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A Resource-Sensitive Framework for Defining and Measuring Equality of Opportunity in Health

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Abstract

We offer a new framework for defining and measuring disparities in the distribution of health opportunities. These are conceived as inversely related to the cost of a specified bundle of health services of given quality, computed by monetizing all the concrete impediments that must be overcome to get access. In the ex-ante perspective we adopt, what is salient is the distribution of costs across cells, where each cell is defined by a set of characteristics determining access barriers. Differently from the existing health literature, our approach allows to disentangle the opportunities individuals enjoy from the mere utilization of health services, working equally well with monetary as well as real costs of access (formal and effective equality of opportunity), where real costs accounts for socioeconomic conditions. Accordingly, an index for the measurement of equality of health opportunities is proposed and resource-conditional policy suggestions are deducted. In particular, given available resources, the design of egalitarian policies is found to depend on how chances of access and socioeconomic conditions are distributed, as well as on the level of cost borne by the individual occupying the best-off cell.

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  • Antonio Abatemarco & Sergio Beraldo & Francesca Stroffolini, 2016. "A Resource-Sensitive Framework for Defining and Measuring Equality of Opportunity in Health," CSEF Working Papers 437, Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy.
  • Handle: RePEc:sef:csefwp:437
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    1. Paolo Li Donni & Vito Peragine & Giuseppe Pignataro, 2014. "Ex‐Ante And Ex‐Post Measurement Of Equality Of Opportunity In Health: A Normative Decomposition," Health Economics, John Wiley & Sons, Ltd., vol. 23(2), pages 182-198, February.
    2. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
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    4. Frank Cowell & Udo Ebert, 2004. "Complaints and inequality," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 23(1), pages 71-89, August.
    5. Amartya Sen, 2002. "Why health equity?," Health Economics, John Wiley & Sons, Ltd., vol. 11(8), pages 659-666, December.
    6. Culyer, A. J. & Wagstaff, Adam, 1993. "Equity and equality in health and health care," Journal of Health Economics, Elsevier, vol. 12(4), pages 431-457, December.
    7. Fleurbaey, Marc, 1995. "Equality and responsibility," European Economic Review, Elsevier, vol. 39(3-4), pages 683-689, April.
    8. Olsen, Edgar O. & Rogers, Diane Lim, 1991. "The welfare economics of equal access," Journal of Public Economics, Elsevier, vol. 45(1), pages 91-105, June.
    9. Cylus, Jonathan & Papanicolas, Irene, 2015. "An analysis of perceived access to health care in Europe: How universal is universal coverage?," Health Policy, Elsevier, vol. 119(9), pages 1133-1144.
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    More about this item

    Keywords

    Health; Equality of opportunity; Access costs;

    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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