Nothing Special   »   [go: up one dir, main page]
IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v17y2008i12p1379-1392.html
   My bibliography  Save this article

Distributional consequences of the transition from age‐based to income‐based prescription drug coverage in British Columbia, Canada

Author

Listed:
  • Gillian E. Hanley
  • Steve Morgan
  • Jeremiah Hurley
  • Eddy van Doorslaer
Abstract
In May, 2003, British Columbia transitioned from an age‐based public drug program, with public subsidy primarily based on age, to an age‐irrelevant income‐based drug program, in which public subsidy is based primarily on household income. As one of the specific aims of the policy change was to improve fairness by increasing the extent to which payment for drugs is based on ability to pay, we measure the progressivity of pharmaceutical financing before and after the policy change in BC using Kakwani indices. Our results suggest that pharmaceutical financing became less regressive after the policy change. However, this decrease in regressivity arose primarily because high‐income seniors were making greater direct contributions to pharmaceutical financing and not because low‐income households were making smaller direct contributions. Our results also suggest that if the public financing of pharmaceuticals were maintained or increased, a change from age‐based to income‐based eligibility can unambiguously improve equity in finance. As populations in developed countries age, governments will increasingly consider reforms to publicly financed health‐care programs with age‐based eligibility. In assessing policy options, financial equity is likely to be a key consideration. These results suggest that income‐based pharmacare can improve financial equity especially when implemented with a commitment to maintain or increase public funding for prescription drugs. Copyright © 2008 John Wiley & Sons, Ltd.

