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Need, equity and the NHS: the distribution of health care expenditure 1974-87

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  • Carol Propper
  • Richard Upward

Abstract

It is widely accepted proposition that one of the aims of the UK National Health Service is to allocate health care on the basis of need. However, while there may be considerable consensus over the legitimacy of this goal, there is also considerable debate as to whether the goal has been met. If care is allocated according to need, then the corollary is, after controlling for difference in need, there should be no systematic differences in the amount of care received by persons of different ability to pay. Allocation according to need means that ability to pay should be unimportant. Thus an empirical test of whether the NHS allocates according to need is to examine horizontal equity in the delivery of health care, controlling for differences in need.

Suggested Citation

  • Carol Propper & Richard Upward, 1992. "Need, equity and the NHS: the distribution of health care expenditure 1974-87," Fiscal Studies, Institute for Fiscal Studies, vol. 13(2), pages 1-21, February.
    • Handle: RePEc:ifs:fistud:v:13:y:1992:i:2:p:1-21
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    Cited by:

    1. Eric French & Elaine Kelly & Richard Cookson & Carol Propper & Miqdad Asaria & Rosalind Raine, 2016. "Socio‐Economic Inequalities in Health Care in England," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 371-403, September.
    2. Richard Layte & Anne Nolan, 2015. "Income-related inequity in the use of GP services by children: a comparison of Ireland and Scotland," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(5), pages 489-506, June.
    3. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
    4. Mohammad Hajizadeh & Luke Brian Connelly & James Robert Gerard Butler, 2014. "Health Policy and Equity of Health Care Financing in Australia: 1973–2010," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 60(2), pages 298-322, June.
    5. Layte, Richard & Nolan, Anne, 2013. "Income-Related Inequity in the Use of GP Services: A Comparison of Ireland and Scotland," Papers WP454, Economic and Social Research Institute (ESRI).
    6. Cormac O'Dea & Ian Preston, 2012. "The distributional impact of public spending in the UK," IFS Working Papers W12/06, Institute for Fiscal Studies.
    7. Magnus Lindelow, 2002. "Sometimes More Equal than Others How the choice of welfare indicator can affect the measurement of health inequalities and the incidence of public spending," Economics Series Working Papers WPS/2002-15, University of Oxford, Department of Economics.
    8. Hugh Gravelle, 2003. "Measuring income related inequality in health: standardisation and the partial concentration index," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 803-819, October.

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