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on Health Economics |
| By: | Hendrik Jürges (Schumpeter School of Business and Economics, University of Wuppertal); Sophie-Charlotte Meyer (Schumpeter School of Business and Economics, University of Wuppertal) |
| Abstract: | We investigate sources of educational differences in smoking. Using a large German data set containing retrospective information on the age at smoking onset, we compare age-specific hazard rates of starting smoking between (future) low and high educated individuals. We find that up to 90% of the educational differences in smoking develop before the age of 16, i.e. before compulsory schooling is completed. This education gap persists into adulthood. Further, we examine the role of health-related knowledge (proxied by working in health-related occupations) and find it hardly explains smoking decisions. Our findings suggest that (unobserved) factors determining both the selection into smoking and education are almost exclusively responsible for educational differences in smoking. Only small parts of the education gap seem to be caused by general or health-specific education. The effectiveness of education policy to combat smoking is thus likely limited. |
| Keywords: | education, smoking initiation, health-related knowledge |
| JEL: | I12 J22 J13 |
| Date: | 2017–02 |
| URL: | http://d.repec.org/n?u=RePEc:bwu:schdps:sdp17001&r=hea |
| By: | Olivier Deschenes (University of California, Santa Barbara); Michael Greenstone (University of Chicago); Joseph S. Shapiro (Cowles Foundation, Yale University) |
| Abstract: | The demand for air quality depends on health impacts and defensive investments, but little research assesses the empirical importance of defenses. A rich quasi-experiment suggests that the Nitrogen Oxides (NOx) Budget Program (NBP), a cap-and-trade market, decreased NOx emissions, ambient ozone concentrations, pharmaceutical expenditures, and mortality rates. The annual reductions in pharmaceutical purchases, a key defensive investment, and mortality are valued at about $800 million and $1.1 billion, respectively, suggesting that defenses are over one-third of willingness-to-pay for reductions in NOx emissions. Further, estimates indicate that the NBP’s benefits easily exceed its costs and that NOx reductions have substantial benefits. |
| Keywords: | Health, NOx, Emissions |
| JEL: | H40 I10 Q40 |
| Date: | 2017–03 |
| URL: | http://d.repec.org/n?u=RePEc:cwl:cwldpp:2086&r=hea |
| By: | Cameron, Lisa A. (Monash University); Shah, Manisha (University of California, Los Angeles) |
| Abstract: | This paper evaluates the effectiveness of a widely used sanitation intervention, Community-Led Total Sanitation (CLTS), using a randomized controlled trial. The intervention was implemented at scale across rural East Java in Indonesia. CLTS increases toilet construction, reduces roundworm infestations, and decreases community tolerance of open defecation. Financial constraints faced by poorer households limit their ability to improve sanitation. We also examine the program's scale up process which included local governments taking over implementation of CLTS from professional resource agencies. The results suggest that all of the sanitation and health benefits accrue from villages where resource agencies implemented the program, while local government implementation produced no discernible benefits. |
| Keywords: | impact evaluation, sanitation, scale up, development, health |
| JEL: | O12 I15 |
| Date: | 2017–03 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp10619&r=hea |
| By: | Aytalina Azarova; Darja Irdam; Alexi Gugushvili; Mihaly Fazekas; Gábor Scheiring; Pia Horvat; Denes Stefler; Irina Kolesnikova; Vladimir Popov; Ivan Szelenyi; David Stuckler; Michael Marmot; Michael Murphy; Martin McKee; Martin Bobak; Lawrence King |
| Abstract: | Population-level data suggest that economic disruptions in the early 1990s increased working-age male mortality in post-Soviet countries. This study uses individual-level data, using an indirect estimation method, to test the hypothesis that fast privatisation increased mortality in Russia. |
| JEL: | N0 |
| Date: | 2017–04–11 |
| URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:73617&r=hea |
| By: | Anna E. Afanasyeva (National Research University Higher School of Economics) |
| Abstract: | A series of plague outbreaks that occurred in the Kazakh steppe between 1899 and 1910s, with several thousand people dead, made the region a focus of medical, state and public attention of the period. The epidemics initiated a wide-scale research on the ways of life and conditions of living of the local population, resulting in the largest amount of texts ever written on the Kazakh steppe. The region turned into an arena of cutting-edge medical research performed by the leading bacteriologists of Russia, whose findings played an important role in the development of plague epidemiology worldwide. This paper concentrates on both the scope of the measures undertaken by Russian medical administration to control the disease, and the range of explanatory theories produced by the doctors in their attempts to identify the cause of the recurrent epidemic and provide the means of its eradication. |
