Equity in health care financing in Palestine: The value-added of the disaggregate approach

Mohammad Abu-Zaineh (), Awad Mataria, Stéphane Luchini () and Jean-Paul Moatti
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Mohammad Abu-Zaineh: AMSE - Aix-Marseille Sciences Economiques - EHESS - École des hautes études en sciences sociales - AMU - Aix Marseille Université - ECM - École Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique
Stéphane Luchini: CNRS - Centre National de la Recherche Scientifique, AMSE - Aix-Marseille Sciences Economiques - EHESS - École des hautes études en sciences sociales - AMU - Aix Marseille Université - ECM - École Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique
Jean-Paul Moatti: Université de la Méditerranée - Aix-Marseille 2, Epidémiologie et Sciences Sociales Appliquées à l'Innovation Médicale - Université de la Méditerranée - Aix-Marseille 2 - INSERM - Institut National de la Santé et de la Recherche Médicale

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Abstract: This paper analyzes the redistributive effect and progressivity associated with the current health care financing schemes in the Occupied Palestinian Territory, using data from the first Palestinian Household Health Expenditure Survey conducted in 2004. The paper goes beyond the commonly used ''aggregate summary index approach'' to apply a more detailed ''disaggregate approach''. Such an approach is borrowed from the general economic literature on taxation, and examines redistributive and vertical effects over specific parts of the income distribution, using the dominance criterion. In addition, the paper employs a bootstrap method to test for the statistical significance of the inequality measures. While both the aggregate and disaggregate approaches confirm the pro-rich and regressive character of out-of-pocket payments, the aggregate approach does not ascertain the potential progressive feature of any of the available insurance schemes. The disaggregate approach, however, significantly reveals a progressive aspect, for over half of the population, of the government health insurance scheme, and demonstrates that the regressivity of the out-ofpocket payments is most pronounced among the worst-off classes of the population. Recommendations are advanced to improve the performance of the government insurance schemes to enhance its capacity in limiting inequalities in health care financing in the Occupied Palestinian Territory.

Keywords: Progressivity; Bootstrap method; Developing countries; Occupied Palestinian Territory; Redistributive effect; Equity; Health care financing; Health care financing Equity Redistributive effect Progressivity Bootstrap method Developing countries Occupied Palestinian Territory (search for similar items in EconPapers)
Date: 2008-03-07
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Published in Social Science & Medicine, 2008, 66, pp.2308 - 2320. ⟨10.1016/j.socscimed.2008.01.028⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-05575917

DOI: 10.1016/j.socscimed.2008.01.028

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