국가 간 자료에 기초한 소득불평등과 보건비지출의 규모 및 구성 간의 관련성 = The Relationship between Income Inequality and the Size and Composition of Health Expenditure: A Cross-Country Analysis

다국어 초록 (Multilingual Abstract)

Using 112 cross-country evidence, this paper establishes the association between income inequality (measured by Income Gini Index around the year 1990) and the size and composition of health expenditure. The size of health expenditure is measured by total health expenditure, and its composition is divided into public and private health expenditure, as a percentage of GDP in 1990~2005. It is found that there exist positive associations between income inequality and private health expenditure as well as total health expenditure. However, the impact of income inequality on public health expenditure provides little evidence. The empirical results suggest a plausible possibility that a country with greater income inequality tends to pay less attention to the public health expenditure that has a stronger redistributive propensity. On the contrary, income inequality has a positive effect on the costs of health care, which increases the relative amount of private health expenditure. The results are robust to the inclusion of some explanatory variables, for a few different econometric methods, and to a sub-sample of non-OECD counties.

국문 초록 (Abstract)

본 연구는 112개 국가 간 통계자료를 이용해 1990년경의 소득불평등(‘소득지니지수’로 측정)이 1990∼2005년 기간의 보건비지출규모(‘GDP 대비 총보건비지출 비율’) 및 구성(‘GDP 대비 공공 보건비지출 비율’과 ‘GDP 대비 민간 보건비지출 비율’)에 미치는 영향을 분석했다. 실증분석 결과 소득불평등이 심한 국가일수록 민간 보건비지출의 수준이 높게 나타났으며, 이로 인해 상대적으로 보건비지출의 규모가 큰 것으로 관측됐다. 그러나 소득불평등이 공공 보건비지출에 미치는 영향은 통계적으로 유의하지 않는 것으로 추정됐다. 즉 실증분석 결과는 소득불평등이 심한 국가일수록 소득재분배적 성향이 강한 공공 보건비지출에 대해서는 관심이 적은 반면, 민간 보건비지출에 의존해 의료서비스 비용을 높게 설정하는 방식을 취할 가능성이 증가할 수 있음을 시사한다. 이상의 결과는 추정방법, 모형의 선택 및 표본의 선택에 관계없이 대체로 성립했다.

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