Adam Wagstaff

TL;DR: This paper compares two indices of horizontal inequity in the delivery of health care, the index proposed by Wagstaff, van Doorslaer, and Paci (1991), and another index derived in this paper, containing an empirical illustration of both sets of methods using data from the 1992 Dutch Health Interview Survey.

TL;DR: The proportion of the population that is supposed to be covered by health insurance schemes or by national or subnational health services is a poor indicator of financial protection and what is required is increasing the share of total health expenditure that is prepaid, particularly through taxes and mandatory contributions.

TL;DR: It is concluded that tax-financed systems tend to be proportional or mildly progressive, that social insurance systems are regressive and that private systems are even more regressive.

TL;DR: It is found that the incomes of urban households are more vulnerable to health shocks than rural households, that health shocks may precipitate increases in unearned income that partially offset reductions in earned income and large increases in medical spending even among insured households.

TL;DR: The research on the pre-2003 system suggests that while the recently announced further reforms are a step in the right direction, the hoped-for improvements in China's health system will far more likely occur if the reforms become less timid in certain key areas, namely provider payments and intergovernmental fiscal relations.