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1.
Internet resource in Portuguese | LIS -Health Information Locator, LIS-controlecancer | ID: lis-49796

ABSTRACT

Considerando que as bebidas alcóolicas causam ao menos oito tipos de câncer e que não há limite seguro de consumo, promover a taxação e política de preços tem potencial de reduzir o consumo dessas bebidas.


Subject(s)
Taxes , Alcoholic Beverages
2.
Internet resource in Portuguese | LIS -Health Information Locator, LIS-controlecancer | ID: lis-49797

ABSTRACT

Assim como o tabaco, as carnes processadas - salsichas, linguiças, mortadelas, dentre outras - causam câncer e não existe limite seguro de consumo. Assim, promover a taxação e política de preços tem potencial para reduzir o consumo dessas carnes processadas.


Subject(s)
Taxes , Food, Processed
4.
PLoS One ; 19(9): e0310241, 2024.
Article in English | MEDLINE | ID: mdl-39292695

ABSTRACT

Promoting the seamless integration of the digital economy with the real economy, mitigating the adverse impacts of widespread corporate tax avoidance, and optimizing tax governance are critical imperatives in the era of digital economy. This study examines all A-share listed companies from 2007 to 2022 as research samples. It utilizes multiple perspectives including signal theory, information asymmetry theory, and the T-O-E (Technology-Organisation-Environment) framework to investigate the primary impacts of digital transformation on corporate tax avoidance, along with the intermediate mechanisms and foundational conditions that influence its effectiveness. After conducting both theoretical and empirical analyses, this paper presents the following conclusions. (1) The implementation of digital transformation significantly reduces corporate tax avoidance, a conclusion supported by rigorous robustness tests. Moreover, digital transformation enhances corporate productivity through the suppression of tax avoidance. (2) Digital transformation diminishes corporate tax avoidance through enhanced innovation and efficiency in resource allocation (technology level), improved quality of internal controls (organization level), and decreased industry competition (environment level). (3) The impact of digital transformation in reducing tax avoidance is significantly greater for enterprises in their growth phase, experiencing lower financing constraints, particularly those situated in the central and western regions. (4) Lower business risk is essential for maximizing the effectiveness of digital transformation and reducing corporate tax avoidance. This is crucial for governments seeking to improve tax administration, guide market and regional development, and enhance the impact of corporate digital transformation on mitigating tax avoidance.


Subject(s)
Taxes , Humans , Commerce/economics
5.
J Environ Manage ; 369: 122314, 2024 Oct.
Article in English | MEDLINE | ID: mdl-39217901

ABSTRACT

Climate policy uncertainty (CPU) may have an adverse impact on the environment by interfering with the effectiveness of environmental policies, but there is currently little evidence to support this indirect effect. By incorporating CPU into the transition function, this paper utilizes the panel smooth transition regression (PSTR) to dynamically analyze how CPU affects the relationship between environmental taxes (ETR) and energy transition. When CPU exceeds the threshold, the promoting effect of ETR on energy transition weakens or reverses. The robustness of the main conclusions is demonstrated by establishing a PSTR estimator with the instrumental variable. This paper also constructs a counterfactual scenario, showing that CPU reduces the positive impact of ETR on renewable energy consumption and generation by 7.6% and 3.5%, respectively. Further analysis indicates that this negative effect arises because CPU likely increases investment risk, particularly for long-term green projects, thereby inhibiting the clean energy market and energy-related green technological innovation. Heterogeneity analysis find that the weakening effect of CPU on the effectiveness of ETR is stronger in countries with low energy resource endowment, high energy intensity, and lower economic development levels, underscoring the need for tailored policy approaches. This research emphasizes that for countries with ambitious energy transition goals, climate policy stability is crucial for ensuring the healthy development of environmental taxes policy and renewable energy markets.


Subject(s)
Environmental Policy , Taxes , Uncertainty , Climate Change
6.
Mar Pollut Bull ; 207: 116896, 2024 Oct.
Article in English | MEDLINE | ID: mdl-39226819

ABSTRACT

The gradual implementation of environmental protection tax policies has incentivized enterprises to engage in green production, effectively promoting China's accelerated achievement of the "dual­carbon" goal. Although environmental protection tax has an important impact on the investment and financing decisions of heavily polluting enterprises (HPE), few studies have focused on the relationship between environmental protection tax and mismatch of financing and investment maturities. In this paper, we consider China's environmental protection tax reform as a "quasi-natural experiment", and utilize the data of A-share listed companies from 2013 to 2022, and use a difference-in-differences (DID) model to assess the impact of this policy on the degree of mismatch of financing and investment maturities of HPE. The study shows that the implementation of the environmental protection tax policy (EPTP) significantly reduces the investment and financing maturities mismatch of the HPE, but this effect "fails" in the high tax rate area, and the policy is difficult to reverse the financing difficulties of the enterprises with a large degree of their own investment and financing maturities mismatch. The mediation mechanism test proves the EPTP acts on the mismatch of financing and investment maturities through two paths: alleviating the financing constraints faced by enterprises and increasing external supervision pressure; the impact of the policy has a time-differentiated effect, which is weakened year by year.


