Abstract
We offer a framework for identifying disparities in the distribution of healthcare opportunities. In line with the Rawlsian tradition of fair equality of opportunity, we argue that these have to be primarily defined in terms of access to a (bundle of) health services of appropriate quality. Our approach allows to disentangle the opportunities individuals enjoy—assessed by jointly considering chances of access and disparities in access conditions—from the mere utilization of health services while preserving normative consistency with the principle of equal (access to) health care for those in equal need of health care. A simple exercise based on real data shows that the definition we provide can be easily applied to gather policy-relevant insights.
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Notes
Travel costs are computed using the Michelin Guide, once all the distances separating any given province from the nearest hospital suitable for care are determined. Accommodation costs—incurred by whoever provides assistance to the patient during the three weeks, on average, he/she is hospitalized—are calculated using information on the accommodation prices required by the B&Bs advertized on the Hospitals’ websites, in the area dedicated to inform patients about accommodation opportunities.
As income information for each province is not made available by the Bank of Italy for privacy reasons, we have imputed to each province belonging to the same region, the same endowment.
Notably, the financial endowment of each province, \(y_{j}\) would be: (1) the maximum value in the income distribution at the provincial level, for \(\rho \rightarrow +\infty\); (2) the arithmetic mean for \(\rho \rightarrow 1\); (3) the geometric mean for \(\rho \rightarrow 0\); (4) the harmonic mean for \(\rho \rightarrow -1\); the minimum value in the jth distribution of resources for \(\rho \rightarrow -\infty\).
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Acknowledgements
The present paper is a deeply revised version of one published as a working paper of the Center for Studies in Economics and Finance (CSEF), WP 437/2016. We wish to thank all the seminar participants at the Center for Studies in Economics and Finance (CSEF), The University of Roma Tre and the University of Trento for useful discussion. The usual disclaimers apply.
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Abatemarco, A., Beraldo, S. & Stroffolini, F. Equality of opportunity in health care: access and equal access revisited. Int Rev Econ 67, 13–29 (2020). https://doi.org/10.1007/s12232-019-00342-9
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DOI: https://doi.org/10.1007/s12232-019-00342-9