Measuring progressivity of health care payments Introduction

Who pays for health care? To what extent are payments toward health care related to ability to pay? Is the relationship proportional? Or is it progressive; do health care payments account for an increasing proportion of ability to pay (ATP) as the latter rises? Or, is there a regressive relationship, in the sense that payments comprise a decreasing share of ATP? The policymaker’s preferred relationship between health care payments and ATP will vary with his or her conception of fairness, but quantification of the relationship [3,9] is of interest from a wide range of equity perspectives.