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The informal sector is generally believed to be more vulnerable to various risks due to limited access to social insurance, but little empirical evidence exists to support this statement. This paper examines the relationship between informality and protection from health risks in Yemen. The formal sector, when defined based on pension coverage, largely overlaps with public employment where the better educated, more experienced, and better informed tend to work. The results indicate that, even after accounting for socioeconomic status, water supply and quality conditions, risky behavior patterns, and unobserved heterogeneity, formal sector households have better accessibility and affordability to health service. This may in part explain better health outcomes among formal households, although large heterogeneity across regions (urban/rural) exists. However, the role of the existing health insurance is found to be unclear. The findings reconfirm the importance of policies that promote universal access to health service and a risk pooling avenue delinked from employment types as well as healthy living conditions and lifestyles.

Access To Health Service --- Health Economics & Finance --- Health Insurance --- Health Monitoring & Evaluation --- Health Outcomes --- Health Spending --- Health Systems Development & Reform --- Health, Nutrition and Population --- Informality --- Labor Markets --- Safety Nets and Transfers --- Social Protections and Labor

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This paper exploits the staggered rollout of Vietnam's hospital autonomization policy to estimate its impacts on several key health sector outcomes including hospital efficiency, use of hospital care, and out-of-pocket spending. The authors use six years of panel data covering all Vietnam's public hospitals, and three stacked cross-sections of household data. Autonomization probably led to more hospital admissions and outpatient department visits, although the effects are not large. It did not, however, affect bed stocks or bed-occupancy rates. Nor did it increase hospital efficiency. Oddly, despite the volume effects and the unchanged cost structure, the analysis does not find any evidence of autonomization leading to higher total costs. It does, however, find some evidence that autonomization led to higher out-of-pocket spending on hospital care, and higher spending per treatment episode; the effects vary in size depending on the data source and hospital type, but some are quite large-around 20 percent. Autonomy did not apparently affect in-hospital death rates or complications, but in lower-level hospitals it did lead to more intensive style of care, with more lab tests and imaging per case.

Disease Control & Prevention --- Health Law --- Health Monitoring & Evaluation --- Health Systems Development & Reform --- Hospital autonomization --- Hospital autonomy --- Hospital efficiency --- Out-of-pocket health spending --- Population Policies --- Public Sector Development --- Social Development --- Vietnam

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Excise taxes on alcohol and tobacco have long been a dependable and significant revenue source in many countries. More recently, considerable attention has been paid to the way in which such taxes may also be used to attain public health objectives by reducing the consumption of products with adverse health and social impacts. Some have gone further and argued that explicitly earmarking excise taxes on alcohol and tobacco to finance public health expenditures-marrying sin and virtue as it were-will make increasing such taxes more politically acceptable and provide the funding needed to increase such expenditures, especially for the poor. The basic idea-tax "bads" and do "good" with the proceeds-is simple and appealing. But designing and implementing good "sin" taxes is a surprisingly complex task. Earmarking revenues from such taxes for health expenditures may also sound good and be a useful selling point for new taxes. However, such earmarking raises difficult issues with respect to budgetary rigidity and political accountability. This note explores these and other issues that lurk beneath the surface of the attractive concept of using increased sin excises on alcohol and tobacco to finance "virtuous" social spending on public health.

Accounting --- Added tax --- Addiction --- Aged --- Alcohol consumption --- Alcohol taxation --- Alcohol taxes --- Alcoholism --- Alternative minimum tax --- Children --- Crime --- Debt markets --- Differential taxation --- Earmarked tax --- Economic analysis --- Economic development --- Economic efficiency --- Economic theory & research --- Effective tax rates --- Equity --- Evasion --- Exchange --- Excise tax --- Exercises --- Expenditure --- Externalities --- Families --- Finance --- Finance and financial sector development --- Gambling --- Good --- Goods --- Governments --- Health --- Health care --- Health effects --- Health monitoring & evaluation --- Health outcomes --- Health policy --- Health promotion --- Health spending --- Health, nutrition and population --- Implementation --- Indirect taxation --- Inflation --- International bank --- Intervention --- Isolation --- Knowledge --- Labor --- Laws --- Levy --- Local finance --- Local governments --- Macroeconomic conditions --- Macroeconomics and economic growth --- Management --- Market --- Marketing --- Nutrition --- Passive smoking --- People --- Per --- Product taxes --- Psychology --- Public --- Public economics --- Public expenditures --- Public funds --- Public health --- Public revenues --- Regressive taxes --- Regulation --- Revenue --- Revenue sources --- Risks --- Sales taxes --- Services --- Sin tax --- Sin' tax --- Sin' taxes --- Smokers --- Smoking --- Social policy --- Social research --- Social welfare --- Spending --- Stress --- Tax --- Tax administration --- Tax base --- Tax burdens --- Tax changes --- Tax competition --- Tax evasion --- Tax incidence --- Tax increases --- Tax law --- Tax policy --- Tax rate --- Tax receipts --- Tax reduction --- Tax reform --- Tax revenue --- Tax structures --- Tax system --- Taxation --- Taxation & subsidies --- Taxes --- Tobacco tax --- Transparency --- Uniform taxes --- Use taxes --- Value added tax --- Weight