Equity in financing and use of health care in
Anne Mills, John E Ataguba, James Akazili, Jo Borghi, Bertha Garshong, Suzan Makawia, Gemini Mtei, Bronwyn Harris, Jane Macha, Filip Meheus,
The Lancet, 15 May 2012doi:10.1016/S0140-6736(12)60357-2
“…..Universal coverage of health care is now receiving substantial worldwide and national attention, but debate continues on the best mix of financing mechanisms, especially to protect people outside the formal employment sector. Crucial issues are the equity implications of different financing mechanisms, and patterns of service use. We report a whole-system analysis—integrating both public and private sectors—of the equity of health-system financing and service use in
We used primary and secondary data to calculate the progressivity of each health-care financing mechanism, catastrophic spending on health care, and the distribution of health-care benefits. We collected qualitative data to inform interpretation.
Overall health-care financing was progressive in all three countries, as were direct taxes. Indirect taxes were regressive in
Analyses of the equity of financing and service use provide guidance on which financing mechanisms to expand, and especially raise questions over the appropriate financing mechanism for the health care of people outside the formal sector. Physical and financial barriers to service access must be addressed if universal coverage is to become a reality.
Funding European Union and International Development Research Centre…..”
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