Equity in the finance of health care: some international comparisons

J Health Econ. 1992 Dec;11(4):361-87. doi: 10.1016/0167-6296(92)90012-p.


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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cross-Cultural Comparison
  • Delivery of Health Care / economics*
  • Delivery of Health Care / statistics & numerical data
  • Europe
  • Financing, Government / economics*
  • Financing, Government / methods
  • Financing, Government / statistics & numerical data
  • Health Expenditures / statistics & numerical data
  • Health Services Research
  • Insurance, Health / economics*
  • Internationality*
  • Models, Econometric
  • National Health Programs / economics*
  • National Health Programs / organization & administration
  • National Health Programs / statistics & numerical data
  • Regression Analysis
  • State Medicine / economics*
  • State Medicine / organization & administration
  • State Medicine / statistics & numerical data
  • Taxes / economics
  • United States