Hostname: page-component-7c8c6479df-ws8qp Total loading time: 0 Render date: 2024-03-28T05:21:33.266Z Has data issue: false hasContentIssue false

Informal payments for health care – the phenomenon and its context

Published online by Cambridge University Press:  05 May 2011

Nissim Cohen*
Affiliation:
Department of Management and Economics, The Open University of Israel, Raanana 43107, Israel
*
*Correspondence to: Nissim Cohen, Department of Management and Economics, The Open University of Israel, P.O.B. 808, Raanana 43107, Israel. Email: NissimCo@openu.ac.il

Abstract

This paper reviews current research and literature on the issue of informal payments for health care and its context and suggests a new perspective for a better understanding of this phenomenon. This perspective, based on political culture and behavior and on wider social processes, is already used to explain various phenomena from different fields of public policy. The paper explains the impact of a specific type of political culture, called ‘alternative politics’ (AP) in the Israeli literature, on healthcare policy and institutional healthcare settings. AP is based on a ‘do-it-yourself’ approach adopted by citizens to address their dissatisfaction with governmental services. When such a mode of political culture is diffused to all sectors and levels of society, all players, including bureaucrats and politicians, are guided by short-term considerations and apply unilateral strategies that bypass formal rules either through illegal activity or by marginalizing formal rules. Explaining informal payments by analyzing social processes and political culture and behavior has some disadvantages, but it provides us with a better understanding of the phenomenon while covering most of its characteristics and configurations.

Type
Articles
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adaman, F. (2003), ‘Study on the Social Protection Systems in Turkey’, in Study on the Social Protection Systems in the 13 Applicant Countries, European Commission. http://www.monitoringris.org/documents/tools_nat/sy/TUR.pdfGoogle Scholar
Aharoni, Y. (1998), ‘The changing political-economy of Israel’, Annals of the American Academy of Political and Social Science, 555: 127146.CrossRefGoogle Scholar
Akashi, H., Yamada, T., Huot, E., Kanal, K.Sugimoto, T. (2004), ‘User fees at a public hospital in Cambodia: effects on hospital performance and provider attitudes’, Social Science and Medicine, 58(3): 553564.CrossRefGoogle Scholar
Arian, A. (1998), The Second Republic: Politics in Israel, Chatham, NJ: Chatham House.Google Scholar
Balabanova, D. (1999), ‘Informal Payments for Health Care in Bulgaria’, Observatory Case Study, London School of Economics, London, UK.Google Scholar
Balabanova, D.McKee, M. (2002), ‘Understanding informal payments for health care: the example of Bulgaria’, Health Policy, 62: 243273.CrossRefGoogle ScholarPubMed
Balabanova, D., McKee, M., Pomerleau, J., Haerpfer, R. R.Haerpfer, C. (2004), ‘Health service utilisation in the Former Soviet Union: evidence from eight countries’, Health Services Research, 39: 19271950.CrossRefGoogle ScholarPubMed
Barber, S., Bonnet, F.Bekedam, H. (2004), ‘Formalizing under-the-table payment to control out-of-pocket hospital expenditures in Cambodia’, Health Policy and Planning, 19(40): 199208.CrossRefGoogle ScholarPubMed
Belli, P., Shahriari, H.Gotzadze, G. (2004), ‘Out of pocket and informal payments in the health sector: evidence from Georgia’, Health Policy, 70: 109123.CrossRefGoogle ScholarPubMed
Belli, P., Shahriari, H., Lewis, H. (2001), ‘Institutional Issues in Informal Health Payments in Poland: Report on the Qualitative Part of the Study’, HNP Thematic Group Working Paper, World Bank.Google Scholar
