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Equity in health care financing in Palestine: The value-added of the disaggregate approach

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  • Abu-Zaineh, Mohammad
  • Mataria, Awad
  • Luchini, Stéphane
  • Moatti, Jean-Paul

Abstract

This paper analyzes the redistributive effect and progressivity associated with the current health care financing schemes in the Occupied Palestinian Territory, using data from the first Palestinian Household Health Expenditure Survey conducted in 2004. The paper goes beyond the commonly used "aggregate summary index approach" to apply a more detailed "disaggregate approach". Such an approach is borrowed from the general economic literature on taxation, and examines redistributive and vertical effects over specific parts of the income distribution, using the dominance criterion. In addition, the paper employs a bootstrap method to test for the statistical significance of the inequality measures. While both the aggregate and disaggregate approaches confirm the pro-rich and regressive character of out-of-pocket payments, the aggregate approach does not ascertain the potential progressive feature of any of the available insurance schemes. The disaggregate approach, however, significantly reveals a progressive aspect, for over half of the population, of the government health insurance scheme, and demonstrates that the regressivity of the out-of-pocket payments is most pronounced among the worst-off classes of the population. Recommendations are advanced to improve the performance of the government insurance schemes to enhance its capacity in limiting inequalities in health care financing in the Occupied Palestinian Territory.

Suggested Citation

  • Abu-Zaineh, Mohammad & Mataria, Awad & Luchini, Stéphane & Moatti, Jean-Paul, 2008. "Equity in health care financing in Palestine: The value-added of the disaggregate approach," Social Science & Medicine, Elsevier, vol. 66(11), pages 2308-2320, June.
  • Handle: RePEc:eee:socmed:v:66:y:2008:i:11:p:2308-2320
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    Citations

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    Cited by:

    1. Alice Sanwald & Engelbert Theurl, 2015. "Out-of-pocket payments in the Austrian healthcare system - a distributional analysis," Working Papers 2015-05, Faculty of Economics and Statistics, University of Innsbruck.
    2. Jean-Paul Moatti & Bruno Ventelou, 2009. "Économie de la santé dans les pays en développement des paradigmes en mutation," Revue économique, Presses de Sciences-Po, vol. 60(2), pages 241-256.
    3. Mohammad Abu-Zaineh & Habiba Romdhane & Bruno Ventelou & Jean-Paul Moatti & Arfa Chokri, 2013. "Appraising financial protection in health: the case of Tunisia," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 73-93, March.
    4. Cavatorta, Elisa & Pieroni, Luca, 2013. "Background risk of food insecurity and insurance behaviour: Evidence from the West Bank," Food Policy, Elsevier, vol. 43(C), pages 278-290.
    5. 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.
    6. Aurelio Mejía, 2013. "Is tax funding of health care more likely to be regressive than systems based on social insurance in low- and middle-income countries?," PUBLICACIONES 015615, GRUPO DE ECONOMÍA DE LA SALUD.
    7. Elisa Cavatorta, 2010. "A competing risk model for health and food insecurity in the West Bank," Birkbeck Working Papers in Economics and Finance 1013, Birkbeck, Department of Economics, Mathematics & Statistics.
    8. Awad Mataria & Firas Raad & Mohammad Abu-Zaineh & Cam Donaldson, 2010. "Catastrophic healthcare payments and impoverishment in the occupied Palestinian territory," Applied Health Economics and Health Policy, Springer, vol. 8(6), pages 393-405, November.
    9. Abu-Zaineh, Mohammad & Mataria, Awad & Luchini, Stéphane & Moatti, Jean-Paul, 2009. "Equity in health care finance in Palestine: The triple effects revealed," Journal of Health Economics, Elsevier, vol. 28(6), pages 1071-1080, December.
    10. Mejía Mejía, Aurelio, 2013. "Is tax funding of health care more likely to be regressive than systems based on social insurance in low and middle-income countries?," REVISTA LECTURAS DE ECONOMÍA, UNIVERSIDAD DE ANTIOQUIA - CIE, issue 78, pages 229-239, March.
    11. Abu-Zaineh, Mohammad & Mataria, Awad & Moatti, Jean-Paul & Ventelou, Bruno, 2011. "Measuring and decomposing socioeconomic inequality in healthcare delivery: A microsimulation approach with application to the Palestinian conflict-affected fragile setting," Social Science & Medicine, Elsevier, vol. 72(2), pages 133-141, January.

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