Subject(s)
Conservation of Natural Resources , Investments , Taxes , China , Environmental Pollution , Environmental Policy
9.
Washington, D.C.; PAHO; 2024-09-25. (PAHO/NMH/RF/24-0005).
Non-conventional in English | PAHO-IRIS | ID: phr-61688

ABSTRACT

The harmful use of alcohol is one of the leading risk factors for population health. It is linked with over 200 health conditions, including noncommunicable diseases (NCDs) and mental health conditions, maternal and child health, infectious diseases, and injuries. This psychoactive substance caused 5.5% of all deaths and 6.7% of all disability-adjusted life years in the Region of the Americas in 2016. It also causes a significant social burden and imposes substantial direct treatment costs and indirect economic costs that represent a serious threat to economic and social development. This impact is recognized by target 3.5 of the Sustainable Development Goals aiming to “strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol”. The amount and frequency of alcohol consumed by an individual is determined, in large part, by the affordability of alcoholic beverages. Such affordability depends on the real price of alcoholic beverages, the price of other goods and services, and consumers’ incomes. Thus, there is strong health and economic rationale for the use of fiscal policies targeting alcoholic beverages. The World Health Organization (WHO) recommends reducing the harmful use of alcohol through increased excise taxes on alcoholic beverages as part of the WHO Global strategy to reduce the harmful use of alcohol, and the Pan American Health Organization (PAHO) Plan of Action to Reduce the Harmful Use of Alcohol. It is also part of the WHO recommended most cost-effective, evidence-based policies to prevent and control NCDs, and it is highlighted as one of five high-impact strategies of the SAFER technical package. Although 33 out of the 35 PAHO Member States apply excise taxes on alcoholic beverages, there is great heterogeneity in their design and rates, and most could be further leveraged to improve their impact on alcohol consumption and health. PAHO is committed to providing Member States with accurate, relevant, and internationally comparable information that they can use to guide the development of policy and to evaluate the impact of measures to prevent the harmful use of alcohol. Developing a tax share indicator is necessary to monitor taxes on alcoholic beverages, enable standardized comparisons across countries and over time, establish best practices in tax design, and provide a powerful tool for advocacy. Since 2016, the Department of Noncommunicable Diseases and Mental Health (NMH) at PAHO has been working on developing standardized and comparable indicators of the share of indirect taxes in the price of alcoholic beverages. Building on this experience and the WHO methodology for monitoring tobacco taxes, this brochure presents the results of pioneering tax share and complementary price and tax policy indicators for alcoholic beverages—including beer, wine, and spirits—in 30 PAHO Member States. This brochure is a tool for data dissemination to the different sectors involved in alcohol taxation in the Region of the Americas and, likewise, to help countries in designing, planning, and evaluating alcohol taxes to reduce the harmful use of alcohol.


Subject(s)
Alcoholic Beverages , Alcoholics , Alcoholism , Taxes , Taxes , Risk Factors , Mental Health , Noncommunicable Diseases
10.
JAMA Health Forum ; 5(9): e242896, 2024 Sep 06.
Article in English | MEDLINE | ID: mdl-39302669

