Top Banner

of 38

Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

Aug 07, 2018

Download

Documents

Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    1/38

     

    KHOD Wlrid`g Rkpar ^ardas

    Djpknts le Q`dvarskc Fakctf Nlvarkga=

    K Jdnrl-elu`hah Jknrlanl`ljdn Rarspantdva

    Vdk`gul Fuk`g k`h@klyuid Tlsfd`l

    @l. 1>>Mu`a ?2;1 

    Ksdk` Havaclpja`t Ok`i D`stdtuta

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    2/38

     

    Xfa Wlrid`g Rkpar sardas ds k nl`td`uktdl` le tfa elrjarcy `kjah Hdsnussdl` Rkpar sardas9tfa `ujoard`g le tfa pkpars nl`td`uah wdtflut d`tarruptdl` lr nfk`ga. KHOD—s wlrid`gpkpars raecant d`dtdkc dhaks l` k tlpdn k`h kra plstah l`cd`a elr hdsnussdl`. KHOD a`nlurkgasrakhars tl plst tfadr nljja`ts l` tfa jkd` pkga elr aknf wlrid`g pkpar (gdva` d` tfandtktdl` oaclw). ^lja wlrid`g pkpars jky havaclp d`tl ltfar elrjs le puocdnktdl`.

    ^uggastah ndtktdl`=

    Fuk`g, V., k`h @. Tlsfd`l. ?2;1. Djpknts le Q`dvarskc Fakctf Nlvarkga= K Jdnrl-elu`hahJknrlanl`ljdn Rarspantdva. KHOD Wlrid`g Rkpar 1>>. Xliyl= Ksdk` Havaclpja t̀ Ok`iD`stdtuta. Kvkdckoca= fttp=//www.kho.lrg/puocdnktdl`s/djpknts-u`dvarskc-fakctf-nlvarkga-jdnrl-elu`hah-jknrlanl`ljdn-parspantdva/

    Rcaksa nl`tknt tfa kutflrs elr d`elrjktdl` kolut tfds pkpar.

    Ajkdc= marry.fuk`gBkjrl-ksdk.lrg9 `ylsfd`lBkhod.lrg

    Vdk`gul Fuk`g ds k rasakrnfar kt tfa K^AK@+> Jknrlanl`ljdns _asakrnf Leedna(KJ_L), ^d`gkplra. Xfa ed`hd`gs, d`tarpratktdl`s, k`h nl`ncusdl`s axprassah d` tfdspkpar raprasa`t tfa vdaws le tfa kutflr(s) k`h kra `lt `anasskrdcy tflsa le KJ_L lr dtsjajoar kutflrdtdas. @adtfar KJ_L `lr dts jajoar kutflrdtdas sfkcc oa fach raspl`sdoca

    elr k`y nl`saqua`na le tfa usa le tfa d`elrjktdl` nl`tkd`ah tfarad`.

    @klyuid Tlsfd`l ds Hak` k`h NAL le tfa Ksdk` Havaclpja`t Ok`i D`stdtuta.

    Xfa vdaws axprassah d` tfds pkpar kra tfa vdaws le tfa kutflrs k`h hl `lt `anasskrdcyraecant tfa vdaws lr plcdndas le KHOD, KHO, dts Olkrh le Hdrantlrs, lr tfa glvar`ja`tstfay raprasa`t. KHOD hlas `lt gukrk`taa tfa knnurkny le tfa hktk d`ncuhah d` tfds pkpark`h knnapts `l raspl`sdodcdty elr k`y nl`saqua`nas le tfadr usa. Xarjd`lclgy usah jky`lt `anasskrdcy oa nl`sdsta`t wdtf KHO leedndkc tarjs.

    Wlrid`g pkpars kra suomant tl elrjkc ravdsdl` k`h nlrrantdl` oaelra tfay kra ed`kcdzahk`h nl`sdharah puocdsfah.

     Ksdk` Havaclpja`t Ok`i D`stdtutaIksujdgksaid Oudchd`g 6E

    >-?-1 Iksujdgksaid, Nfdylhk-iuXliyl ;22-5226, Mkpk`

    Xac= +6;->->14>-1122Ekx= +6;->->14>-117;Q_C= www.khod.lrgA-jkdc= d`elBkhod.lrg

    © ?2;1 Ksdk` Havaclpja`t Ok`i D`stdtuta

    mailto:[email protected]:[email protected]:[email protected]:[email protected]

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    3/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    Kostrknt

    Xfds pkpar stuhdas tfa djpknt le tkx-ed`k`nah u`dvarskc fakctf nlvarkga snfajas l`jknrlanl`ljdn kspants le ckolr suppcy, kssat flchd`g, d`aqukcdty, k`h wacekra, wfdca tkid`gd`tl knnlu`t eakturas nljjl` tl havaclpd`g anl`ljdas, sunf ks d`elrjkc ajpclyja`t k`h

    tkx kvldhk`na, oy nl`struntd`g k hy`kjdn stlnfkstdn ga`arkc aqudcdorduj jlhac wdtffatarlga`alus kga`ts. Kga`ts fkva hdeeara`t ahunktdl` cavacs, ajpclyja`t stktusas, k`hdhdlsy`nrktdn sflnis. Gdva` tfraa tkx ed`k`nd`g lptdl`s, nkcdorktdl` rasucts suggast tfkt tfaed`k`nd`g lptdl`s jkttar elr lutnljas oltf kt tfa kggragkta k`h hdskggragkta cavacs.Q`dvarskc fakctf nlvarkga, ed`k`nah oy ckolr d`nlja tkx rava`ua, nluch rahuna d`aqukcdtyhua tl dts ckrga rahdstrdoutdva rlca. ^lndkc wacekra nk``lt oa djprlvah wfa` ckolr handsdl`skra a`hlga`lus k`h hdstlrtdl`s kra fdgfar tfk` tfa rahdstrdoutdva gkd`s elr kcc tkx ed`k`nd`glptdl`s. D` tfa kosa`na le ckolr suppcy nfldna, jdch wacekra gkd`s kra elu`h.

    MAC Nckssdednktdl`= A?8, A?5, A5?, M;;, F?>, F1; 

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    4/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    Nl`ta`ts

    ;.  D`trlhuntdl` ................................................................................................................ > 

    ?.  Anl`ljdn A`vdrl`ja`t .............................................................................................. 1 

    ?.;  Hajlgrkpfdns ................................................................................................ 1 ?.?  D`hdvdhukcs ...................................................................................................... 1 ?.>  Rraeara`na k`h Rrlhuntdl` ............................................................................ 5 ?.8  Glvar`ja t̀ ................................................................................................... 7 ?.1   Kga`ts— Rrlocajs ........................................................................................... 6 ?.5  Nljpatdtdva Aqudcdorduj ................................................................................. 4 

    >.  Nkcdorktdl` ................................................................................................................. 4 

    >.;  Rraeara`na k`h Rrlhuntdl` .......................................................................... ;2 

    >.?  Hajlgrkpfdns k`h Ahunktdl` ...................................................................... ;2 >.>  Ajpclyja`t k`h ^antlr Xrk`sdtdl` .............................................................. ;; >.8  D`hdvdhukc Rrlhuntdvdty, ^antlr, k`h Ahunktdl` Aeednda`ny.............................. ;; >.1  Fakctf Axpa`hdtura ^flnis .......................................................................... ;? >.5  ^lndkc ^anurdty ^ystaj ................................................................................ ;? >.7  Glvar`ja`t Edsnkc _ava`ua k`h Axpa`hdtura ............................................. ;> 

    8.   K`kcysds ................................................................................................................... ;8 

    8.;  Oa`nfjkri Anl`ljy ................................................................................... ;8 8.?  Xkx-oksah Ed`k`nd`g Lptdl`s ...................................................................... ;5 8.>  Ckolr ^uppcy k`h Kssat Flchd`g .................................................................. ;7 

    8.8  D`nlja Hdstrdoutdl` ...................................................................................... ;4 8.1  Wacekra Nljpkrdsl` le Ed`k`nd`g Lptdl`s ................................................... ?2 

    1.  Hdsnussdl` ............................................................................................................... ?? 

    5.  Nl`ncusdl` ............................................................................................................... ?? 

    _aeara`nas ......................................................................................................................... ?8 

     Kppa`hdx K= Nkcdorktdl` Rrlnass ......................................................................................... ?5 

     Kppa`hdx O= Ukrdlus Jlhac Anl`ljdas............................................................................... >; 

     Kppa`hdx N= Nljputktdl` Rrlnahura .................................................................................. >> 

     Kppa`hdx H= ^a`sdtdvdty Xasts .............................................................................................. >8 

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    5/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    ;. D@X_LHQNXDL@

    D` jlst havaclpd`g nlu`trdas, tfa glkc le u`dvarskc fakctf nlvarkga (QFN) ds `lt aksy tlraknf hua tl tfa eknt tfkt ckrga, raslurna-pllr plpucktdl`s fkva cdjdtah knnass tl fakctfsarvdnas. ;  Gdva` tfkt raslurna-pllr palpca nk``lt keelrh lut-le-plniat fakctf

    axpa`hdturas, lr nk` l`cy hl sl oy sknrdednd`g ltfar prdlrdtdas, k fakctf ed`k`nd`g systajwfara palpca kra raqudrah tl pky elr usa hdrantcy ds l`a le tfa jkmlr okrrdars tl raknfd`gQFN. Kctflugf nlst sfkrd`g ds `anasskry tl prava`t tfa lvarutdcdzktdl` le fakctf sarvdnaskrdsd`g erlj tfa plta`tdkc prlocaj le jlrkc fkzkrh, u`dvarskc nlvarkga ds jlra cdiacy tloa raknfah wfa` tfa lut-le-plniat rktdl elr hdrant pkyja`t ds sueednda`tcy clw. Kgkd`sttfds oknihrlp le tfa racktdl`sfdp oatwaa` QFN k`h hdrant pkyja`t, k wky tl raknf QFNds tl clwar lut-le-plniat axpa`hdtura tl sunf k hagraa tfkt palpca kra `lt cdiacy tl sueeared`k`ndkc fkrhsfdp.? K nrlss-nlu`try astdjktdl` oksah l` 14 nlu`trdas oy Vu at kc. (?2;2)suggasts tfkt wfa` tfa lut-le-plniat rktdl ds clwar tfk` ;1%„?2% le tltkc fakctfaxpa`hdtura, tfa nfk`na le d`nurrd`g ed`k`ndkc nktkstrlpfa nluch oa `agcdgdoca.

    Elr plcdnyjkiars wfl kra eknah wdtf tfa kga`hk le QFN, dssuas sunf ks flw tl rkdsaracktah rava`ua k`h aeeantdvacy rahuna tfa lut-le-plniat rktdl kra tfa jkd` nl`nar`s.D`surk`na k`h tkx rava`ua kra d` prkntdna twl jkmlr kpprlknfas elr fakctf systajed`k`nd`g, wfdnf hdeear oy eu`hs oad`g pllcah hdrantcy d` tfa elrjar k`h d`hdrantcy d` tfackttar. Flwavar, hua tl tfa ckrga prasa`na le anl`ljdn d`elrjkcdty d` havaclpd`gnlu`trdas (^nf`adhar ?22?), ed`k`nd`g tfrlugf nljpucslry wkga-oksah fakctf d`surk`nanl`trdoutdl`s nk` l`cy oa a`elrnah d` tfa elrjkc santlr k`h ds rastrdntah d` snkca.Jlralvar, vlcu`tkry prdvkta fakctf d`surk`na fks k cdjdtah pkrtdndpktdl` rkta k`h pckys kjkrgd`kc rlca d` jlst havaclpd`g nlu`trdas (Hranfscar k`h Muttd`g ?221).

    Edgura ;= Fakctf Axpa`hdtura k`h Lut-le-plniat _ktdl d` Xfkdck`h

    (%)

    GHR : grlss hljastdn prlhunt, CF^ : caet-fk`h snkca, _F^ : rdgft-fk`h snkca.

    ^lurna= Wlrch Ok`i, Wlrch Havaclpja`t D`hdnktlrs.

    ; Knnlrhd`g tl tfa Wlrch Fakctf Lrgk`dzktdl` (?2;2), QFN ds haed`ah ks tfa glkc tfkt kcc palpca fkva knnass

    tl fakctf sarvdnas k`h hl `lt sueear ed`k`ndkc fkrhsfdp d` pkyd`g elr tfaj.? Xfa Wlrch Fakctf Lrgk`dzktdl` khvlnktas tfkt kjl`g kcc dssuas le QFN, dt ds jlst nrdtdnkc tl havaclp k

    fakctf ed`k`nd`g systaj tfkt nk` aeeantdvacy rajlva tfa ed`k`ndkc okrrdars tl fakctf sarvdna knnass. 

    2

    1

    ;2

    ;1

    ?2

    ?1

    >2

    >1

    82

    81

    2.2

    2.1

    ;.2

    ;.1

    ?.2

    ?.1

    >.2

    >.1

    8.2

    8.1

    ;441 ;446 ?22; ?228 ?227 ?2;2

    Xltkc fakctf axpa`hdtura ks % le GHR (CF^)

    Lut-le-plniat axpa`hdtura ks % le tltkc fakctf axpa`hdtura (_F^)

    >

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    6/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

     Kctar`ktdvacy, QFN snfajas ed`k`nah oy glvar`ja`t rava`ua fkva kttkd`ah u`dvarskcnlvarkga aeeantdvacy d` havaclpd`g nlu`trdas sunf ks Orkzdc, Jaxdnl, k`h Xfkdck`h. D` tfanksa le Xfkdck`h, k QFN snfaja nkccah tfa Q`dvarskc Nlvarkga ^nfaja (QN^),ed`k`nah tfrlugf ga`arkc glvar`ja`t rava`ua sd`na ?22?, wks djpcaja`tahsunnasseuccy tl prlvdha jlra aeeantdva nlvarkga. Ks k rasuct le tfa snfaja, oy ?2;?, tfakvarkga lut-le-plniat fakctf axpa`hdtura rktdl d` Xfkdck`h fkh hancd`ah tl ;>% (ks

    sflw` d` Edgura ;) k`h kcjlst ;22% fakctf prltantdl` nlvarkga fkh oaa` raknfah.Xfkdck`h—s axparda`na sflws tfkt raknfd`g u`dvarskc nlvarkga ed`k`nah oy glvar`ja`trava`ua nk` oa eaksdoca.

    Oasdhas tfa twl ed`k`nd`g lptdl`s kolva, k Wlrch Fakctf Lrgk`dzktdl` (?2;2) raplrthdsnussas jk`y ltfar d``lvktdva jatflhs, d`ncuhd`g elradg` axnfk`ga trk`skntdl` tkx,ok`i knnlu`t trk`skntdl` tkx, k`h vkrdlus axndsa tkxas. Flwavar, tfa kppcdnkodcdty leslja le tfasa lptdl`s fks yat tl oa avkcuktah k`h jlra ktta`tdl` sfluch oa pkdh tlaxdstd`g tkx-oksah ed`k`nd`g snfajas (^kvahlee ?228). D` khhdtdl`, stuhdas racktah tlQFN ed`k`nd`g fkva oaa` eaw, k`h cdtarktura k`kcyzd`g tfa djpknts le QFN ds ava`snkrnar, aspandkccy ragkrhd`g tfa aeeants erlj k jknrl parspantdva. > 

    Xfds pkpar trdas tl edcc tfa rasakrnf gkp oy axpclrd`g tfa elcclwd`g quastdl`s. Edrst, wfkt ds

    tfa djpknt l` d`hdvdhukcs d` tarjs le tfadr lptdjkc handsdl`s elr ckolr suppcy k`h kssatflchd`gs< ^anl`h, wfkt kra tfa djpknts l` d`aqukcdty k`h slndkc wacekra< Xfdrh, wfktkra tfa hdeeara`t djpknts kt oltf tfa kggragkta k`h hdskggragkta cavacs. Xl quk`tdtktdvacyk`swar tfasa quastdl`s, tfa pkpar khlpts k jlhar` hy`kjdn stlnfkstdn ga`arkcaqudcdorduj erkjawlri, wfdnf ds oad`g d`nraksd`gcy usah elr tfa stuhy le slndkc sanurdtyk`h puocdn ed`k`na.

