Catastrophic and Impoverishing Health Expenditure in Argentina, 1997-2005

FELICIA KNAUL; DANIEL MACEIRA; REBECCA WONG; HECTOR ARREOLA ; URSULA GIEDON; ROBERTO IUNES FONTES; LIV LAFONTAINE NAVARRO; MARÍA DOLORES MONTOYA RIVAS

Financial Health in Latin America. Household Spending and Impoverishment. Volume 1

Global Equity Initiative, Harvard University Press

Lugar: Cambridge; Año: 2012; p. 81 - 108

This paper proposes the use of standardized indicators to measure financially catastrophic and impoverishing spending in the health system in Argentina. From the definition of "financial contribution for health" of the families (Xu et al.) and thresholds and health expenditure as a proportion of income that lead to families below the poverty line (Wagstaff and Van Doorsaler ), indexes were developed to establish how catastrophic is the pocket health payments, capturing the intensity, impact, and its variation with income, which are identified for different levels of poverty and extreme poverty line and measurement criteria. The empirical analysis compares information from the Survey of Household Spending 2005 and 1997. The results show, with exceptions, certain Homogeneity in the values reached between indicators and methodologies, with an incidence of catastrophic spending between 14 and 9.2 on the threshold of 20% being so affected decreasing with income level. Measurements of household location affect relatively urban areas over rural, just as it involves more exposure to those households with older and smaller scale. Comparative static analysis of 1997-2005 highlights a systematic improvement to the most vulnerable groups in terms of income (quintiles behind, rurality, large families and with children), and pro-equity bias in health policy after the crisis culminating in the devaluation in 2001. Both the calculation of indicators for both years as multivariate regression analysis shows that the population covered by health insurance would be more formal exposed to catastrophic costs than not covered population. This argument arouses a question about the interrelationship of consumer lending with its counterpart in the health system, and allows the development of a dynamic game that models the possibility that providers, given their information advantage, induce demand for services based economic capabilities of their patients.