The Distributional Impacts of Health-Related Government Tax and Program Expenditures: How Policy Contributes to Social Inequality

Other External Scholars:
Claudia Schur, Social & Scientific Systems
Mark Berk, Social & Scientific Systems
Jack Feldman, Social & Scientific Systems
Project Date:
Jun 2007
Award Amount:
Project Programs:
Social, Political, and Economic Inequality

A variety of changes have taken place in health care policy over the past three decades, but it is not clear whether the net effects of these changes have acted to moderate or magnify economic inequalities. Economist Claudia Schur and sociologists Marc Berk and Jacob Feldman will address this question by constructing a careful inventory of relevant health policy changes over the past thirty years. They will then estimate the distribution of costs and benefits to different population groups from major health related expenditures. In addition, they will undertake a rigorous examination of the way the current system of employer-sponsored health insurance contributes to health care inequality. They will, in addition, investigate how the system affects different groups, particularly low-income workers. Finally, they will use their framework for analyzing the incidence of health care subsidies to assess the ways in which different proposed approaches to health care reform are likely to affect economic inequality.


The primary data sources for the quantitative parts of the project will be the Medical Expenditure Panel Survey (MEPS) and its predecessor survey, the National Medical Care Expenditure Survey (NMCES). Both surveys provide information on household composition, income, health status, service use, insurance status and costs, and employment. The results will represent the most complete accounting to date of the way in which government health care expenditures are distributed across the population, and how the economic impact of health policies has changed over the past three decades. The results will be disseminated in a series of journal articles.


RSF: The Russell Sage Foundation Journal of the Social Sciences is a peer-reviewed, open-access journal of original empirical research articles by both established and emerging scholars.


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