    D` k jlhac anl`ljy, tfara kra fatarlga`alus kga`ts wfl fkva hdeeara`t ajpclyja`tstktusas lvar tdja, k glvar`ja`t tfkt nlccants rava`ua k`h spa`hs l` tfa prlvdsdl` leslndkc sanurdty k`h ltfar axpa`hdturas, k`h edrjs tfkt ajpcly ckolr k`h nkpdtkc elrprlhund`g gllhs d` k nljpatdtdva a`vdrl`ja`t. Wfdca eknd`g d`nlja k`h axpa`hdturardsis, d`hdvdhukc kga`ts le hdeeard`g kgas k`h cavacs le ahunktdl` jkia tfadr handsdl`s l`ckolr k`h nl`sujptdl`. QFN ds jlhaccah oy tfa clward`g le tfa lut-le-plniat rktdl, sd`naed`k`nd`g ds l`a le tfa jlst djplrtk`t kspants. Xfa nkcdorktah axarndsa ds oksah l` tfaXfkd anl`ljy usd`g oltf jdnrl flusaflch survay pk`ac hktk k`h jknrl d`hdnktlrs.Jdnrl flusaflch hktk erlj tfa Xfkd ^lndl-Anl`ljdn ^urvay (^A^) ?221„?227,d`ncuhd`g 5,222 flusaflchs k`h jlra tfk` ?2,222 d`hdvdhukcs, kra usah tl astdjkta tfavkcua k`h sflnis le fakctf axpa`hdtura k`h trk`sdtdl`s le ajpclyja`t, wfdca tfa ltfariay jknrl d`hdnktlrs kra tkia` lr astdjktah ks tkrgats le tfa oa`nfjkri jlhac.

    Xfds stuhy ds nclsacy racktah tl stuhdas l` fakctf d`surk`na sunf ks tflsa oy Masia k`hIdtkl (?224) k`h Fsu (?2;?), out hdeears oy elnusd`g l` tkx-oksah QFN k`h kcclwd`gwlriars tl trk`sdtdl` tl hdeeara`t santlrs, wfdnf nkusas aeednda`ny k`h tkx hdeeara`nas. 8 Dtds kcsl racktah tl stuhdas le ckolr suppcy (k`h slndkc sanurdty) sunf ks Fanijk` (;44>),^kaz (?22?), Djrlflrlgcu k`h Idtkl (?224), k`h Idtkl (?2;8). Axta`hd`g erlj Fsu at kc.

    (?2;8), tfds pkpar kcclws elr a`hlga`lus ckolr handsdl`s k`h k jlra nljprafa`sdvaslndkc sanurdty struntura. Xfa pkpar kcsl tkrgats d`nlja hdstrdoutdl`s oltf kt tfakggragkta cavac k`h tfa hdskggragkta cavac, wfdca ranlg`dzd`g tfa aeednda`ny hdeeara`nastfkt krdsa hua tl hdeeara`nas oatwaa` santlrs k`h hdeeard`g cavacs le ahunktdl`.

    > K eaw stuhdas clli kt tfa djpknt l` ckolr jkriats erlj k pkrtdkc aqudcdorduj parspantdva, sunf ks Ktardhl,

    Fkccwkrh-Hrdajadar, k`h Rkgas (?2;;) k`h Wkgstkee k`h Jk`knfltpfl`g (?2;?).8 Ltfar racktah cdtarktura d`ncuhas Iltcdilee (;465), Fuggatt (;44>), k`h Kdykgkrd (;448). 

    8

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    7/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    Xfa pkpar ds nl`struntah d` tfa elcclwd`g lrhar. ^antdl` ? d`trlhunas tfa jlhac. ^antdl`> axpckd`s tfa hatkdcs le nkcdorktdl`. ^antdl` 8 k`kcyzas tfa oa`nfjkri anl`ljy k`h tfaed`hd`gs oksah l` vkrdlus axpardja`ts. Ed`kccy, ^antdl` 1 gdvas tfa nl`ncuhd`g rajkris.

    ?. ANL@LJDN A@UD_L@JA@X

     Kga`ts d` tfa anl`ljy kra a`hlwah wdtf twl typas le ahunktdl` k`h gl tfrlugf tfadrcdeanynca erlj ylu`g tl lch. Wfa` tfay kra ylu`g, tfay kra a`hlwah wdtf l`a u`dt leckolr tdja kt aknf pardlh, out ekna u`ajpclyja`t rdsi. De tfay wlri, tfay kra adtfarajpclyah d` tfa elrjkc santlr lr tfa d`elrjkc l`a. Kcc ylu`g, wlrid`g kga`ts eknadhdlsy`nrktdn aeednda`ny rdsis tfkt nk``lt oa d`surah. D` khhdtdl`, oltf ylu`g k`h lchkga`ts ekna fakctf axpa`hdtura rdsis tfkt nk` l`cy oa pkrtdkccy d`surah. Xfa glvar`ja`tnlccants nl`sujptdl` tkx, nkpdtkc d`nlja tkx, ckolr d`nlja tkx, k`h slndkc sanurdtynl`trdoutdl`s. Kjl`g tfaj, tfa ckolr d`nlja tkx k`h slndkc sanurdty nl`trdoutdl`s krakssujah tl oa nlccantah l`cy d` tfa elrjkc santlr. Xfa edsnkc lutckys le glvar`ja`td`ncuha pa`sdl` pkyja`ts, puocdn fakctf axpa`hdtura, slndkc kssdstk`na, k`h ltfarglvar`ja`t axpa`hdtura. Xfds santdl` hasnrdoas eakturas le tfa oa`nfjkri anl`ljy.

    ?.; Hajlgrkpfdns

    Xfa plpucktdl` nl`sdsts le wlrid`g ylu`g k`h ratdrah lch palpca. Tlu`g kga`ts ratdrawdtf prlokodcdty  k`h lch kga`ts hda wdtf prlokodcdty  d` aknf pardlh, k`h sunfprlokodcdtdas kra kssujah `lt tl vkry oy ahunktdl` cavac lr santlr. Wfa` k` lch kga`thdas d` k pardlh, k `awolr` ylu`g kga`t rapcknas tfa lch kt tfa oagd``d`g le tfa skjapardlh, sl tfkt tfa jaksura le tfa a`tdra plpucktdl` rajkd`s tfa skja.

    ?.? D`hdvdhukcs

    Aknf kga`t ds a`hlwah wdtf l`a typa le ahunktdl` tfkt hlas `lt nfk`ga lvar tfa

    d`hdvdhukc—s cdeatdja. Jak`wfdca, kga`ts ekna tfa elcclwd`g d`hdvdhukc sflnis= ajpclyja`tstktus sflnis (hatarjd`d`g wfatfar kga`ts fkva k nfk`na tl wlri k`h, de sl, d` wfdnfsantlr), d`hdvdhukc prlhuntdvdty dhdlsy`nrktdn sflnis, k`h fakctf axpa`hdtura sflnis.

    ?.?.; Ahunktdl`

    Xfa sfkras le fdgf ahunktdl` k`h clw ahunktdl` d` tfa plpucktdl` kra  k`h ; . Waha`lta ahunktdl` typa oy , le wfdnf tfa sat ds gdva` oy

    : ℀, fdgf ahunktdl`, clw ahunktdl`   (;)Dt ds kssujah tfkt tfa ahunktdl` hdeeara`na djplsas ahunktdl`-spandedn aeednda`ndas

     

    parjk`a`tcy l` tfa kga`ts ks pkrt le tfadr d`hdvdhukc ckolr aeednda`ny.

    ?.?.? Ajpclyja`t ^tktus ^flni

    Tlu`g kga`ts ekna ajpclyja`t stktus sflnis. Xfay fkva k nfk`na le adtfar wlrid`g lroad`g u`ajpclyah. Wfa` tfay wlri, tfay fkva k nfk`na le oad`g adtfar d` tfa elrjkcsantlr lr tfa d`elrjkc santlr. Xfa elrjkc santlr ds haed`ah ks k` anl`ljdn santlr d`wfdnf ckolr d`nlja ds tkxah, slndkc sanurdty nl`trdoutdl`s kra nlccantah knnlrhd`gcy, k`hracktah slndkc sanurdty oa`aedts kra prlvdhah upl` nl`trdoutdl`. D` nl`trkst, tfa d`elrjkc

    1

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    8/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    santlr ds nfkrkntardzah oy tkx kvldhk`na k`h `l`-pkrtdndpktdl` d` slja slndkc sanurdtyprlgrkjs. Wa ha`lta ajpclyja`t stktus ks , le wfdnf tfa sat ds

      :  , elrjkc santlr, d`elrjkc santlr

    , u`ajpclyah.

      (?)

    ^unf stktus sflnis avlcva stlnfkstdnkccy vdk @-stkta Jkrilv nfkd`s, . Jak`wfdca,santlrs kra kssujah tl oa ksslndktah wdtf santlr-spandedn aeednda`ndas, , k`h kga`ts—tltkc d`hdvdhukc ckolr aeednda`ndas kra keeantah knnlrhd`gcy wfa` tfay trk`sdt erlj l`asantlr tl k`ltfar.

    ?.?.> D`hdvdhukc Rrlhuntdvdty ^flni

    Xfa d`hdvdhukc ckolr aeednda`ndas le wlrid`g ylu`g kga`ts kra mld`tcy keeantah oy tfadra`hlwah ahunktdl`-spandedn aeednda`ndas, , santlr-spandedn aeednda`ndas racktah tl tfasantlr wfara tfay wlri, , k`h tdja-vkryd`g ahunktdl`-hapa`ha`t dhdlsy`nrktdn sflnis,, avlcvd`g stlnfkstdnkccy vdk ahunktdl`-hapa`ha`t Jkrilv nfkd`s, , wdtf aknf stktavkcua tkia` erlj gdva` ed`dta sats,

    . Xfaraelra, tfa `kturkc clgkrdtfj le tltkc d`hdvdhukc

    ckolr aeednda`ny, , ds hatarjd`ah oy() : () + () + ()  (>) Ks kga`ts hl `lt nfk`ga tfadr ahunktdl` typa lvar tfadr cdea nynca,  ds nl`stk`t l`natfay kra a`hlwah wdtf l`a typa le ahunktdl`. Xfa vkrdktdl` le ckolr aeednda`ny,tfaraelra, nljas erlj tfa trk`sdtdl`s le ajpclyja`t stktus, , k`h dhdlsy`nrktdnsflnis, .?.?.8 Fakctf Axpa`hdtura ^flni

    _agkrhcass le tfa hdeeara`nas knrlss ahunktdl` typa k`h santlr, kcc kga`ts ekna tfau`nartkd`ty le kga-hapa`ha`t fakctf axpa`hdturas nkusah oy fakctf axpa`hdtura

    sflnis, , wfara : , ylu`g, lch.   (8)Xfa fakctf axpa`hdtura sflnis, , tkia tfa vkcuas erlj gdva` ed`dta sats, , k`h avlcvastlnfkstdnkccy vdk Jkrilv nfkd`s, Τ. Xfa rktdls le lut-le-plniat fakctf axpa`hdtura kraha`ltah oy .?.> Rraeara`na k`h Rrlhuntdl`

     K utdcdty praeara`na eu`ntdl` d`ncuhd`g oltf nl`sujptdl` k`h cadsura ds haed`ah ks

    :

     (

    ,

    )  (1)

    wfara   ds tfa d`hdvdhukc nl`sujptdl` k`h   tfa kjlu`t le d`hdvdhukc ckolr suppcy d`aknf pardlh._aqudrd`g oltf d`puts le ckolr k`h nkpdtkc, tfa prlhuntdl` eu`ntdl` ds wrdtta` ks : (, )  (5)wfara   ds tfa tltkc ekntlr prlhuntdvdty,  ds tfa kggragkta nkpdtkc par nkpdtk d` tfaanl`ljy, k`h   ds tfa aeeantdva ckolr par nkpdtk ajpclyah oy tfa edrjs. Xfa nkpdtkc dskssujah tl oa fljlga`lus knrlss santlrs k`h kcc jkriats oafkva nljpatdtdvacy.

    5

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    9/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    ?.8 Glvar`ja`t

    ?.8.; Xkx _ava`ua k`h ^lndkc ^anurdty Nl`trdoutdl`

    Xfa glvar`ja`t nlccants k nl`sujptdl` tkx, (), k nkpdtkc d`nlja tkx, (), wkga-oksah slndkc sanurdty nl`trdoutdl`s,

    (

    ), k`h k ckolr d`nlja tkx,

    (

    ), wfara tfa

    tkxkoca ckolr d`nlja, , ds tfa `at ckolr d`nlja ketar tfa hahuntdl` le slndkc sanurdtynl`trdoutdl`, ha`ltah oy :  () . _agkrhd`g tfa tkx rava`uas lr slndkcsanurdty nl`trdoutdl`s kolva, tfa nlrraspl`hd`g rktas kra , , , k`h .D` tfa nl`taxt le tfa anl`ljy wdtf k` d`elrjkc santlr wfara tfa nlccantdl` le tkx dsnl`strkd`ah oy anl`ljdn d`elrjkcdty, tfa wkga-oksah ckolr d`nlja tkx, (), k`h tfaslndkc sanurdty nl`trdoutdl`s, (), kra kssujah tl oa l`cy a`elrnah d` tfa elrjkcsantlr.

    ?.8.? ^lndkc ^anurdty Axpa`hdtura

    Xfa glvar`ja`t prlvdhas lch-kga pa`sdl` oa`aedts, , tl a`tdtcah kga`ts wflnl`trdouta tl k pa`sdl` pllc wfa` tfay wlri d` tfa elrjkc santlr. Dt kcsl prlvdhas slndkc

    prltantdl`, , wfara k jd`djuj nl`sujptdl` cavac ds gukrk`taah. D` khhdtdl`, elrpalpca wfl pravdluscy wlriah d` tfa elrjkc santlr oaelra a`nlu`tard`g u`ajpclyja`tsflnis, tfa glvar`ja`t kssdsts tfaj wdtf k` u`ajpclyja`t oa`aedt, . K nl`trdoutdl`-oksah fakctfnkra snfaja ds prlvdhah tl wlriars d` tfa elrjkc santlr. D`lrhar tl raknf u`dvarskc fakctf nlvarkga, tfa glvar`ja`t kcsl ru`s k u`dvarskc nlvarkgasnfaja tl clwar lut-le-plniat fakctf axpa`hdtura elr d`elrjkc wlriars k`h `l`-wlriars(ratdrah palpca) tl k cavac nljpkrkoca tl tfa elrjkc wlriars— snfaja. Ed`k`nah hdrantcyoy tfa glvar`ja`t ouhgat, k` d`nraksa le tfa puocdn fakctf axpa`hdtura  (; ) +(; )   clwars tfa prdvkta lut-le-plniat rktdls, ekndcdtktd`g aksdar knnass tl fakctfsarvdnas elr kcc palpca k`h facpd`g tl knfdava u`dvarskc fakctf nlvarkga.

    ?.8.> Ouhgat Okck`na

     Kssujd`g tfkt tfa glvar`ja t̀ okck`nas tfa ouhgat kt aknf pardlh, tfa glvar`ja t̀ouhgat okck`na ds ha`ltah oy : , (7)wfara : ∩{() + ( + ) + () + ()}Υ() + ‿, k`h

    :  + + + (; ) + (; )Υ() + (; + ) +  sfluch oa sktdsedah kt aknf k`h avary pardlh.

