title: Evaluating the redistributive impact of public health expenditure using an insurance value approach.
abstract: This article analyses the redistributive impact of public health expenditure in Spain using an insurance value approach to compute individual and household's value of health services non-cash benefit. We model the intensity of use of different health care services using a count data framework on a nationally representative health care survey and then predict probabilities on the 2006 Spanish EU-SILC sample. This allows us to extend disposable income with the expected monetary value of public health services and to compare it with strictly cash income. Since non-cash income due to public health services is associated with health needs, we use needs-adjusted equivalence scales to perform distributional analysis and poverty/inequality comparisons. The results show that public health expenditure in Spain acts progressively on income distribution, and that health in-kind benefits, once considered as part of disposable income, can be extremely effective in reducing poverty and inequality.
authors.affiliation: Department of Applied Economics, University of the Balearic Islands, Cra Valldemossa km 7.5, 07122, Palma de Mallorca, Spain.
authors.forename: Amedeo
authors.initials: A
authors.lastname: Spadaro
authors.forename: Lucia
authors.initials: L
authors.lastname: Mangiavacchi
authors.forename: Ignacio
authors.initials: I
authors.lastname: Moral-Arce
authors.forename: Marta
authors.initials: M
authors.lastname: Adiego-Estella
authors.forename: Angela
authors.initials: A
authors.lastname: Blanco-Moreno
mesh_terms: D005260:Female; D019538:Health Care Surveys; D005102:Health Expenditures / Q000706:statistics & numerical data; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D008297:Male; D017059:Models, Econometric; D011634:Public Health / Q000191:economics*; D012923:Social Class; D013030:Spain