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Redistributing to the sick: How should health expenditures be integrated into the tax system?

I study the optimal joint taxation of income and health expenditures in a model in which individuals face idiosyncratic prices for leisure and health. First-best redistribution based on potential wage rates and health status is not feasible. Within a class of quasi-linear schedules, the conditions for an optimal tax/subsidy system depend on the own and cross price compensated elasticities of demand for leisure and health in a way that generalizes the standard results from the optimal linear income tax literature. Numerical simulations are employed to illustrate the sensitivity of tax and subsidy rates to the correlation between health status and wages. In these simulations, the effective marginal income tax rate optimally increases with health expenditures. However, the welfare gain from optimally incorporating health expenditures into the tax system appears to be very limited, compared with the effect of properly designing the income tax itself.

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Paper provided by Georgetown University, Department of Economics in its series Working Papers with number gueconwpa~03-03-16.

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Date of creation: 03 Sep 2003
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Handle: RePEc:geo:guwopa:gueconwpa~03-03-16
Contact details of provider: Postal: Georgetown University Department of Economics Washington, DC 20057-1036
Phone: 202-687-6074
Fax: 202-687-6102
Web page: http://econ.georgetown.edu/
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Order Information: Postal: Roger Lagunoff Professor of Economics Georgetown University Department of Economics Washington, DC 20057-1036
Web: http://econ.georgetown.edu/ Email:


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  1. CREMER, Helmuth & PESTIEAU, Pierre, 1995. "Redistributive Taxation and Social Insurance," CORE Discussion Papers 1995054, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  2. Helmuth Cremer & Jean-Marie Lozachmeur & Pierre Pestieau, 2002. "Social Security, Retirement Age and Optimal Income Taxation," CESifo Working Paper Series 693, CESifo Group Munich.
  3. Gahvari, Firouz, 1994. "In-kind transfers, cash grants and labor supply," Journal of Public Economics, Elsevier, vol. 55(3), pages 495-504, November.
  4. Angus Deaton, 2003. "Health, Inequality, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 41(1), pages 113-158, March.
  5. Feldstein, Martin S, 1973. "The Welfare Loss of Excess Health Insurance," Journal of Political Economy, University of Chicago Press, vol. 81(2), pages 251-80, Part I, M.
  6. Anne Case, 2001. "Health, Income and Economic Development," Working Papers 207, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
  7. Atkinson, A. B. & Stiglitz, J. E., 1976. "The design of tax structure: Direct versus indirect taxation," Journal of Public Economics, Elsevier, vol. 6(1-2), pages 55-75.
  8. Blomqvist, Ake & Horn, Henrik, 1984. "Public health insurance and optimal income taxation," Journal of Public Economics, Elsevier, vol. 24(3), pages 353-371, August.
  9. Mussa, Michael & Rosen, Sherwin, 1978. "Monopoly and product quality," Journal of Economic Theory, Elsevier, vol. 18(2), pages 301-317, August.
  10. Armstrong, Mark, 1996. "Multiproduct Nonlinear Pricing," Econometrica, Econometric Society, vol. 64(1), pages 51-75, January.
  11. PESTIEAU, Pierre, . "Social insurance and redistribution," CORE Discussion Papers RP -1642, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  12. Stiglitz, Joseph E & Boskin, Michael J, 1977. "Some Lessons from the New Public Finance," American Economic Review, American Economic Association, vol. 67(1), pages 295-301, February.
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