In Kind Food Transfers

In Kind Transfers
(with some references to food)
John Scott,
CIDE
2013 World Bank Conference on Equity
Commitment to Equity in Fiscal Policy
Some General Issues
• Traditional BIA focuses on least relevant redistributive aspects
of IK transfers
– Effect on income distribution (indirect & short run): freeing up
income for other uses
– Financial resources: public spending
– Coverage, access, use of services
– But still very useful…what governments are trying to do, revealed
social preferences, constraints; net benefits
• What would be more relevant?
– effective access, quality: progressivity of health ane education IK
transfers may be grossly overestimated
– Impact on non-income dimensions, intrinisically valued
– Long term (life-cycle) impact on income distribution through HK
Effective access, Quality
Cuadro 1. Indicadores de calidad de los servicios salud por quintiles de hogares (ordenados por
consumo): 2002
Quintil 1
Quintil 2
Institución proveedora (%)
SSA
43
41
IMSS/ISSSTE
44
42
Privada
6
4
Características de clínicas (%)
Con Laboratorio
29
46
Clínica participa en Oportunidades
63
47
Realizan ultrasonidos
24
37
Realizan Rayos X
30
45
Salario mensual director (pesos)
9,321
12,138
Falto material/ equipo ult. Semana
27
22
Fuente: Susan Parker 2008, a partir de ENNVIH-1.
Quintil 3
Quintil 4
Quintil 5
37
48
5
27
52
9
22
50
13
57
38
43
58
14,464
16
61
27
52
62
15,684
14
69
25
61
70
18,149
13
Benefits proportional to spending?
900
800
700
600
500
Gasto Público Salud PNA
400
300
200
100
Benefits proportional to spending?
900
800
700
600
Gasto Público Salud PNA
Camas censables
500
Consultorios
Unidades consulta externa
400
Unidades hospitalización
Médicos
300
200
100
Enfermeras
450
400
60%
350
50%
300
40%
250
30%
200
150
20%
100
10%
50
0%
0
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
OOP (% total)
Public ($)
OOP ($)
Billion pesos (2010)
70%
Goods vs services vs. administration:
proportion of health spending on medicines to ambulatory care
50%
45%
40%
35%
30%
25%
20%
15%
10%
5%
0%
2002
2003
2007
Public Uninsured
2008
Public SS
2009
OOP
2010
Private Insurance
2011
Redistributive objectives of IK
transfers: What is “fair” distribution?
• Progressivity in non-income as well as income
dimensions
• Inequality/poverty of opportunities, access to
specific goods
– Concentration curve of multidimensional poverty
– Benefits received proportional to need
• Financial protection: catastrophic,
empoverishing expenditures
Food transfers
• Valuation of benefits not as challenging as in
services: closer to cash transfers…
• But cash vs. in kind important for indirect, GE
effects
– Cash transfers can increase local food (and other)
prices, and may have multiplier effects by boosting
local demand
– IK food transfers may reduce local prices,
increasing benefits to consumers, but harming
local producers
Food transfers
– These effects can be important in remote rural
communities: Mexico’s PAL program experiments
(Cunha & De Giorgi 2013)
• IK transfers reduced price of transferred goods by 8% relative
to cash transfers, benefit to consumers = + 40% of direct
transfer
• cash transfers lead to a 4 percent increase in overall food
prices; 8 percent increase in aggregate village income, on
average.
Food transfers
• Measuring objective important practical issue
– Access to Food, self-perceived: food security scales
(ELASA, Multidimensional poverty, Coneval)
– Malnutrition in children: low height/age, low
weight/height
– Extreme absolute PL
– Dietary diversity
Derek Headey & Olivier Ecker , Improving the Measurement of Food Security , IFPRI DP 01225l
November 2012
Panorama de la seguridad alimentaria y nutricional en México, Informe País, FAO,
2013.
Reditributive objectives of IK transfers:
What is “fair” distribution?
• Concentration curves of non-income poverty
dimensions
• Equality of opportunities
• Benefits received proportional to need
• Costs of reaching poorer communities: public
spending may need to be more than
proportional
Food transfers
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Desnutrición (baja talla/edad preescolares)
Rezago Acceso Alimentos (EMSA)
Total Food Programs
Oportunidades
PAL
Liconsa
Diconsa
90%
100%
Health
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Rezago Acceso a Salud
Total Public Spending
SSA
IMSS
ISSSTE
IMSS-Oportunidades
Seguro Popular
100%
Education
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Rezago Educativo
Total Public Educatio Spending
Básica
Media Superior
Superior
Becas Oportunidades
Otras becas públicas
100%
Social security
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Rezago Seguridad Social
Total Social Security
IMSS
ISSSTE
70 y más
Adultos Mayores Estados
100%
Reducing specific economic inequalities:
health/education spending
Beyond measurement: determinants
• Economic costs (user fees, contributory finance,
labor opp costs, purchasing power…) vs. capture…
• Inequality increases both, makes redsistribution
more difficult
• History, path-dependence: education coverage
• Quality and self-selection
– Redistributive impact vs. Redistributive “effectiveness”:
increasing financing of “universal” public services, if
effective in increasing service quality, will reduce equity
35%
Participación porcentual
30%
25%
20%
15%
10%
5%
0%
1
2
3
4
5
6
7
8
9
10
Deciles
Total
Básica
Media Superior
Superior
Becas Oportunidades
Otras becas públicas
Education (concentration coefficients)
0.6
0.5
0.4
0.3
0.2
0.1
0.0
-0.1
-0.2
-0.3
1992
1994
Total
1996
Primary
1998
2000
Lower Secondary
2002
2006
Upper Secondary
2008
Tertiary
2010
Health (use)
0.8
0.6
0.4
0.2
0.0
-0.2
-0.4
-0.6
1996
Total (A)
1998
SSA (A)
2000
IMSS (A)
2002
ISSSTE (A)
2006
2008
Seguro Popular (affiliation)
2010
Total (B)