Public spending on health care and the poor

Gupta, Sanjeev; Verhoeven, Marijn; Tiongson, Erwin R.

doi:10.1002/hec.759

Cited by 149 publications

(125 citation statements)

References 16 publications

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“…While the distribution of the subsidy is not pro-poor, the subsidy can still shift the distribution of health care in a pro-poor direction. These hypotheses are consistent with evidence showing that public spending has no significant effect on health of the non-poor but a positive marginal impact on the health of the poor (Bidani and Ravallion 1997;Gupta et al 2003;Wagstaff 2003). The evidence shows that, on average, the better-off typically receive most of the subsidy.…”

Section: Inequalityincreasingsupporting

confidence: 86%

Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings

Doorslaer

O’Donnell²

2011

Health Inequality and Development

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This paper describes approaches to the measurement and explanation of income-related inequality and inequity in health care financing, health care utilization and health and considers the applicability and the feasibility of these methods in low-income countries.Results from a comparative study of 14 Asian countries are used to illustrate the main issues. The structure of health finance in low-income countries, in particular the heavy reliance on out-of-pocket payments, means that the equity issues in finance are quite different from those of concern in high-income countries. Primary concern is not with the distribution of contributions to pre-payment mechanisms but with the deterrent effect of payments on utilization and the distribution of uninsured payment risks. Measurement of inequity in utilization of health care in low-income countries is constrained by the lack of reliable measures of health that can be used to standardize …/ Keywords: health inequality, equity JEL classification: H22, H42, H51 for need. Nonetheless, sufficient is known of the distribution of need in many circumstances in order to make inferences about equity from inequality in health care use. The empirical analyses demonstrate that, in low-income countries, the better-off tend to pay more for health care, both absolutely and in relative terms. But they also consume more health care. Health care is financed is largely according to the benefit principle. Assessing the distributional performance of health systems in low-income settings therefore requires examination of finance and utilization simultaneously. AcknowledgementsThe authors are grateful to the European Commission, INCO-DEV programme for funding the EQUITAP project (ICA4-CT-2001-10015) from which this paper derives and the EQUITAP partners for permission to use illustration material from the joint working papers.

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Section: Inequalityincreasingsupporting

confidence: 86%

Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings

Doorslaer

O’Donnell²

2011

Health Inequality and Development

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“…This is especially important for developing countries as improving the health status of their citizens could substantially ameliorate their economic performance. Moreover, it has been shown that public spending on health care matters more for the poor in general (Gupta et al, 2003). Finally, this paper is innovative as it examines the effects of natural resources on inputs rather than human development outcomes as the latter might reflect factors beyond policymakers' control.…”

Section: Discussionmentioning

confidence: 99%

“…The lower health expenditures in resource-rich countries therefore represent an important missed opportunity to use natural resource wealth to secure long term economic prosperity. Moreover, the importance of public health expenditures goes beyond the mere economic consequences, as it entails wide-ranging social implications and can be crucial in alleviating poverty (Gupta et al, 2003). This paper focuses on inputs rather than health outcomes, as to grasp to what extent governments in resource-rich countries fail to prioritize policies geared towards the poor and human development.…”

Section: Introductionmentioning

confidence: 99%

Extending the concept of the resource curse: Natural resources and public spending on health

Cockx

Francken

2014

Ecological Economics

119

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This paper extends the concept of the resource curse by studying whether and through which transmission channels natural resource wealth affects social spending. Even though the availability of vast natural capital reserves has commonly been linked to the neglect of human development, most of the literature has continued to focus on economic performance. This paper is the first to empirically investigate the link between natural resource wealth and public health expenditures in light of the hypothesis that resource wealth as a source of unearned state income enhances state autonomy and increases volatility, which leads to policies that fail to prioritize human development. Using a large panel dataset of world countries covering the period from 1995 to 2009, we find a robust, significant inverse relationship between natural resource dependence, and even abundance, and public health spending over time. The effect remains significant after controlling for state autonomy, volatility, and other factors.These findings have implications for national authorities as well as the extractive industry. Governments should be made accountable for natural resource wealth and correct taxation could provide additional resources, earmarked for health. The extractive industry could increase their investments in sustainable Corporate Social Responsibility operations, specifically in the health sector.

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“…15 Nor do the two studies cited here. They estimate the distribution of effects under sometimes strong assumptions -discussed in Gupta et al 2003. 19 under-estimation of the beneficial effects of health expenditure , and I have argued that this might explain some of the negative findings in the literature. The identified effect is robust to controls for state-specific rainfall shocks and other state-level variables including education, inequality and media prevalence.…”

Section: Discussionmentioning

confidence: 99%

Spending to save? State health expenditure and infant mortality in India

Bhalotra

2007

Health Economics

110

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in Spending to Save? State Health Expenditure and Infant Mortality in IndiaSonia Bhalotra D I S C U S S I O N P A P E R S E R I E S ABSTRACT Spending to Save? State Health Expenditure and Infant Mortality in India *There are severe inequalities in health in the world, poor health being concentrated amongst poor people in poor countries. Poor countries spend a much smaller share of national income on health expenditure than do richer countries. What potential lies in political or growth processes that raise this share? This depends upon how effective government health spending in developing countries is. Existing research presents little evidence of an impact on childhood mortality. Using specifications similar to those in the existing literature, this paper finds a similar result for India, which is that state health spending saves no lives. However, upon allowing lagged effects, controlling in a flexible way for trended unobservables and restricting the sample to rural households, a significant effect of health expenditure on infant mortality emerges, the long run elasticity being about -0.24. There are striking differences in the impact by social group. Slicing the data by gender, birth-order, religion, maternal and paternal education and maternal age at birth, I find the weakest effects in the most vulnerable groups (with the exception of a large effect for scheduled tribes). JEL Classification:I18, I38, O15, O12

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Public spending on health care and the poor

Cited by 149 publications

References 16 publications

Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings

Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings

Extending the concept of the resource curse: Natural resources and public spending on health

Spending to save? State health expenditure and infant mortality in India

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