Suggested Citation

  • Gillian E. Hanley & Steve Morgan & Jeremiah Hurley & Eddy van Doorslaer, 2008. "Distributional consequences of the transition from age‐based to income‐based prescription drug coverage in British Columbia, Canada," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1379-1392, December.
    • Handle: RePEc:wly:hlthec:v:17:y:2008:i:12:p:1379-1392
    DOI: 10.1002/hec.1337
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.1337
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.1337?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Puig-Junoy, Jaume, 2004. "Incentives and pharmaceutical reimbursement reforms in Spain," Health Policy, Elsevier, vol. 67(2), pages 149-165, February.
    2. Kakwani, Nanok C, 1977. "Measurement of Tax Progressivity: An International Comparison," Economic Journal, Royal Economic Society, vol. 87(345), pages 71-80, March.
    3. Wagstaff, Adam & van Doorslaer, Eddy & van der Burg, Hattem & Calonge, Samuel & Christiansen, Terkel & Citoni, Guido & Gerdtham, Ulf-G & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "Equity in the finance of health care: some further international comparisons1," Journal of Health Economics, Elsevier, vol. 18(3), pages 263-290, June.
    4. Aronson, J Richard & Johnson, Paul & Lambert, Peter J, 1994. "Redistributive Effects and Unequal Income Tax Treatment," Economic Journal, Royal Economic Society, vol. 104(423), pages 262-270, March.
    5. Wagstaff, Adam & van Doorslaer, Eddy, 1992. "Equity in the finance of health care: Some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 361-387, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. repec:hal:spmain:info:hdl:2441/3ihldo33ik9ee94procjtfki5f is not listed on IDEAS
    2. Mark Stabile & Sarah Thomson, 2014. "The Changing Role of Government in Financing Health Care: An International Perspective," Journal of Economic Literature, American Economic Association, vol. 52(2), pages 480-518, June.
    3. Hicks, Jeffrey & Simard-Duplain, Gaëlle & Green, David A. & Warburton, William, 2022. "The effect of reducing welfare access on employment, health, and children's long-run outcomes," CLEF Working Paper Series 51, Canadian Labour Economics Forum (CLEF), University of Waterloo.
    4. repec:spo:wpmain:info:hdl:2441/3ihldo33ik9ee94procjtfki5f is not listed on IDEAS
    5. Cunningham, Colleen M. & Hanley, Gillian E. & Morgan, Steve, 2010. "Patterns in the use of benzodiazepines in British Columbia: Examining the impact of increasing research and guideline cautions against long-term use," Health Policy, Elsevier, vol. 97(2-3), pages 122-129, October.
    6. Hanley, Gillian E. & Morgan, Steve & Barer, Morris & Reid, Robert J., 2011. "The redistributive effect of the move from age-based to income-based prescription drug coverage in British Columbia, Canada," Health Policy, Elsevier, vol. 101(2), pages 185-194, July.
    7. Jeremiah Hurley & Emmanuel Guindon, 2008. "Private Health Insurance in Canada," Centre for Health Economics and Policy Analysis Working Paper Series 2008-04, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Gillian E. Hanley & Steve Morgan & Jeremiah Hurley & Eddy van Doorslaer, 2008. "Distributional consequences of the transition from age-based to income-based prescription drug coverage in British Columbia, Canada," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1379-1392.
    2. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & Citoni, Guido & Di Biase, Rita & Gerdtham, Ulf-G. & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "The redistributive effect of health care finance in twelve OECD countries," Journal of Health Economics, Elsevier, vol. 18(3), pages 291-313, June.
    3. Eddy van Doorslaer & Owen O'Donnell, 2008. "Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings," WIDER Working Paper Series DP2008-04, World Institute for Development Economic Research (UNU-WIDER).
    4. O'Donnell, Owen & van Doorslaer, Eddy & Rannan-Eliya, Ravi P. & Somanathan, Aparnaa & Adhikari, Shiva Raj & Akkazieva, Baktygul & Harbianto, Deni & Garg, Charu C. & Hanvoravongchai, Piya & Herrin, Ale, 2008. "Who pays for health care in Asia?," Journal of Health Economics, Elsevier, vol. 27(2), pages 460-475, March.
    5. Adam Wagstaff & Marcel Bilger & Zurab Sajaia & Michael Lokshin, 2011. "Health Equity and Financial Protection : Streamlined Analysis with ADePT Software," World Bank Publications - Books, The World Bank Group, number 2306.
    6. Adam Wagstaff, 2002. "Reflections on and alternatives to WHO's fairness of financial contribution index," Health Economics, John Wiley & Sons, Ltd., vol. 11(2), pages 103-115, March.
    7. Bilger, Marcel, 2008. "Progressivity, horizontal inequality and reranking caused by health system financing: A decomposition analysis for Switzerland," Journal of Health Economics, Elsevier, vol. 27(6), pages 1582-1593, December.
    8. Gemini Mtei & Josephine Borghi & Kara Hanson, 2015. "Predicting Consumption Expenditure for the Analysis of Health Care Financing Equity in Low Income Countries: a Comparison of Approaches," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 124(2), pages 339-355, November.
    9. Wagstaff, Adam & Doorslaer, Eddy van, 2001. "Paying for health care : quantifying fairness, catastrophe, and impoverishment, with applications to Vietnam, 1993-98," Policy Research Working Paper Series 2715, The World Bank.
    10. Mohammad Hajizadeh & Luke Brian Connelly & James Robert Gerard Butler, 2014. "Health Policy and Equity of Health Care Financing in Australia: 1973–2010," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 60(2), pages 298-322, June.
    11. Gerdtham, Ulf-G. & Sundberg, Gun, 1996. "Redistributive Effects of the Swedish Health Care Financing System," SSE/EFI Working Paper Series in Economics and Finance 115, Stockholm School of Economics.
    12. Wagstaff, Adam & van Doorslaer, Eddy & van der Burg, Hattem & Calonge, Samuel & Christiansen, Terkel & Citoni, Guido & Gerdtham, Ulf-G & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "Equity in the finance of health care: some further international comparisons1," Journal of Health Economics, Elsevier, vol. 18(3), pages 263-290, June.
    13. Cinaroglu, Songul, 2024. "Trends in out-of-pocket health expenditure inequality in Turkey under comprehensive health reforms," World Development Perspectives, Elsevier, vol. 34(C).
    14. Adam Wagstaff, 2007. "Health systems in East Asia: what can developing countries learn from Japan and the Asian Tigers?," Health Economics, John Wiley & Sons, Ltd., vol. 16(5), pages 441-456, May.
    15. Gabriel M. Leung & Keith Y. K. Tin & Owen O'Donnell, 2009. "Redistribution or horizontal equity in Hong Kong's mixed public–private health system: a policy conundrum," Health Economics, John Wiley & Sons, Ltd., vol. 18(1), pages 37-54, January.
    16. Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Progressivity, horizontal equity and reranking in health care finance: a decomposition analysis for the Netherlands," Journal of Health Economics, Elsevier, vol. 16(5), pages 499-516, October.
    17. Sterling Edmonds & Mohammad Hajizadeh, 2019. "Assessing progressivity and catastrophic effect of out-of-pocket payments for healthcare in Canada: 2010–2015," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(7), pages 1001-1011, September.
    18. Thierry Debrand & Christine Sorasith, 2010. "Bouclier sanitaire : choisir entre égalité et équité ? Une analyse à partir du modèle ARAMMIS," Working Papers DT32, IRDES institut for research and information in health economics, revised Jun 2010.
    19. Abu-Zaineh, Mohammad & Mataria, Awad & Luchini, Stéphane & Moatti, Jean-Paul, 2008. "Equity in health care financing in Palestine: The value-added of the disaggregate approach," Social Science & Medicine, Elsevier, vol. 66(11), pages 2308-2320, June.
    20. Junyi Zhu, 2014. "Bracket Creep Revisited - with and without r > g: Evidence from Germany," Journal of Income Distribution, Ad libros publications inc., vol. 23(3), pages 106-158, November.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:17:y:2008:i:12:p:1379-1392. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.