| Keywords: | Russian empire, epidemiology, anti-plague campaigns, medical administration, knowledge |
| JEL: | Z |
| Date: | 2017 |
| URL: | http://d.repec.org/n?u=RePEc:hig:wpaper:145/hum/2017&r=hea |
| By: | Pilny, Adam; Wübker, Ansgar; Ziebarth, Nicolas R. |
| Abstract: | To equalize differences in health plan premiums due to differences in risk pools, the German legislature introduced a simple Risk Adjustment Scheme (RAS) based on age, gender and disability status in 1994. In addition, effective 1996, consumers gained the freedom to choose among hundreds of existing health plans, across employers and state-borders. This paper (a) estimates RAS pass-through rates on premiums, financial reserves, and expenditures and assesses the overall impact on market price dispersion. Moreover, it (b) characterizes health plan switchers and their annual and cumulative switching rates over time. Our main findings are based on representative enrollee panel data linked to administrative RAS and health plan data. We show that sickness funds with bad risk pools and high pre-RAS premiums lowered their total premiums by 42 cents per additional euro allocated by the RAS. Consequently, post-RAS, health plan prices converged but not fully. Because switchers are more likely to be white collar, young and healthy, the new consumer choice resulted in more risk segregation and the amount of money redistributed by the RAS increased over time. |
| Keywords: | Employer-based health insurance,free health plan choice,risk adjustment,health plan switching,adverse selection: German sickness funds,SOEP |
| JEL: | D12 H51 I11 I13 I18 |
| Date: | 2017 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:rwirep:682&r=hea |
| By: | Niimi, Yoko |
| Abstract: | This paper examines the implications of providing care to elderly parents for adult children’s retirement plans using micro data from a Japanese survey. We find no significant effect of caregiving on family caregivers’ planned retirement age if we do not take into account caregiving intensity but find a negative and significant effect onretirement plans for intensive caregivers, particularly among women. These findings suggest that relying on family members to provide elderly care can pose a serious challenge to the ongoing efforts of the government to promote the labor supply of women and the elderly to address the shrinkage of the working-age population in Japan. The estimation results suggest that ensuring access to formal care services can help family members reconcile their paid work with caregiving requirements, thereby alleviating the adverse effect of caregiving on their retirement plans. The results also suggest that the financial burden of formal care services could require caregivers to postpone retirement in some cases. |
| Keywords: | Aging, caregiving, elderly care, informal care, Japan, labor supply, long-term care, parental care, retirement, Aging, caregiving, elderly care, informal care, Japan, labor supply, long-term care, parental care, retirement, D10, J14, J26 |
| Date: | 2017–03 |
| URL: | http://d.repec.org/n?u=RePEc:agi:wpaper:00000127&r=hea |
| By: | Heinrich, Nils; Wübker, Ansgar; Wuckel, Christiane |
| Abstract: | Long waiting lines are a common feature and a major concern in many public health care delivery systems. The waiting lines are often characterized as inefficient, because they are a burden to patients without generating any gains for providers. There is an ongoing debate in Germany regarding the preferential treatment given to private health insurance (PHI) holders while statutory health insurance (SHI) holders face continuously increasing waiting times. In order to tackle this problem in the outpatient sector, in 2015 Germany introduced a reform that was aimed at providing SHI holders with appointments within an acceptable time frame. We exploited longitudinal experimental data to examine waiting times for six elective outpatient treatments in Germany and assessed the reform's impact on this issue. We found a sizeable difference in waiting times favoring private patients. For SHI holders, waiting times remained stable over time (27.5 days in 2014; 30.7 days in 2016; ? 3.2 days, p-value = 0.889), while PHI holders experienced a significant improvement (13.5 days in 2014; 7.8 days in 2016; ? 5.7 days, p-value = 0.002). The results indicate that there is an unequal access to elective outpatient treatment depending on the patient's insurance status. Our conclusion is that, the reform did not repair the existing inequalities. The gap has rather widened. |
| Keywords: | Waiting times,outpatient care,Germany,public health insurance,private health insurance |
| JEL: | I10 I11 I18 |
