scholarly journals Redistributive effects of health care out-of-pocket payments in Cameroon

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Augustin Ntembe ◽  
Regina Tawah ◽  
Elkanah Faux
Keyword(s):  
Health Care ◽  
Low Income ◽  
Health Care Financing ◽  
Household Survey ◽  
Poverty Line ◽  
Goods And Services ◽  
Income Groups ◽  
Out Of Pocket Payments ◽  
Redistributive Effects ◽  
Using Data

Abstract Background The bulk of health care financing in Cameroon is derived from out-of-pocket payments. Given that poverty is pervasive, with a third of the population living below the poverty line, health care financing from out-of-pocket payments is likely to have redistributive and equity effects. In addition, out-of-pocket payments on health care can limit the ability of households to afford non-healthcare goods and services. Method The study estimates the Kakwani index for analyzing tax progressivity and applies the model developed by Aronson, Johnson, and Lambert (1994) to measure the redistributive effects of health care financing using data from the 2014 Cameroon Household Survey. The estimated indexes measure the extent of the progressivity of health care payments and the reranking that results from the payments. Results The results indicate that out-of-pocket payments for health care in Cameroon in 2014 represented a significant share of household prepayment income. The results also show some evidence of inequity as few people change ranks after payment despite the slight progressivity of health care out-of-pocket payments. Conclusion The existence of some disparities among income groups implies that the burdens of ill-health and out-of-pocket payments are unequal. The detected disparities within income groups can be reduced by targeting low-income groups through increases in government expenditures on health care and pro-poor prioritization of the expenditures.

scholarly journals Redistributive Effects of Health Care Out-of-Pocket Payments in Cameroon

2021 ◽  
Author(s):  
Augustin Ntembe Ntembe ◽  
Regina Tawah ◽  
Elkanah Faux
Keyword(s):  
Health Care ◽  
Health Care Financing ◽  
Household Survey ◽  
Poverty Line ◽  
Horizontal Inequity ◽  
Tax Progressivity ◽  
Goods And Services ◽  
Out Of Pocket Payments ◽  
Redistributive Effects ◽  
Redistributive Effect

Abstract Background: The bulk of health care financing in Cameroon is derived from out-of-pocket payments. Given that poverty is pervasive with a third of the population living below the poverty line, health care financing from out-of-pocket payments is likely to have redistributive and equity effects. Out-of-pocket payments on health care limit the ability of households to afford non-healthcare goods and services.Method: The study uses data from the 2014 Cameroon Household Survey to estimate the Kwakwani index for analyzing tax progressivity and the model developed by Aronson, Johnson, and Lambert (1994) to measure the redistributive effect of out-of-pocket payments for health care. The estimated indexes measure the extent of the progressivity of health care payments and the reranking that results from the payments.Results: The results indicate that out-of-pocket payments for health care in Cameroon in 2014 represented a significant share of household prepayment income. The estimates also show that the redistributive effect is positive implying that health care payments are weakly progressive and will weakly enhance equity and post-payment reranking is low. Conclusion: The study concludes that out-of-pocket payments on health care in Cameroon are progressive (income redistributive effect = 0.00144). A positive redistributive effect suggests that out-of-pocket payments on health care exert an equalizing effect on the distribution of post-payment incomes. However, the existence of some horizontal inequity and re-ranking implying that people in the same income band are treated unequally depending on the burden of ill-health.

Analysis of the Effect of Private Healthcare Financing on Poverty in Nigeria: Evidence from Edo State

2021 ◽  
Vol 8 (2) ◽  
pp. 73-80
Author(s):  
Olaniyi O ◽  
Abubakar Idris
Keyword(s):  
Health Care ◽  
Low Income ◽  
Health Care Financing ◽  
Well Being ◽  
Survey Method ◽  
Income Poverty ◽  
Private Health Care ◽  
Healthcare Financing ◽  
Out Of Pocket Payments ◽  
Edo State

Poverty is one of the problems that challenge economies in Africa. Though it is a complex phenomenon which requires efforts by different experts to reduce or eliminate, conventional wisdom posits that “health is wealth”. Health status is a component of human capital development which plays a fundamental role in the poverty and well-being of individuals and national economies. Paradoxically the cost of accessing quality healthcare is an important contributor to income poverty among low income households. Thus adequate healthcare financing mechanisms (public and private) are required to attain quality health outcomes. This study therefore investigates the adequacy or otherwise of the current means of private health care financing in Edo state of Nigeria and it employed the survey method and multinomial logistic regression technique. Results revealed that the dominant means of private health care financing in Edo state is “out of pocket” payments which has negative effect on the income of households. It therefore recommends the introduction of a more effective collective healthcare financing mechanism to mitigate the financial burden associated with out-of-pocket spending. Also funding should be provided for research and development of locally manufactured drugs with high local content to enhance the availability and affordability of effective drugs.

