Puncturing pessimism: The success of old-fashioned tax-funded systems

Background: In the past five years, the Equitap collaboration profiled equity in health systems financing and delivery in 17 Asian economies, ranging from Bangladesh to Hong Kong. Although higher income economies generally do better than poorer economies, significant differences exist in countries at similar income levels, and significant similarities between groups of countries at different income levels. These differences require explanation. Objectives: This paper focuses on the relative performance of those economies, where public financing for health services is almost exclusively general taxation, thus excluding those where social insurance is significant. This focus is justified as social insurance appears generally unfeasible at scale in the poorest countries with weakest capacity. The objectives are to identify the specific differences between countries…