Abstract: |
In this paper, I examine the role of household income in determining who
bribes and how much they bribe in health care in Peru and Uganda. I find that
rich patients are more likely than other patients to bribe in public health
care: doubling household consumption increases the bribery probability by
0.2-0.4 percentage points in Peru, compared to a bribery rate of 0.8%;
doubling household expenditure in Uganda increases the bribery probability by
1.2 percentage points compared to a bribery rate of 17%. The income elasticity
of the bribe amount cannot be precisely estimated in Peru, but is about 0.37
in Uganda. Bribes in the Ugandan public sector appear to be fees-for-service
extorted from the richer patients amongst those exempted by government policy
from paying the official fees. Bribes in the private sector appear to be
flat-rate fees paid by patients who do not pay official fees. I do not find
evidence that the public health care sector in either Peru or Uganda is able
to price-discriminate less effectively than public institutions with less
competition from the private sector. |