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Including Private Health Care Costs in Measuring Nations’ Redistributive Effort

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  • Katherine Baird

    (Division of Politics, Philosophy and Public Affairs, School of Interdisciplinary Arts and Sciences, University of Washington Tacoma.)

Abstract

Because they do not account for the private component of household’s health care expenses, measures of nations’ redistributive effort inconsistently account for the financial burden their health-care system places on different households. We recalculate the effect of government policy on income distribution by adjusting household income not just for taxes and social transfers, but also for private health expenditures. Examining eight LIS datasets, we show the degree of bias in typical measures of post-government income distribution. In Switzerland and the U.S., for instance, post-government poverty rates climb by 3-4 percentage points once households’ private medical expenses are subtracted from income. Future assessments of governments’ redistributive effect should uniformly account for the distributional impact of their health-care financing policies.

Suggested Citation

  • Katherine Baird, 2018. "Including Private Health Care Costs in Measuring Nations’ Redistributive Effort," Journal of Income Distribution, Ad libros publications inc., vol. 26(2), pages 1-21, July.
    • Handle: RePEc:jid:journl:y:2018:v:26:i:2:p:1-21
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    1. Irwin Garfinkel & Lee Rainwater & Timothy M. Smeeding, 2006. "A re-examination of welfare states and inequality in rich nations: How in-kind transfers and indirect taxes change the story," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 25(4), pages 897-919.
    2. Gustafsson, Bjorn & Li, Shi, 2004. "Expenditures on education and health care and poverty in rural China," China Economic Review, Elsevier, vol. 15(3), pages 292-301.
    3. Mariam Camarero & Josep Lluís Carrion‐i‐Silvestre & Cecilio Tamarit, 2015. "The Relationship Between Debt Level And Fiscal Sustainability In Organization For Economic Cooperation And Development Countries," Economic Inquiry, Western Economic Association International, vol. 53(1), pages 129-149, January.
    4. 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.
    5. 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.
    6. Law, Michael R. & Daw, Jamie R. & Cheng, Lucy & Morgan, Steven G., 2013. "Growth in private payments for health care by Canadian households," Health Policy, Elsevier, vol. 110(2), pages 141-146.
    7. Katherine Baird, 2016. "The Incidence of High Medical Expenses by Health Status in Seven Developed Countries," LIS Working papers 670, LIS Cross-National Data Center in Luxembourg.
    8. Sommers, Benjamin D. & Oellerich, Donald, 2013. "The poverty-reducing effect of Medicaid," Journal of Health Economics, Elsevier, vol. 32(5), pages 816-832.
    9. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & Citoni, Guido & Di Biase, Rita & Gerdtham, Ulf-G. & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "The redistributive effect of health care finance in twelve OECD countries," Journal of Health Economics, Elsevier, vol. 18(3), pages 291-313, June.
    10. Baird, Katherine Elizabeth, 2016. "The incidence of high medical expenses by health status in seven developed countries," Health Policy, Elsevier, vol. 120(1), pages 26-34.
    11. Asiskovitch, Sharon, 2010. "Gender and health outcomes: The impact of healthcare systems and their financing on life expectancies of women and men," Social Science & Medicine, Elsevier, vol. 70(6), pages 886-895, March.
    12. Pickett, Kate E. & Wilkinson, Richard G., 2015. "Income inequality and health: A causal review," Social Science & Medicine, Elsevier, vol. 128(C), pages 316-326.
    13. Łuczak, Julita & García-Gómez, Pilar, 2012. "Financial burden of drug expenditures in Poland," Health Policy, Elsevier, vol. 105(2), pages 256-264.
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    More about this item

    Keywords

    Gini; poverty reduction; Reynolds-Smolensky; inequality; international comparison; health care financing;
    All these keywords.

    JEL classification:

    • H20 - Public Economics - - Taxation, Subsidies, and Revenue - - - General
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I32 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Measurement and Analysis of Poverty

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