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Estimating income equity in social health insurance system

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  • Galina Besstremyannaya

    (Center for Economic and Financial Research at New Economic School)

Abstract

TThe paper measures horizontal equity in health care access and utilization in Japan by estimating the coefficients for income groups in a multi-part model which distinguishes between non-users of health care, the users of inpatient and outpatient care. To account for consumer unobservable characteristics, we apply a latent class approach. We address a retransformation problem of logged health care expenditure, using generalized linear models. Our sample is the 2009 data for 4,022 adult consumers (Japan Household Panel Survey). The coefficients for income groups are insignificant both in the binary choice models for inpatient/outpatient health care use, and in the models for health care expenditure. Consumers separate into two latent classes in the generalized linear model for outpatient health care expenditure. Although the results reveal horizontal equity in health care access and utilization in Japan, horizontal inequity remains in health insurance premiums and the prevalence of catastrophic coverage.

Suggested Citation

  • Galina Besstremyannaya, 2012. "Estimating income equity in social health insurance system," Working Papers w0172, Center for Economic and Financial Research (CEFIR).
    • Handle: RePEc:cfr:cefirw:w0172
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    References listed on IDEAS

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    1. Mullahy, John, 1998. "Much ado about two: reconsidering retransformation and the two-part model in health econometrics," Journal of Health Economics, Elsevier, vol. 17(3), pages 247-281, June.
    2. John Mullahy, 1998. "Much Ado About Two: Reconsidering Retransformation and the Two-Part Model in Health Economics," NBER Technical Working Papers 0228, National Bureau of Economic Research, Inc.
    3. Peter Zweifel & Friedrich Breyer, 2012. "The Economics of Social Health Insurance," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 12, Edward Elgar Publishing.
    4. Bera, Anil K & Jarque, Carlos M & Lee, Lung-Fei, 1984. "Testing the Normality Assumption in Limited Dependent Variable Models," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 25(3), pages 563-578, October.
    5. Duan, Naihua, et al, 1984. "Choosing between the Sample-Selection Model and the Multi-part Model," Journal of Business & Economic Statistics, American Statistical Association, vol. 2(3), pages 283-289, July.
    6. Andrew M. Jones (ed.), 2006. "The Elgar Companion to Health Economics," Books, Edward Elgar Publishing, number 3572.
    7. Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1991. "Horizontal equity in the delivery of health care," Journal of Health Economics, Elsevier, vol. 10(2), pages 251-256, July.
    8. Jones, Andrew M. & Wildman, John, 2008. "Health, income and relative deprivation: Evidence from the BHPS," Journal of Health Economics, Elsevier, vol. 27(2), pages 308-324, March.
    9. Deb, Partha & Trivedi, Pravin K, 1997. "Demand for Medical Care by the Elderly: A Finite Mixture Approach," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 12(3), pages 313-336, May-June.
    10. Buntin, Melinda Beeuwkes & Zaslavsky, Alan M., 2004. "Too much ado about two-part models and transformation?: Comparing methods of modeling Medicare expenditures," Journal of Health Economics, Elsevier, vol. 23(3), pages 525-542, May.
    11. Manning, Willard G., 1998. "The logged dependent variable, heteroscedasticity, and the retransformation problem," Journal of Health Economics, Elsevier, vol. 17(3), pages 283-295, June.
    12. Anthony J. Culyer, 2005. "The Dictionary of Health Economics," Books, Edward Elgar Publishing, number 2934.
    13. Blough, David K. & Madden, Carolyn W. & Hornbrook, Mark C., 1999. "Modeling risk using generalized linear models," Journal of Health Economics, Elsevier, vol. 18(2), pages 153-171, April.
    14. Culyer, A. J. & Wagstaff, Adam, 1993. "Equity and equality in health and health care," Journal of Health Economics, Elsevier, vol. 12(4), pages 431-457, December.
    15. Manning, Willard G. & Mullahy, John, 2001. "Estimating log models: to transform or not to transform?," Journal of Health Economics, Elsevier, vol. 20(4), pages 461-494, July.
    16. Hurley, Jeremiah, 2000. "An overview of the normative economics of the health sector," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 2, pages 55-118, Elsevier.
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    Cited by:

    1. Matthias Eckardt & Christian Brettschneider & Hendrik van den Bussche & Hans‐Helmut König & MultiCare Study Group, 2017. "Analysis of Health Care Costs in Elderly Patients with Multiple Chronic Conditions Using a Finite Mixture of Generalized Linear Models," Health Economics, John Wiley & Sons, Ltd., vol. 26(5), pages 582-599, May.
    2. Galina Besstremyannaya, 2014. "Urban inequity in the performance of social health insurance system: evidence from Russian regions," Working Papers w0204, Center for Economic and Financial Research (CEFIR).
    3. Galina Besstremyannaya, 2014. "Urban inequity in the performance of social health insurance system: evidence from Russian regions," Working Papers w0204, New Economic School (NES).

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    More about this item

    Keywords

    health care demand; equity; income elasticity; generalized linear models; latent class; two-part model; four-part model; social health insurance;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • R22 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - Household Analysis - - - Other Demand

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