Informal payments in Romanian health care system. A sample selection correction
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Nov 10, 2020
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Abstract
This paper draws on economic theory, sociology and political science approaches to explain informal payments in the Romanian health care system. It estimates the likelihood of paying a bribe (informal payment) using a reduced health care demand equation in a probit model with sample selection correction. Social capital, as having a relationship with doctors, and the perception of the health care system, as corrupt, are found to influence the probability of making an informal payment. The likelihood of making an informal payment in the Romanian health care system is modelled using a maximum-likelihood probit estimation with sample selection correction. In the selection equation, reduced health care demand, self-perceived health status and being afraid of diseases are used as exclusion restrictions for identifying the parameters of the econometric model.
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This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
Buligescu, B., & Espinoza Peňa, H. (2020). Informal payments in Romanian health care system. A sample selection correction. Sociologie Românească, 18(2), 40-73. https://doi.org/10.33788/sr.18.2.2
References
Balabanova, D. & McKee, M. (2002). Understanding informal payments in Bulgaria. Health Policy, 62, 243-273.
Belli, P. (2002). Formal and Informal Household Spending on Health: A Multicountry Study in Central and Eastern Europe. Harvard School of Public Health. Boston, MA.
Cameron, A. C. & Trivedi, P. K. (2005). Microeconometrics: Methods and applications, New York: Cambridge University Press.
Ensor, T. (2004). Informal payment for health care in transition economies. Social Science and Medicine, 58, 237-246.
European Observatory on Health Care System (2000). Health care systems in transition: Romania. European Observatory on Health Care System. Copenhagen: WHO Regional Office for Europe. Available at https://apps.who.int/iris/handle/10665/108365. Accessed on August 10, 2020.
Gaal, P. (1998). Under-the-table payment and health care reforms in Hungary. Unpublished. Bucharest: Health Service Management Training Centre, Semmelweis University of Medicine. Budapest.
Gaal, P. & McKee, M. (2004). Informal payment for health care and the theory of ‘INXIT’. International Journal of Health Planning and Management, 19, 163-178.
Greene, W.H. (2012). Econometric Analysis. Seventh Edition, One Lake Street, Upper Saddle River, New Jersey: Prentice Hall.
Grossman, M. (1999). The Human Capital Model of the Demand for Health. NBER Working paper, 7078.
Guerrero, M. A. & Rodríguez-Oreggia, E. (2005). About the decisions to commit corruption in Mexico: the role of the perceptions, individual and social effects. Serie Documentos de Trabajo, Mexico City: Universidad Iberoamericana, A.C.
Gupta, S., Davoodi, H., R. & Tiongson, E. (2000). Corruption and the Provision of Health Care and Education Services. IMF Working Paper, WP/00/116, 1-33.
Heckman, J. J. (1976). The Common Structure of Statisticals Models of Truncation, Sample Selection, and Limited Dependent Variables and a Simple Estimator for such Models. Annals of Economic and Social Measurement, 5, 475-492.
Heckman, J. J. (1979). Sample selection as specification error. Econometrica, 47, 153-161.
Kornai, J. (2000). Hidden in an envelope: Gratitude payments to medical doctors in Hungary. Paper for the Festschrift in honour of George Soros. Budapest: Central European University Press. Available at http://www.kornai-janos.hu/Kornai2000-Hidden-in-an-envelope.pdf.
Ledeneva, A. (1998). Russia’s Economy of Favours: Blat, Networking and Informal Exchange. Cambridge Russian and Post-Soviet Studies, 102, 1-235.
Lewis, M. (2002). Informal health payments in central and eastern Europe and the former Soviet Union: issues, trends and policy implications, in E. Mosssialos, A. Dixon, J. Figueras & J. Kutzin (eds.), Funding Health Care: Options for Europe, Open University Press: Buckingham.
Lewis, M. (2007). Informal payments and the Financing of Health Care in Developing and Transition Countries. Health Affairs, 4, 984-997.
