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Is tax funding of health care more likely to be regressive than systems based on social insurance in low and middle-income countries?

Aurelio Mejía Mejía ()

Revista Lecturas de Economía, 2013, issue 78, 229-239

Abstract: ABSTRACT: One of the main functions of health care systems is to collect enough revenue to finance health expenditures. This revenue can be obtained through different sources (taxes, social insurance contributions, out-of-pocket payments, donations), each of which has different implications in terms of equity. The equity implications of the different forms of revenue collection are an important component of health systems performance evaluation. The international evidence suggests that tax funded systems seem to be a more progressive health care financing mechanism than systems based on social insurance in low- and middle-income countries. However, progressivity results are sensitive to the choice of ability to pay measures and, therefore, policy makers must be aware of this fact when interpreting results of studies on health care financing. RESUMEN: Una de las funciones principales de los sistemas de salud es recaudar recursos suficientes para financiar el gasto en salud. Estos recursos provienen de diversas fuentes (impuestos, donaciones, contribuciones a la seguridad social, gasto de bolsillo), las cuales pueden tener diferentes implicaciones en términos de equidad, componente clave en la evaluación del desempeño de los sistemas sanitarios. La evidencia internacional sugiere que en los países de ingresos bajos y medios los sistemas que recaudan los ingresos fundamentalmente vía impuestos tienden a ser más progresivos que los sistemas basados en aseguramiento. Sin embargo, este resultado depende de la medida de capacidad de pago elegida y, por lo tanto, los responsables de tomar decisiones deben tener en cuenta este hecho al interpretar los resultados de los estudios sobre la progresividad en el financiamiento de los sistemas de salud.

Keywords: Financiamiento de sistemas de salud; progresividad; equidad (search for similar items in EconPapers)
JEL-codes: I11 I14 (search for similar items in EconPapers)
Date: 2013
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