Published in Health Policy, the study by Thomas Rice, Karsten Vrangbæk, Ingrid S. Saunes, and colleagues examines the progressivity of public revenue collection for healthcare financing across 29 high-income countries. The authors assess three primary sources of revenue—income taxes, social insurance contributions, and consumption taxes—developing a qualitative index to measure their impact on equity.
The study finds that countries with more progressive income tax systems tend to have multiple tax brackets and larger marginal rate differences. More equitable social insurance schemes lack an upper-income cap and provide exemptions or reductions for lower-income individuals. In contrast, consumption taxes generally contribute to regressivity, though countries with lower overall income inequality tend to implement less regressive policies. The research highlights strategies for making healthcare funding more progressive, offering valuable insights for policymakers aiming to enhance fairness in revenue collection for public health systems.