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The financial protection impact of the public health system and private insurance in Brazil

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  • Waters, Hugh R.
  • Bós, Antonio M.

Abstract

This research assesses the effectiveness of the Brazilian public healthsystem and of private insurance in Brazil in providing financial protectionin health care. The determinants of catastrophic health expendituresare estimated by probit regressions with Heckman selection adjustmentcontrolling for health-care need. Findings show that the public systemprovides a significant reduction (47%); in the probability of a householdhaving catastrophic health expenditures, and that private insurancemakes such expenditures more likely by 36%. Recommendations includeimprovements in the quantity, accessibility, quality and reliability of publicproviders, more appropriate provision of drugs by the public system andtighter regulation of private insurance.

Suggested Citation

  • Waters, Hugh R. & Bós, Antonio M., 2008. "The financial protection impact of the public health system and private insurance in Brazil," Revista CEPAL, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL), August.
  • Handle: RePEc:ecr:col070:11313
    Note: Includes bibliography
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    References listed on IDEAS

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    3. Cornwall, Andrea & Shankland, Alex, 2008. "Engaging citizens: Lessons from building Brazil's national health system," Social Science & Medicine, Elsevier, vol. 66(10), pages 2173-2184, May.
    4. repec:idb:brikps:42178 is not listed on IDEAS
    5. Diaz, Maria Dolores M., 2003. "Desigualdades Socioeconômicas na Saúde," Revista Brasileira de Economia - RBE, EPGE Brazilian School of Economics and Finance - FGV EPGE (Brazil), vol. 57(1), January.
    6. Paul Gertler & Jonathan Gruber, 2002. "Insuring Consumption Against Illness," American Economic Review, American Economic Association, vol. 92(1), pages 51-70, March.
    7. Michael P. Murray, 2006. "Avoiding Invalid Instruments and Coping with Weak Instruments," Journal of Economic Perspectives, American Economic Association, vol. 20(4), pages 111-132, Fall.
    8. Hulme, David & Shepherd, Andrew, 2003. "Conceptualizing Chronic Poverty," World Development, Elsevier, vol. 31(3), pages 403-423, March.
    9. Waters, Hugh R., 2000. "Measuring equity in access to health care," Social Science & Medicine, Elsevier, vol. 51(4), pages 599-612, August.
    10. Waters, Hugh R. & Anderson, Gerard F. & Mays, Jim, 2004. "Measuring financial protection in health in the United States," Health Policy, Elsevier, vol. 69(3), pages 339-349, September.
    11. Van de Ven, Wynand P. M. M. & Van Praag, Bernard M. S., 1981. "The demand for deductibles in private health insurance : A probit model with sample selection," Journal of Econometrics, Elsevier, vol. 17(2), pages 229-252, November.
    12. World Bank, 2001. "World Development Report 2000/2001," World Bank Publications - Books, The World Bank Group, number 11856, December.
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