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Equity of health care financing in Iran

Hajizadeh, Mohammad and Connelly, Luke B. (2009): Equity of health care financing in Iran.

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Abstract

This study presents the rst analyses of the equity of health care financing in Iran. Kakwani Progressivity Indices (KPIs) and concentration indices (CIs) are estimated using ten national household expenditure surveys, which were conducted in Iran from 1995/96 to 2004/05. The indices are used to analyze the progressivity of two sources of health care financing: health insurance premium payments and consumer co-payments (and the sum of these), for Iran as a whole, and for rural and urban areas of Iran, separately. The results suggest that health insurance premium payments became more progressive over the study period; however the KPIs for consumer co-payments suggest that these are still mildly regressive or slightly progressive, depending upon whether household income or expenditure data are used to generate the indices. Interestingly, the Urban Inpatient Insurance Scheme (UIIS), which was introduced by the Iranian government in 2000 to extend insurance to uninsured urban dwellers, appears to have had a regressive impact on health care nancing, which is contrary to expectations. This result sounds a cautionary note about the potential for public programs to crowd out private sector, charitable activity, which was prevalent in Iran prior to the introduction of the UIIS.

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