OECD/European Observatory on Health Systems and Policies (2017). Romania: Country Health Profile 2017, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels. Available at http://dx.doi.org/10.1787/9789264283534-en. Accesed on August 11, 2020.
Rose, R. (1998). Getting things done in an anti-modern society: Social capital networks in Russia. Social Capital initiative Working Paper no. 6, World Bank.
Rose-Ackerman, S. (2001). Trust, Honesty and Corruption: Theories and Survey Evidence from Post-Socialist Societies. Kyklos, 54, 12-3.
Paun, L. (2017). Modernizarea legislației naționale în domeniul sanitar și implicații pentru securitatea națională. PhD Thesis, Academia națională de informații “Mihai Viteazul” Școala doctorală “Informații și securitate națională”.
Preker, A. & Harding, A. (2000). The Economics of Public and Private roles in Health care: Insights from institutional Economics and Organizational Theory. World Bank Health, Nutrition and Population Discussion Paper.
Schneider, P. (2007). Issues affecting the sustainability of health financing in several countries of South-East Europe. World Bank Report.
Stanciu, M. (2013). The Romanian system of public medical services Romania in the European context. Quality of Life Journal, XXIV, 1, 47-80.
Stepurko, T., Pavlova, M., Gryga, I. & Groot, W. (2015). To pay or not to pay? A multicountry study on informal payments for health-care services and consumers’ perceptions. Health Expectations, 18, 2978-2993.
Szlender, A. & Cuyler, A. J. (2006). The inequity of informal payments for health care: The case of Hungary. Health Policy, 75, 262-271.
Van de Ven, W. P. M. M. & Van Praag, B. M. S. (1981). The demand for Deductibles in Private Health Insurance: A Probit Model with Sample Selection. Journal of Econometrics 17, 229-252.
Vladescu, C. & Radulescu, S. (2001). Improving primary health care: Output based contracting in Romania. Public Policy for the Private Sector, 239: 73-79.
Williams, C. C. & Horodnic, A. (2017). Rethinking informal payments in Europe an institutional approach. Health Policy, 121(10), 1053-1062.
Williams, R. (2012). Using the margins command to estimate and interpret adjusted predictions and marginal effects. The STATA Journal, 12(2), 308-331.
Wooldridge, J. (2010). Econometric Analysis of Cross Section and Panel Data. Second Edition, Cambridge, Massachusetts: MIT Press.
World Bank (2001). Diagnostic Surveys of Corruption in Romania. Final Report prepared at request of the Government of Romania. Available at http://www1.worldbank.org/publicsector/anticorrupt/romenglish.pdf. Accessed on August 11, 2020.
Belli, P. (2002). Formal and Informal Household Spending on Health: A Multicountry Study in Central and Eastern Europe. Harvard School of Public Health. Boston, MA.
Cameron, A. C. & Trivedi, P. K. (2005). Microeconometrics: Methods and applications, New York: Cambridge University Press.
Ensor, T. (2004). Informal payment for health care in transition economies. Social Science and Medicine, 58, 237-246.
European Observatory on Health Care System (2000). Health care systems in transition: Romania. European Observatory on Health Care System. Copenhagen: WHO Regional Office for Europe. Available at https://apps.who.int/iris/handle/10665/108365. Accessed on August 10, 2020.
Gaal, P. (1998). Under-the-table payment and health care reforms in Hungary. Unpublished. Bucharest: Health Service Management Training Centre, Semmelweis University of Medicine. Budapest.
Gaal, P. & McKee, M. (2004). Informal payment for health care and the theory of ‘INXIT’. International Journal of Health Planning and Management, 19, 163-178.
Greene, W.H. (2012). Econometric Analysis. Seventh Edition, One Lake Street, Upper Saddle River, New Jersey: Prentice Hall.
Grossman, M. (1999). The Human Capital Model of the Demand for Health. NBER Working paper, 7078.
Guerrero, M. A. & Rodríguez-Oreggia, E. (2005). About the decisions to commit corruption in Mexico: the role of the perceptions, individual and social effects. Serie Documentos de Trabajo, Mexico City: Universidad Iberoamericana, A.C.