ABSTRACT

Importance: Approximately 30% of US families with employer-sponsored health insurance, disproportionately drawn from high-income groups, benefit from flexible spending accounts (FSAs) or health savings accounts (HSAs). The combined association through both out-of-pocket spending and premiums of these tax-favored accounts with health care expenditures and tax expenditures remain uncertain. Objective: To compare the health care and health-related tax expenditures among families holding FSAs, HSAs, or neither type of account. Design, Setting, and Participants: This cross-sectional study used family-level data from the Medical Expenditure Panel Survey from January 1, 2011, to December 31, 2019, and conducted regression models, controlling for demographic and socioeconomic characteristics, chronic conditions, prior health care expenditures, and marginal tax rates to analyze how holding tax-favored accounts is associated with families' health care spending and tax expenditures. The sample was restricted to families included in the survey for 2 years, with no members 65 years or older, and with at least 1 policyholder covered (only) by full-year employer-sponsored insurance. Data were analyzed from December 1, 2023, to April 30, 2024. Exposures: Holding FSAs or HSAs. Main Outcomes and Measures: Out-of-pocket and insurance-paid health expenditures overall and by service were measured. Health-related tax expenditures were based on tax-excluded insurance premiums and tax-sheltered out-of-pocket expenses. Results: Of the 17 038 families included in the study sample, 2628 held FSAs (weighted 17%) and 1845 (weighted 13%) held HSAs. In regression-adjusted models, families with FSAs spent a mean of 20% or $2033 (95% CI, $789-$3276) more on health care annually than non-account holding families, largely due to increased insurer-paid expenses. Families with HSAs spent a mean of 44% or $697 (95% CI, $521-$873) more on out-of-pocket expenditures and had insignificantly higher insurance-paid expenditures than families without accounts, resulting in overall expenditures comparable to those of non-account holders. The additional tax expenditures associated with FSAs were a mean of $1306 (95% CI, $536-$2076) annually per family. Both types of funds were associated with significant increases in tax expenditures from additional office-based visits ($445 [95% CI, $244-$645] for FSAs and $174 [95% CI, $11-$336] for HSAs), outpatient visits ($330 [95% CI, $132-$528] for FSAs and $250 [95% CI, $15-$485] for HSAs), dental visits ($180 [95% CI, $126-$233] for FSAs and $165 [95% CI, $104-$226] for HSAs), and vision care ($36 [95% CI, $28-$45] for FSAs and $52 [95% CI, $40-$64] for HSAs). Conclusions and Relevance: Participation in FSAs is associated with higher health care expenditures and tax expenditures, while HSAs are not associated with reduced expenditures. Tax policy could be better targeted to enhance insurance coverage and health care accessibility.


Subject(s)
Health Expenditures , Medical Savings Accounts , Taxes , Humans , Health Expenditures/statistics & numerical data , Cross-Sectional Studies , Taxes/economics , Female , Male , United States , Middle Aged , Adult , Medical Savings Accounts/economics , Medical Savings Accounts/statistics & numerical data , Health Benefit Plans, Employee/economics , Health Benefit Plans, Employee/statistics & numerical data , Adolescent , Young Adult
11.
Front Public Health ; 12: 1152710, 2024.
Article in English | MEDLINE | ID: mdl-39257955

ABSTRACT

Introduction: Obesity, which is partly driven by the consumption of sugar-sweetened beverages (SSBs), significantly increases the risk of type-2 diabetes and cardiovascular diseases, leading to substantial health and economic burdens. Methods: This study aims to quantify the monetary value of health harms caused by SSB consumption, along with the associated internalities, through a contingent valuation survey. The results are crucial for determining the socially optimal tax rate. Results: We surveyed 293 residents of Wellington, New Zealand, to assess their willingness to pay (WTP) for reductions in the risks of diabetes, stroke, and heart disease associated with SSB intake. Logistic regression analysis revealed the marginal WTP for a 1% risk reduction in diabetes, stroke, and heart disease to be NZ$404.86, NZ$809.04, and NZ$1,236.84, respectively. Based on these values, we estimate the marginal harm from SSB consumption to be approximately NZ$17.37 per liter in New Zealand, with internalities amounting to NZ$6.43 per liter, suggesting an optimal tax rate of NZ$6.49 per liter. Discussion: Implementing such a tax is feasible and would likely double or triple the price of SSBs in New Zealand.


Subject(s)
Sugar-Sweetened Beverages , Taxes , Humans , Sugar-Sweetened Beverages/economics , Sugar-Sweetened Beverages/adverse effects , Male , Female , New Zealand , Adult , Middle Aged , Taxes/economics , Surveys and Questionnaires , Obesity/economics , Diabetes Mellitus, Type 2/economics , Cardiovascular Diseases/economics , Cardiovascular Diseases/etiology , Aged
12.
Br Dent J ; 237(5): 302, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39271854
13.
Front Public Health ; 12: 1446248, 2024.
Article in English | MEDLINE | ID: mdl-39234086

