Working Paper: NBER ID: w17069
Authors: Guido Cataife; Charles J. Courtemanche
Abstract: Since Brazil's adoption of universal health care in 1988, the country's health care system has consisted of a mix of private providers and free public providers. We test whether income-based disparities in medical visits and medications remain in Brazil despite universal coverage using a nationally representative sample of over 48,000 households. Additional income is associated with less public sector utilization and more private sector utilization, both using simple correlations and regressions controlling for household characteristics and local area fixed effects. Importantly, the increase in private care use is greater than the drop in public care use. Also, income and unmet medical needs are negatively associated. These results suggest that access limitations remain for low-income households despite the availability of free public care.
Keywords: health care utilization; income disparities; universal health coverage; Brazil
JEL Codes: I01; I12
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| income (E25) | private medical visits (I11) |
| income (E25) | number of private medical visits conditional on participation (I11) |
| income (E25) | public medical visits (I18) |
| income (E25) | overall health care consumption (I11) |
| income (E25) | unmet medical needs due to cost (I13) |