 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Pia H Schneider, IHA, Abt Associates Inc. and London School of Hygiene and Tropical Medicine, 4800 Montgomery Lane, Suite 600, Bethesda, MD 20814, 202 332 2941, Pia_Schneider@abtassoc.com
This paper compares for insured and non-insured individuals the impact of health care payments on equity in utilization and financing of care, and on protection of income. The egalitarian equity principle and the minimum standard approach serve as a conceptual framework. The egalitarian equity notion emphasizes horizontal equity, implying equal utilization for equal needs of health care; and progressive financing with an increasing proportion of income going to health care as households’ level of income rises. In a poor environment, the egalitarian equity view may not be enough to protect the poor against the financial implications of using health care. Therefore, the minimum standard concept - in terms of the poverty line - serves as a benchmark to investigate the extent to which health care payments push households into poverty or further into poverty. The methods use household survey data collected by the USAID funded Partnerships for Health Reform (PHR) project to estimate indices for both approaches. Results suggest that insurance through mutual health organization (MHO) provides a means to ensure horizontal equity in utilization of health care while at the same time significantly increase utilization; and to prevent that households are pushed into poverty or further into poverty as a result of their use for health care. Although MHO has significantly decreased members’ payments for an episode of illness, health payments appear to be regressive on income for the insured. Policy implications discuss the MHO expansion to a district level health insurance, to enhance overall equity goals.
Learning Objectives:
Keywords: Equal Access, Poverty
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.