ABSTRACT

Introduction: With the aging population, the relationship between human health and the ecological environment has gained increasing attention. In China, it is imperative to evaluate the policy effects of the Environmental Protection Tax (EPT) on improving the ecological environment and enhancing the health of middle-aged and older adult people. Methods: This study, based on data from the China Health and Retirement Longitudinal Study (CHARLS), employs a Difference-in-Differences (DID) model to assess the health effects of the EPT policy. Results: The findings indicate that the EPT policy significantly improves the health of middle-aged and older adult individuals and reduces the prevalence of chronic diseases. The EPT policy affects the health of middle-aged and older adult through two main mechanisms: emission reduction and psychological effects. These are evidenced by reductions in PM10 particle concentration and sulfur dioxide emissions, improvements in public sleep quality and memory, and significant changes in environmental awareness and concern. Discussion: Heterogeneity analysis reveals differences across urban and rural areas, age groups, and education levels. Following the implementation of the EPT policy, there are notable improvements in reduction of chronic diseases among rural residents, self-rated health among urban residents, and overall health among the older adult and individuals with a junior high school education or lower. The study's results confirm the importance of environmental policies in promoting public health, providing a reference for the refinement of the EPT system, and offering insights for environmental pollution control in developing countries.


Subject(s)
Taxes , Humans , China , Middle Aged , Aged , Longitudinal Studies , Male , Female , Health Status , Chronic Disease/prevention & control , Rural Population/statistics & numerical data
14.
PLoS One ; 19(9): e0309387, 2024.
Article in English | MEDLINE | ID: mdl-39236036

ABSTRACT

This study utilizes data from A-share listed companies between 2011 and 2020 to empirically investigate the impact and mechanism of public welfare donations on the internal income gap of enterprises. The research findings indicate that public welfare donations significantly increase the per capita salary of management, while their impact on the per capita salary of ordinary employees is not significant, thus leading to an expansion of the internal income gap within enterprises. The results from mechanism testing reveal that the income tax benefits resulting from charitable donations and the rise in corporate operating income have contributed to an increase in excess rent shared by enterprises and employees. Due to a stronger bargaining power, management shares more excess rents, thereby widening the income gap within the enterprise. Heterogeneity analysis demonstrates that public welfare donations have a greater impact on the internal income gap of non-state-owned enterprises; however, limiting executive compensation and enhancing employees' bargaining power can mitigate this widening effect caused by public welfare donations on enterprise's internal income gap. The research value of this study is threefold. Firstly, there is a scarcity of studies on the impact of public welfare donations on the income gap within enterprises, and this study contributes to enriching the research in this area. Secondly, this paper examines the effect of tax incentives for public welfare donations on the internal income gap of enterprises, thereby deepening the research on the impact of tax reduction and fee reduction, as well as expanding our understanding of corporate income tax preferential policies. Thirdly, it offers insights into improving enterprise compensation systems and enhancing corporate governance. Senior executives can potentially allocate more excess rent through their strong bargaining power. If their compensation remains unrestricted, it may lead to a widening internal income gap and negatively affect company operational efficiency.


Subject(s)
Income , Social Welfare , Humans , Social Welfare/economics , Salaries and Fringe Benefits/statistics & numerical data , Taxes/economics , Public Assistance/economics , Income Tax
15.
Environ Sci Pollut Res Int ; 31(40): 53008-53025, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39167145

ABSTRACT

The implementation of the environmental protection tax (EPT) is a crucial step in the tasks of achieving the "double-carbon" objective and fostering comprehensive green economic and social growth. The literature on the effect of EPT policies has focused mainly on environmental effects and economic effects and has rarely paid attention to social effects, such as the impact of such policies on employment. By reference to data regarding pollution-intensive listed companies in China from 2014 to 2022, this article uses the 2018 EPT reform as a quasi-natural experiment to explore the effects of EPT on employment within these industries. The EPT reform is shown to have a significant dampening effect on corporate employment in the pollution industry, a conclusion that continues to hold after a number of robustness tests, including the differences-in-differences-in-differences (DDD) tests, the parallel trend test, the placebo test, and the PSM-DID test. Further analysis shows that the EPT reform suppressed employment in polluting industries mainly through two pathways: the output effect and the factor substitution effect. Moreover, the EPT reform generated more significant disincentives to employment in non-state-owned enterprises, large-scale enterprises, and mining industries. This study's findings can serve as a crucial reference for policies in China that aim to promote high-quality full employment in the context of environmental governance. The results of this research can also serve as a reference for a cost‒benefit analysis of environmental policies in China in terms of employment and provide a theoretical basis for and practical experience regarding the task of coordinating the relationship between environmental governance and employment regulation in China.


