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Health care and economic well-being: estimating equivalence scales for public health care utilization

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  • Jan Klavus

    (STAKES, National Research and Development Centre for Welfare and Health, Health Services Research Unit, Helsinki, Finland)

Abstract

Inconsistency between the income concept and the needs associated with its use can yield seriously misleading welfare assessments in comparisons concerning different household types. Equivalence scales are typically estimated from expenditure data that make them compatible with welfare adjustments involving cash income. However, if the welfare analysis extends to economic benefits other than cash income, the equivalence scale must be adjusted to account for needs relevant to the particular form of benefit. This paper derives needs-based equivalence scales for public health care utilization. The scales are estimated from the health care utilization data of different services. In addition, redistributional analysis is used to investigate the effects of adopting various income concepts and allowing for health care needs in the equivalence scale. The results clearly reveal the conceptual importance of accounting for health status, household size and age in welfare comparisons concerning non-cash transfers. It is also shown that the redistributive effect of public health care is heavily dependent upon assumptions made about its scope. Copyright © 1999 John Wiley & Sons, Ltd.

Suggested Citation

  • Jan Klavus, 1999. "Health care and economic well-being: estimating equivalence scales for public health care utilization," Health Economics, John Wiley & Sons, Ltd., vol. 8(7), pages 613-625.
  • Handle: RePEc:wly:hlthec:v:8:y:1999:i:7:p:613-625
    DOI: 10.1002/(SICI)1099-1050(199911)8:7<613::AID-HEC480>3.0.CO;2-W
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    References listed on IDEAS

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    1. Klavus, Jan & Hakkinen, Unto, 1996. "Health care and income distribution in Finland," Health Policy, Elsevier, vol. 38(1), pages 31-43, October.
    2. Jones, Andrew & O'Donnell, Owen, 1995. "Equivalence scales and the costs of disability," Journal of Public Economics, Elsevier, vol. 56(2), pages 273-289, February.
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    6. Mullahy, John, 1998. "Much ado about two: reconsidering retransformation and the two-part model in health econometrics," Journal of Health Economics, Elsevier, vol. 17(3), pages 247-281, June.
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    9. Pfahler, Wilhelm, 1987. "Redistributive Effects of Tax Progressivity: Evaluating a General Class of Aggregate Measures," Public Finance = Finances publiques, , vol. 42(1), pages 1-31.
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    Cited by:

    1. Paulus, Alari & Sutherland, Holly & Tsakloglou, Panos, 2009. "The distributional impact of in kind public benefits in European countries," EUROMOD Working Papers EM10/09, EUROMOD at the Institute for Social and Economic Research.
    2. Leibbrandt, Murray & Lilenstein, Kezia & Shenker, Callie & Woolard, Ingrid, 2013. "The influence of social transfers on labour supply: A South African and international review," SALDRU Working Papers 112, Southern Africa Labour and Development Research Unit, University of Cape Town.
    3. Christos Koutsampelas & Panos Tsakloglou, 2012. "The distribution of full income in Greece," University of Cyprus Working Papers in Economics 03-2012, University of Cyprus Department of Economics.
    4. Christos Koutsampelas & Panos Tsakloglou, 2013. "The distribution of full income in Greece," International Journal of Social Economics, Emerald Group Publishing, vol. 40(4), pages 311-330, March.
    5. Alari Paulus & Holly Sutherland & Panos Tsakloglou, 2010. "The distributional impact of in-kind public benefits in European countries," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 29(2), pages 243-266.

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