scholarly journals Inequity under Equality: Research on the Benefits Equity of Chinese Basic Medical Insurance

2020 ◽  
Author(s):  
Li Diao ◽  
Yiwei Liu
Keyword(s):  
Health Care ◽  
Low Income ◽  
Choice Model ◽  
Empirical Test ◽  
Medical Insurance ◽  
High Income ◽  
Mechanism Analysis ◽  
Basic Medical Insurance ◽  
Income Groups ◽  
Basic Medical

Abstract Background: The pursuit of equity is one of the basic principles behind the strengthening of health care reform. China's new rural cooperative medical insurance (NRCMI) and urban residents' basic medical insurance (URBMI) are both “equalized” in terms of fundraising and reimbursement. This paper studies the benefits equity under this "equalized" system.Methods: The data analysed in this paper are from the China Family Panel Studies (CFPS) from 2014 to 2016, implemented by the Institute of Social Science Survey at Peking University. A two-part model and a binary choice model are used in the empirical test.Results: The empirical test revealed that high-income people benefit more from basic medical insurance than low-income people. Mechanism analysis demonstrated that high-income people have higher medical insurance applicability and can utilize better health care. Since low-income people are unhealthier, inequity in benefits exacerbates health inequity. We also found that the benefits equity of URBMI is better than that of NRCMI.Conclusions: The government needs to pay more attention to the issue of medical insurance inequity. We should consider allowing different income groups to pay different premiums according to their medical expenses or applying different reimbursement policies for different income groups.

scholarly journals Nonlinear Dynamics in the Finance-Inequality Nexus in China-CHNS Data

2019 ◽  
Vol 11 (1) ◽  
pp. 191 ◽  
Author(s):  
Mohammad Masudur Rahman ◽  
Guan Fuquan ◽  
Laila Arjuman Ara
Keyword(s):  
Financial Development ◽  
Low Income ◽  
Income Group ◽  
High Income Group ◽  
Middle Income ◽  
Linear Effect ◽  
Quantile Regression Model ◽  
Income Groups ◽  
Using Data ◽  
The Impact

This paper empirically investigates the effects of financial development on incomes of Chinese residents particularly within various income groups using data from six provinces by applying the Quantile Regression model. The Greenwood and Jovanovich hypothesis that illustrates the inverted U shaped relationship between financial development and income inequality is tested. This empirical study demonstrates that financial development has a positive but non-linear effect on the annual income of individuals from various income groups at different quantiles. The effect is an inverted U or Kuznets effect indicating an increase at first and then a drop. As for the distribution of the impact on various income groups, the low-income group is under the most dominant influence followed by the high-income group with the middle-income groups receiving relatively smaller influence. Findings indicate that promoting balanced financial development would help to ease the income gap between Chinese residents.

Implementation and evaluation of primary health care financing strategies for low-income communities of Rio De Janeiro, Brazil

1987 ◽  
Vol 21 (2) ◽  
pp. 93-103 ◽  
Author(s):  
Karen Johnson Lassner ◽  
Beatriz B. Collere Hanff ◽  
Glaucia Maria Bon ◽  
Luiz Claudio De Souza Benguigui ◽  
Barnett R. Parker ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Low Income ◽  
Rio De Janeiro ◽  
Health Care Financing ◽  
Primary Health

Designing primary health care financing strategies for low-income communities of Rio De Janeiro: A heuristic solution

1987 ◽  
Vol 21 (2) ◽  
pp. 79-91 ◽  
Author(s):  
Barnett R. Parker ◽  
Karen Johnson Lassner ◽  
Magda Soares Smarzaro ◽  
Carlos Augusto Barros Riberro
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Low Income ◽  
Rio De Janeiro ◽  
Health Care Financing ◽  
Heuristic Solution ◽  
Primary Health

scholarly journals Inequity under Equality: Research on the Benefits Equity of Chinese Basic Medical Insurance

2020 ◽  
Author(s):  
Li Diao ◽  
Yiwei Liu
Keyword(s):  
Health Care ◽  
Low Income ◽  
Choice Model ◽  
Empirical Test ◽  
Medical Insurance ◽  
High Income ◽  
Mechanism Analysis ◽  
Basic Medical Insurance ◽  
Income Groups ◽  
Basic Medical