Ben-Porat, G.Mizrahi, S. (2005), ‘Political culture, alternative politics and foreign policy: the case of Israel’, Policy Sciences, 38: 177194.CrossRefGoogle Scholar
Bloom, G., Han, L.Li, X. (2001), ‘How health workers earn a living in China’, Human Resources for Health Development Journal, 5(1): 2538.Google Scholar
Bruno, M. (1993), Crisis Stabilization and Economic Reform: Therapy by Consensus, Oxford: Oxford University Press.CrossRefGoogle Scholar
Chakraborty, S., Gatti, R., Klugman, J., Gray-Molina, G. (2002), ‘When Is “Free” Not So Free’?, Informal Payments for Basic Health Services in Bolivia, Mimeo.Google Scholar
Chawla, M., Berman, P.Kawiorska, D. (1998), ‘Financing health services in Poland: new evidence on private expenditures’, Health Economics, 7: 337346.3.0.CO;2-Z>CrossRefGoogle ScholarPubMed
Chernichovsky, D. (1991), Lessons of the Crisis in the Israeli Health-Care System: Key Principles and Proposals for Reform, Jerusalem: JDC-Brookdale Institute.Google Scholar
Chernichovsky, D.Chinitz, D. (1995), ‘The political economy of health system reform in Israel’, Health Economics, 4(2): 127141.CrossRefGoogle ScholarPubMed
Cohen, N. (2010), ‘Institutional Changes, Alternative Politics and Public Policy: The Case of the Formulation and Implementation of Health Policy in Israel’, Beer Sheva: Ben-Gurion University of the Negev, Unpublished PhD dissertation written within the Department of Public Policy and Administration. (Hebrew).Google Scholar
Cohen, N., Mizrahi, S. (2010), ‘Health Policy, alternative politics and institutions: A conceptual framework and the Israeli Case’, in H. Katz and E. Zfadia (eds), States ‘Abandonment and Surveillance’: New Perspective of the Welfare State in a Neo-Liberal Economy, Tel Aviv: Resling Hebrew: 363–386.Google Scholar
Cohen, N., Mizrahi, S.Yuval, F. (2008), ‘The Welfare State, Public Policy and Public Opinion: Israel 2008’, Working Paper no. 3. (Hebrew), Beer-Sheva: Department of Public Policy and Administration, Ben-Gurion University.Google Scholar
Cunningham, R. B.Sarayrah, Y. K. (1993), Wasta; the hidden force in Middle Eastern society, Paeger: Westport Connecticut.Google Scholar
Dabalen, A., Wane, W. (2008), ‘Informal Payments and Moonlighting in Tajikistan's Health Sector’, Policy Research Working Paper PRWP-4555, The World Bank, Europe and Central Asia Region, Poverty Reduction & Economic Management Sector Unit.CrossRefGoogle Scholar
Delcheva, E., Balabanova, D., McKee, M. (1997), ‘Under-the-counter payments for health care: evidence from Bulgaria’, Health Policy, 42: 89100.CrossRefGoogle ScholarPubMed
Di Tella, R.Savedoff, W. D. (2001), ‘Shining Light in Dark Corners’, in R. Di Tella and W. D. Savedoff (eds), Diagnosis Corruption, Washington, DC: Inter-American Development Bank, 126.Google Scholar
Ensor, T. (2004), ‘Informal payments for health care in transition economies’, Social Science and Medicine, 58(2): 237246.CrossRefGoogle ScholarPubMed
Ensor, T.Savelyeva, A. (1998), ‘Informal payments for health care in the Former Soviet Union: some evidence from Kazakhstan’, Health Policy Plan, 13: 4149.CrossRefGoogle Scholar
Ensor, T.Witter, S. (2001), ‘Health economics in low income countries: adapting to the reality of the unofficial economy’, Health Policy, 57: 113.CrossRefGoogle Scholar
Falkingham, J. (2004), ‘Poverty, out-of-pocket payments and access to health care: evidence from Tajikistan’, Social Science and Medicine, 58: 247258.CrossRefGoogle ScholarPubMed
Feeley, F. G., Sheiman, I. M.Shiskin, S. V. (1999), Health Sector Informal Payments in Russia, Boston: Boston University.Google Scholar