Gupta, S., Davoodi, H., R. & Tiongson, E. (2000). Corruption and the Provision of Health Care and Education Services. IMF Working Paper, WP/00/116, 1-33.
Heckman, J. J. (1976). The Common Structure of Statisticals Models of Truncation, Sample Selection, and Limited Dependent Variables and a Simple Estimator for such Models. Annals of Economic and Social Measurement, 5, 475-492.
Heckman, J. J. (1979). Sample selection as specification error. Econometrica, 47, 153-161.
Kornai, J. (2000). Hidden in an envelope: Gratitude payments to medical doctors in Hungary. Paper for the Festschrift in honour of George Soros. Budapest: Central European University Press. Available at http://www.kornai-janos.hu/Kornai2000-Hidden-in-an-envelope.pdf.
Ledeneva, A. (1998). Russia’s Economy of Favours: Blat, Networking and Informal Exchange. Cambridge Russian and Post-Soviet Studies, 102, 1-235.
Lewis, M. (2002). Informal health payments in central and eastern Europe and the former Soviet Union: issues, trends and policy implications, in E. Mosssialos, A. Dixon, J. Figueras & J. Kutzin (eds.), Funding Health Care: Options for Europe, Open University Press: Buckingham.
Lewis, M. (2007). Informal payments and the Financing of Health Care in Developing and Transition Countries. Health Affairs, 4, 984-997.
OECD/European Observatory on Health Systems and Policies (2017). Romania: Country Health Profile 2017, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels. Available at http://dx.doi.org/10.1787/9789264283534-en. Accesed on August 11, 2020.
Rose, R. (1998). Getting things done in an anti-modern society: Social capital networks in Russia. Social Capital initiative Working Paper no. 6, World Bank.
Rose-Ackerman, S. (2001). Trust, Honesty and Corruption: Theories and Survey Evidence from Post-Socialist Societies. Kyklos, 54, 12-3.
Paun, L. (2017). Modernizarea legislației naționale în domeniul sanitar și implicații pentru securitatea națională. PhD Thesis, Academia națională de informații “Mihai Viteazul” Școala doctorală “Informații și securitate națională”.
Preker, A. & Harding, A. (2000). The Economics of Public and Private roles in Health care: Insights from institutional Economics and Organizational Theory. World Bank Health, Nutrition and Population Discussion Paper.
Schneider, P. (2007). Issues affecting the sustainability of health financing in several countries of South-East Europe. World Bank Report.
Stanciu, M. (2013). The Romanian system of public medical services Romania in the European context. Quality of Life Journal, XXIV, 1, 47-80.
Stepurko, T., Pavlova, M., Gryga, I. & Groot, W. (2015). To pay or not to pay? A multicountry study on informal payments for health-care services and consumers’ perceptions. Health Expectations, 18, 2978-2993.
Szlender, A. & Cuyler, A. J. (2006). The inequity of informal payments for health care: The case of Hungary. Health Policy, 75, 262-271.
Van de Ven, W. P. M. M. & Van Praag, B. M. S. (1981). The demand for Deductibles in Private Health Insurance: A Probit Model with Sample Selection. Journal of Econometrics 17, 229-252.
Vladescu, C. & Radulescu, S. (2001). Improving primary health care: Output based contracting in Romania. Public Policy for the Private Sector, 239: 73-79.
Williams, C. C. & Horodnic, A. (2017). Rethinking informal payments in Europe an institutional approach. Health Policy, 121(10), 1053-1062.
Williams, R. (2012). Using the margins command to estimate and interpret adjusted predictions and marginal effects. The STATA Journal, 12(2), 308-331.
Wooldridge, J. (2010). Econometric Analysis of Cross Section and Panel Data. Second Edition, Cambridge, Massachusetts: MIT Press.
World Bank (2001). Diagnostic Surveys of Corruption in Romania. Final Report prepared at request of the Government of Romania. Available at http://www1.worldbank.org/publicsector/anticorrupt/romenglish.pdf. Accessed on August 11, 2020.