Working Paper: NBER ID: w13034
Authors: Jennifer Hunt
Abstract: In this paper, I examine the role of household income in determining who bribes and how much they bribe in health care in Peru and Uganda. I find that rich patients are more likely than other patients to bribe in public health care: doubling household consumption increases the bribery probability by 0.2-0.4 percentage points in Peru, compared to a bribery rate of 0.8%; doubling household expenditure in Uganda increases the bribery probability by 1.2 percentage points compared to a bribery rate of 17%. The income elasticity of the bribe amount cannot be precisely estimated in Peru, but is about 0.37 in Uganda. Bribes in the Ugandan public sector appear to be fees-for-service extorted from the richer patients amongst those exempted by government policy from paying the official fees. Bribes in the private sector appear to be flat-rate fees paid by patients who do not pay official fees. I do not find evidence that the public health care sector in either Peru or Uganda is able to price-discriminate less effectively than public institutions with less competition from the private sector.
Keywords: bribery; health care; Peru; Uganda; household income
JEL Codes: H4; K4; O1
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Increase in household income (D19) | Increase in bribe amount in Uganda (H57) |
| Public health care sector pricing (H51) | Bribery (H57) |
| Increased household expenditure in Uganda (D12) | Higher probability of bribery (H57) |
| Doubling household expenditure in Uganda (D19) | Higher probability of bribery (H57) |
| Increased household consumption in Peru (D10) | Higher probability of bribery (H57) |
| Doubling household consumption in Peru (D10) | Higher probability of bribery (H57) |