    D` Aquktdl` (7), tfa caet sdha, , ds tfa edsnkc rava`ua tfkt tfa glvar`ja`t nlccants erljtfa a`tdra anl`ljy, d`ncuhd`g tfa tkx rava`uas k`h slndkc sanurdty nl`trdoutdl`sja`tdl`ah akrcdar. D` khhdtdl`, ʴ  ds tfa haot dssuah d` tfa nurra`t pardlh k`h ds pkrt leglvar`ja`t rava`ua. Elr tfa nlccantdl` le nkpdtkc d`nlja tkx rava`ua,   ds k cujp sujtrk`sear le knndha`tkc oaquasts nlccantah erlj tfa hanaha`t k`h rahdstrdoutah tl kccsurvdvlrs, wfdnf ds wrdtta` ks elcclws= : ∩h()  (6)

    7

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    10/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

     Ks elr nkpdtkc, tfa oaquast ds tkxah knnlrhd`gcy. () ds tfa hdstrdoutdl` le tfa plpucktdl`lvar k stkta spkna , wfara : (,, , ∟;, , ).Xfa tltkc glvar`ja`t edsnkc lutckys l` tfa rdgft-fk`h sdha,  , nl`sdst le tfakelraja`tdl`ah slndkc sanurdty pkyja`ts, rahajptdl` le haot, k`h ltfar glvar`ja`taxpa`hdtura.

     ds tfa l`a-pardlh haot dssuah d` tfa pravdlus pardlh k`h ds kssujah tl oa

    euccy rahaajah wdtf k` d`tarast pkyja`t kt k rkta le .   ds tfa suj le spa`hd`gtfkt d`ncuhas kcc ltfar glvar`ja`t axpa`hdtura.?.1 Kga`ts— Rrlocajs

    Gdva` tfa stkta elr k` kga`t wdtf ahunktdl`  k`h kga , k`h tfa axpantktdl` tfrlugftrk`sdtdl` prlokodcdtdas elr d`hdvdhukc aeednda`ny k`h fakctf axpa`hdtura, tfa kga`ts—prlocajs kra wrdtta` ks elcclws=

    () : jkx (,) + (; )()|+ Y()|Z     : jkx{(, ) + (; )Y()|Z}     :    (4)

    suomant tl(; + ) + ʴ :  +   (;2)ʴ ≡ 2  (;;)

    wfara

    ≫⎤

    + ( ; + (; )) () (),   :     :   + ( ; + (; )) ,   :     : ; + (; ) +     ∟; :  2, ℀ ,   :     :  + ; + (; ) ,   : ,  (;?)

    k`h  ≫ jkx{(; + ) , 2}  (;>) ≫ ∩Υ()  (;8) ≫ (ΐ)∩Υ()  (;1)D` tfa vkcua eu`ntdl`, Aquktdl` (4), tfa eutura vkcua ds hdsnlu`tah oy k hdsnlu`t ekntlr, ,k`h ds k wadgftah kvarkga le tfa nl`hdtdl`kc axpantktdl`s le ylu`g k`h lch kga`ts elrtfa prlocaj le ylu`g kga`ts, wfara tfa ratdraja`t prlokodcdty, , sarvas ks tfa wadgft._agkrhd`g tfa prlocaj elr lch kga`ts, tfa eutura vkcua ds hdsnlu`tah oy tfa hdsnlu`tekntlr ketar khmustja`t le tfa survdvkc prlokodcdty. Aquktdl` (;2) ds tfa ouhgat nl`strkd`tk`h tfa tltkc raslurna elr kcclnktdl` wfara tfa raslurna nljas erlj tfa `at wakctf, Wac, 

    k`h tfa trk`sear elr tfa slndkc nl`sujptdl` d`surk`na, , nl`hdtdl`kccy._agkrhd`g   d` Aquktdl` (;?), wlrid`g ylu`g kga`ts d` tfa elrjkc santlr fkva ckolrd`nlja k`h knnruah nkpdtkc d`nlja, pky kcc id`hs le tkxas, k`h jkia slndkc sanurdtynl`trdoutdl`s, ks sflw` d` tfa edrst rlw, wfara  k`h  kra tfa lut-le-plniataxpa`hdtura rktdl k`h tfa tltkc fakctf axpa`hdtura elr ylu`g kga`ts. Xfa sanl`h rlwd`hdnktas tfa kvldhk`na le ckolr tkx k`h slndkc sanurdty nl`trdoutdl`s d` tfa d`elrjkcsantlr, k`h u`ajpclyah ylu`g kga`ts wfl hl `lt fkva ckolr d`nlja k`h jky ranadvau`ajpclyja`t oa`aedts, hapa`hd`g l` tfadr pravdlus ajpclyja`t stktus, kra spandedah d`

    6

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    11/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    tfa tfdrh rlw. Ed`kccy, tfa elurtf rlw haed`as tfa wakctf le lch kga`ts, wfara  ds tfadrpa`sdl` oa`aedt k`h  ds tfadr lut-le-plniat fakctf axpa`hdtura.Aquktdl` (;>) gdvas tfa haed`dtdl` le . Ks sflw` d` Aquktdl`s (;8) k`h (;1), tfau`ajpclyja`t oa`aedt, , k`h tfa pa`sdl` pkyja`t, , kra parna`tkgas le tfakvarkga ckolr d`nlja le aknf ahunktdl` grlup. Eurtfarjlra, ks sflw` d` Aquktdl` (;1),

    tfa rapcknaja`t rkta, (), ds k eu`ntdl` le tfa nl`trdoutdl` tdja, .?.5 Nljpatdtdva Aqudcdorduj K stktdl`kry ranursdva nljpatdtdva aqudcdorduj nl`sdsts le k sat le quk`tdtdas {,ʴ,,} elr aknf ylu`g d`hdvdhukc k`h aknf lch d`hdvdhukc wdtf adtfar fdgf lr clw ahunktdl`, d` tfaelrjkc lr d`elrjkc santlr raspantdvacy, k sat le prdnas {, } hatarjd`ah oy tfa kggragktankpdtkc par nkpdtk, , k`h tfa ckolr par nkpdtk, , glvar`ja`t plcdndas{ , , , , , (), ,, }, k`h k stktdl`kry hdstrdoutdl` le tfa plpucktdl` lvartfa stkta spkna () wfdnf ds nfkrkntardzah oy

    (d) sfkras le tfa plpucktdl` hdeeard`g oy ahunktdl`, wfdnf kra

     k`h ;

    9

    (dd) k ratdraja`t prlokodcdty, , k`h k haktf prlokodcdty, 9(ddd) k` d`hdvdhukc aeednda`ny, , nkusah oy ahunktdl` aeednda`ndas, , santlrkcaeednda`ndas, , k`h dhdlsy`nrktdn prlhuntdvdty sflnis, , wdtf vkcuas erlj  avlcvah wdtf trk`sdtdl` prlokodcdty jktrdnas 9 k`h(dv) fakctf axpa`hdtura sflnis, , wdtf vkcuas erlj   avlcvah wdtf trk`sdtdl`prlokodcdty jktrdnas Τ,

    sunf tfkt

    (d) kga`ts wdtf fdgf k`h clw ahunktdl`, erlj tfa elrjkc k`h d`elrjkc santlrs, k`htfa u`ajpclyah, kt ylu`g k`h lch kgas, slcva tfadr raspantdva d`hdvdhukcnl`strkd`ah jkxdjdzktdl` prlocajs9

    (dd) edrjs slcva tfa prledt jkxdjdzktdl` prlocaj9

    (ddd) tfa raslurna eaksdodcdty nl`hdtdl`, :  + + + , ds sktdsedah, wfara : ʴ (; ) k`h  : ∩ ()9(dv) glvar`ja`t plcdndas sktdsey tfa glvar`ja`t ouhgat nl`strkd`t Aquktdl` (7)9

    (v) oltf tfa ckolr k`h nkpdtkc jkriats ncakr wfa` : ∩() k`h : ∩ (),wfdnf d`tagrktas  k`h ;  sfkras le tfa plpucktdl` wdtf fdgf k`h clw ahunktdl`d` tarjs le kssat flchd`gs k`h ckolr suppcy.

    >. NKCDO_KXDL@

    Eu`ntdl` elrjs, oclnis le pkrkjatars, k`h iay eakturas le tfa jlhac kra prasa`tah d`tfds santdl`. Xfa eu`ntdl` elrjs d`ncuha tfa flusaflch utdcdty, edrj prlhuntdl`, wlriaraeednda`ny, k`h pa`sdl` oa`aedt rapcknaja`t rkta. Qtdcdzd`g pk`ac hktk erlj tfa Xfkd ^A^?221„?227 k`h vkrdlus ltfar slurnas, tfds santdl` d`trlhunas tfa hatkdcs le raearrah k`hastdjktah pkrkjatars usah d` tfa jlhac, wfdca pld`td`g lut ltfar pkrkjatars elrnkcdorktdl` tkrgats tfkt kra khlptah d` tfa oa`nfjkri anl`ljy.

    4

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    12/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    >.; Rraeara`na k`h Rrlhuntdl`

     K `l`-sapkrkoca nl`sujptdl`-cadsura utdcdty eu`ntdl`, (,), nljpktdoca wdtf k okck`nahgrlwtf pktf, ds kssujah d` tfa anl`ljy. Dt ds wrdtta` ks

    (

    ,

    ) :

    Y

    (;∟

    )Z()

    ;∟  (;5)

    wfara  hatarjd`as tfa nfldna oatwaa` nl`sujptdl` k`h cadsura.  hatarjd`as tfad`tar-tajplrkc ackstdndty le suostdtutdl` le tfa nl`sujptdl`-cadsura ou`hca k`h ds racktahtl tfa rdsi kvarsdl`. ^unf rdsi kvarsdl`, , ks hardvah oy Fakctfnlta at kc. (?226), dsgdva` oy : ; +   (;7) K nl`td`uuj le edrjs d` k nljpatdtdva gllhs jkriat ds fljlga`lus k`h kssujah tlelcclw k Nloo-Hlugcks prlhuntdl` eu`ntdl` elr oltf santlrs ks : ;∟ .  (;6)Xfa twl ekntlr prdnas hardvah erlj tfa edrj lptdjdzktdl` prlocaj kra ks elcclws=

    : (; ) ∟  (;4) : ∟;(;∟)   (?2)wfara tfa nkpdtkc haprandktas kt k rkta le   d` aknf pardlh k`h dts d`nlja sfkra dsd`hdnktah oy .Xfa jlhac pardlh ds k``ukc k`h tfa hdsnlu`t ekntlr, , d` tfa kga`ts— prlocaj Aquktdl`(4) ds khmustah tl jktnf tfa nkpdtkc lutput rktdl le >.8. Xfa utdcdty pkrkjatar, , tkrgatstfa slndkc kvarkga wlrid`g flurs le ;/>, k`h   ds sat tl tkrgat k jahduj vkcua le rdsikvarsdl` le ?. D` tfa prlhuntdl` eu`ntdl`, tfa tltkc ekntlr prlhuntdvdty, , ds `lrjkcdzah tloa u`dtkry. Xfa nkpdtkc d`nlja sfkra, , elcclws tfa astdjktah vkcua le 2.>;88 d` Kfumkat kc. (?228) k`h tfa k``ukc nkpdtkc haprandktdl` rkta,

    , ds astdjktah erlj tfa hktk kt

    1.?%.

    >.? Hajlgrkpfdns k`h Ahunktdl`

    Xfa ratdraja`t prlokodcdty, , ds sat kt k vkcua d`hdnktd`g tfkt ylu`g kga`ts kra axpantahtl wlri elr 81 yakrs, k`h tfa haktf prlokodcdty, , ds nflsa` sl tfkt tfa hapa`ha`nyrktdl le lch lvar ylu`g palpca ds ;>%. Xartdkry ahunktdl` (d`ncuhd`g vlnktdl` snfllc) k`hkolva ds haed`ah ks –fdgf ahunktdl`‚ wfdca tfa sanl`hkry snfllc k`h oaclw kra haed`ahks –clw ahunktdl`‚, knnlu`td`g elr ?1% k`h 71% le wlrielrna, raspantdvacy, astdjktaherlj tfa hktk. ^unf sfkras kra ha`ltah oy  k`h ;  d` tfa jlhac.Xfa sfkras le tfa wlrid`g plpucktdl` d` tfa d`elrjkc santlr k`h tfa elrjkc santlr kra

     mld`tcy hatarjd`ah oy tfa trk`sdtdl` jktrdnas k`h tfa sfkras le tfa plpucktdl` wdtfhdeeara`t cavacs le ahunktdl`. Wa kssuja tfara ds k trk`sdtlry odks ks k rasuct le tfa sflrtpardlh le tfa pk`ac, le wfdnf tfa pkrkjatar ds usah tl tkrgat tfa ckolr elrna sfkra, gdva`tfkt 5?% le tfaj wlri d` tfa d`elrjkc santlr. Eurtfar, wa nkcdorkta tfa parjk`a`taeednda`ny gkp pkrkjatars, , ks rasuct le tfa ahunktdl` hdeeara`na d` Aquktdl` (>) oytkrgatd`g tfa Gd`d nlaeednda`t le 2.>48 (tfa Gd`d nlaeednda`t le Xfkdck`h d` ?2;2 knnlrhd`gtl Wlrch Ok`i astdjktas). Ks tfa aeednda`ndas  (  k`h ) kra d` racktdva tarjs, tfaelrjar ds `lrjkcdzah k`h tfa ckttar ds nkcdorktah knnlrhd`gcy.

    ;2

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    13/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    >.> Ajpclyja`t k`h ^antlr Xrk`sdtdl`

     Kga`ts kra suomant tl ajpclyja`t sflnis tfkt nkusa wlrid`g kga`ts tl oa d` tfa elrjkcsantlr, tfa d`elrjkc santlr, lr u`ajpclyah. Jkrilv-nfkd` trk`sdtdl` prlokodcdty jktrdnaskra nl`struntah erlj tfa ^A^ hktk wdtf tfraa ajpclyja`t stktusas k`h nlrraspl`hd`gtrk`sdtdl` prlokodcdtdas, sflw` d` Xkoca ;. 

    Xfa trk`sdtlry santlr aeednda`ndas  ( k`h  9 tfa vkcua ds zarl wfa` u`ajpclyah) krausah tl tkrgat tfa  santlr—s sfkras le lutput, wfara tfa lutput le tfa d`elrjkc santlrknnlu`ts elr 88%.1 D` tfa skja eksfdl` ks , wa l`cy nkcdorkta  wfdca `lrjkcdzd`g .

    Xkoca ;= Xrk`sdtdl` Rrlokodcdtdas le Ajpclyja`t ^tktus

    Fdgf Ahunktdl`

    Elrjkc D`elrjkc Q`ajpclyah

    Elrjkc 2.7216 2.?51? 2.2?42

    D`elrjkc 2.7>15 2.?>58 2.2?62

    Q`ajpclyah 2.5482 2.?7;1 2.2>81

    Clw Ahunktdl`

    Elrjkc D`elrjkc Q`ajpclyah

    Elrjkc 2.>576 2.5251 2.2?17

    D`elrjkc 2.?;;4 2.7164 2.2?4?

    Q`ajpclyah 2.>?48 2.5725 2.2222^lurna= Xfkdck`h ̂ A^9 kutflrs— nkcnucktdl`s, trk`sdtlry odks khmustah.

    >.8 D`hdvdhukc Rrlhuntdvdty, ^antlr, k`h Ahunktdl` Aeednda`ny

    Elr Aquktdl` (>), le wfdnf tfa nkcdorktdl` tkrgats  k`h  fkva oaa` hasnrdoah d`^antdl`s >.? k`h >.>, tfa rajkd`d`g dhdlsy`nrktdn sflni, , ds kssujah tl elcclw k`

     K_(;) prlnass wrdtta` ks

    c` : c`ʴ+   (?;)wfara  ∳ (2,?).Xfa parsdsta`na pkrkjatars le K_ (;)  kra kssujah tl oa tfa skja knrlss ahunktdl`k`h tfa astdjktas le Fuookrh at kc. (;441) le 2.41 elr oltf fdgf k`h clw ahunktdl`grlups kra usah.5 Xfaraelra, wa nkcdorkta twl vkcuas le tfa stk`hkrh arrlr  ( k`h  raspantdvacy) oy tkrgatd`g Gd`d nlaeednda`ts le wkga d`nlja d` aknf ahunktdl` grlup.Astdjktah erlj tfa skja hktk, tfa Gd`d nlaeednda`ts le wkga d`nlja elr grlups wdtf fdgfk`h clw cavacs le ahunktdl` kra 2.8>8 k`h 2.>6; raspantdvacy.

     Ks ckolr suppcy ds a`hlga`lus d` tfa jlhac, tfa nlrraspl`hd`g wkga d`nlja d`aqukcdtyds mld`tcy hatarjd`ah oy a`hlga`lus ckolr flurs, tfa prlhunt le tltkc d`hdvdhukc aeednda`ny,

    , tfa slndkc wkga rkta, k`h ckolr flurs. Xfa K_(;) prlnass le Aquktdl` (?;) ds tfa`

    kpprlxdjktah oy k edva-stkta Jkrilv nfkd` usd`g tfa jatflh le Xkunfa` (;465).

    1 Ks astdjktah d` @A^HO k`h @^L (?228). 

    5 Ks oltf  k`h  nk` oa usah tl tkrgat tfa wdtfd`-grlup Gd`d nlaeednda`t, tfa kctar`ktdva sattd`g le nkcdorktd`g  wfdca

    stk`hkrhdzd`g  hlas `lt keeant tfa rasucts. Xfa astdjktdl` le parsdsta`na wluch l`cy oa plssdoca elr pk`ac hktk wdtf kcl`gar tdja flrdzl`..

    ;;

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    14/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    >.1 Fakctf Axpa`hdtura ^flnis

    Xl pkrkjatardza fakctf axpa`hdtura sflnis elr ylu`g k`h lch kga`ts, Fsu at kc. (?2;8)nkcdorktah hdrantcy erlj tfa ^A^ pk`ac hktk elcclwd`g tfa jatflh le Masia k`h Idtkl(?224). Aknf prlnass ds sdjpcdedah wdtf l`cy twl stktas, d`ncuhd`g –clw‚ k`h –fdgf‚ elr tfaclwar 41% k`h tlp 1% le tfa fakctf axpa`hdtura hdstrdoutdl`. Xfa fakctf axpa`hdtura elrylu`g kga`ts  k`h lch kga`ts   ds stktah racktdva tl tfa kvarkga slndkc wkga, k`havlcvas vdk tfa trk`sdtdl` prlokodcdtdas Τ  k`h Τ , raspantdvacy. Wa elcclw tfa skjajatflh k`h raear tl tfa vkcuas astdjktah oy Fsu at kc. (?2;8).

    >.5 ^lndkc ^anurdty ^ystaj

    Xfa Xfkd slndkc sanurdty systaj d`ncuhas lch-kga pa`sdl`, slndkc d`surk`na,u`ajpclyja`t, k`h fakctf nlvarkga snfajas. Xfds suosantdl` ackolrktas l` sunfslndkc sanurdty tdars.

    Q`ajpclyja`t oa`aedt.  Q`ajpclyah ylu`g kga`ts kra a`tdtcah tl u`ajpclyja`toa`aedts de tfay wlriah d` tfa elrjkc santlr d` tfa pardlh oaelra oanljd`g u`ajpclyah.