Subject(s)
Employment , Environmental Pollution , Industry , Taxes , China , Conservation of Natural Resources
16.
Asian Pac J Cancer Prev ; 25(8): 2885-2893, 2024 Aug 01.
Article in English | MEDLINE | ID: mdl-39205587

ABSTRACT

OBJECTIVES: The illicit cigarette trade endangers public health because it increases access to cheaper tobacco products, hence fueling the tobacco epidemic and undermining tobacco control policies. The objective of this study was to evaluate the execution of an illicit cigarette eradication program under the jurisdiction of the local government in Indonesia. We sought to provide insights into the effectiveness of current policies and their impact on the illicit cigarette trade in line with the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) protocol to eliminate illicit trade in tobacco products. METHODS: We conducted semistructured interviews with key policy-makers and semistructured FGDs with consumers and small- to medium-scale cigarette manufacturers at the district level. We indentified Pasuruan and Kudus as the districts or cities with the highest proportion of DBH CHT, and Jepara and Malang as a district with a highest illicit cigarette incident. We used reflective thematic analysis to identify the important opportunities and challenges facing illicit cigarette eradication programs in the three districts. RESULTS: We identified four opportunities and four challenges related to illicit cigarette eradication program implementation under the local government. The opportunities for illicit cigarette eradication lie in strong central government regulatory and multisectoral authority support, consumer awareness, and local governments' commitment to tobacco supply chain control. The key challenges facing illicit cigarette eradication include ineffective public dissemination programs, rapidly changing regulatory designs, consumers' preferences for illicit products, and a lack of industrial involvement in tobacco supply chain control programs. CONCLUSION: In addition to significant budget allocation and increasing consumer awareness, local programs to eradicate illicit cigarette production require considerable evaluation to rethink the program's design and external stakeholders' engagement within the local government's scope.


Subject(s)
Commerce , Taxes , Tobacco Products , Humans , Tobacco Products/economics , Tobacco Products/legislation & jurisprudence , Taxes/economics , Indonesia/epidemiology , Commerce/economics , Qualitative Research , Tobacco Industry/economics , Tobacco Industry/legislation & jurisprudence , Smoking Prevention/economics , Smoking Prevention/methods , Crime/prevention & control , Crime/economics , Smoking/epidemiology , Smoking/economics
17.
Glob Public Health ; 19(1): 2394806, 2024 Jan.
Article in English | MEDLINE | ID: mdl-39183469

ABSTRACT

Taxes, legislation and politics are social determinants of health, which can impact health through multiple pathways. The purpose of this study was to review regulations regarding sugar-sweetened beverage (SSB) taxation and describe taxation/exemption of various beverage categories. We reviewed SSB taxation regulations from Mexico, the United Kingdom, Berkeley, Philadelphia, San Francisco and South Africa. Supplementary government documents and academic publications were also reviewed to further discern beverage taxation/exemption and zero-rating. There were a number of beverage types that fell clearly into typically taxed or exempt/zero-rated categories across all six jurisdictions (e.g. pop/soda as taxed and water as zero-rated). Exemptions and ambiguities within the six regulations can generally be grouped as a lack of clarity regarding the meaning and use of milk; the meaning of 'medical purposes' and 'supplemental'; the point at which a beverage is prepared; the form of concentrate (i.e. liquid/frozen/powder) or medium used (e.g. water, coffee); and location of preparation or business size of retailer. SSB tax regulations are complex, unclear, vary across jurisdiction and leave several beverage types with added sugar exempt from taxation or at risk of a legal challenge. Lastly, tax exemptions generally reflect and perpetuate existing sociopolitical dynamics within the food system.


Subject(s)
Social Justice , Sugar-Sweetened Beverages , Taxes , Sugar-Sweetened Beverages/economics , Sugar-Sweetened Beverages/legislation & jurisprudence , Humans , Taxes/legislation & jurisprudence , South Africa , Mexico , Tax Exemption/legislation & jurisprudence
18.
PLoS One ; 19(8): e0307561, 2024.
Article in English | MEDLINE | ID: mdl-39190658