Filc, D. (2001), ‘Commodification of Health Care’, in A. Ofir and Y. Peled (eds), Civil Society in Israel, Jerusalem: Van Leer Institute and Hakibbutz Hamehuhad, 262280.Google Scholar
Gaal, P., Belli, P. C., McKee, M.Szocska, M. (2006), ‘Informal payments for health care: definitions, distinctions, and dilemmas’, Journal of Health Politics, Policy and Law, 31(2): 251293.CrossRefGoogle ScholarPubMed
Gaal, P.McKee, M. (2004), ‘Informal payment for health care and the theory of “INXIT” ’, The International Journal of Health Planning and Management, 19(2): 163178.CrossRefGoogle ScholarPubMed
Gaal, P.McKee, M. (2005), ‘Fee-for-service or donation? Hungarian perspectives on informal payment for health care’, Social Science and Medicine, 60(7): 14451457.CrossRefGoogle ScholarPubMed
Gatti, R., Gray-Molina, G.Klugman, J. (2003), Determinants of Corruption in Local Health Care Provision: Evidence from 108 Municipalities in Bolivia, Washington DC: World Bank.Google Scholar
Giedion, U., Morales, L. G.Acosta, O. L. (2001), ‘The Impact of Health Reforms on Irregularities in Bogotá Hospitals’, in R. Di Tella and W. D. Savedoff (eds), Diagnosis Corruption, Washington, DC: Inter-American Development Bank, 163198.Google Scholar
Gidron, B., Bar, M.Katz, H. (2003), The Third Sector in Israel: between Welfare State and Civil Society, Tel Aviv: Hakibbutz Hameuchad.Google Scholar
Gopakumar, K. (1998), ‘Citizen Feedback Surveys to Highlight Corruption in Public Services: the Experience of Public Affairs Centre’, Mimeo, Bangalore.Google Scholar
Gray-Molina, G., de Rada, E. P.Yanez, E. (2001), ‘Does Voice Matter? Participation and Controlling Corruption in Bolivian Hospitals’, in R. Di Tella and W. D. Savedoff (eds), Diagnosis Corruption, Washington, DC: Inter-American Development Bank, 2656.Google Scholar
Hirschman, A. O. (1970), Exit Voice and Loyalty: Responses to Decline in Firms, Organizations and States, Cambridge: Cambridge University Press.Google Scholar
Hofbauer, H. (2006), ‘Citizens’ Audit in Mexico Reveals Paper Trail of Corruption’, Global Corruption Report 2006, Transparency International: 43–45.Google Scholar
Horowitz, D.Lissak, M. (1978), Origins of the Israeli Polity, Chicago: Chicago University Press.Google Scholar
Horowitz, D.Lissak, M. (1989), Trouble in Utopia, Albany: SUNY Press.Google Scholar
Jaen, M. H.Paravinski, D. (2001), ‘Wages, Capture and Penalties in Venezuela's Public Hospitals’, in R. Di Tella and W. D. Savedoff (eds), Diagnosis Corruption, Washington, DC: Inter-American Development Bank, 5794.Google Scholar
Killingsworth, J. (2003), Formal and Informal Fees for Health Care, Manila: WHO Regional Office for the Western Pacific.Google Scholar
Killingsworth, J., Hossain, N., Hedrick-Wong, Y., Thomas, S., Rahman, A.Begum, T. (1999), ‘Unofficial fees in Bangladesh: price, equity and institutional issues’, Health Policy and Planning, 14: 152163.CrossRefGoogle ScholarPubMed
Kutzin, J., Maeimanaliev, T., Ibraimova, A., Cashin, C., O'Dougherty, S. (2003), ‘Formalizing Informal Payments in Kyrgyz Hospitals: Evidence from Phased Implementation of Financing Reforms’, Paper presented at IHEA Conference, San Francisco, California.Google Scholar
Lachman, R.Noy, S. (1998), A Black Stain on the White Gown, Tel-Aviv: Ramot.Google Scholar
Lehman-Wilzig, S. N. (1991), ‘Loyalty, voice, and quasi-exit: Israel as a case study of proliferating alternative politics’, Comparative Politics, 24(1): 97108.CrossRefGoogle Scholar
Lehman-Wilzig, S. N. (1992), Wildfire: Grassroots Revolts in Israel in the Post-Socialist Era, Albany: SUNY Press.Google Scholar