    D` prkntdna, k` u`ajpclyah parsl` ranadvas 12% le fds lr far kvarkga skckry lvar tfapkst 1 yakrs elr 5 jl`tfs.7 Gdva` tfa k``ukc eraqua`ny le tfa jlhac, tfa u`ajpclyja`toa`aedt rktdl, , ds sat kt ?1% le tfa kvarkga ckolr d`nlja hurd`g tfa edrst pardlh leu`ajpclyja`t k`h tfa kga`t hlas `lt ranadva eurtfar oa`aedts de tfa u`ajpclyja`tstktus nkrrdas l` ketar tfa edrst pardlh.

    ^lndkc d`surk`na.  Xfa glvar`ja`t prlvdhas slndkc d`surk`na elr jd`djujnl`sujptdl`, wfdnf kga`ts d` tfa anl`ljy nk` ranadva de tfadr lw` `at wakctf ds oaclw kprahatarjd`ah cavac. Xfa kjlu`t le nl`sujptdl` suosdhy, tfa hdeeara`na oatwaa`jd`djuj nl`sujptdl` k`h `at wakctf, ds astdjktah erlj tfa hktk kt 6.81% d` tarjs letfa slndkc kvarkga wkga d` tfa jlhac.

    Lch-kga pa`sdl`.  D` khhdtdl`, tfa wlriars wfl fkva nl`trdoutah tl tfa slndkc sanurdty

    pllc wfdca wlrid`g d` tfa elrjkc santlr kra kcsl a`tdtcah tl lch-kga pa`sdl` oa`aedts l`natfay kra ratdrah. Xfa pa`sdl` oa`aedt ds k parna`tkga, , le tfa ahunktdl`-hapa`ha`tkvarkga ckolr d`nlja le tfa ckst 1 yakrs. 6  Xfa elrjuck le tfa rapcknaja`t rkta d`Xfkdck`h, , ds ks elcclws (Reku k`h Ktdslpfl` ?224)=() : ;.1∟?.1;22   (??)wfara  raprasa`ts tfa `ujoar le yakrs le nl`trdoutdl`s tl tfa pa`sdl` systaj.

     Kga`ts kra kssujah tl nl`trdouta tl tfa pky-ks-ylu-gl lch-kga pa`sdl` systaj wfa`tfay kra d` tfa elrjkc santlr. Ks tfa sflni le ajpclyja`t ds trk`sdtlry, kcc kga`ts wlri d`tfa elrjkc santlr elr slja tdja, adtfar cl`gar lr sflrtar. ^uggastah oy tfa stktdl`kryvkcuas le tfa trk`sdtdl` jktrdx elr ajpclyja`t le Xkoca ;, k wlriar wdtf fdgf ahunktdl`

    fks k fdgfar prlokodcdty tl wlri d` tfa elrjkc santlr. Ks k rasuct, gdva` tfkt tfa axpantahwlrid`g yakrs le ylu`g kga`ts kra tfa skja, tfa vkcua le   ds fdgfar elr kga`ts wdtffdgf ahunktdl` nljpkrah wdtf clw ahunktdl`.7 Xl kvldh tfa axpl`a`tdkc nljputktdl`kc nlst tl trkni tfa edva-pardlh fdstlry, d`stakh le nkcnucktd`g tfa 1-yakr kvarkga

    ckolr d`nlja axpcdndtcy, wa kpprlxdjkta dt oy tfa ahunktdl`-hapa`ha`t nrlss-santdl`kc kvarkga vkcua.6 Xfa vkcua ds kpprlxdjktah oy tfa nrlss-santdl` kvarkga hua tl tfa skja raksl` ks tfa nkcnucktdl` le tfa u`ajpclyja`t

    oa`aedt.

    ;?

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    15/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    Fakctf nkra snfajas.  Oaelra tfa djpcaja`tktdl` le tfa QN^, slndkc sanurdtypkrtdndpktdl` wks cdjdtah tl wlriars d` tfa elrjkc santlr oksah l` k nl`trdoutdl`-oa`aedtprd`ndpca. Wdtf tfa djpcaja`tktdl` le tfa QN^ ed`k`nah oy ga`arkc tkx rava`ua, wlriarsd` tfa d`elrjkc santlr k`h kcc ratdraas, wfl wara `lt a`tdtcah ltfarwdsa, nluch oa nlvarahwdtf k clwar lut-le-plniat rktdl. Xfa kggragkta eckt lut-le-plniat rktdl ds usah elr tfakpprlxdjktdl` le kntukc rktdls. Xfa rktdls le lut-le-plniat fakctf axpa`hdtura elr tfa

    ylu`g ga`arktdl` k`h tfa lch ga`arktdl`, , ks k parna`tkga le tltkc axpa`hdtura l`fakctf, kra sat kt k u`delrj rkta le ;8% ketar tfa djpcaja`tktdl` le QN^. Rrdlr tl tfaQN^, tfa rktdl elr tfa elrjkc wlriars wks tfa skja ks ketarwkrh, wfdca tfa rktdl wks satkt >7% elr tfa pravdluscy cass d`surah grlup. Xltkc fakctf axpa`hdtura ds 8% le GHR.

    ^lndkc sanurdty nl`trdoutdl`s k`h ltfars. Xfa nl`trdoutdl` rkta, , ds ;2%, tfa sujle nl`trdoutdl`s erlj ajpclyars k`h ajpclyaas d` tfa anl`ljy. Xfa jlhac trdas tlnkptura tflsa pdcckr snfajas wfdca sdjpcdeyd`g tfa axdstd`g slndkc sanurdty systaj d` tfaXfkd anl`ljy. Xfa sdjpcdednktdl`s d`ncuha tfa elcclwd`g nktaglrdas. Edrst, slja eakturasle oa`aedts nkcnucktdl`s fkva oaa` hacdoarktacy caet lut, sunf ks tfa jd`djuj k`h nkp leoa`aedt. ^anl`h, ltfar tdars le slndkc sanurdty, sunf ks jktar`dty k`h wlri d`mury, kra kcsl`lt d`ncuhah d` tfa jlhac sd`na tfay pcky k racktdvacy jd`lr rlca. Ed`kccy, ltfar sanl`hkry

    pa`sdl` snfajas kra kcsl `lt pkrt le tfa jlhac.

    >.7 Glvar`ja`t Edsnkc _ava`ua k`h Axpa`hdtura

    Glvar`ja`t rava`ua nl`sdsts le nl`sujptdl` tkx, nkpdtkc d`nlja tkx, ckolr d`nlja tkx,k`h slndkc sanurdty nl`trdoutdl`s. Elcclwd`g Hdkz-Gdja`az k`h Hdkz-^kkvahrk (?224),wa nkcdorkta tfraa tkx rktas, d`ncuhd`g , , k`h , oy tkrgatd`g tfa sfkras le tfanlrraspl`hd`g tkx rava`uas, d` tfa parna`tkgas le GHR. D` khhdtdl`, slndkc sanurdtynl`trdoutdl`s pkdh oy wlriars d` tfa elrjkc santlr kra nlccantah oy tfa glvar`ja`t ksrava`ua, le wfdnf tfa rkta ds ha`ltah oy .Glvar`ja`t edsnkc lutckys d`ncuha kcc id`hs le slndkc sanurdty axpa`hdtura, d`tarastpkyja`t, k`h glvar`ja`t nl`sujptdl`. Xfa glvar`ja`t dssuas ol`hs, wfdnf kra

    kssujah tl oa fach l`cy elr l`a pardlh, rapcknd`g tfa axdstd`g haot wfdca iaapd`g tfahaot-tl-GHR rktdl, /, nl`stk`t. Gdva` sunf k sdjpcdednktdl`, l`cy d`tarast pkyja`tslnnur. D` tfa oa`nfjkri anl`ljy, glvar`ja`t nl`sujptdl`,  , ds a`hlga`luscyhatarjd`ah tl okck`na tfa glvar`ja`t ouhgat. ^lndkc sanurdty axpa`hdturas sunf ks lch-kga pa`sdl`, u`ajpclyah oa`aedt, slndkc kssdstk`na, k`h puocdn fakctf axpa`hdtura krahatarjd`ah oy tfa plcdny nfldnas le ,(), ,   k`h ltfar a`hlga`lus vkrdkocas

     mld`tcy.

    Xfa hatkdcs le oltf tfa astdjktah pkrkjatars k`h nkcdorktdl` tkrgats kra d`ncuhah d` Kppa`hdx K elr eurtfar raeara`na. Wa nl`ncuha tfds santdl` oy sujjkrdzd`g tfapkrkjatars le tfa vkcuas tl oa nkcdorktah d` tfa elcclwd`g santdl`. ^unf pkrkjatarsnl`sdst le tfa hdsnlu`t ekntlr,

    , tfa utdcdty pkrkjatars,

     k`h

    , tfa hajlgrkpfdn

    pkrkjatars,  k`h , tfa ahunktdl` k`h santlr spandedn aeednda`ny pkrkjatars,  k`h, tfa stk`hkrh havdktdl`s le dhdlsy`nrktdn sflnis, , k`h tfa tkx rktas, ,  k`h . D`khhdtdl`, ()  ds hatarjd`ah oy , wfdnf hapa`hs l` tfa Jkrilv-nfkd` stktdl`kryhdstrdoutdl` le tfa ajpclyja`t trk`sdtdl` jktrdnas.

    ;>

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    16/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    8. K@KCT^D^

    D` tfds santdl`, tfa nl`struntah oa`nfjkri anl`ljy ds hasnrdoah pkrtdnuckrcy wdtfnljpkrdsl` le kntukc oa`nfjkri vkcuas k`h tkrgatah vkcuas. Xfa k`kcysas elnus l` tfastakhy-stkta aqudcdorduj. Edrstcy, k oa`nfjkri anl`ljy wdtf QN^ ds nkcdorktah wdtf iay

    tkrgats oad`g jktnfah tl tfa hktk le tfa Xfkd anl`ljy, kssujd`g glvar`ja`tnl`sujptdl` tl okck`na tfa glvar`ja`t ouhgat. Kcc tfa `l`-rktdl vkcuas kra d` rakctarjs, d`stakh le `ljd`kc l`as. Xfa tkrgat vkcuas fkva oaa` nflsa` oksah l` tfakvarkga vkcuas ketar ?227, wfdnf ds tfa pardlh ketar eucc djpcaja`tktdl` le QN^.

    Xl d`vastdgkta tfa aeeants le QN^, tfds pkpar nl`hunts sdjucktdl`s le rajlvd`g QN^, d`wfdnf tfa lut-le-plniat rktdl le wlriars d` tfa d`elrjkc santlr k`h kcc lch palpca ds rkdsahokni tl tfa pra-QN^ cavac. Xfa rasucts u`har hdeeara`t tkx ed`k`nd`g lptdl`s kranljpkrah wdtf tfa oa`nfjkri anl`ljy, d`ncuhd`g tfa djpknts l` vkrdlus hdja`sdl`ssunf ks ckolr suppcy, kssat flchd`gs, slndkc wacekra, k`h d`aqukcdty. Xfa nljputktdl`prlnahura ds a`nclsah d` Kppa`hdx N.

    8.; Oa`nfjkri Anl`ljy

    Xkoca ? sflws tfa iay eakturas le sunf k oa`nfjkri anl`ljy, wdtf nclsacy jktnfd`gnkcdorktdl` tkrgats raprasa`td`g vkrdlus iay eakturas le tfa Xfkd anl`ljy. Elr d`stk`na,tfa nkpdtkc lutput rktdl k`h fakctf axpa`hdtura lutput rktdl kra >.828? k`h >.44%,raspantdvacy, gdva` tfa tkrgats le >.8 k`h 8.2%. Xfa Gd`d nlaeednda`ts le tfa oa`nfjkrianl`ljy kra l`cy scdgftcy fdgfar tfk` tfa nkcdorktdl` tkrgats, kt 2.8>7;, 2.>6>?, k`h2.>451 nljpkrah wdtf 2.8>82, 2.>6;2, k`h 2.>48 elr tfa wdtfd` grlup k`h anl`ljy-wdhaGd`d nlaeednda`ts. Xfa hatkdcs le sunf nkcdorktdl` tkrgats kra a`nclsah d` Kppa`hdx K.

    Xkoca ?= Iay Anl`ljdn Eakturas le tfa Oa`nfjkri Anl`ljy

    @kja Nkcdorktdl` Xkrgat Oa`nfjkri Ukcua

    Nkpdtkc lutput rktdl >.8222 >.828?Xltkc fakctf axpa`hdtura lutput rktdl 8.22% >.44%

    _dsi kvarsdl` le utdcdty eu`ntdl` ?.2222 ?.2222

     Kggragkta ckolr flurs par wlriar ;/> 2.>>88

    Wlrid`g yakrs 81 81

    Lch-kga hapa`ha`ny rktdl ;>% ;>%

    D`elrjkc santlr sdza (% le wlri elrna) 5?% 5?%

    D`elrjkc santlr lutput (% le tltkc lutput) 88.22% 88.42%

    Gd`d nlaeednda`t elr ckolr d`nlja (fdgf ahunktdl`) 2.8>82 2.8>7;

    Gd`d nlaeednda`t elr ckolr d`nlja (clw ahunktdl`) 2.>6;2 2.>6>?

    Gd`d nlaeednda`t elr d`nlja (slndkc kvarkga) 2.>482 2.>451

    Ckolr d`nlja tkx (% le GHR) ?.?2% ?.;6%

    Nkpdtkc tkx (% le GHR) 1.82% 1.87%

    Nl`sujptdl` tkx (% le GHR) ;2.62% ;2.74%GHR : grlss hljastdn prlhunt.

    ^lurna= Jd`dstry le Ed`k`na, Xfkdck`h9 @A^HO, Xfkdck`h9 Wlrch Ok`i9 Q`dtah @ktdl`s9 kutflrs— nkcnucktdl`s.

    ;8

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    17/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    Rkrkjatars le tfa oa`nfjkri anl`ljy kra d`ncuhah d` Xkoca > ks k` lvarvdaw. D`khhdtdl` tl tfa pkrkjatars hasnrdoah d` tfa akrcdar santdl`, tfa nkcdorktah vkcuas le tfarajkd`d`g pkrkjatars kra sat ks elcclws.  ds 2.4282 ks k rasuct le nkcdorktd`g tfa nkpdtkclutput rktdl le >.8222.  k`h  kra gdva` oy >.11;2 k`h 2.>4?2 elr ckolr flurs k`h rdsikvarsdl`.  k`h  kra sat kt 2.???2 k`h 2.;742, elr wfdnf ylu`g kga`ts wlri elr 81yakrs l` kvarkga k`h tfa lch-kga hapa`ha`ny rktdl ds hatarjd`ah kt ;>%. Gdva` tfa

    vkcuas le 2.7?7> k`h 2.7222, tfa ahunktdl` k`h santlr-spandedn aeednda`ndas,  k`h ,nluch facp tl tkrgat tfa anl`ljy-wdha Gd`d nlaeednda`t le 2.>482 k`h tfa lutput sfkra letfa d`elrjkc santlr le 88.22%, raspantdvacy. Ed`kccy tfa tkx rktas, , , k`h , wfdnf kra;5%, 5.8%, k`h >1%, kra kcsl nkcdorktah tl jktnf tfa tkx rava`ua sfkras le ?.?%,1.8%, k`h ;2.6%, knnlrhd`gcy.

    Xkoca >= Rkrkjatars le tfa Oa`nfjkri Anl`ljy

    Rkrkjatar Ukcua Hasnrdptdl`

    Flusaflchs  2.4282 Hdsnlu`t ekntlr

      >.11;2 Qtdcdty pkrkjatar

      2.>4?2 Nl`sujptdl`-cadsura pkrkjatar  2.???2 _atdraja`t prlokodcdty  2.;724 Haktf prlokodcdty  2.;822 Lut-le-plniat rktdl  2.?122 ^fkra le fdgf ahunktdl` grlup  ;.2222 Ahunktdl`-spandedn aeednda`ny (fdgf ahunktdl`), `lrjkcdzah  2.7?7> Ahunktdl`-spandedn aeednda`ny (clw ahunktdl`)  2.4122 K_(;) parsdsta`na (Fuookrh at kc. ;441)

      2.??>2 K_(;) stk`hkrh havdktdl` (fdgf ahunktdl`)

      2.;742 K_(;) stk`hkrh havdktdl` (clw ahunktdl`)Edrjs  2.>;88 Nkpdtkc d`nlja sfkra (Kfumk at kc. ?228)  2.21?2 Haprandktdl` rkta   ;.2222 Xltkc ekntlr prlhuntdvdty  ;.2222 ^antlr-spandedn aeednda`ny (elrjkc santlr), `lrjkcdzah  2.7222 ^antlr-spandedn aeednda`ny (d`elrjkc santlr)Glvar`ja`t  2.;522 Nl`sujptdl` tkx rkta

      2.2582 Ckolr d`nlja tkx rkta

      2.>122 Nlrplrkta d`nlja tkx rkta  2.;222 ^lndkc sanurdty nl`trdoutdl` rkta  2.?122 Q`ajpclyja`t oa`aedt  2.2681 Jd`djuj nl`sujptdl` trk`sear le slndkc kvarkga wkga  Aq. (??) Ra`sdl` oa`aedt rapcknaja`t rkta/  2.8>22 Ruocdn haot rktdl^lurna= Kutflrs.

