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Who Pays What for Primary Health Care? Patterns and Determinants of the Fees Paid by Patients in a Mixed Public-Private Financing Model


  • Jackie Cumming

    () (Victoria University of Wellington)

  • Steven Stillman

    () (Motu Economic and Public Policy Research)

  • Michelle Poland

    () (Motu Economic and Public Policy Research)


The New Zealand government introduced a Primary Health Care Strategy (PHCS) in 2001 aimed at improving access to primary health care, improving health, and reducing inequalities in health. The Strategy represented a substantive increase in health funding by government and a move from a targeted to a universal funding model. This paper uses representative national survey data to examine the distribution of fees paid for primary health care by different individuals under the mixed public-private financing model in place prior to the introduction of PHCS. Using multivariate regression analysis, we find that fees do vary, with people who might be expected to have greater needs paying less. However, apart from people with diabetes, there is no direct link between self-reported health status and fees paid. The findings indicate that a mixed public-private financing model can result in a fee structure which recognises differences across different population groups. The findings also provide a baseline against which changes in funding brought about by the PHCS can be evaluated.

Suggested Citation

  • Jackie Cumming & Steven Stillman & Michelle Poland, 2009. "Who Pays What for Primary Health Care? Patterns and Determinants of the Fees Paid by Patients in a Mixed Public-Private Financing Model," Working Papers 09_01, Motu Economic and Public Policy Research.
  • Handle: RePEc:mtu:wpaper:09_01

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    References listed on IDEAS

    1. Jeffrey Richardson & Stuart Peacock & Duncan Mortimer, 2006. "Does an increase in the doctor supply reduce medical fees? An econometric analysis of medical fees across Australia," Applied Economics, Taylor & Francis Journals, vol. 38(3), pages 253-266.
    2. Glenn Jones & Elizabeth Savage & Kees Van Gool, 2008. "The Distribution of Household Health Expenditures in Australia," The Economic Record, The Economic Society of Australia, vol. 84(s1), pages 99-114, September.
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    More about this item


    General Practitioner; Primary Health Care; Doctor Fees; Health User-Charge; New Zealand;

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

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