Equity in the finance of health care: Some international comparisons

Adam Wagstaff*, Eddy van Doorslaer

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

153 Citations (Scopus)


This paper presents the results of a ten-country comparative study of health care financing systems and their progressivity characteristics. It distinguishes between the tax-financed systems of Denmark, Portugal and the U.K., the social insurance systems of France, the Netherlands and Spain, and the predominantly private systems of Switzerland and the U.S. It concludes 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. Out-of-pocket payments are in most countries an especially regressive means of raising health care revenues.

Original languageEnglish
Pages (from-to)361-387
Number of pages27
JournalJournal of Health Economics
Issue number4
Publication statusPublished - Dec 1992


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