    ;1

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    18/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    Xfa oa`nfjkri jlhac ds nclsah oy nfllsd`g glvar`ja`t nl`sujptdl` tl oaa`hlga`luscy hatarjd`ah. Wdtf glvar`ja`t nl`sujptdl` kt ;8.2;% le GHR, tfaglvar`ja`t okck`nas tfa ouhgat knnlu`td`g elr ??.??% le GHR. Xfa a`hlga`lusd`tarast rkta ds 8.2>% k`h tfa wkga rkta ds ;.?2?7, sarvd`g ks tfa ekntlr prdnas elr nkpdtkck`h ckolr. Jlra hatkdcs le tfa oa`nfjkri anl`ljy nk` oa elu`h d` Nlcuj` (;) le

     Kppa`hdx O, Xkoca O;. 

    8.? Xkx-oksah Ed`k`nd`g Lptdl`s

    D` k rakc-wlrch anl`ljy, ga`arkc rava`ua d`stakh le nartkd` akr-jkriah ed`k`ndkcraslurnas ds leta` usah tl ed`k`na tfa d`nraja`t le puocdn fakctf axpa`hdtura krdsd`gerlj k QFN snfaja. Flwavar, erlj k plcdny-jkid`g parspantdva, dt jdgft oa jlraracavk`t tl axkjd`a tfa aeeants gdva` k spandedn ed`k`nd`g lptdl`. D` tfa jlhac anl`ljyhasnrdoah kolva wfara tfa glvar`ja`t rava`ua nljas erlj vkrdlus slurnas sunf ksckolr d`nlja tkx, nl`sujptdl` tkx, k`h nkpdtkc d`nlja tkx, wa axkjd`a aknf le tfajsapkrktacy.

    Xfa oa`nfjkri anl`ljy d` tfa akrcdar suosantdl` djpcaja`ts k tkx-ed`k`nah QFN

    snfaja tfrlugf wfdnf tfa d`elrjkc k`h lch-kga kga`ts nk` knnass fakctfnkra wdtf kclwar lut-le-plniat rktdl, ed`k`nah oy glvar`ja`t rava`ua. D` tfds suosantdl`, tfrlugfnlu`tarekntukc axpardja`ts le rajlvd`g tfa nlvarkga snfaja, tfraa nlrraspl`hd`ganl`ljdas hardvah e rlj tfa oa`nfjkri kra nl`struntah d` lrhar tl axkjd`a hdeeara`ted`k`nd`g sna`krdls.4 

    Edgura ?= Ed`k`nd`g Nlst le Q`dvarskc Fakctf Nlvarkga 

    ^lurna= Kutflrs.

    Wfa` tfa ckolr d`nlja tkx ds kssujah tl ed`k`na tfa axpa`hdtura d` k QFN anl`ljy,nlu`tarekntukccy, tfa ckolr d`nlja tkx rkta ekccs erlj 5.8% tl >.6?% de `l sunf nlvarkgasnfaja ds djpcaja`tah.;2  De tfa nl`sujptdl` tkx ds kssujah tl ed`k`na tfa snfaja, tfa

    ed`k`ndkc nlst ds jlra aqukccy sfkrah knrlss hdeeara`t slndkc grlups. Xfk`is tl k ckrgartkx oksa, tfa nfk`ga le tfa nl`sujptdl` tkx rkta ds cass, erlj ;5% tl ;8.6%, wdtf tfarajlvkc le tfa snfaja. Ed`kccy, rajlvkc le tfa fakctf nlvarkga snfaja jkias tfa

    4^lndkc sanurdty nl`trdoutdl` ds aqudvkca`t tl ckolr d`nlja tkx elr dts tkx aeeant, k`h tfa haot„GHR rktdl ds kssujah tl oa

    nl`stk`t, wfdnf prava`ts tfa glvar`ja`t erlj rkdsd`g rava`ua tfrlugf dssud`g khhdtdl`kc haot. Knnlrhd`gcy, wa hl `ltgdva eurtfar k`kcysds elr tfasa twl lptdl`s.

    ;2 Ks tfa aeeant le ga`arkc aqudcdorduj d`ecua`nas tfa cavacs le fakctf axpa`hdtura k`h glvar`ja`t nl`sujptdl` d` tfa vary

    sflrt ru`, wa edx oltf axpa`hdturas kt tfa vkcuas d`stakh le rktdls kt tfa kctar`ktdva anl`ljdas tl prava`t sunf sflrt-ru` khmustja`t.

    ?.16%

    ;.?2%

    8.>1%

    2.2%

    2.1%

    ;.2%

    ;.1%

    ?.2%

    ?.1%>.2%

    >.1%

    8.2%

    8.1%

    1.2%

    Ckolr d`nlja tkx rkta Nl`sujptdl` tkx rkta Nkpdtkc d`nlja tkx rkta

       X  k  x

      r  k   t  a

      n   f

      k  `  g  a

    ;5

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    19/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    nkpdtkc d`nlja tkx rkta ekcc erlj >1% tl >2.51% de tfa nkpdtkc d`nlja tkx ds kssujah elrtfa purplsa le ed`k`nd`g (tfa hatkdcs le tfasa anl`ljdas kra sflw` d` Kppa`hdx O, XkocaO;, nlcuj`s (?)„(8)).

    D` ltfar wlrhs, gdva` tfa d`nujoa`t tkx struntura, d`nraksd`g tfa ckolr d`nlja tkx rktaelr elrjkc wlriars oy ?.16% (tfa tkx rkta hdeeara`na wdtf k`h wdtflut tfa u`dvarskc

    nlvarkga snfaja), lr nl`sujptdl` tkx oy ;.?%, lr nkpdtkc d`nlja oy 8.>1% ds raqudrahtl ed`k`na tfa fakctf nlvarkga snfaja d` lrhar elr tfa glvar`ja`t tl okck`na dtsouhgat, ks sflw` d` Edgura ?.

    8.> Ckolr ^uppcy k`h Kssat Flchd`g

    Xl jaat tfa ed`k`nd`g `aahs le tfa QFN snfaja, tfraa tkxas nk` oa nflsa` tl okck`natfa glvar`ja`t ouhgat, ks ja`tdl`ah kolva. Flwavar, tfadr aeeants nk` hdeear kt oltftfa jknrl k`h d`hdvdhukc cavacs tfrlugf hdeeara`t trk`sjdssdl` nfk``acs. Wa slcva tfajlhac `ujardnkccy k`h trkni tfa handsdl` rucas k`h hdstrdoutdl`s, wfdnf a`kocas us tlaxkjd`a k` d`hdvdhukc kga`t—s oafkvdlr d` tarjs le nl`sujptdl`, ckolr, k`h kssatflchd`gs kt aknf stkta spkna. Elr sdjpcdndty le axprassdl`, tfds santdl` hasnrdoas tfa

    pkttar`s le ckolr suppcy k`h kssat flchd`gs ketar grlupd`g d`hdvdhukcs knnlrhd`g tl tfadrahunktdl` typa k`h santlr stktus. L` tlp le tfkt, tfa jknrl-kggragktah vkcuas kra kcslaxkjd`ah.

    Ckolr suppcy.  D` tfa kosa`na le k u`dvarskc nlvarkga snfaja, k ckrga plrtdl` le tfaplpucktdl`, d`ncuhd`g d`elrjkc wlriars k`h acharcy palpca, `aah tl sace-ed`k`na fdgfarlut-le-plniat fakctf axpa`hdturas. Xfaraelra, prankutdl`kry skvd`g kgkd`st ckrgaraxpa`hdtura sflnis nljas d`tl pcky, wfdnf tfay tkia d`tl knnlu`t d` tfadr nl`sujar„cadsura handsdl`s.

    D` tfa oa`nfjkri anl`ljy wfara sunf k nlvarkga snfaja ds prlvdhah, d` nl`trkst, waed`h k QFN anl`ljy nluch hdsnlurkga ckolr suppcy kt tfa kggragkta cavac wfa` dt dsed`k`nah oy ckolr d`nlja tkx k`h nl`sujptdl` tkx, out a`nlurkgas ckolr suppcy wfa` dt

    ds ed`k`nah oy nkpdtkc d`nlja tkx. Ks sflw` d` Xkoca 8, tfa `agktdva djpknt le ckolrd`nlja tkx ed`k`nd`g ds sdjdckr tl, out scdgftcy cass tfk`, nl`sujptdl` tkx („2.1;%nljpkrah wdtf „2.52%), tkid`g d`tl knnlu`t tfa sfkras le tfa wlrid`g plpucktdl` d` tfaelrjkc k`h d`elrjkc santlrs elr hdeeara`t ahunktdl` grlups. Nkpdtkc d`nlja tkx, flwavar,fks k plsdtdva djpknt oy d`nraksd`g tfa ckolr suppcy, wdtf k racktdvacy sjkcc 2.;?%d`nraksa d` kggragktdl`.

     Kt tfa hdskggragkta cavac, tfa rasucts kra nl`sdsta`t wdtf tfa cdtarktura tfkt ckolr d`nljatkx fks tfa fdgfast hdstlrtdl` elr tfa ckolr suppcy. Wa ed`h tfkt d` tfa elrjkc santlr,wfara tfa ckolr d`nlja tkx ds a`elrnah, ckolr suppcy ds hdsnlurkgah jlra nljpkrah wdtftfa cass-hdstlrtdva nl`sujptdl` tkx. Kga`ts wdtf clw ahunktdl` kra aspandkccy cass wdccd`gtl wlri, kt k rahuntdl` le ?.6;% nljpkrah wdtf 2.8?% wfa` tfa nl`sujptdl` tkx dsusah tl ed`k`na tfa snfaja.

    Dt ds wlrtf `ltd`g tfkt elr tfa nksa le ckolr d`nlja tkx ed`k`nd`g, kga`ts d` tfa d`elrjkcsantlr, d` nl`trkst, d`nraksa tfadr suppcy le ckolr. Aspandkccy elr kga`ts wdtf fdgfahunktdl`, tfadr ckolr suppcy d`nraksas oy >.86%. Gdva` tfkt ajpclyja`t sflnis kratrk`sdtlry, tfa elrwkrh-cllid`g rktdl`kc kga`ts nluch tkia khvk`tkga le `lt oad`g tkxahwfa` tfay wlri d` tfa d`elrjkc santlr, elrasaad`g tfkt tfay fkva tl oakr k` d`nraksahckolr d`nlja tkx rkta d` tfa elrjkc santlr. Wa hl `lt losarva sunf k pkttar` wfa`nl`sujptdl` tkx lr nkpdtkc d`nlja tkx ds usah.

    ;7

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    20/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    Xkoca 8= Ckolr ^uppcy Nfk`gas le Xkx-ed`k`nah Q`dvarskc Fakctf Nlvarkga

    Ckolr D`nlja Xkx Nl`sujptdl` Xkx Nkpdtkc D`nlja Xkx

     Kcc -2.1;% -2.52% 2.;?%

    Fdgf ahunktdl` -2.81% -2.1;% 2.;1%

    Elrjkc -;.11% -2.86% 2.;8%D`elrjkc >.86% -2.7>% 2.;;%

    Clw ahunktdl` -2.1;% -2.52% 2.;1%

    Elrjkc -?.6;% -2.8?% 2.;1%

    D`elrjkc 2.16% -2.56% 2.;5%^lurna= Kutflrs.

    Erlj tfa ed`hd`gs kolva, wa losarva hdvarsa djpknts l` tfa ckolr suppcy oltf kt tfakggragkta k`h hdskggragkta cavacs erlj tfasa tkx lptdl`s. Kt tfa jdnrl cavac elr wlrid`gkga`ts, tfadr ckolr suppcdas kra `agktdvacy racktah tl kssat flchd`gs k`h plsdtdvacy racktahtl prlhuntdvdty, k`h raspl`h hdeeara`tcy tl vkrdlus tkxas k`h ekntlr prdnas.

    Xkoca 1= Kssat Flchd`g Nfk`gas oy Xkx-ed`k`nd`g Lptdl`

    Ckolr D`nlja Xkx Nl`sujptdl` Xkx Nkpdtkc D`nlja Xkx

     Kcc -8.12% ->.51% ->.;;%

    Fdgf ahunktdl` -?.;4% -2.25% 2.;1%

    Elrjkc -?.>4% 2.2;% 2.?>%

    D`elrjkc -;.;;% 2.?8% 2.85%

    Q`ajpclyahk  -;.4>% 2.>8% 2.1;%

    Q`ajpclyaho  -2.14% 2.54% 2.6;%

    Lch kga -8.?6% -?.?7% -?.?4%

    Clw ahunktdl` -1.52% -1.>6% -8.57%

    Elrjkc -5.8?% -1.;?% -8.88%

    D`elrjkc -1.24% -1.?8% -8.1?%

    Q`ajpclyahk  -5.72% -1.>7% -8.7;%

    Q`ajpclyaho  -1.81% -1.61% -1.;>%

    Lch kga -7.88% -7.11% -5.67%;Q`ajpclyah erlj tfa elrjkc santlr.

    ?Q`ajpclyah erlj tfa d`elrjkc santlr.

    ^lurna= Kutflrs.

    Kssat flchd`gs. Xfa nfk`gas le kssat flchd`gs tur` lut tl oa jlra prlelu`h tfk` tfanfk`gas le ckolr suppcy wdtf k nlupca le hdstd`ntdva pkttar`s oad`g losarvah d` tfaelcclwd`g. Edrst, kt tfa kggragkta cavac, kcc ed`k`nd`g lptdl`s cakh tl clwar kssat flchd`gssd`na tfa prlvdsdl` le u`dvarskc nlvarkga hkjpa`s tfa `aah elr prankutdl`kry skvd`g d`tfa slndkc kvarkga. ^anl`h, tfa lch ga`arktdl` hanraksas kssats u`har kcc ed`k`nd`glptdl`s k`h tfa sdza le tfa rahuntdl` ds graktar tfk` elr tfa ylu`g ga`arktdl`. Xfdrh, tfaed`k`nd`g lptdl` le ckolr d`nlja tkx nkusas tfa ylu`g kga`ts wdtf oltf fdgf k`h clwahunktdl` tl flch eawar kssats, wfdca l`cy ylu`g kga`ts wdtf clw ahunktdl` rahunakssats wfa` tfa ltfar twl ed`k`nd`g lptdl`s kppcy.

    ;6

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    21/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    Lutput. ^lndkc sanurdty snfajas sunf ks k QFN snfaja ed`k`nah oy k nartkd` typa letkx rava`ua nluch keeant lutput tfrlugf k eaw trk`sjdssdl` nfk``acs. Edrst, d` k pkrtdkcaqudcdorduj, sattd`g flchd`g tkx nl`stk`t, oattar slndkc sanurdty ds cdiacy tl hdsnlurkga oltfckolr suppcy k`h skvd`g. ^anl`h, oattar d`surk`na kgkd`st axpa`hdtura sflnis facpskga`ts sjlltf tfadr nl`sujptdl` jlra aeednda`tcy. Xfdrh, wfa` slurnas le ed`k`nd`g kratkia` d`tl knnlu`t, rdsd`g tkx rktas nluch keeant d`hdvdhukcs— handsdl`s ks wacc. Ed`kccy, l`

    tlp le tfasa nfk``acs, tfa nfk`gas le wkga rkta k`h d`tarast rkta hua tl ga`arkcaqudcdorduj aeeants d`ecua`na oafkvdlr ks wacc. Ks k nl`saqua`na le kcc tfa ekntlrs kolva,hdvarsa djpknts le ckolr suppcy k`h kssat flchd`g raspl`hd`g tl hdeeara`t tkx lptdl`s, kssflw` d` Xkoca 8 k`h 1, cakh tl nfk`gas le prlhuntdl`, wfdnf ds k eu`ntdl` le ckolr k`hnkpdtkc. Ed`k`nd`g QFN wdtf kcc tfraa tkx lptdl`s rasucts d` k `agktdva djpknt l` lutputckrgacy hua tl k hancd`d`g kggragkta nkpdtkc. D` nljpkrdsl`, kjl`g tfasa tfraa, nkpdtkctkx nluch oa praearrah tl tfa ltfar twl tkxas, gdva` k` d`nraksa le ckolr suppcy k`h kcassar rahuntdl` le nkpdtkc.

