Who Receives Medical Care?: Income, Implicit Prices, and the Distribution of Medical Services among Pregnant Women in the United States
The distribution of medical services among pregnant married women in the United States in 1980 is very unequal. This distribution is examined to assess the predominant effect of tax, transfer, and insurance schemes on the implicit prices of medical services facing women differing by socioeconomic status, healthiness and race. Estimates of the determinants of the probability of receiving four major prenatal medical services are obtained, controlling both for socioeconomic status and for initial health status, as inferred from estimates of health technology determining birthweight. Results reject the hypotheses that medical services are provided only on the basis of medical need or are allocated in a market in which the implicit price of care is invariant to husband's income. The combined effect of taxes and transfers is found to reduce the implicit price paid for these four medical services by rich compared to poor married women in the United States, and thus to encourage their use by higher income (and education) groups.