| Date: | 2017 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:rwirep:683&r=hea |
| By: | Deborah Peikes; Grace Anglin; Erin Fries Taylor; Stacy Dale; Ann O'Malley; Arkadipta Ghosh; Kaylyn Swankoski; Lara Converse; Rosalind Keith; Mariel Finucane; Jesse Crosson; Anne Mutti; Thomas Grannemann; Aparajita Zutshi; Randall Brown |
| Abstract: | This article describes the impacts for Medicare fee-for-service beneficiaries’ cost, service use, quality of care, and patient experience of the first three years of the Comprehensive Primary Care (CPC) initiative. |
| Keywords: | Comprehensive Primary Care Initiative, advanced primary care, risk-stratified care management, patient centered medical home, Medicare fee for service, multi-payer, health information technology, propensity score matching |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:70714de1cb3d4620a5957f68dde5ce2e&r=hea |
| By: | Deborah Peikes; Grace Anglin; Erin Fries Taylor; Stacy Dale; Ann O'Malley; Arkadipta Ghosh; Kaylyn Swankoski; Lara Converse; Rosalind Keith; Mariel Finucane; Jesse Crosson; Anne Mutti; Thomas Grannemann; Aparajita Zutshi; Randall Brown |
| Abstract: | This article describes the impacts for Medicare fee-for-service beneficiaries’ cost, service use, quality of care, and patient experience of the first three years of the Comprehensive Primary Care (CPC) initiative. |
| Keywords: | Comprehensive Primary Care Initiative, advanced primary care, risk-stratified care management, patient centered medical home, Medicare fee for service, multi-payer, health information technology, propensity score matching |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:9047e20fb04b4bc99cdf309d8a2db56a&r=hea |
| By: | Ohinata, Asako; Picchio, Matteo |
| Abstract: | We analyse how the financial support for long-term elderly care affects the household’s propensity to save. Using the difference-in-differences estimator, we investigate the 2002 Scottish reform, which introduced free formal personal care for all the Scottish elderly aged 65 and above. We find that the policy reduced the household saving rate by 1:9 percentage points. This amounts to an annual reduction in the flow of saving of £503. Moreover, the estimated effect is heterogeneous across the age of the head of household. The largest effect is observed when the household head is in his/her 40s, with the reduction in the saving rate of 3:5 percentage points or £1; 213 per year. |
| Keywords: | Long-term elderly care,ageing,means tested financial support,saving rate,difference-in-differences |
| JEL: | C21 D14 I18 J14 |
| Date: | 2017 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:glodps:43&r=hea |
| By: | Dhaval Dave; Bo Feng; Michael F. Pesko |
| Abstract: | We use difference-in-differences models and individual-level data from the national and state Youth Risk Behavior Surveillance System (YRBSS) from 1991 to 2015 to examine the effects of e-cigarette Minimum Legal Sale Age (MLSA) laws on youth cigarette smoking, alcohol consumption, and marijuana use. Our results suggest that these laws increased youth smoking participation by 0.7 to 1.4 percentage points, approximately half of which could be attributed to smoking initiation. We find little evidence of higher cigarette smoking persisting beyond the point at which youth age out of the law. Our initial results also show little effect of the law on youth drinking, binge drinking, and marijuana use. Taken together, our findings suggest a possible unintended effect of e-cigarette MLSA laws—rising cigarette use in the short term while youth are restricted from purchasing e-cigarettes. |
| JEL: | D12 I12 I18 |
| Date: | 2017–04 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:23313&r=hea |
| By: | James M. Poterba; Steven F. Venti; David A. Wise |
| Abstract: | Education is strongly related to participation in the Social Security Disability Insurance (DI) program. To explore this relationship, we describe the correlation between education and DI participation, and then explore how four factors related to education – health, wealth, occupation, and employment – feature in this correlation. We label these four factors “pathway” variables. We find that a large component of the relationship between education and DI participation – more than one-third for men, and over two-thirds for women – can be attributed to the correlation of education with health, and of health with DI receipt. We use data from the Health and Retirement Study for the 1992-2012 period to explore the corresponding roles for each of the pathway variables, and also to study how changes over time in these variables, such as the widening gap between the health status of those with high and low educational attainment, have affected DI participation. |
| JEL: | H53 H55 I26 |
| Date: | 2017–04 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:23307&r=hea |
| By: | Amélie Adeline; Eric Delattre (Université de Cergy-Pontoise, THEMA) |
