The Demand for Public Health Care and the Progressivity of Health Care Services in Ghana

This paper examines the choice of health care and progressivity of health care services in Ghana. Using a combination of benefit incidence analysis and a discrete choice model and data from the Ghana Living Standards Survey, our results give clear evidence of progressivity with consistent ordering: postnatal and prenatal services are the most progressive, followed by clinic visits, and then hospital visits. Child health care services are more progressive than adult. Own price and income elasticities are higher for public health care than private health care and for adults than children. Poorer households are substantially more price responsive than wealthy ones, implying that fee increases for public health care will impact negatively on equity in health care. Simulations show the importance of opportunity costs in health care decisions and suggest that reforms that focus only on out-of-pocket expenses will have a limited ability to extend public health care to all potential users.