Lewis, M. (2000), Who is Paying for Health Care in Eastern Europe and Central Asia?, Washington, DC: Human Development Sector Unit, Europe and Central Asia Region, The World Bank.CrossRefGoogle Scholar
Lewis, M. (2006), ‘Governance and Corruption in Public Health Care Systems’, Working Paper no. 78, Center for Global Development.CrossRefGoogle Scholar
Lewis, M. (2007), ‘Informal payments and the financing of health care in developing and transition countries’, Health Affairs, 26(4): 984997.CrossRefGoogle ScholarPubMed
Liaropoulos, L.Tragakes, E. (1998), ‘Public/private financing in the Greek health care system: implications for equity’, Health Policy, 43: 153169.CrossRefGoogle ScholarPubMed
Lindelow, M., Serneels, P.Lemma, T. (2003), Synthesis of Focus Group Discussions with Health Workers in Ethiopia, DEC Draft Paper. Washington, DC: World Bank.Google Scholar
Lindelow, M., Ward, P.Zorzi, N. (2004), Expenditure Tracking and Service Delivery Survey, The Health Sector in Mozambique, Final Report, Washington DC: World Bank.Google Scholar
McMenamin, I.Timonen, V. (2002), ‘Poland's health reform: politics, markets and informal payments’, Journal of Social Policy, 31: 103118.CrossRefGoogle Scholar
McPake, B., Asiimwe, D., Mwesigye, F., Ofumbi, M., Ortenblad, L., Streefland, P., et al. (1999), ‘Informal economic activities of public health workers in Uganda: implications for quality and accessibility of care’, Social Science and Medicine, 49(7): 849865.CrossRefGoogle ScholarPubMed
Migdal, J. (1989), ‘The Crystallization of the State and the Struggles over Rulemaking: Israel in Comparative Perspective’, in B. Kimmerling (ed.), The Israeli State and Society: Boundaries and Frontiers, Albany: SUNY Press, pp. 127.Google Scholar
Mizrahi, S.Meydani, A. (2003), ‘Political participation via the judicial system: exit, voice and quasi-exit in Israeli Society’, Israel Studies, 8: 118138.CrossRefGoogle Scholar
Mizrahi, S.Meydani, A. (2006), Public Policy between Society and Law, Jerusalem: Carmel.Google Scholar
Mizrahi, S.Vigoda-Gadot, E. (2009), ‘Citizens’ learning, involvement, and participation in decision-making under the democratic ethos: a theoretical framework and the Israeli experience’, International Journal of Public Administration, 32(5): 438460.CrossRefGoogle Scholar
Mizrahi, S., Vigoda-Gadot, E.Cohen, N. (2009), ‘Trust, participation, and performance in public administration: an empirical examination of health services in Israel’, Public Performance and Management Review, 33(1): 733.CrossRefGoogle Scholar
Mizrahi, S., Vigoda-Gadot, E.Cohen, N. (2010), ‘Trust, participation and performance in welfare supply organizations: the case of social security organization in Israel’, Public Management Review, 12(1): 99126.CrossRefGoogle Scholar
Mossialos, E., Allin, S., Karras, K.Davaki, K. (2005), ‘An investigation of caesarean sections in three Greek Hospitals: the impact of financial incentives and convenience’, European Journal of Public Health, 15(3): 288295.CrossRefGoogle ScholarPubMed
Narayan, D. (2000), Voices of the Poor, Washington, DC: World Bank and Oxford University Press.Google Scholar
Report of the Investigation Committee for the Health System – Majority Report (1990), The Netanyahu Investigation Committee, Hebrew.Google Scholar
Rosen, B. (2003), ‘Health Care Systems in Transition: Israel’, in S. Thomson and E. Mossialos (eds), Health Care Systems in Transition: Israel, Copenhagen: European Observatory on Health Care Systems, 5(1), http://www.euro.who.int/__data/assets/pdf_file/0003/85449/E81826.pdfGoogle Scholar
Sari, N., Langenbrunner, J. C.Lewis, M. (2000), ‘Affording Out-of-Pocket Payments for Health Services: Evidence from Kazakhstan’, EuroHealth, 16(2): 3739.Google Scholar