    8.8 D`nlja Hdstrdoutdl`

    D` tarjs le djpknts l` d`nlja hdstrdoutdl`, tfa tfraa tkx lptdl`s tl ed`k`na QFN kcsl

    oakr hdeeara`t djpcdnktdl`s. _agkrhd`g tfa djpknt l` (tltkc) d`nlja d`aqukcdty jaksurahoy tfa Gd`d nlaeednda`t, tfa ckolr d`nlja tkx nluch rahuna tfa d`nlja Gd`d nlaeednda`t oy2.8>%, ks sflw` d` tfa edrst nlcuj` le Edgura >. D` nl`trkst, tfa nl`sujptdl` tkxd`nraksas tfa Gd`d nlaeednda`t oy 2.?>% k`h nkpdtkc d`nlja tkx oy 2.82%. A`elrnah d` tfaelrjkc santlr wfara wlriars fkva fdgfar d`nljas l` kvarkga, tfa ckolr d`nlja tkx fksk ckrgar rahdstrdoutdva aeeant tl rahuna d`aqukcdty anl`ljy-wdha, nljpkrah wdtf tfa ltfarlptdl`s.

    Edgura >= D`nlja Gd`d Nlaeednda`t Nfk`gas oy Xkx-ed`k`nd`g Lptdl`

    y\c : ckolr d`nlja9 y\i : nkpdtkc d`nlja.^lurna= Kutflrs.

     Ks tfara kra twl id`hs le d`nlja‘nkpdtkc d`nlja elr kcc kga`ts wfl flch kssats k`hckolr d`nlja elr kga`ts wfl wlri‘wa axkjd`a oltf tfa Gd`d nlaeednda`ts le nkpdtkcd`nlja k`h ckolr d`nlja elr tfa raspantdva grlups. Xfa sanl`h tl elurtf nlcuj`s leEdgura > pclt tfa nfk`gas d` tfa Gd`d nlaeednda`ts elr ckolr d`nlja k`h nkpdtkc d`nlja (elrhatkdcs, saa Kppa`hdx O, Xkoca O;).

    -?.2%

    -;.2%

    2.2%

    ;.2%

    ?.2%

    >.2%

    8.2%

    1.2%

    kcc y\c= fdgf ahu y\c= clw ahu y\i= fdgf ahu y\i= clw ahu

    Ckolr d̀ nlja tkx rkta Nl`sujptdl` tkx rkta Nkpdtkc d̀ nlja tkx rkta

    ;4

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    22/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    _agkrhd`g tfa wdtfd`-grlup nfk`gas le d`aqukcdty, elr kcc tfraa tkx lptdl`s, tfa d`nraksd`gtkx rkta cakhs tl k fdgfar Gd`d nlaeednda`t le tfa fdgf ahunktdl` grlup—s ckolr d`nlja k`holtf grlups— nkpdtkc d`nljas. Xfara ds k `agktdva djpknt l` tfa ckolr d`nlja Gd`d elr tfaed`k`nd`g nksas le ckolr d`nlja tkx k`h nkpdtkc d`nlja tkx, kppcyd`g l`cy tl tfa clw-ahunktdl` grlup wdtf hanraksas le 2.17% k`h 2.21%, raspantdvacy. Xfa jlstprl`lu`nah d`nraksas le tfa wdtfd`-grlup Gd`d kra d` tfa nkpdtkc d`nlja Gd`d le tfa clw-

    ahunktdl` grlup, rk`gd`g erlj >.?8% tl >.71% hapa`hd`g l` tfa tkx lptdl`. ^unfwdtfd`-grlup vkrdktdl` le tfa Gd`d nlaeednda`t ds tfa nl`saqua`na le d`hdvdhukcs— handsdl`s,ks ja`tdl`ah d` ^antdl` 8.>, wfara aknf d`hdvdhukc kga`t wdtfd` tfa grlup ra-jkiaslptdjkc handsdl`s le wlri tdja k`h skvd`gs u`har tfa `aw ndrnujstk`nas le fakctfaxpa`hdtura nlvarkga k`h tkx ourha`.

    D` tfds suosantdl`, wa axkjd`a tfa tkx-ed`k`nah QFN—s djpknts l` tfa d`nljahdstrdoutdl`s avkcuktah oy tfa Gd`d nlaeednda`ts, d`ncuhd`g d`nlja anl`ljy-wdha k`hgrlup-oksah nljpl`a`t d`nljas. Lur axpardja`ts suggast tfkt tfa ckolr d`nlja tkxnluch rahuna d`aqukcdty wfdca tfa nkpdtkc d`nlja tkx nluch d`nraksa dt. Kt tfahdskggragkta nljpl`a`t d`nlja cavac, nkpdtkc d`nlja d`aqukcdty d`nraksas elr kcc tfraanksas.

    8.1 Wacekra Nljpkrdsl` le Ed`k`nd`g Lptdl`s

    D` tfds santdl`, wa eurtfar axkjd`a tfa djpknt l` wacekra jaksurah oy nl`sujptdl`-aqudvkca`t vkrdktdl` (NAU) wdtf tfa jaksura  lotkd`ah oy

    : ∩()()∩()()() ;  (?8)

    wfara () k`h  kra tfa vkcua eu`ntdl`s le kga`ts d` k` kctar`ktdva anl`ljy k`htfa oa`nfjkri anl`ljy. ∩()()  hasnrdoas tfa kvarkga axpantah cdeatdja vkcuasle kcc kga`ts d` tfa anl`ljy, , wfara   ds tfa kctar`ktdva anl`ljy k`h  ds tfaoa`nfjkri anl`ljy.;; 

    Wa wluch cdia tl axkjd`a edrst le kcc wfatfar QFN nluch ord`g oattar wacekra lr `lt, gdva`hdeeara`t ed`k`nd`g lptdl`s9 k`h sanl`hcy, hatarjd`a wfdnf tkx ed`k`nd`g ds oattar kjl`gQFN anl`ljdas. Xl k`swar tfa edrst quastdl`, wa nljpkra tfa `l`-QFN anl`ljdasoksah l` tfa kssujptdl`s le hdeeara`t ed`k`nd`g lptdl`s wdtf tfa oa`nfjkri anl`ljy.Xfa rasucts suggast tfkt k` anl`ljy wdtflut QFN nluch fkva fdgf wacekra wdtf gkd`serlj ;.;7% tl ;.8>% hapa`hd`g l` tfa ed`k`nd`g lptdl`s elr tfa QFN anl`ljy. D` ltfarwlrhs, QFN anl`ljdas kra wlrsa-lee d` tarj le wacekra nfk`ga (saa Kppa`hdx O, XkocaO> elr jlra hatkdcs).

    Xfa aeeants l` wacekra nluch oa kttrdoutah tl oltf tfa cavac nfk`ga k`h tfa hdstrdoutdl`nfk`ga le cdeatdja utdcdty, wfdnf kra hatarjd`ah oy nl`sujptdl` k`h cadsura. D` k QFNanl`ljy, kga`ts jdgft jlstcy oa`aedt erlj k fdgfar cavac le cadsura out jdgft kcsl fkva

    tl knnapt k clwar cavac le lutput (k`h nl`sujptdl`) l` kvarkga. K `agktdva djpknt l`wacekra nluch rasuct wfa` tfa tltkc gkd` le tfa oa`aedndkry ds cass tfk` tfa tltkc clss le tfahdskhvk`tkgalus grlup, tkid`g sunf d`hdvdhukc cavac aeeants k`h slndkc hdstrdoutdl` aeeantsd`tl knnlu`t.

    ;; ^aa Cunks (;467), Faktfnlta at kc. (?2;>), k`h Fsu k`h Tk`g (?2;>) elr hatkdcs racktah tl tfa hardvktdl` le Aquktdl`

    (?8).

    ?2

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    23/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    Xl k`swar tfa sanl`h quastdl`, wa nl`strunt twl  jlra anl`ljdas ed`k`nah oynl`sujptdl` tkx k`h nkpdtkc d`nlja tkx, raspantdvacy.;? Kt tfa anl`ljy-wdha cavac, oltftfa nl`sujptdl` tkx k`h tfa nkpdtkc d`nlja tkx kra praearrah tl ckolr d`nlja tkx wdtfplsdtdva vkcuas le NAU kt 2.;8% k`h 2.;1%, raspantdvacy. Ks sflw` d` Xkoca 5, sunfNAU gkd`s kra nl`trdoutah oy tfa jlra prlhuntdva fdgf-ahunktdl` grlup wdtf suostk`tdkc;.24% k`h ;.;4% nfk`gas, lutwadgfd`g tfa clssas le tfa clw-ahunktdl` grlup le 2.;6%

    k`h 2.?2% wdtf k ckrgar plpucktdl` sdza, elr tfa nksas le tfa nl`sujptdl` tkx ed`k`nd`gk`h tfa nkpdtkc d`nlja tkx ed`k`nd`g, raspantdvacy. Xfa fdgf-ahunktdl` ylu`g ga`arktdl`kcsl praears tfa nkpdtkc d`nlja tkx tl tfa ckolr d`nlja tkx, wfdca tfa clw-ahunktdl`ylu`g ga`arktdl` praears tfa lpplsdta.

    Xkoca 5= Wacekra Nl`sujptdl`-aqudvkca`t Ukrdktdl` Nljpkrah wdtf Ckolr D`nljaXkx Ed`k`nd`g

    Grlup Ed`k`nah oy Nl`sujptdl` Xkx Ed`k`nah oy Nkpdtkc D`nlja Xkx

    NAU= Kcc 2.;8% 2.;1%

    NAU= Fdgf ahunktdl` ;.24% ;.;4%

    Tlu`g ga`arktdl` ;.;?% ;.;4%

    Lch ga`arktdl` 2.>5% ;.>4%

    NAU= Clw ahunktdl` -2.;6% -2.?2%

    Tlu`g ga`arktdl` -2.?;% -2.?5%

    Lch ga`arktdl` 2.?6% 2.72%NAU : nl`sujptdl`-aqudvkca`t vkrdktdl`.

    ^lurna= Kutflrs.

    Xfa lch ga`arktdl` gkd`s erlj tfa kctar`ktdva anl`ljdas wdtf adtfar k fdgfarnl`sujptdl` tkx lr k fdgfar nkpdtkc d`nlja tkx, nljpkrah wdtf tfa anl`ljy wdtf kfdgfar ckolr d`nlja tkx. Kctflugf lch palpca fkva tl oa tkxah jlra d` tfa twlkctar`ktdva anl`ljdas nljpkrah wdtf tfa oa`nfjkri anl`ljy, wfara tfa fdgfar ckolrd`nlja tkx rkta hlas `lt kppcy tl tfaj, tfay stdcc fkva tfa wacekra gkd` d` tfa fdgfar tkxanl`ljdas. ^unf gkd`s kra ckrgacy hua tl tfa eknt tfkt tfay racy l` kssat d`nlja k`hpa`sdl` oa`aedts elr cdvd`g, wfdnf hapa`h l` ekntlr prdnas k`h lutput. Xfa tltkc aeeants lesunf ekntlr prdnas k`h lutput kra jlra ekvlrkoca tl tfa lch palpca d` tfa kctar`ktdvaanl`ljdas.

    Xfa ed`hd`gs kolva suggast tfkt tfara kra hdeeard`g wacekra djpcdnktdl`s elr palpca wdtfhdeeara`t prlhuntdvdtdas k`h kgas. Wfdca tfa ylu`g palpca wdtf fdgf prlhuntdvdty praear tfankpdtkc d`nlja tkx tl tfa ckolr d`nlja tkx, tfa ylu`g palpca wdtf clw prlhuntdvdty ekvlrtfa lpplsdta. Lch palpca kra sdjdckr tl tfa fdgfcy prlhuntdva ylu`g palpca. ^l, gdva` tfaplpucktdl` struntura, fdgfcy prlhuntdva ylu`g palpca k`h lch palpca nk` gkd` jlra d`tltkc tfk` tfa tltkc clss le tfa clw-prlhuntdvdty ylu`g palpca, k`h tfa nkpdtkc d`nlja tkx,nclsacy elcclwah oy tfa nl`sujptdl` tkx, ds oattar tfk` tfa ckolr d`nlja tkx d` tarjs le

    tfa NAU wacekra nfk`ga.Nljpkrd`g Xkoca 5 wdtf tfa rasucts le Fsu at kc. (?2;8), wfara ckolr suppcy dsaxlga`lus, wacekra nfk`gas kt tfa grlup cavac sflw k sdjdckr sdg` jlstcy wfdca hdeeard`gd` sdza wfa` ckolr ds a`hlga`luscy hatarjd`ah. D` nksas le nl`sujptdl` tkx ed`k`nd`g lrnkpdtkc d`nlja tkx ed`k`nd`g, tfa fdgf-ahunktdl` grlup ds junf oattar-lee nljpkrah wdtf

    ;? K` anl`ljy wdtflut QFN ds nl`struntah ks sflw` d` Kppa`hdx O, Xkoca O;, Nlcuj` (?), kssujd`g ckolr d`nlja ds

    usah elr ed`k`nd`g d` tfa oa`nfjkri. Oksah l` tfds, k` anl`ljy wdtf QFN ed`k`nah oy nl`sujptdl` tkx ds nl`struntahks sflw` d` Nlcuj` (1) k`h k` anl`ljy wdtf QFN ed`k`nah oy nkpdtkc d`nlja tkx ds sflw` d` Nlcuj` (5), Xkoca O;.

    ?;

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    24/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    tfa nksa le ckolr d`nlja ed`k`nd`g, wfdca tfa clw-ahunktdl` grlup ds cass wlrsa lee. Ava`wdtf k junf sjkccar sfkra le tfa plpucktdl`, tfa tltkc gkd` le tfa fdgf-ahunktdl` grluplutwadgfs tfa clss le tfa clw-ahunktdl` grlup k`h rasucts d` k `at gkd` elr tfa wflcaanl`ljy.

    1. HD^NQ^^DL@Xfa khmustja`ts le tfa ckolr suppcy erlj ylu`g wlrid`g kga`ts fkva kntah ks k`djplrtk`t nfk``ac tl oueear kgkd`st sflnis k`h plcdny nfk`gas, d`ncuhd`g nfk`gas tlfakctf nlvarkga k`h tfa nlrraspl`hd`g tkx rkta nfk`gas. De tfa ckolr suppcy dsaxlga`lus, tfa djpknts l` d`nlja hdstrdoutdl` k`h slndkc wacekra nk` oa hdeeara`twdtflut sunf khhdtdl`kc nfk``acs elr d`hdvdhukc lptdjdzktdl`.

    Xfa djpknt l` d`nlja hdstrdoutdl` nk` oa hkjpa`ah wdtflut ckolr suppcy khmustja`t. Knnlrhd`g tl lur k`kcysds, hdeeara`t QFN ed`k`nd`g snfajas keeant tfa nkpdtkc d`nljahdstrdoutdl` k`h tltkc d`nlja hdstrdoutdl`. Flwavar, wfdca tfa sdg`s rajkd` tfa skja, tfadjpknts kra sjkccar d` jkg`dtuha tfk` elr tfa nksa le a`hlga`lus ckolr. Jak`wfdca, tfackolr hdstlrtdl`s le tkx nk` oa rahunah suostk`tdkccy wdtflut ckolr khmustja`t. Xfawacekra djpknt l` ylu`g kga`ts wdtf fdgf ahunktdl` hanraksas, wfdca tfa wacekra djpkntl` lch kga`ts wdtf fdgf ahunktdl` d`nraksas. Xfa wacekra djpknt tur`s lut tl oa plsdtdvaelr ylu`g k`h lch kga`ts wdtf clw ahunktdl` k`h d` kggragktdl` tfa slndkc NAU suggastsk `at wacekra gkd` d` tfa rk`ga le 2.?;%„2.?7%. Xfaraelra, u`har tfasa ndrnujstk`nas,tfa nfkrkntardstdns le tfa ckolr jkriat, sunf ks tfa ckolr khmustja`t le hdeeara`t wlrid`ggrlups, nluch oa tfa iay hatarjd`k`ts elr tfa lutnlja le slndkc wacekra (saa jlrahatkdcs d` Kppa`hdx H).

    Wa kcsl axkjd`ah tfa sa`sdtdvdtdas le ahunktdl`-spandedn k`h santlr-spandedn aeednda`nypkrkjatars. Wfa` adtfar aeednda`ny hdeeara`na ds sjkccar, tfa Gd`d nlaeednda`t le tltkcd`nlja aqukcdty kcsl oanljas sjkccar. De tfara ds `l hdeeara`na d` santlr aeednda`ny, tfaQFN anl`ljy ed`k`nah oy ckolr d`nlja tkx nk``lt rahuna d`aqukcdty. Gdva` tfa clwar

    rahdstrdoutdl` wfa` aeednda`ny ds aqukcdzah knrlss ahunktdl` lr knrlss santlrs, tfawacekra clss tl ed`k`na k QFN anl`ljy nluch oa ckrgar sd`na tfa gkd` erlj rahdstrdoutdl`tl leesat tfa clss le hdstlrtdl` wfa` ckolr ds a`hlga`lus ds cass.

