Master of Public Policy   Master of International Affairs  

Inequality in the finance and distribution of health

Our world is living longer and healthier – life expectancy at birth has increased from 50 years in 1950 to 73 in 2017. While policies within and outside the health domain often focus on improving the level of health, the distribution of health is often ignored in policymaking – life expectancy at birth varied from 51 years in Central African Republic to 85 years in Singapore. Not only is health distributed unequally between regions and countries, stark inequalities persist even within a country. The socioeconomic gradient is well known – education, gender, income, race and occupational class all determine health, accessibility and utilisation, as well as affordability of healthcare. While health as an outcome in itself is a goal, the financing of healthcare poses unique challenges – catastrophic expenditures on health force families into poverty in developing countries, regressive/progressive payments for health are often of interest to policymakers. Such social disparities will merit attention in future policy discourse, which will demand expertise in understanding and quantifying inequality in the finance and distribution of health, identifying its determinants and applying the correct policy levers to address these disparities.

This course will equip students with the necessary theoretical foundations on inequality in health through relevant theories, empirical literature and case studies. Students will be able to differentiate between inequality and inequity, analyse and quantify the degree of inequality by computing inequality indices, decompose it into its determinants, and visualise and present findings succinctly. The course will also familiarise students with financing mechanisms in health and equip them with the tools to assess progressivity/regressivity of health systems. Finally, policy implications based on students’ findings will be discussed, critiqued and debated.

This course is for 2nd year MIA and MPP students only.