Schargrodsky, E., Mera, J.Weinschelbaum, F. (2001), ‘Transparency and Accountability in Argentina's Hospitals’, in R. Di Tella and W. D. Savedoff (eds), Diagnosis Corruption, Washington, DC: Inter-American Development Bank, 95122.Google Scholar
Schneider, A. (2007), ‘Shadow economies and corruption all over the world: new estimates for 145 countries’, Economics: The Open-Access, Open-Assessment E-Journal, 1. Version 1, http://www.economics-ejournal.org/economics/journalarticles/2007-9CrossRefGoogle Scholar
Schneider, A.Buehn, F. (2007), ‘Shadow economies and corruption all over the world: revised estimates for 120 countries’, Economics: The Open-Access, Open-Assessment E-Journal, 1. Version 2, http://www.economics-ejournal.org/economics/journalarticles/2007-9CrossRefGoogle Scholar
Shahriari, H., Belli, P.Lewis, M. (2001), Qualitative Study on Informal Payment in Health in Poland, Washington, DC: World Bank.Google Scholar
Sharkansky, I.Zalmanovitch, Y. (1999), ‘Improvisation in public administration and policy making in Israel’, Public Administration Review, 60(4): 321329.CrossRefGoogle Scholar
Shvarts, S., Leeuw, D. L. D., Granit, S.Benbassat, J. (1999), ‘From socialist principles to motorcycle maintenance: the origin and development of the salaried physician model in the Israeli public health services, 1918 to 1998’, American Journal of Public Health, 89(2): 248253.CrossRefGoogle ScholarPubMed
Spector, B. (2005) (ed.). Fighting Corruption in Developing Countries, Bloomfield, CT: Kumarian Press, Inc.Google Scholar
Sprinzak, E. (1999), Brother against Brother. Violence and Extremism in Israeli Politics from Altalena to the Rabin Assassination, New York: The Free Press.Google Scholar
Szende, A.Culyer, A. J. (2006), ‘The inequity of informal payments for health care: the case of Hungary’, Health Policy, 75(3): 262271.CrossRefGoogle ScholarPubMed
Tatar, M., Ozgen, H., Sahin, B., Belli, P.Berman, P. (2007), ‘Informal payments in the health sector: a case study from Turkey’, Health Affairs, 26(4): 10291039.CrossRefGoogle ScholarPubMed
The Israeli State Comptroller's Annual Report (1990), State Comptroller's Office. Jerusalem, Hebrew, 188–191.Google Scholar
Thampi, G. K. (2002), Corruption in South Asia, Insights & Benchmarks from Citizen Feedback Surveys in Five Countries, Transparency International, http://unpan1.un.org/intradoc/groups/public/documents/apcity/unpan019883.pdfGoogle Scholar
Thompson, R.Witter, S. (2000), ‘Informal payments in transitional economies: implications for health sector reform’, International Journal of Health Planning and Management, 15(3): 169187.Google ScholarPubMed
Vian, T., Gryboski, K., Sinoimeri, Z.Hall, R. (2006), ‘Informal payments in government health facilities in Albania: results of a qualitative study’, Social Science and Medicine, 62(10): 877887.CrossRefGoogle ScholarPubMed
Weimer, D. L.Vining, A. R. (2005), Policy Analysis: Concepts and Practice, 4th edn, Englewood Cliffs: Prentice Hall.Google Scholar
World Bank (1992), ‘Vietnam: Population, Health, and Nutrition Sector Review’, Report no. 10289-VN. Washington, DC: East Asia and Pacific Region. World Bank, Population and Human Resources Operation Division.Google Scholar
World Bank. (2000), Armenia Institutional and Governance Review.Google Scholar
Yogev, A. (1999), ‘Order in the Chaos: Israel Education Policy in the Post-modern Era’, in D. Nachmias and G. Menachem (eds), Public Policy in Israel, Jerusalem: The Israeli Democracy Institute, 291326.Google Scholar
Zinger, R. (2004), Guarding Home by Private Police, Ha'aretz Daily, August 13, Hebrew.Google Scholar