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Progressivity, horizontal inequality and reranking caused by health system financing: A decomposition analysis for Switzerland

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  • Bilger, Marcel

Abstract

This paper presents an application of the Duclos et al. [Duclos, J.-Y., Jalbert, V., Araar A., 2003. Classical horizontal inequity and reranking: an integrated approach. Research on Economic Inequality 10, 65-100] decomposition to an analysis of the 1998 Swiss health system financing. We see that in addition to measuring horizontal inequality in the classical sense, this decomposition is more efficient and flexible than earlier ones. It is also pointed out that methods involving a nonparametric estimation lead to asymptotically biased vertical and horizontal effects. A procedure to estimate this bias is given. Finally, it is shown that despite a major reform, health system financing is still very regressive and social health insurance is more regressive than direct financing.

Suggested Citation

  • Bilger, Marcel, 2008. "Progressivity, horizontal inequality and reranking caused by health system financing: A decomposition analysis for Switzerland," Journal of Health Economics, Elsevier, vol. 27(6), pages 1582-1593, December.
  • Handle: RePEc:eee:jhecon:v:27:y:2008:i:6:p:1582-1593
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    1. Robert E. Leu & Martin Schellhorn, 2004. "The evolution of income-related health inequalities in Switzerland over time," Diskussionsschriften dp0414, Universitaet Bern, Departement Volkswirtschaft.
    2. Wagstaff, Adam, 2008. "Measuring financial protection in health," Policy Research Working Paper Series 4554, The World Bank.
    3. Robert E. Leu & Martin Schellhorn, 2004. "The evolution of income-related inequalities in health care utilization in Switzerland over time," Diskussionsschriften dp0413, Universitaet Bern, Departement Volkswirtschaft.
    4. van de Ven, Justin & Creedy, John & Lambert, Peter J, 2001. " Close Equals and Calculation of the Vertical, Horizontal and Reranking Effects of Taxation," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 63(3), pages 381-394, July.
    5. Jean-Yves Duclos & Peter J. Lambert, 2000. "A normative and statistical approach to measuring classical horizontal inequity," Canadian Journal of Economics, Canadian Economics Association, vol. 33(1), pages 87-113, February.
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    7. Jean-Yves Duclos, 2000. "Gini Indices and the Redistribution of Income," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 7(2), pages 141-162, March.
    8. Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Progressivity, horizontal equity and reranking in health care finance: a decomposition analysis for the Netherlands," Journal of Health Economics, Elsevier, vol. 16(5), pages 499-516, October.
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    Cited by:

    1. Luca Crivelli & Paola Salari, 2012. "Fiscal federalism and income redistribution through healthcare financing: An empirical analysis for the Swiss cantons," CEPRA working paper 1204, USI Università della Svizzera italiana.
    2. Cavagnero, Eleonora & Bilger, Marcel, 2010. "Equity during an economic crisis: Financing of the Argentine health system," Journal of Health Economics, Elsevier, vol. 29(4), pages 479-488, July.
    3. 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.
    4. Thierry Debrand & Christine Sorasith, 2010. "Bouclier sanitaire : choisir entre égalité et équité ? Une analyse à partir du modèle ARAMMIS," Working Papers DT32, IRDES institut for research and information in health economics, revised Jun 2010.
    5. repec:eee:socmed:v:189:y:2017:i:c:p:1-10 is not listed on IDEAS
    6. Ivica, Urban, 2011. "Duclos-Jalbert-Araar decomposition of redistributive effect: implementation issues," MPRA Paper 28068, University Library of Munich, Germany.
    7. Ivica Urban, 2013. "Implementation Issues in the Duclos–Jalbert–Araar Decomposition of Redistributive Effect," Public Finance Review, , vol. 41(1), pages 121-143, January.
    8. Mototsugu Fukushige & Noriko Ishikawa & Satoko Maekawa, 2012. "A modified Kakwani measure for health inequality," Health Economics Review, Springer, vol. 2(1), pages 1-7, December.

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