| Abstract: | Income-related health inequalities have gained much attention. Using the Survey of Health, Ageing and Retirement in Europe (SHARE), this paper tests three hypotheses concerning the link between health, income and income inequalities. The Absolute Income Hypothesis states that income has a positive and concave effect on health. The second hypothesis, the strong version of Income Inequality Hypothesis, states that income inequalities affect all members in a society equivalently. The last one is the weak version of Income Inequality Hypothesis which assumes that income inequalities may hurt the health of only the least well off in a society. Results show strong evidence for the three hypotheses on the self-perceived health status, a subjective measure, using a set of income inequalities indexes and robust methods to consider the subjective nature of this health measure. |
| Keywords: | Health inequalities, income inequalities, self-reported health, Europe. |
| JEL: | I14 D31 |
| Date: | 2017 |
| URL: | http://d.repec.org/n?u=RePEc:ema:worpap:2017-01&r=hea |
| By: | Guido Erreygers; Roselinde Kessels; Linkun Chen; Philip Clarke |
| Abstract: | We consider three different types of decomposition analysis: decomposition by health components, decomposition by subgroups, and regression-based decomposition. We show that level-dependent indices perform better than rank-dependent indices. We explore different approaches to decompose or explain socioeconomic inequality of health. The first looks at the contributions of components of health, the second aims to split inequality into between- and within-group inequality, and the third uses regression techniques. Our paper compares the decomposition properties of both rank-dependent and level-dependent indices of socioeconomic inequality of health. As far as decomposition by components and regression-based decomposition is concerned, there are no essential differences between the types of indices. When it comes to decomposition by population subgroups, however, level-dependent indices are clearly superior. The fact that the basic level-dependent index can be decomposed perfectly into a 'within' and a 'between' component, and the extended level-dependent index nearly so, constitutes a strong argument in favour of using these indices alongside, and maybe even instead of, the still dominant rank-dependent indices. |
| Keywords: | Australia, Miscellaneous, Modeling: new developments |
| Date: | 2016–07–04 |
| URL: | http://d.repec.org/n?u=RePEc:ekd:009007:9574&r=hea |
| By: | Allison B. Rosen; Kaushik Ghosh; Emily S. Pape; Marcelo Coca Perraillon; Irina Bondarenko; Kassandra L. Messer; Trivellore Raghunathan; Susan T. Stewart; David M. Cutler |
| Abstract: | As health care financing, organization, and delivery innovations proliferate, the need for comprehensive, detailed data on medical spending has never been more apparent. This study builds on previous work to provide a more comprehensive accounting of medical spending at the individual level than has been done in the past. We account for spending by the entire population: the civilian, non-institutionalized population that is the subject of past studies, as well as high medical spenders, the institutionalized, the incarcerated, and active-duty military personnel. We use within-imputation and other adjustments to build a micro dataset and reconcile survey data based on our estimate of medical spending to the National Health Expenditure Accounts (NHEA). The micro dataset we build can be used for more detailed policy evaluations that more closely reflect true national personal health expenditure at the individual level. |
| JEL: | I1 |
| Date: | 2017–03 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:23290&r=hea |
| By: | Kai Hong; Kacie Dragan; Sherry Glied |
| Abstract: | Prior research suggests that high quality universal pre-kindergarten (UPK) programs can generate lifetime benefits, but the mechanisms generating these effects are not well-understood. In 2014, New York City made all 4-year-old children eligible for high-quality UPK programs that emphasized developmental screening. We examine the effect of this program on the health and healthcare utilization of children enrolled in Medicaid using a difference-in-regression discontinuity design that exploits both the introduction of UPK and the fixed age cut-off for enrollment. The introduction of UPK increased the probability that a child was diagnosed with asthma or with vision problems, received treatment for hearing or vision problems, or received a screening during the prekindergarten year. UPK accelerated the timing of diagnoses of vision problems. We do not find any increases in injuries, infectious diseases, or overall utilization. These effects are not offset by lower screening rates in the kindergarten year, suggesting that one mechanism through which UPK might generate benefits is that it accelerates the rate at which children are identified with conditions that could potentially delay learning and cause behavioral problems. We do not find significant effects of having a child who was eligible for UPK on mothers’ health, fertility, or healthcare utilization. |
