Working Paper: NBER ID: w13885
Authors: Sherry A. Glied
Abstract: Inequality in access to health care services, through private purchase, appears to pose policy challenges greater than inequality in other spheres. This paper explores how inequality in access to health care services relates to social welfare. I examine the sources of private demand for health insurance and the ramifications of this demand for health, for patterns for government spending on health care services, and for individual and social well-being. Finally, I evaluate the implications of a health tax as a response to the externalities of health service consumption, and provide a rough measure of the tax in the context of the Canadian publicly-financed health care system.
Keywords: public health insurance; private coverage; health care consumption; externalities
JEL Codes: H23; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| private health insurance purchases (G52) | negative externalities for nonpurchasers (D62) |
| private health insurance purchases (G52) | increased waiting times (J29) |
| private health insurance purchases (G52) | reduced access to public services (I14) |
| higher-income individuals (D31) | consume more health services (I11) |
| consume more health services (I11) | limit availability for lower-income individuals (H53) |
| private health insurance purchases (G52) | increase in aggregate public health expenditures (H51) |
| increase in aggregate public health expenditures (H51) | fiscal externality on the public system (H49) |
| private purchases (H57) | increased demand for public services (H49) |
| private purchases (H57) | inefficiencies in resource allocation (D61) |
| private purchases (H57) | alter public perceptions of adequacy of health care services (I14) |
| alter public perceptions of adequacy of health care services (I14) | increased demand for public spending (H59) |