Equity of health care financing in South Korea: 1990–2016

Background The National Health Insurance in Korea has been in operation for more than 30 years since having achieved universal health coverage in 1989 and has gone through several policy reforms. Despite its achievements, the Korean health insurance has some shortfalls, one of which concerns the fairness of paying for health care. Method Using the population representative Household Income and Expenditure Survey data in Korea, this study examined the yearly changes in the vertical equity of paying for health care between 1990 and 2016 by the source of financing using the Kakwani index, considering health insurance and other related policy reforms in Korea during this period. Results The study results suggest that direct tax was the most progressive mode of health care financing in all years, whereas indirect tax was proportional. The out-of-pocket payments were weakly regressive in all years. The Kakwani index for health insurance contributions was regressive but now is proportional to the ability to pay, whereas the Kakwani index for private health insurance premiums turned from progressive to weakly regressive. The Kakwani index for overall health care financing showed a weak regressivity during the study period. Discussion The overall health care financing in Korea has transformed from a slight regressivity to proportional over time between 1990 and 2016. It is expected that these changes were closely related to the improved equity of health insurance contributions from 1998 to 2008, which was the result of a merger of the health insurance societies and an amendment in the health insurance contribution structure. These results suggest that standardizing insurance managing organizations and financing rules potentially has positive implications for the equity of healthcare financing in a country where the major method of health care financing is social health insurance.

Accessibility-Based Equity of Public Facilities: a Case Study in Xiamen, China

China's rapid economic development has led to inequality in terms of property, education, and health. Equal access to basic public facilities has become a key concern of inclusive development policies. However, previous studies have paid little attention to the effects of different travel modes on the accessibility of basic public facilities. The present research fills this gap. Taking Xiamen city as a case study, it explores the degrees of horizontal and vertical equity by examining the accessibility of various basic public facilities, paying attention to different travel modes and travel times. The results for Xiamen city show that disadvantaged groups experience a greater level of inequity. By taking these aspects into account, one is better equipped to identify areas in the city where access to basic public facilities is in need of substantial improvement.

Examining the Equitability of Public Transit Policies in Montreal, Toronto, and Vancouver

This major research paper (MRP) will provide a comparative analysis of the equity policies within the transportation networks of three major Canadian cities: Montréal, Toronto, and Vancouver. During the course of researching this MRP, it became evident that Vancouver’s TransLink transit system would be a useful model to utilize as the basis of this comparative study, due to its extensive equity policies, and funding of its transit network, in relation to the transportation systems of Toronto and Montréal. In addition, TransLink has implemented these equitable measures without being mandated to do so by the Government of British Columbia. Vancouver’s transit policies employ a number of comprehensive equity measures, which were examined using two theoretical lenses of horizontal and vertical equity, and these were then compared to Montréal’s Société de Transport and the Toronto Transit Commission (TTC). These lenses aid in providing a deeper understanding of the policies employed by these transportation networks; as well as affording a basis for the comparative analysis.

Examining the Equitability of Public Transit Policies in Montreal, Toronto, and Vancouver

This major research paper (MRP) will provide a comparative analysis of the equity policies within the transportation networks of three major Canadian cities: Montréal, Toronto, and Vancouver. During the course of researching this MRP, it became evident that Vancouver’s TransLink transit system would be a useful model to utilize as the basis of this comparative study, due to its extensive equity policies, and funding of its transit network, in relation to the transportation systems of Toronto and Montréal. In addition, TransLink has implemented these equitable measures without being mandated to do so by the Government of British Columbia. Vancouver’s transit policies employ a number of comprehensive equity measures, which were examined using two theoretical lenses of horizontal and vertical equity, and these were then compared to Montréal’s Société de Transport and the Toronto Transit Commission (TTC). These lenses aid in providing a deeper understanding of the policies employed by these transportation networks; as well as affording a basis for the comparative analysis.

Vertical equity in access to health insurance services: An exploration of perceptions and enrolment in the Jirapa Municipality, north-western Ghana

Given concerns about the spiralling cost of health services in low and middle-income countries (LMICs), this study draws on a framework for assessing poverty and access to health services to ascertain progress towards achieving vertical equity in the National Health Insurance Scheme (NHIS) in a rural setting in northern Ghana. Rural-urban disparities in financial access to NHIS services are seldom explored in equity-related studies although there is a knowledge gap of progress and challenges of implementing the scheme’s vertical equity objectives to inform social health protection planning and implementation. A qualitative approach was used to collect and analyse the data. Specifically, in-depth interviews and observation were deployed to explore participants’ lived experiences, the relationship between location, livelihoods and ability to pay for health insurance services. The article found that flat rate contributions for populations in the informal sector of the economy and lack of flexibility and adaptability of timing premium collections to the needs of rural residents make the cost of membership disproportionately higher for them, and this situation contradicts the vertical equity objectives of the NHIS. The study concludes that the current payment regimes serve as important deterrence to poor rural residents enrolling in the scheme. Based on this, we advocate strict adherence and implementation of the scheme’s vertical equity measures through the adoption of the Ghana National Household Register (GNHR) as a tool for ensuring that contributions are based on income, and collection is well-timed

Asas Keadilan Pemungutan Pajak dalam Peraturan Pemerintah No 23 Tahun 2018 Tentang Pajak Penghasilan

In mid-2018, the government issued new regulations in the field of taxation which is expected to be an increadible impact for tax revenues. The rules are set out in the Government Regulation Number 23 Year 2018 regarding Income Tax on Income Effort Received or Provided Taxpayers Who Have Specific Gross Distribution (Government Regulation Number 23 Year 2018). Various responses from the community came after the release of the Government Regulation. One is the aspect of fairness in the taxation of income that seems to be ruled out with the advent of the Government Regulation. The principle of fairness in income tax collection adheres to vertical equity, the higher the income (net) earned or received by the higher taxes that are owed. Vertical Justice not accommodated in the regulation is to make the basis for the calculation of gross turnover tax payable. As a result, taxpayers who have the same gross turnover is considered to have the same economic additional capabilities. Estuary of the principle of vertical equity is a theory that emphasizes the style bear minimum cost of living.

The Optimal Distribution Rule of Federal Funds to States in India: A Suggested Methodology

A federal country like India distributes centrally collected funds through certain distribution rules, framed by the finance commission every five years, which primarily aims at horizontal equity among the states, although the goal of vertical equity has also been accommodated lately. The distribution rules do change, but they are largely governed by population and taxable capacity in a static sense. As a result, this brings some horizontal equity in the stated time frame but misses the root cause of inequity among states. This highlights the importance of the dynamics of growth of per capita income of the states which depends on public capital formation since private investment is complementary to public investment. This also raises the issue of time preference along with the attitude towards inequality aversion on the part of individuals in different states in India, which determines the savings that set the limits to private capital formation. This helps one to estimate the optimal value of public capital in a state which would ensure certain predetermined growth target along with inclusivity. If the finance commission could accommodate in its distribution rule the development gap of each state in terms of actual and optimal public capital as mentioned, the horizontal as well as vertical equity can be pursued in a sustainable manner since this addresses both inequity among and within states over time.