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.
Highlights
Atenţie is the Romanian word defining an informal payment in addition to the cost of the services paid to the physicians, doctors and nurses in the Romanian public health care system2
We present the results of three alternative specifications of the probability of making an informal payment in the Romanian health care system
Suggesting policies to improve the current situation of the Romanian Health Care System, must take into account that corruption is part of the public services in Romania
Summary
Atenţie is the Romanian word defining an informal payment (in the form of money, gifts or services) in addition to the cost of the services paid to the physicians, doctors and nurses in the Romanian public health care system. Some figures, calculated from the Barometer of public opinion 2004-2005, indicated that the payment of “atenţie” was widespread. About 30% of the population older than 18 years old has been involved in informal payments to receive medical care in 2005. In 2017, the figure was 18% according to Eurobarometer 4703. Based on figures from Lewis (2002) and the World Health Organization (WHO) data set, Romanians spend around 450 mills US PPP$ in “atenţie”.
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