ABSTRACT

The difficulty in transforming old industrial areas constitutes a significant factor contributing to regional development imbalances. Can regional tax incentives, as a crucial component of regional policies, polish the "rust belt" regions? This study leverages the inaugural Value-Added Tax (VAT) reform in China as an opportunity to explore the potential of regional tax incentives in achieving sustainable development in traditional industrial areas. Drawing upon a comprehensive industrial enterprise database, we employ a Propensity Score Matching-Difference in Differences (PSM-DID) approach to examine the efficacy of these tax incentives. Our findings reveal that: (1) Regional tax incentives primarily enhance firms productivity by stimulating investment in enterprises, yet they do not contribute to improved investment efficiency or spur innovation within firms. (2) Regional tax incentives have alleviated financing constraints for enterprises in old industrial bases, significantly enhancing the Total Factor Productivity (TFP) of firms with higher financing constraints. This policy has had an even stronger impact on improving the TFP of state-owned and monopolistic enterprises. (3) Regional tax incentives have impeded productivity growth by preventing the exit of low-efficiency firms and the entry of high-efficiency ones. These incentives also increased the likelihood of "zombie firms" forming and failed to promote endogenous economic growth in the Northeast region. Additionally, they have distorted the allocation of resources towards capital and technology-intensive industries in that area. In China's old industrial bases, regional tax incentives should be coordinated with market-oriented reforms; these regional tax incentive policies should also be further enriched.


Subject(s)
Motivation , Taxes , Taxes/economics , China , Humans , Efficiency , Industry/economics , Industry/legislation & jurisprudence , Investments/economics , Economic Development
19.
BMC Public Health ; 24(1): 2278, 2024 Aug 22.
Article in English | MEDLINE | ID: mdl-39174939

ABSTRACT

BACKGROUND: This study evaluated the impact of the tax increase in January 2019 on changes in intention to quit and the effect of cigarette prices on quit attempts and successful quitting among male cigarette smokers in Vietnam. METHODS: Data were derived from the ITC project in Vietnam, which included 1585 adult smokers at baseline (Wave 1, Aug-Oct 2018) followed up to waves 2 (Sep-Nov 2019) and 3 (Sep-Dec 2020). Generalized estimating equations regression was performed to estimate changes in the intention to quit. Multiple logistic regression analysis was used to evaluate the cigarette price of a cigarette pack in relation to quit attempts and successful quitting. RESULTS: The increase in cigarette tax in 2019 did not significantly increase the likelihood of the intention to quit. After the tax increase, 63.6% of participants who smoked made a quit attempt, and 27.6% successfully quit smoking in the follow-up waves. However, the price of a cigarette pack was not significantly associated with quit attempts and successful quitting. The study did not observe a significant impact of cigarette prices on quit attempts and successful quitting in all subgroups of household income. Factors associated with quit attempts included the number of cigarettes smoked and the intention to quit, while those associated with successful quitting included age, dual use of cigarettes and other tobacco products, and the intention to quit. CONCLUSION: Current cigarette prices were not associated with cessation behaviors even within the lowest household income group. Therefore, a sharp rise in cigarette tax is required to incentivize smokers to quit smoking.


Subject(s)
Commerce , Smoking Cessation , Taxes , Tobacco Products , Humans , Male , Vietnam , Smoking Cessation/economics , Smoking Cessation/statistics & numerical data , Smoking Cessation/psychology , Adult , Tobacco Products/economics , Middle Aged , Commerce/statistics & numerical data , Taxes/statistics & numerical data , Intention , Smokers/statistics & numerical data , Smokers/psychology , Young Adult , Surveys and Questionnaires , Adolescent
20.
Health Policy ; 148: 105147, 2024 Oct.
Article in English | MEDLINE | ID: mdl-39178753

ABSTRACT

Most research on health care equity focuses on accessing services, with less attention given to how revenue is collected to pay for a country's health care bill. This article examines the progressivity of revenue collection among publicly funded sources: income taxes, social insurance (often in the form of payroll) taxes, and consumption taxes (e.g., value-added taxes). We develop methodology to derive a qualitative index that rates each of 29 high-income countries as to its progressivity or regressivity for each of the three sources of revenue. A variety of data sources are employed, some from secondary data sources and other from country representatives of the Health Systems and Policy Monitor of the European Observatory on Health Systems and Policies. We found that countries with more progressive income tax systems used more income-based tax brackets and had larger differences in marginal tax rates between the brackets. The more progressive social insurance revenue collection systems did not have an upper income cap and exempted poorer persons or reduced their contributions. The only pattern regarding consumption taxes was that countries that exhibited the fewest overall income inequalities tended to have least regressive consumption tax policies. The article also provides several examples from the sample of countries on ways to make public revenue financing of health care more progressive.


Subject(s)
Financing, Government , Taxes , Humans , Taxes/economics , Social Security/economics , Income Tax/economics , Developed Countries , Delivery of Health Care/economics
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