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Equity of Health Care Financing in Iran: The Effect of Extending Health Insurance to the Uninsured


  • Mohammad Hajizadeh
  • Luke Connelly


This paper examines the progressivity of health insurance premiums and consumer co-payments in Iran by calculating Kakwani Progressivity Indices using data from annual national household surveys between 1995/96 and 2006/07. During this period, the Urban Inpatient Insurance Scheme in 2000 and the Rural Health Insurance Scheme in 2005 extended health insurance coverage in urban and rural areas. Unexpectedly, the results suggest that both of these initiatives had regressive impacts on the distribution of health care financing in Iran, which could be explained by public sector activity having crowded out private sector charitable activity. Although this study does not address changes in the distribution of health care utilization, these results for health care financing suggest the need for caution in the implementation of such programmes in low-income and middle-income countries. If charitable activity already results in the provision of health care to the poor at zero or low prices, public intervention may not improve the progressivity of health care financing.

Suggested Citation

  • Mohammad Hajizadeh & Luke Connelly, 2010. "Equity of Health Care Financing in Iran: The Effect of Extending Health Insurance to the Uninsured," Oxford Development Studies, Taylor & Francis Journals, vol. 38(4), pages 461-476.
  • Handle: RePEc:taf:oxdevs:v:38:y:2010:i:4:p:461-476 DOI: 10.1080/13600818.2010.524697

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    References listed on IDEAS

    1. Sambanis, Nicholas, 1999. "Ethnic partition as a solution to ethnic war - an empirical critique of the theoretical literature," Policy Research Working Paper Series 2208, The World Bank.
    2. Servaas Van Der Berg & Megan Louw, 2004. "Changing Patterns Of South African Income Distribution: Towards Time Series Estimates Of Distribution And Poverty," South African Journal of Economics, Economic Society of South Africa, vol. 72(3), pages 546-572, September.
    3. Ukoha Ukiwo, 2005. "The Study of Ethnicity in Nigeria," Oxford Development Studies, Taylor & Francis Journals, vol. 33(1), pages 7-23.
    4. Maasoumi, Esfandiar, 1986. "The Measurement and Decomposition of Multi-dimensional Inequality," Econometrica, Econometric Society, vol. 54(4), pages 991-997, July.
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    Cited by:

    1. Mohammad Hajizadeh & Luke B. Connelly & James R.G. Butler & Aredshir Khosravi, 2012. "Unmet need and met unneed in health care utilisation in Iran," International Journal of Social Economics, Emerald Group Publishing, vol. 39(6), pages 400-422, May.
    2. Mohammad Hajizadeh & Hong Nghiem, 2011. "Out-of-pocket expenditures for hospital care in Iran: who is at risk of incurring catastrophic payments?," International Journal of Health Economics and Management, Springer, vol. 11(4), pages 267-285, December.

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