| JEL: | I1 I20 I28 J13 |
| Date: | 2017–03 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:23297&r=hea |
| By: | Katharina Böhm (Johannes Gutenberg University Mainz); Claudia Landwehr (Johannes Gutenberg University Mainz) |
| Abstract: | The paper presents two cases of Europeanization in health policy an area that has so far been viewed as hardly affected by European integration. We show that even in the less likely case of coverage decision-making, some traces of Europeanization can be found. This is possible because the Commission has a strong interest in further integration in this field and all other relevant actors have motives to at least engage in cooperation. Our first case deals with the EU’s transparency directive and shows that this has forced member states to establish formal decision-making procedures, but did not result in a harmonization of decision-making processes and institutions, which is why the Commission has fostered cooperation and networking. The second case looks at the Europeanization of health technology assessment, demonstrating how cooperation and policy learning take place and how the Commission has successfully promoted the emergence of a new policy field. |
| Keywords: | Europeanization, policy convergence, health care reimbursement, health technology assessment |
| Date: | 2017 |
| URL: | http://d.repec.org/n?u=RePEc:jgu:wpaper:1707&r=hea |
| By: | Katharina Böhm (Johannes Gutenberg University Mainz); Claudia Landwehr (Johannes Gutenberg University Mainz); Nils Steiner (Johannes Gutenberg University Mainz) |
| Abstract: | In times of increasing cost pressures public health care systems in the OECD countries face the question whether and to which extent new high-tech drugs are to be financed within their public health care systems. Systematic empirical research that tries to explain across-country variation in these coverage decisions is, however, almost non-existent. We analyze an original dataset that contains coverage decisions for 11 controversial drugs in 25 OECD countries via multilevel modeling. Our results indicate that regulations to what extent a pharmaceutical is publicly financed are unrelated to wealth and general expenditure levels for health care, while societal health care systems tend to be more generous. By taking into account that rationing decisions have been (at least partially) delegated to specialized agencies in all of the countries under investigation, we also uncover suggestive evidence that institutional characteristics of the underlying decision processes matter systematically for coverage decisions. |
| Keywords: | Delegation; independent regulatory agencies; health care; priority setting; multilevel analysis |
| Date: | 2017 |
| URL: | http://d.repec.org/n?u=RePEc:jgu:wpaper:1708&r=hea |
| By: | Emily Sama-Miller; Lauren Akers; Andrea Mraz-Esposito; Marykate Zukiewicz; Sarah Avellar; Diane Paulsell; Patricia Del Grosso |
| Keywords: | The Patient Protection and Affordable Care Act, improve outcomes for at-risk pregnant women and mothers and children from birth through age 5, Maternal, Infant, Early Childhood Home Visiting Program (MIECHV), home visiting services |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7fb9d519dbd847a191ad0d3695065732&r=hea |
| By: | Bardey, David; De Donder, Philippe; Mantilla, Cesar |
| Abstract: | We compare two genetic testing regulations, Disclosure Duty (DD) and Consent Law (CL), in an environment where individuals choose to take a genetic test or not. DD forces agents to reveal the test results to their insurers, resulting in a discrimination risk. CL allows agents to withhold that information, generating adverse selection. We complement our model with an experiment. We obtain that a larger fraction of agents test under CL than under DD, and that the proportion of individuals preferring CL to DD is non-monotone in the test cost when adverse selection is set endogenously at its steady state level. |
| Keywords: | Consent Law, Disclosure Duty, Personalised Medicine, Test take up rate, pooling health insurance contracts |
| JEL: | C91 D82 I18 |
| Date: | 2017–03 |
| URL: | http://d.repec.org/n?u=RePEc:tse:wpaper:31557&r=hea |
| By: | Takalani Grace Tshitangano (University of Venda) |
| Abstract: | This paper explored the factors that influence health care workers? implementation of ineffectivetuberculosis control measures at rural public hospitals of Vhembe district, South Africa. A qualitative approach ofan exploratory design was used to collect data from fifty-seven focus group members of maximum variation thatwere purposively selected from a pool of health care workers in each hospital. Necessary approvals were obtained.Ethical principles of research and participants? rights were observed. The study revealed that health care workersin rural hospitals are faced with numerous challenges such as lack tuberculosis control guidelines; inadequatetuberculosis control training; inappropriate designs of buildings; inadequate material resources; inadequate humanresources; inadequate management support; incorrect tuberculosis control attitudes; and inadequate tuberculosiscontrol knowledge. Hospital managers supported by the department of health should craft strategies to deal withthese challenges with an aim of improving health care workers? working conditions. |