    5. NL@NCQ^DL@

    D` tfds pkpar, wa stuhdah k elrj le u`dvarskc fakctf nlvarkga ed`k`nah tfrlugfglvar`ja`t tkx rava`ua d` tfa sattd`g le havaclpd`g nlu`trdas, wfara tfa d`elrjkcanl`ljy fks k ckrga prasa`na k`h tkx kvldhk`na ds `lt `agcdgdoca. Jak`wfdca, tfk`is tltfa olttlj-up kpprlknf cd`id`g d`hdvdhukc oafkvdlr tl tfa jknrl ck`hsnkpa, wa kcclwd`hdvdhukcs tl jkia handsdl`s gdva` ekntlr prdnas, wfdca tfadr nlccantdva oafkvdlr kcslhatarjd`as ekntlr prdnas. D` khhdtdl`, cd`ikgas oatwaa` slndkc sanurdty axpa`hdtura k`hed`k`nd`g slurnas kra kcsl jlhaccah axpcdndtcy.

    D` sunf k` anl`ljy wfara fatarlga`alus kga`ts hdeear oy kodcdty, cuni, d`hdvdhukc wlriaeelrt, k`h axpa`hdtura sflnis, k`h ekna hdeeara`t cavacs le tkx locdgktdl` k`h slndkcsanurdty prltantdl`, wa axkjd`ah tfa djpknts le QFN kt oltf tfa kggragkta k`hhdskggragkta cavacs, l` vkrdlus anl`ljdn erl`ts sunf ks ckolr, nkpdtkc, lutput, d`nljahdstrdoutdl`, k`h slndkc wacekra. Wa ed`h tfkt tfa oafkvdlr le kga`ts hdeears d` tarjs leckolr suppcy, kssat flchd`gs, k`h nl`sujptdl`, nkusah oy parjk`a`t k`h trk`sdtlryprlhuntdvdty sflnis.

    ??

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    25/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    _agkrhd`g tfa djpknts l` d`nlja hdstrdoutdl` k`h wacekra, kjl`g tfraa tkx ed`k`nd`glptdl`s elr QFN, ckolr d`nlja tkx ed`k`nah QFN nluch jdtdgkta d`nlja d`aqukcdty hua tldts ckrga rahdstrdoutdva aeeant. Flwavar, kcc tkx-ed`k`nah QFN snfajas ekdcah tl djprlvaslndkc wacekra wfa` ckolr ds kssujah tl oa a`hlga`lus k`h tfa hdstlrtdl` le ckolrsuppcy handsdl` nluch oa racktdvacy fdgf. D` tfa kosa`na le sunf nfldna le ckolr suppcy,jdch wacekra gkd`s nluch oa wdt`assah elr sunf tkx-ed`k`nah QFN snfajas.

    ?>

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    26/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    _AEA_A@NA^

     Kfumk, K., Rau`gnfk`nfkdiuc, N., k`h Rdykgkr`, @. ?228. L` Jl`atkry k`h Edsnkc RlcdnyJdx lvar Xfkdck`h—s Ousd`ass Nyncas. Ok`i le Xfkdck`h Hdsnussdl` Rkpar,HR/24/?228. Ok`gili= Ok`i le Xfkdck`h.

     Kdykgkrd, .̂ _. ;448. Q`d`surah Dhdlsy`nrktdn _dsi k`h Kggragkta ̂ kvd`g. Xfa [ukrtarcyMlur`kc le Anl`ljdns ;24(>)= 514„568.

     Ktardhl, _., J. Fkccwkrh-Hrdajadar, k`h N. Rkgas. ?2;;. Hlas Axpk`hd`g FakctfD`surk`na oayl`h Elrjkc-santlr Wlriars A`nlurkga D`elrjkcdty< Jaksurd`g tfaDjpknt le Jaxdnl—s ^agurl Rlpuckr. Wlrch Ok`i Rlcdny _asakrnf Wlrid`g Rkpar^ardas @l. WR^1761. Wksfd`gtl`, HN= Wlrch Ok`i.

    Nkrrlcc, N. H. ?225. Xfa Jatflh le A`hlga`lus Grdh Rld`ts elr ^lcvd`g Hy`kjdn^tlnfkstdn Lptdjdzktdl` Rrlocajs. Anl`ljdns Cattars 4;(>)= >;?„>?2.

    Hdkz-Gdja`az, M., k`h M. Hdkz-^kkvahrk. ?224. Hackyd`g _atdraja`t d` ^pkd`. _avdaw leAnl`ljdn Hy`kjdns ;?(;)= ;87„;57.

    Hranfscar, H., k`h M. R. Muttd`g. ?221. Ds Xfara k _lca elr Rrdvkta Fakctf D`surk`na d`Havaclpd`g Nlu`trdas< HDW Hdsnussdl` Rkpar 1;7. Oarcd`= Garjk` D`stdtuta elrAnl`ljdn _asakrnf.

    Faktfnlta, M., I. ^tlrascatta`, k`h G. C. Udlck`ta. ?226. D`surk`na k`h Lpplrtu`dtdas= KWacekra K`kcysds le Ckolr Jkriat _dsi. Mlur`kc le Jl`atkry Anl`ljdns 11(>)=12;„1?1.

    Fanijk`, M. M. ;44>. Wfkt Fks Oaa` Cakr`ah kolut Ckolr ^uppcy d` tfa Rkst Xwa`tyTakrs< Xfa Kjardnk` Anl`ljdn _avdaw  6>(?)= ;;5„;?;.

    Fsu, J. ?2;?. Fakctf D`surk`na k`h Rrankutdl`kry ^kvd`g= K ^trunturkc K`kcysds._avdaw le Anl`ljdn Hy`kjdns.

    Fsu, J., k`h N. N. Tk`g. ?2;>. Lptdjkc Cd`akr k`h Xwl-orkniat D`nlja Xkxas wdtfDhdlsy`nrktdn Akr`d`gs _dsi. Mlur`kc le Ruocdn Anl`ljdns ;21(5)= 16„7;.

    Fsu, J., V. Fuk`g, k`h ^. Tupfl. ?2;8. Xfa Havaclpja`t le Q`dvarskc FakctfNlvarkga d` Xfkdck`h= Nfkcca`gas le Rlpucktdl` Kgad`g k`h D`elrjkc Anl`ljy.Q`puocdsfah jk`usnrdpt.

    Fuookrh, _. G., M. ^id``ar, k`h ^. R. ]achas. ;441. Rrankutdl`kry ^kvd`g k`h ^lndkcD`surk`na. Xanf`dnkc raplrt. Nkjordhga, JK= @ktdl`kc Ouraku le Anl`ljdn_asakrnf.

    Fuggatt, J. ;44>. Xfa _dsi-eraa _kta d` Fatarlga`alus-kga`t D`nljpcata-d`surk`naAnl`ljdas. Mlur`kc le Anl`ljdn Hy`kjdns k`h Nl`trlc  ;7(1)= 41>„454.

    Djrlflrlgcu, ^., k`h ^. Idtkl. ?224. Ckolr ^uppcy Ackstdndty k`h ^lndkc ^anurdty _aelrj.Mlur`kc le Ruocdn Anl`ljdns 4>(7)= 657„676.

    Masia, I., k`h ^. Idtkl. ?224. Q^ Xkx Rlcdny k`h Fakctf D`surk`na Hajk`h= Nk` k_agrassdva Rlcdny Djprlva Wacekra< Mlur`kc le Jl`atkry Anl`ljdns 15(?)= ?;2„??;.

    Idtkl, ^. ?2;2. Ckolr-hapa`ha`t Nkpdtkc D`nlja Xkxktdl`. Mlur`kc le Jl`atkryAnl`ljdns 17(6)= 414„478.

    ?8

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    27/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    Idtkl, ^. ?2;8. ^ustkd`koca ^lndkc ^anurdty= Elur Lptdl`s. _avdaw le Anl`ljdnHy`kjdns ;7(8)= 715„774.

    Iltcdilee, C. M. ;465. Fakctf Axpa`hdturas k`h Rrankutdl`kry ^kvd`gs. @OA_ Wlrid`gRkpar @l. ?226. Nkjordhga, JK= @ktdl`kc Ouraku le Anl`ljdn _asakrnf.

    Cunks Mr., _. A. ;467. Jlhacs le Ousd`ass Nyncas, Trml Mkf`ssl` Canturas ^ardas.

    Cl`hl`= Ockniwacc.

    Leedna le tfa @ktdl`kc Anl`ljdn k`h ^lndkc Havaclpja`t Olkrh, Xfkdck`h, k`h @ktdl`kc^tktdstdnkc Leedna le Xfkdck`h (@A^HO k`h @^L). ?228. Xfa Jaksuraja`t le tfa@l`-Losarvah Anl`ljy d` Xfkdck`h @ktdl`kc Knnlu`t. Rkpar prapkrah elr tfaLANH/A^NKR/KHO Wlrisflp l` Kssassd`g k`h Djprlvd`g ^tktdstdnkc [ukcdty=Jaksurd`g tfa @l`-losarvah Anl`ljy, ;;„;8 Jky, Ok`gili.

    Reku, W. H., k`h U. Ktdslpfl`. ?224. Djpknt le tfa @ktdl`kc Ra`sdl` Eu`h l` tfa^udtkodcdty le Acharcy Ra`sdl`s d` Xfkdck`h. Ksdk` Anl`ljdn Mlur`kc  ?>(;)= 8;„5>.

    ^kaz, A. ?22?. Lptdjkc D`nlja Xrk`sear Rrlgrkjs= D`ta`sdva varsus Axta`sdva Ckolr^uppcy _aspl`sas. Xfa [ukrtarcy Mlur`kc le Anl`ljdns ;;7(>)= ;2>4„;27>.

    ^kvahlee, W. H. ?228. Xkx-oksah Ed`k`nd`g elr Fakctf ^ystajs= Lptdl`s k`hAxparda`nas. WFL Hdsnussdl` Rkpar @l.8-?228. Ga`avk, ^wdtzarck`h= WlrchFakctf Lrgk`dzktdl`.

    ^nf`adhar, E. ?22?. ^dza k`h Jaksuraja`t le tfa D`elrjkc Anl`ljy d` ;;2 Nlu`trdas.Wlrisflp l` Kustrkcdk` @ktdl`kc Xkx Na`tra. Kustrkcdk` @ktdl`kc Q`dvarsdty,Nk`oarrk. Mucy ;7.

    Xkunfa`, G. ;465. Ed`dta ^tkta Jkrilv-nfkd` Kpprlxdjktdl`s tl Q`dvkrdkta k`h Uantlr Kutlragrassdl`s. Anl`ljdns Cattars ?2(?)= ;77„;6;.

    Wkgstkee, K., k`h W. Jk`knfltpfl`g. ?2;?. Xfa Fakctf Aeeants le Q`dvarskc FakctfNkra= Avdha`na erlj Xfkdck`h. Wlrch Ok`i Rlcdny _asakrnf Wlrid`g Rkpar5;;4. Wksfd`gtl`, HN= Wlrch Ok`i.

    Wlrch Fakctf Lrgk`dzktdl`. ?2;2. Fakctf ^ystajs Ed`k`nd`g= Xfa Rktf tl Q`dvarskcNlvarkga. Wlrch Fakctf _aplrt . Ga`avk, ^wdtzarck`h= Wlrch FakctfLrgk`dzktdl`.

    Vu, I., R. ^kisa`k, J. Mlwatt, N. D`hdikhkfa`k, M. Iutzd`, k`h H. O. Avk`s. ?2;2.Axpclrd`g tfa Xfrasflchs le Fakctf Axpa`hdtura elr Rrltantdl` kgkd`st Ed`k`ndkc_dsi. Wlrch Fakctf _aplrt . Ga`avk, ^wdtzarck`h. Wlrch Fakctf Lrgk`dzktdl`.>?6„>>>.

    Tlu`g, A. _. ?2;2. ^lcvd`g tfa D`nljpcata Jkriats Jlhac wdtf Kggragkta Q`nartkd`tyQsd`g tfa Irusacc„^jdtf Kcglrdtfj k`h @l`-stlnfkstdn ^djucktdl`s. Mlur`kc leAnl`ljdn Hy`kjdns k`h Nl`trlc  >8(;)= >5„8;.

    ?1

    http://www.sciencedirect.com/science/journal/10942025/17/4http://www.sciencedirect.com/science/journal/10942025/17/4

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    28/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    KRRA@HDV K= NKCDO_KXDL@ R_LNA^^

    K;. Ajpclyja`t Xrk`sdtdl`

    Wa usa tfa ^A^ hktk tl nl`strunt tfa trk`sdtdl`s elr tfa ajpclyja`t k`h fakctfaxpa`hdtura sflnis. Xfa vkrdkoca –k\;;‚ ds usah tl hdstd`gudsf tfa wlri elrna erljkjl`g kcc tfa skjpcas k`h tfa vkrdkoca–e1\;‚ ds usah tl dha`tdey wlriars erlj tfa elrjkck`h d`elrjkc santlrs. Kjl`g tfa grlups, tfa –ajpclyar‚ k`h –prdvkta nljpk`yajpclyaa‚ grlups kra tfa l`as wfara dt ds hdeednuct tl tacc wfatfar wlriars kra erlj tfaelrjkc lr d`elrjkc santlr. Xfa ajpclyar skjpcas kra `lt d`ncuhah sd`na tfa jlhac ds knljpatdtdva jlhac wdtf `l khhdtdl`kc nkpdtkc ra`t caet lvar elr ajpclyars. ^anl`h, wfa` kwlriar ds prdvkta nljpk`y ajpclyah, tfa khhdtdl`kc d`elrjktdl` kolut typa le wkga–e4\;‚ ds usah tl sarva ks k nrdtardl` tl hdeeara`tdkta wlriars erlj l`a santlr tl tfa ltfar.Xfa wlrielrna d` tfa elrjkc santlr nl`sdsts le palpca wlrid`g d` glvar`ja`t, stktaa`tarprdsas, k`h prdvkta nljpk`das wdtf raguckr jl`tfcy pkyja`t9 tfa wlrielrna led`elrjkc santlr nl`sdsts le palpca wfl kra sace-ajpclyah wdtflut ajpclyaas, wlrid`gwdtflut pkyd`g elr k flusaflch ousd`ass, k`h wlrid`g d` prdvkta nljpk`das wdtflutraguckr jl`tfcy pkyja`t. ^unf k strktagy le hdeeara`tdktd`g santlrs nk` kcsl oa elu`h d`Wkgstkee k`h Jk`knfltpfl`g (?2;?). Wa kssuja tfara ds k trk`sdtdl` odks astdjktaherlj tfa hktk k`h nkcdorkta k odks pkrkjatar, ΰ;, elr dts stktdl`kry sfkra le tfa elrjkck`h d`elrjkc santlrs d` tarjs le plpucktdl`, elr wfdnf wa tkrgat >6% le wlriars d` tfaelrjkc santlr k`h 5?% wlrid`g d` tfa d`elrjkc santlr.

    K?. Fakctf Axpa`hdtura Xrk`sdtdl`

    Xfa raplrtah fakctf axpa`hdtura wks lut-le-plniat axpa`hdtura. Gdva` tfa cdjdtktdl`s lesunf ax-plst hktk, tfa elcclwd`g staps kra tkia` tl kpprlxdjkta tfa u`losarvahd`elrjktdl`. Edrst, k vkrdkoca wdtf tfa d`elrjktdl` l` lut-le-plniat pkyja`ts ds usah,–f??‚ (axpa`hdtura l` fakctfnkra), tl axkjd`a tfa hdstrdoutdl` k`h trk`sdtdl`kc hy`kjdns.^anl`h, hua tl tfa cdiacy jdsjktnf le jdnrl survay hktk k`h jknrl d`hdnktlrs, k

    ranlvary eu`ntdl` ds sat tl jktnf tfa tltkc fakctf axpa`hdturas erlj tfa oa`nfjkrianl`ljy tl tfa `ktdl`kc tltkc fakctf axpa`hdtura par nkpdtk. Xfdrh, k trk`sdtlry odks dskssujah d` lrhar tl jktnf tfa hdstrdoutdl` le stktus le fakctf axpa`hdtura wdtf dtsstktdl`kry sfkra. Wa l`cy nkcnuckta fakctf axpa`hdtura stktus oksah l` tfa yakr ?221,d`stakh le k >-yakr kvarkga, sd`na tfa survay sflws tfkt jlst hl `lt fkva k`y fakctfd`surk`na snfaja k`h tfa racktdva hdeeara`na oatwaa` tfa ylu`g k`h lch ga`arktdl` dshdstd`nt d` ?221. Xfa` wa usa k ranlvary khmustja`t eu`ntdl` k`h nkcnuckta tfastktdl`kry vkcua le fakctf nlst oy d`tagrktd`g lvar tfa ylu`g k`h lch ga`arktdl`s. D`khhdtdl`, wa usa tfds pkrkjatar tl khmust tfa tltkc fakctf axpa`hdtura tl jktnf tfa jlrarana`t tkrgat le 8% le tfa ?226„?2;? kvarkga. Xfa trk`sdtlry odks khmustja`t ds sdjdckrtl ajpclyja`t stktus. Xkocas K; k`h K? rapcdnkta Xkocas 5 k`h 7 le Fsu at kc. (?2;8) elrraeara`na.

