Do healthcare tax credits help poor-health individuals on low incomes?

Novi, Cinzia Di; Marenzi, Anna; Rizzi, Dino

doi:10.1007/s10198-017-0884-8

Cited by 6 publications

(7 citation statements)

References 46 publications

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“…More recently, Eggink et al [23] are following a comparable approach to forecast the use of elderly care in the Netherlands. In addition, Di Novi et al [24] are using a static tax-benefit-model to analyze the distributional effects of tax breaks for outof-pocket payments. The third section presents the results of our stochastic microsimulation model and further data analysis showing the contributing factors.…”

Section: Introductionmentioning

confidence: 99%

Adverse selection in the German Health Insurance System – the case of civil servants

2020

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At the beginning of their career civil servants in Germany can choose between the social health insurance (SHI) system and a private plan combined with a direct reimbursement of the government of up to 70 percent. Most civil servants chose the latter, not only but also because they have to cover all contribution payments in the social system themselves, while normal employees get nearly 50 percent from their employers. The city state of Hamburg decided to change the system by paying a share of the contributions if civil servants choose the social plan. We use a stochastic microsimulation model to analyse which socioeconomic types of civil servants could benefit from the Hamburg plan and if this changes the mix of insured persons in the SHI system. Our results show that low income and high morbidity types as well as families have a substantially higher incentive to choose SHI. This reform might thereby increase the adverse selection of high risk cases towards SHI

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Section: Introductionmentioning

confidence: 99%

Adverse selection in the German Health Insurance System – the case of civil servants

2020

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“…The effectiveness of tax-related expenditures in addressing a taxpayer behavioural change is out of the scope of the study, since this would imply the need for information on elasticities for all countries in the very different contexts of housing ownership choices, health and education spending. Morel et al (2019), Branco and Costa (2018) and Di Novi et al (2018) provide interesting examples of country-specific analysis whose extension in a cross-country perspective is hampered by data availability and left for future research developments.…”

Section: Resultsmentioning

confidence: 99%

“…A favourable tax treatment can indeed provide an incentive to low-income individuals to benefit from medical treatments. Overall, these tax provisions supplement benefits provided by government health programmes (see Branco and Costa, 2018, for the case of Portugal and Di Novi et al, 2018, for Italy) and subsidize the cost of private health insurance (Hinde, 2016), reducing the up-front cost of obtaining good health coverage.…”

Section: The Rationale Of Social Tes In the Context Of Personal Incommentioning

confidence: 99%

“…The increased revenue due to abolishing health-related TEs comes mostly from individuals in the top part of the distribution (see Figure A4 in the online Annex), with individuals in the upper half of the income distribution being relatively more favoured by health-related TEs (see Branco and Costa (2018) for a long-term overview of the different health-related TEs in Portugal and Di Novi et al (2018) for Italy) with the main exception of Ireland, where individuals in the first half of the distribution gain relatively more. Moreover, as expected given the prevalence of health-related expenditures, the elderly tend to be favoured by TEs, particularly in Germany, Italy, Latvia and Portugal (Figure 4).…”

Section: Empirical Evidencementioning

confidence: 99%

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The fiscal and equity impact of social tax expenditures in the EU

Barrios

Moscarola

Figari

et al. 2019

Journal of European Social Policy

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Tax expenditures (TEs) are preferential tax treatments granted to specific individuals or categories of households, with the aim of achieving social and economic goals. They are widely used by EU Member States. However, their fiscal and equity impacts are not always clear and their effectiveness and efficiency as a policy instrument need to be carefully evaluated, especially in the present context of constrained public finances. This article quantifies the fiscal and equity effects of social TEs related to housing, education and health in 28 European countries making use of EUROMOD, the EU-wide microsimulation model. We find a variety of effects, in terms of sign and magnitude, across Member States, and within these, among types of households. Overall, our findings suggest that the impact of TE on tax revenues and on income inequalities can be sizable. The redistributive impact of removing TEs can go in both directions, either on the progressive or regressive side, depending on the country and the TE considered.

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“…We found only one study that had assessed how income based policies would affect health inequalities. 32 Di Novi and colleagues 32 found that healthcare tax credits in Italy increased inequalities in health status, and that the policy could be redesigned to reduce this effect. Similarly, Griffin and colleagues 33 estimated that almost onethird of the health interventions recommended by the National Institute for Health and Care Excellence were likely to increase health inequalities.…”

Section: Discussionmentioning

confidence: 99%

The effect of income-based policies on mortality inequalities in Scotland: a modelling study

Richardson

Fenton

Parkinson

et al. 2020

The Lancet Public Health

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Background The unequal distribution of income is a fundamental determinant of health inequalities. Decision making around economic policies could be enhanced by showing their potential health effects. We used scenario modelling to assess the effects of 12 income-based policies on years of life lost (YLL) and inequalities in YLL in Scotland for the 2017-21 period.Methods In this modelling study, we used EUROMOD version H1.0+, a tax-benefit microsimulation model, to estimate the effects of hypothetical fiscal policies on household income for Scottish households in the 2014/15 Family Resources Survey (n=2871). The effects were modelled excluding housing costs. Income change from baseline was estimated for each quintile of the 2016 Scottish Index of Multiple Deprivation (SIMD) after weighting to account for differential non-response to the Family Resources Survey, and incomes were equivalised according to the Organisation for Economic Co-operation and Development's modified equivalence scale. A regression analysis of cross-sectional data was used to estimate the relationship between income change and all-cause mortality, followed up by a sensitivity analysis to account for uncertainties around the assumptions on effect size. Informing Interventions to reduce health Inequalities (Triple I), a health inequalities scenario modelling tool, was used to estimate policy effects on YLL and government spending after five years of theoretical implementation. The Triple I model used population estimates for 2016 stratified by sex, 5-year age group, and SIMD quintile, which were obtained from the National Records of Scotland. Preliminary estimates of relative policy costs were calculated from the EUROMOD-derived combined effects of each policy on tax bills, National Insurance contributions, and benefits receipts for Scottish households.Findings Taxation-based policies did not substantially affect household incomes, whereas benefits-based policies had large effects across the quintiles. The best policy for improving health and narrowing health inequalities was a 50% increase to means-tested benefits (approximately 105 177 [4•7%] YLL fewer than the baseline of 2•2 million, and a 7•9% reduction in relative index of inequality). Effects on YLL and health inequalities were inversely correlated in response to changes in taxation policy. Citizen's Basic Income (CBI) schemes also substantially narrowed inequalities (3•7% relative index of inequality for basic scheme, 5•9% for CBI with additional payments for individuals with disability), and modestly reduced YLL (0•7% for the basic scheme and 1•4% with additional payments). The estimated government spending associated with a policy was proportional to its effect on YLL, but less closely related to its effect on inequalities in YLL.Interpretation Policies that affect incomes could potentially have marked effects on health and health inequalities in Scotland. Our projections suggest that the most effective policies for reducing health inequalities appeared to be those that disproportionat...

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Do healthcare tax credits help poor-health individuals on low incomes?

Cited by 6 publications

References 46 publications

Adverse selection in the German Health Insurance System – the case of civil servants

Adverse selection in the German Health Insurance System – the case of civil servants

The fiscal and equity impact of social tax expenditures in the EU

The effect of income-based policies on mortality inequalities in Scotland: a modelling study

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