| Keywords: | Tuberculosis. Guidelines. Training. Support. Dynamics. Attitudes |
| JEL: | I18 I18 I18 |
| URL: | http://d.repec.org/n?u=RePEc:sek:iacpro:4707108&r=hea |
| By: | Climent Quintana-Domeque (University of Oxford and St Edmund Hall); José Raimundo Carvalho (Universidade Federal do Ceará); Victor Hugo de Oliveira (IPECE) |
| Abstract: | Brazilian health authorities have recommended that pregnant women take meticulous precaution to avoid mosquito bites, and use contraceptive methods to postpone/delay pregnancies. In this article, we present new estimates on the Zika virus prevalence, its correlates and preventive behaviors in the Northeast of Brazil, where the outbreak initiated, using survey data collected between March 30th and June 3rd of 2016. The target population are women aged 15-49 in the capital cities of the nine states of the Northeast region of Brazil. We find that more educated women are less likely to report suffering from Zika (or its symptoms), and more likely to avoid pregnancy in the last 12 months and being informed about the association between Zika and microcephaly. In addition, more educated women are more likely to follow preventive measures against the Zika virus: having used long and light-colored clothes, having used mosquito repellent or insecticides, having used mosquito protective screens or kept windows closed, and having dumped standing water where mosquitoes can breed. |
| Keywords: | Zika virus, education, information, prevention, Survey Data |
| JEL: | I10 J10 |
| Date: | 2017–04 |
| URL: | http://d.repec.org/n?u=RePEc:hka:wpaper:2017-027&r=hea |
| By: | Dauth, Christine (Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany]); Lang, Julia (Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany]) |
| Abstract: | "Demographic change implies an increasing demand for elderly care and a lower labor force potential at the same time. Training unemployed workers in care occupations might mitigate this problem. This study analyzes the effectiveness of subsidized training in elderly care professions for the unemployed in Germany over 12 years. We find that subsidized further training and retraining in elderly care improves the employment chances of unemployed workers substantially in the long term. Moreover, a high share of these re-employed workers remain in the care sector. A high percentage of parttime work and conditional wage gains for only certain retraining participants indicate shortcomings in the quality of employment. However, subsidized training seems to be an adequate measure to re-employ unemployed workers in the elderly care sector and to narrow the gap between demand and supply in elderly care." (Author's abstract, IAB-Doku) ((en)) |
| Keywords: | Arbeitslose, berufliche Reintegration, arbeitsmarktpolitische Maßnahme, Weiterbildung, Altenpflege, Arbeitsmarktchancen, Integrierte Erwerbsbiografien |
| JEL: | I11 J24 J68 |
| URL: | http://d.repec.org/n?u=RePEc:iab:iabdpa:201713&r=hea |
| By: | Paddy Carter; Alex Cobham |
| Abstract: | The global framework for financing development, adopted in 2015, places great emphasis on mobilizing domestic resources to finance the Sustainable Development Goals, which include universal healthcare. In a recent paper Reeves et al. (2015) attribute progress towards universal healthcare to higher levels of taxation, but report a negative association between taxes on goods and services (indirect taxes) and health outcomes, which they hypothesise arises from the impact such taxes have on the real incomes of the poor. This paper revisits the relationship between tax types and health outcomes using the ICTD Government Revenue Dataset, which, crucially, isolates taxes from resource industries. As expected, we confirm increases in revenue are associated with increased public health expenditure; we find some weak evidence that greater reliance on direct taxes is associated with higher health spending and better outcomes, but no evidence that indirect taxes are deleterious to health. We argue these relationships cannot bear the weight of causal interpretation but that they offer some guidance on what to expect from increased domestic revenue mobilization. |
| Date: | 2016 |
| URL: | http://d.repec.org/n?u=RePEc:unu:wpaper:wp2016-171&r=hea |
| By: | Richard Moussa; Eric Delattre (Université de Cergy-Pontoise, THEMA) |
| Keywords: | Causality; Markov chain; Kullback Information; Health; Employment |
| JEL: | C14 C25 D31 I10 J20 |
| Date: | 2017 |
| URL: | http://d.repec.org/n?u=RePEc:ema:worpap:2017-07&r=hea |