    ?5

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    29/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    Xkoca K;= ^tktus le Fakctf Axpa`hdtura

    ^tktus _k`ga Axpa`hdtura (okft)  % le Kvarkga D`nlja

    Tlu`g ga`arktdl` (Vy )Clw 2%„41% ;>7.86 ;.7?%

    Fdgf 41%„;22% >67;.6; 86.88%Lch ga`arktdl` (Vl)

    Clw 2%„41% ?52.17 >.?5%

    Fdgf 41%„;22% 76?;.41 47.65%^lurna= Kutflrs.

    Xkoca K?= Xrk`sdtdl` Rrlokodcdtdas le V

    Tlu`g (Τy) Lch (Τl)Clw Fdgf Clw Fdgf

    Clw 2.412 2.212 Clw 2.418 2.285

    Fdgf ?.48? 2.162 Fdgf 2.671 2.;?1^lurna= Kutflrs.

    K>. Lut-le-Rlniat k`h Xltkc Fakctf Axpa`hdtura

    Xfa raelrj le tfa fakctf nkra systaj tl prljlta tfa u`dvarskc fakctf nlvarkga stkrtaherlj ?22?. Xfa astkocdsfah @ktdl`kc Fakctf ^anurdty Leedna aeeantdvacy djpcaja`tah tfaraelrj d` tfa elcclwd`g yakrs, knnljpk`dah oy clwar prdvkta nl`trdoutdl`s k`h acavktah`ktdl`kc fakctf axpa`hdtura. Ks sflw` d` Edgura ;, tfa lut-le-plniat rktdl fks oaa`hancd`d`g k`h fks oaa` oaclw ;1% sd`na ?227. L` tfa ltfar fk`h, tfa tltkc fakctfaxpa`hdtura fks oaa` rdsd`g k`h stkodcdzah ketar ?227 oatwaa` >.4%„8.;% le GHR.Gdva` sunf k strunturkc nfk`ga le tfa fakctf nkra systaj, wa usa tfa jlra rana`t hktkwdtf tfa kvarkga le ?226„?2;? ks lur tkrgats d` tfa jlhac anl`ljy, d` wfdnf tfa tltkc

    fakctf axpa`hdtura ds 8% le GHR k`h tfa lut-le-plniat rktdl wks ;8% le tltkc fakctfaxpa`hdtura.

    K8. Xfa Nljpl`a`ts le Xkx _ava`ua

    Rarsl`kc d`nlja tkx ckrgacy nl`sdsts le ckolr d`nlja (ajpclyja`t) tkx, hdvdha`hd`nlja, k`h d`tarast d`nlja erlj skvd`gs, ol`hs, atn. Flwavar, hua tl tfa ckni leeurtfar hdskggragkta hktk k`h tfa eknt tfkt ckolr d`nlja tkx knnlu`ts elr tfa jkmlrdty leparsl`kc d`nlja tkx, wa kssuja parsl`kc d`nlja tkx rava`ua ds aqukc tl ckolr d`nljatkx rava`ua. Nlrplrkta d`nlja ds kssujah tl oa tfa skja ks nkpdtkc d`nlja d` tfajlhac ks tfds ds tfa l`cy slurna d` tfa jlhac racktah tl nkpdtkc. D`hdrant tkxas d` vkrdluselrjs, gdva` tfa `ktura tfkt tfay kra uctdjktacy olr`a tl nl`sujars, kra tfaraelra

    sujjah up tl oa raprasa`tah ks nl`sujptdl` tkx d` tfa jlhac. Xfa kvarkgas le ?221„?2;8 le tkx rava`ua ks k parna`tkga le GHR, ?.?%, 1.8%, k`h ;2.6%, kra tfa tkrgatrktdls le tfa oa`nfjkri anl`ljy d` tfa jlhac elr ckolr d`nlja, nkpdtkc d`nlja, k`hnl`sujptdl` tkx rava`ua, raspantdvacy.

    ?7

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    30/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    Edgura K;= ^fkra le Xkx _ava`uas d` Xfkdck`h

    (% le GHR) 

    ^lurna= Jd`dstry le Ed`k`na, Xfkdck`h. 

    K1. Nkpdtkc Lutput _ktdl k`h Haprandktdl` _kta

    Wa haed`a tfa nkpdtkc stlni kt pardlh t , tfa kvarkga le nkpdtkc stlni kt tfa oagd``d`g le

    tfa pardlh k`h tfa a`h le pardlh (tfa oagd``d`g le `axt pardlh) oy : +? . Xfankpdtkc lutput rktdl ds tfa nkpdtkc stlni hdvdhah oy tfa `ljd`kc GHR (kpprlxdjktdl` le

    lutput) lotkd`ah oy :  . Xfa haprandktdl` rkta ds tfa rktdl le tfa hapranktdl` vkcua

    wdtfd` pardlh t   lvar tfa nkpdtkc stlni kt tfa oagd``d`g le pardlh t . Gdva` tfa elcclwd`ghktk, tfa nkpdtkc lutput rktdl k`h haprandktdl` rkta nk` oa nkcnucktah. Xfa ckw le jltdl`

    elr nkpdtkc elcclws +; : (; ) + . Wa tkrgat tfa kvarkga vkcuas le tfa jlstrana`t 1 yakrs, wfdnf gdvas k I/T  rktdl le >.8 k`h k haprandktdl` rkta θ le 1.?%.Edgura K?= Nkpdtkc Lutput _ktdl k`h Hapranktdl` _kta

    CF^ : caet-fk`h snkca, _F^ : rdgft-fk`h snkca.

    ^lurna= @ktdl`kc Anl`ljdn k`h ̂ lndkc Havaclpja`t Olkrh9 Wlrch Ok`i Wlrch Havaclpja`t D`hdnktlrs.

    2

    ?

    8

    5

    6

    ;2

    ;?

    ;8

     ;442 ;44> ;445 ;444 ?22? ?221 ?226 ?2;; ?2;8

    Rarsl`kc d`nlja tkx Nlrplrkta d`nlja tkx

    D`hdrant tkx

    2

    ;

    ?

    >

    8

    1

    5

    7

    2

    2.1

    ;

    ;.1

    ?

    ?.1

    >

    >.1

    8

    8.1

     ;472 ;471 ;462 ;461 ;442 ;441 ?222 ?221 ?2;2

    Nkpdtkc lutput rktdl (CF^) Haprandktdl` rkta (%) (_F^)

    ?6

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    31/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    Xkoca K>= Ukrdkocas elr Nkcnucktd`g Nkpdtkc Lutput _ktdl k`h Hapranktdl` _kta

    Ukrdkocas Haed`dtdl` ^lurna(; )  @at nkpdtkc stlni, tfa vkcua le edxah kssatsketar hahuntd`g haprandktdl`

    @ktdl`kc Anl`ljdn k`h ^lndkcHavaclpja`t Olkrh  Nkpdtkc stlni haprandktdl` @ktdl`kc Anl`ljdn k`h ^lndkcHavaclpja`t Olkrh

      GHR `ljd`kc Wlrch Ok`i Wlrch Havaclpja`tD`hdnktlrsGHR : grlss hljastdn prlhunt.

    K5. Ruocdn Haot tl GHR _ktdlXfa puocdn haot tl GHR rktdl fks oaa` racktdvacy stkoca knrlss tfa pardlh. Wa usa tfakvarkga rktdl le ?224„?2;8 ks lur tkrgat d` tfa jlhac, wfdnf ds 8>%.

    Edgura K>= Ruocdn Haot tl GHR _ktdl

    ^lurna= Jd`dstry le Ed`k`na, Xfkdck`h

    K7. Rlpucktdl` ^truntura d` Xfkdck`h Knnlrhd`g tl hktk erlj tfa Q`dtah @ktdl`s, Xfkdck`h fks stkrtah tl axparda`na k ekstkgd`g tra`h sd`na ?2;2. Xfa lch-kga hapa`ha`ny rktdl le lch palpca (kgah 51+) lvarylu`g palpca (kgah ;1„58) wdcc d`nraksa sfkrpcy d` tfa elcclwd`g hankhas, erlj ;?.8%d` ?2;2 tl ?>.>% d` ?2?1 k`h eurtfar raknfd`g tl 1>.;% d` ?212. Wa usa tfa kvarkga le?224„?2;8 (tfa k``ukc edgura ds astdjktah tfrlugf tfa d`tarplcktdl` le tfa 1-yakr edguras)k`h tkrgat ;>% d` tfa jlhac.

    2

    1

    ;2

    ;1

    ?2

    ?1

    >2

    >182

    81

    12

     ?221 ?225 ?227 ?226 ?224 ?2;2 ?2;; ?2;? ?2;> ?2;8

    Xltkc Ruocdn Haot ks % le GHR

    ?4

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    32/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    Edgura K8= Lch-kga Hapa`ha`ny _ktdl

    ^lurna= Q`dtah @ktdl`s, Hapkrtja`t le Anl`ljdn k`h ̂ lndkc Keekdrs, plpucktdl` astdjktas k`h prlmantdl`s.

    2

    ;2

    ?2

    >2

    82

    1252

    72

    62

    42

    ;412 ;471 ?222 ?2?1 ?212 ?271 ?;22

    Xfkdck`h ^d`gkplra Mkpk` Q`dtah ̂ tktas

    %

    >2

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    33/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    KRRA@HDV O= UK_DLQ^ JLHAC ANL@LJDA^

    Xkoca O;= Anl`ljdn Eakturas le Ukrdlus Anl`ljdas 

    Jlhac (;) (?) (>) (8) (1) (5)

    Ckolr d`nlja tkx rkta (elrjkc) 5.82% >.6?% 5.82% 5.82% >.6?% >.6?%

    Nl`sujptdl` tkx rkta ;5.22% ;5.22% ;8.62% ;8.62% ;7.;6% ;5.22%

    Nkpdtkc d`nlja tkx rkta >1.22% >1.22% >1.22% >2.51% >1.22% >4.48%

     Kggragkta nkpdtkc par nkpdtk ;.?16; ;.>;67 ;.>27> ;.>225 ;.?726 ;.?77?

     Kggragkta ckolr par nkpdtk 2.?;27 2.?;? 2.?;;6 2.?;2> 2.?;; 2.?;?5

     Kggragkta ckolr flur par nkpdtk 2.>>88 2.>>5; 2.>>58 2.>>8 2.>>8? 2.>>54

    D`tarast rkta (r) 8.2>% >.76% >.6?% >.6;% >.46% >.44%

    Wkga rkta (w) ;.?2?7 ;.?;6; ;.?;1> ;.?;14 ;.?214 ;.?21

    Lutput par nkpdtk 2.>545 2.>756 2.>718 2.>7>; 2.>7;; 2.>7>7

    Nkpdtkc lutput rktdl (I/T) >.828? >.1222 >.86?1 >.865> >.8?8 >.8;6?

    Xltkc fakctf axpa`hdtura (V/T) >.44% >.4?% >.4>% >.45% >.46% >.41%

    Edsnkc rava`ua (% le lutput) ??.??% ?;.;4% ?;.??% ?;.>8% ??.;7% ??.25%- Ckolr tkx ?.;6% ;.>?% ?.;7% ?.;6% ;.>?% ;.>?%

    - Nkpdtkc tkx 1.87% 1.?5% 1.>2% 8.16% 1.8>% 5.;>%

    - Nl`sujptdl` tkx ;2.74% ;2.74% 4.46% ;2.62% ;;.14% ;2.74%

    - ^lndkc sanurdty nl`trdoutdl` >.76% >.6?% >.77% >.76% >.6>% >.6?%

    Edsnkc lutcky (% lutput) ??.??% ?;.;6% ?;.??% ?;.>8% ??.;7% ??.25%

    - Lch-kga pa`sdl` >.22% >.2>% >.22% >.22% >.28% >.28%

    - Q`ajpclyja`t oa`aedt 2.28% 2.28% 2.28% 2.28% 2.28% 2.28%

    - ^lndkc kssdst. elr nl`s. ecllr 2.2;% 2.2;% 2.2;% 2.2;% 2.2;% 2.2;%

    - Ruocdn fakctf axpa`hdtura >.8>% ?.78% ?.71% ?.77% >.8?% >.82%

    - Glvar`ja`t nl`sujptdl` ;8.2;% ;>.78% ;>.76% ;>.66% ;>.41% ;>.65%

    - D`tarast pkyja`t ;.7>% ;.5?% ;.58% ;.58% ;.7;% ;.7;%

    Gd`d= Ckolr d`nlja (fdgfahunktdl`) 2.8>7; 2.8>7 2.8>1 2.8>5> 2.8>42 2.8>77

    Gd`d= Ckolr d`nlja (clw ahunktdl`) 2.>6>? 2.>618 2.>6?> 2.>6>8 2.>65? 2.>684Gd`d= Nkpdtkc d`nlja (fdgfahunktdl`) 2.86>1 2.862; 2.8627 2.86 2.86?6 2.86>1Gd`d= Nkpdtkc d`nlja (clwahunktdl`) 2.>481 2.>6;7 2.>747 2.>62; 2.>452 2.>416

    Gd`d= Xltkc d`nlja (slndkc kvarkga) 2.>451 2.>46? 2.>415 2.>484 2.>442 2.8222Nl`s. : nl`sujptdl`.

    @ltas= (;) ds tfa oa`nfjkri QFN anl`ljy9 (?)„(8) kra `l`-QFN anl`ljdas kssujd`g tfa oa`nfjkri ed`k`nahoy ckolr d`nlja, nl`sujptdl`, k`h nkpdtkc d`nlja tkx, raspantdvacy9 (1)„(5) kra QFN anl`ljdas ed`k`nah oy

    nl`sujptdl` k`h nkpdtkc d`nlja tkx, nl`struntah erlj (?) oksah l` tfa kssujptdl` tfkt QFN d` (;) ds ed`k`nahoy ckolr d`nlja tkx.

     Kggragkta ckolr par nkpdtk ds tfa aeeantdva tarj wfdnf ds tfa prlhunt le ckolr flurs k`h d`hdvdhukc aeednda`ny,nljpkrah wdtf ckolr flurs.

    ^lurna= Kutflrs.

    >;

  • 8/20/2019 Impacts of Universal Health Coverage: A Micro-founded Macroeconomic Perspective

    34/38

     KHOD Wlrid`g Rkpar 1>> Fuk`g k`h Tlsfd`l

    Xkoca O?= Djpknt l` D`nlja Gd`d Nlaeednda`t

    GrlupSLptdl`Ckolr D`nlja

    XkxNl`sujptdl`

    Xkx Nkpdtkc D`nlja Xkx

    kcc -2.8>% 2.?>% 2.82%

    fdgf ahunktdl` 2.2?% 2.86% 2.;6%

    clw ahunktdl` -2.17% 2.?>% -2.21%fdgf ahunktdl` 2.72% 2.16% 2.7?%

    clw ahunktdl` >.?8% >.71% >.51%^lurna= Kutflrs— nkcnucktdl`s.

    Xkoca O>= NAU Wacekra Nfk`gas wdtflut QFN

    Grlup (?) (>) (8) (1) (5)

    NAU= Kcc ;.8>% ;.>>% ;.;7% 2.;8% 2.;1%

    - NAU= Fdgf ahunktdl` ?.?5% ;.;6% 2.4>% ;.24% ;.;4%

    - Tlu`g ga`arktdl` ?.>6% ;.?6% ;.21% ;.;?% ;.;4%

    - NAU= Elrjkc ?.>2% ;.?7% ;.21% ;.2>% ;.;2%

    - NAU= D`elrjkc ?.5;% ;.?7% ;.28% ;.>1% ;.8?%

    - NAU= Qjp erlj elrjkc ?.86% ;.?5% 2.2;% ;.?>% ;.>>%

    - NAU= Qjp erlj d`elrjkc ?.85% ;.16% ;.>;% 2.4;% ;.28%

    - Lch ga`arktdl` -;.??% -;.5?% -?.51% 2.>5% ;.>4%

    - NAU= Clw ahunktdl` ;.;5% ;.>6% ;.?5% -2.;6% -2.?2%

    - Tlu`g ga`arktdl` ;.;6% ;.8>% ;.>>% -2.?;% -2.?5%

    - NAU= Elrjkc 2.46% ;.8?% ;.>>% -2.82% -2.85%

    - NAU= D`elrjkc ;.?1% ;.8>% ;.>>% -2.;1% -2.;6%

    - NAU= Qjp erlj elrjkc ;.5>% ;.1?% ;.82% 2.;1% 2.;>%

    - NAU= Qjp erlj d`elrjkc ;.;6% ;.1>% ;.>4% -2.>?% -2.>;%- Lch ga`arktdl` 2.78% 2.18% 2.21% 2.?6% 2.72%

    NAU : nl`sujptdl`-aqudvkca`t vkrdktdl`, ujp : u`ajpclyah.

    @ltas= Kcc nljpkrah wdtf tfa oa`nfjkri QFN anl`ljy9 (?)„(8) kra `l`-QFN anl`ljdas, kssujd`g