
    6. Isabelle Hirtzlin, 2010. "Attaining the "Health for all" commitment. Which model for health insurance ? Some lessons from the European and USA experiences," Working Papers hal-00942771, HAL.
    7. Rocío García-Díaz & Sandra G Sosa-Rubí & Edson Serván-Mori & Gustavo Nigenda, 2018. "Welfare effects of health insurance in Mexico: The case of Seguro Popular de Salud," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-18, July.
    8. Härpfer, Marco & Cacace, Mirella & Rothgang, Heinz, 2009. "And fairness for all? Wie gerecht ist die Finanzierung im deutschen Gesundheitssystem? Eine Berechnung des Kakwani-Index auf Basis der EVS," Working papers of the ZeS 04/2009, University of Bremen, Centre for Social Policy Research (ZeS).
    9. Panagiotis Petrou, 2015. "An Interrupted Time-Series Analysis to Assess Impact of Introduction of Co-Payment on Emergency Room Visits in Cyprus," Applied Health Economics and Health Policy, Springer, vol. 13(5), pages 515-523, October.
    10. Isabelle Hirtzlin, 2010. "Attaining the "Health for all" commitment. Which model for health insurance ? Some lessons from the European and USA experiences," Université Paris1 Panthéon-Sorbonne (Post-Print and Working Papers) hal-00942771, HAL.
    11. Krůtilová, Veronika & Yaya, Sanni, 2012. "Unexpected impact of changes in out-of-pocket payments for health care on Czech household budgets," Health Policy, Elsevier, vol. 107(2), pages 276-288.
    12. Schmid, Achim & Siemsen, Pascal & Götze, Ralf, 2015. "Keeping an eye on IRIS: Risk and income solidarity in OECD healthcare systems," TranState Working Papers 191, University of Bremen, Collaborative Research Center 597: Transformations of the State.
    13. Kronenberg, Christoph & Barros, Pedro Pita, 2014. "Catastrophic healthcare expenditure – Drivers and protection: The Portuguese case," Health Policy, Elsevier, vol. 115(1), pages 44-51.
    14. Rothgang, Heinz & Cacace, Mirella, 2005. "Fair financing in Germany's public health insurance: income-related contributions or flat premiums," TranState Working Papers 26, University of Bremen, Collaborative Research Center 597: Transformations of the State.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Doyle, Orla & Harmon, Colm P. & Walker, Ian, 2005. "The Impact of Parental Income and Education on the Health of their Children," IZA Discussion Papers 1832, Institute of Labor Economics (IZA).
    2. van Kippersluis, Hans & Van Ourti, Tom & O'Donnell, Owen & van Doorslaer, Eddy, 2009. "Health and income across the life cycle and generations in Europe," Journal of Health Economics, Elsevier, vol. 28(4), pages 818-830, July.
    3. van Kippersluis, Hans & O'Donnell, Owen & van Doorslaer, Eddy & Van Ourti, Tom, 2010. "Socioeconomic differences in health over the life cycle in an Egalitarian country," Social Science & Medicine, Elsevier, vol. 70(3), pages 428-438, February.
    4. Currie, Alison & Shields, Michael A. & Price, Stephen Wheatley, 2007. "The child health/family income gradient: Evidence from England," Journal of Health Economics, Elsevier, vol. 26(2), pages 213-232, March.
    5. Apouey, Bénédicte & Geoffard, Pierre-Yves, 2013. "Family income and child health in the UK," Journal of Health Economics, Elsevier, vol. 32(4), pages 715-727.
    6. Johnson Rucker C., 2012. "Health Dynamics and the Evolution of Health Inequality over the Life Course: The Importance of Neighborhood and Family Background," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 11(3), pages 1-69, January.
    7. Johnston, David W. & Propper, Carol & Shields, Michael A., 2009. "Comparing subjective and objective measures of health: Evidence from hypertension for the income/health gradient," Journal of Health Economics, Elsevier, vol. 28(3), pages 540-552, May.
    8. Currie, Alison & Shields, Michael A. & Wheatley Price, Stephen, 2004. "Is the Child Health / Family Income Gradient Universal? Evidence from England," IZA Discussion Papers 1328, Institute of Labor Economics (IZA).
    9. Eddy van Doorslaer & Owen O'Donnell, 2008. "Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings," WIDER Working Paper Series DP2008-04, World Institute for Development Economic Research (UNU-WIDER).
    10. Frijters, Paul & Haisken-DeNew, John P. & Shields, Michael A., 2005. "The causal effect of income on health: Evidence from German reunification," Journal of Health Economics, Elsevier, vol. 24(5), pages 997-1017, September.
    11. Allison, R. Andrew & Foster, James E., 2004. "Measuring health inequality using qualitative data," Journal of Health Economics, Elsevier, vol. 23(3), pages 505-524, May.
    12. Pascual Saez, Marta & Cantarero Prieto, David, 2013. "Understanding Health Economics: A Review of Efficiency, Equity and Inequalities Studies /Entendiendo la Economía de la Salud: Una revisión de los estudios sobre eficiencia, equidad y desigualdades," Estudios de Economia Aplicada, Estudios de Economia Aplicada, vol. 31, pages 281-302, Septiembr.
    13. Martin Siegel & Karl Mosler, 2014. "Semiparametric Modeling Of Age‐Specific Variations In Income Related Health Inequalities," Health Economics, John Wiley & Sons, Ltd., vol. 23(7), pages 870-878, July.
    14. Titus J Galama & Hans van Kippersluis, 2019. "A Theory of Socio-economic Disparities in Health over the Life Cycle," The Economic Journal, Royal Economic Society, vol. 129(617), pages 338-374.
    15. Cisse, Boubou & Luchini, Stephane & Moatti, Jean Paul, 2007. "Progressivity and horizontal equity in health care finance and delivery: What about Africa?," Health Policy, Elsevier, vol. 80(1), pages 51-68, January.
    16. Sterling Edmonds & Mohammad Hajizadeh, 2019. "Assessing progressivity and catastrophic effect of out-of-pocket payments for healthcare in Canada: 2010–2015," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(7), pages 1001-1011, September.
    17. Doyle, Orla & Harmon, Colm & Walker, Ian, 2007. "The Impact of Parental Income and Education on Child Health : Further Evidence for England," The Warwick Economics Research Paper Series (TWERPS) 788, University of Warwick, Department of Economics.
    18. Van Ourti, Tom, 2003. "Socio-economic inequality in ill-health amongst the elderly: Should one use current or permanent income?," Journal of Health Economics, Elsevier, vol. 22(2), pages 219-241, March.
    19. Nesson, Erik T. & Robinson, Joshua J., 2019. "On the measurement of health and its effect on the measurement of health inequality," Economics & Human Biology, Elsevier, vol. 35(C), pages 207-221.
    20. Peter Zweifel, 2006. "Auftrag und Grenzen der Sozialen Krankenversicherung," Perspektiven der Wirtschaftspolitik, Verein für Socialpolitik, vol. 7(s1), pages 5-26, May.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bla:worlde:v:26:y:2003:i:10:p:1459-1479. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www.blackwellpublishing.com/journal.asp?ref=0378-5920 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.