UBC Faculty Research and Publications

Charging Peter to pay Paul : accounting for the financial effects of user charges Evans, Robert G., 1942-; Barer, M. L.; Stoddart, G. L.

Abstract

This is one in a series of articles by the authors about the ongoing debate over user charges in the Canadian health care system. In this paper we outline a formal and comprehensive analytic framework in which income transfers - the principal effects of user charges - can be traced between groups in the population (e.g. the healthy and the sick, the rich and the poor), between payers and health care providers, and among providers. The accounting relationships in this framework, expressed as equatins, are a sub-set of those underlying the economy-wide national income and product accounts. They make it clear that "it is impossible to do only one thing" when charges are imposed -- or removed. The framework is used to analyze the patterns of income transfers associated with different types of user charges.

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Attribution-NonCommercial-NoDerivs 2.5 Canada