Abstract Background: The pursuit of equity is one of the basic principles behind the strengthening of health care reform. China's new rural cooperative medical insurance (NRCMI) and urban residents' basic medical insurance (URBMI) are both “equalized” in terms of fundraising and reimbursement. This paper studies the benefits equity under this "equalized" system.Methods: The data analysed in this paper are from the China Family Panel Studies (CFPS) from 2014 to 2016, implemented by the Institute of Social Science Survey at Peking University. A two-part model and a binary choice model are used in the empirical test.Results: The empirical test revealed that high-income people benefit more from basic medical insurance than low-income people. Mechanism analysis demonstrated that high-income people have higher medical insurance applicability and can utilize better health care. Since low-income people are unhealthier, inequity in benefits exacerbates health inequity. We also found that the benefits equity of URBMI is better than that of NRCMI.Conclusions: The government needs to pay more attention to the issue of medical insurance inequity. We should consider allowing different income groups to pay different premiums according to their medical expenses or applying different reimbursement policies for different income groups.

scholarly journals What has been the progress in addressing financial risk in Uganda?  Analysis of catastrophe and impoverishment due to health payments

2020 ◽  
Author(s):  
Brendan Kwesiga ◽  
Tom Aliti ◽  
Pamela Nabukhonzo ◽  
Susan Najjuko ◽  
Peter Byawaka ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Financial Risk ◽  
Poverty Line ◽  
Financial Risk Protection ◽  
Quality Health Care ◽  
Targeted Interventions ◽  
Out Of Pocket Payments ◽  
Risk Protection ◽  
The Impact

Abstract Background: Monitoring progress towards Universal Health Coverage (UHC) requires an assessment of progress in coverage of health services and protection of households from the impact of direct out-of-pocket payments (i.e. financial risk protection). Although Uganda has expressed aspirations for attaining UHC, out-of-pocket payments remain a major contributor to total health expenditure. This study aims to monitor progress in financial risk protection in Uganda. Methods: This study uses data from the Uganda National Household Surveys for 2005/06, 2009/10, 2012/13 and 2016/17. We measure financial risk protection using catastrophic health care payments and impoverishment indicators. Health care payments are catastrophic if they exceed a set threshold (i.e. 10% and 25%) of the total household consumption expenditure. Health payments are impoverishing if they push the household below the poverty line (the US$1.90/day and Uganda’s national poverty lines). A logistic regression model is used to assess the factors associated with household financial risk.Results: The results show that while progress has been made in reducing financial risk, this progress remains minimal, and there is still a risk of a reversal of this trend. We find that although catastrophic health payments at the 10% threshold decreased from 22.4% in 2005/06 to 13.8% in 2012/13, it increased to 14.2% in 2016/17. The percentage of Ugandans pushed below the national poverty line (US$1.90/day) has decreased from 5.2% in 2005/06 to 2.7% in 2016/17. The distribution of both catastrophic health payments and impoverishment varies across socio-economic status, location and residence. In addition, certain household characteristics (poverty, having a child below 5 years and an adult above 60 years) are more associated with the lack of financial risk protection. Conclusion: There is a need for targeted interventions to reduce OOP payments, especially among those most affected to increase financial risk protection. In the short-term, it is important to ensure that public health services are funded adequately to enable effective coverage with quality health care. In the medium-term, increased reliance on mandatory prepayment will reduce the burden of OOP health spending further.

scholarly journals The temporal evolution of income polarization in Canada’s largest CMAs

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0251430
Author(s):  
Lazar Ilic ◽  
M. Sawada
Keyword(s):  
Low Income ◽  
Spatial Clustering ◽  
High Income ◽  
Fragmented Landscape ◽  
Landscape Mosaic ◽  
Middle Income ◽  
Income Groups ◽  
Income Polarization ◽  
Low Income Groups ◽  
Using Data

Income polarization is a pressing issue which is increasingly discussed by academics and policymakers. The present research examines income polarization in Canada’s eight largest Census Metropolitan Areas (CMAs) using data at the census-tract (CT) level between 1971 and 2016. Generally, there are significant decreasing trends in the middle-income population with simultaneously increasing trends in low-income groups. The high-income groups have been relatively stable with fewer significant increasing population trends. Using conventional mapping and cartograms, patterns of the spatial evolution of income inequality are illustrated. Every CMA examined contains an increasing trend of spatial fragmentation at the patch level within each CMA’s landscape mosaic. The results of a spatial autocorrelation analysis at the sub-patch, CT level, exhibit significant spatial clustering of high-income CTs as one process that dominates the increasingly fragmented landscape mosaic.

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