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Health Care Financing, Efficiency, and Equity

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  • Sherry A. Glied

Abstract

This paper examines the efficiency and equity implications of alternative health care system financing strategies. Using data across the OECD, I find that almost all financing choices are compatible with efficiency in the delivery of health care, and that there has been no consistent and systematic relationship between financing and cost containment. Using data on expenditures and life expectancy by income quintile from the Canadian health care system, I find that universal, publicly-funded health insurance is modestly redistributive. Putting $1 of tax funds into the public health insurance system effectively channels between $0.23 and $0.26 toward the lowest income quintile people, and about $0.50 to the bottom two income quintiles. Finally, a review of the literature across the OECD suggests that the progressivity of financing of the health insurance system has limited implications for overall income inequality, particularly over time.

Suggested Citation

  • Sherry A. Glied, 2008. "Health Care Financing, Efficiency, and Equity," NBER Working Papers 13881, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:13881
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    1. Robert Brown, 1998. "Social Security," North American Actuarial Journal, Taylor & Francis Journals, vol. 2(2), pages 1-23.
    2. Irwin Garfinkel & Lee Rainwater & Timothy M. Smeeding, 2006. "A re-examination of welfare states and inequality in rich nations: How in-kind transfers and indirect taxes change the story," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 25(4), pages 897-919.
    3. Bhattacharya, Jay & Lakdawalla, Darius, 2006. "Does Medicare benefit the poor?," Journal of Public Economics, Elsevier, vol. 90(1-2), pages 277-292, January.
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    Cited by:

    1. Kathleen Cleeren & Lien Lamey & Jan‐Hinrich Meyer & Ko De Ruyter, 2016. "How Business Cycles Affect the Healthcare Sector: A Cross‐country Investigation," Health Economics, John Wiley & Sons, Ltd., vol. 25(7), pages 787-800, July.
    2. White, Joseph, 2013. "Budget-makers and health care systems," Health Policy, Elsevier, vol. 112(3), pages 163-171.
    3. Haizhen Mou, 2012. "The political economy of public health expenditure and wait times in a public‐private mixed health care system," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 45(4), pages 1640-1666, November.

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    More about this item

    JEL classification:

    • H42 - Public Economics - - Publicly Provided Goods - - - Publicly Provided Private Goods
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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