Optimal public rationing and price response

被引:6
作者
Grassi, Simona [1 ,2 ]
Ma, Ching-to Albert [3 ]
机构
[1] Univ Lausanne, Fac Business & Econ, Dept Econ & Econometr, CH-1015 Lausanne, Switzerland
[2] Univ Lausanne, Inst Econ & Management Sante, CH-1015 Lausanne, Switzerland
[3] Boston Univ, Dept Econ, Boston, MA 02215 USA
关键词
Rationing; Price response; Means-testing; Cost effectiveness; HEALTH-INSURANCE; PRIVATE GOODS; WAITING TIME; PROVISION; SERVICE; SECTOR; CROWD; CARE;
D O I
10.1016/j.jhealeco.2011.08.011
中图分类号
F [经济];
学科分类号
02 ;
摘要
We study optimal public health care rationing and private sector price responses. Consumers differ in their wealth and illness severity (defined as treatment cost). Due to a limited budget, some consumers must be rationed. Rationed consumers may purchase from a monopolistic private market. We consider two information regimes. In the first, the public supplier rations consumers according to their wealth information (means testing). In equilibrium, the public supplier must ration both rich and poor consumers, Rationing some poor consumers implements price reduction in the private market. In the second information regime, the public supplier rations consumers according to consumers' wealth and cost information. In equilibrium, consumers are allocated the good if and only if their costs are below a threshold (cost effectiveness). Rationing based on cost results in higher equilibrium consumer surplus than rationing based on wealth. (C) 2011 Elsevier B.V. All rights reserved.
引用
收藏
页码:1197 / 1206
页数:10
相关论文
共 15 条
[1]   Waiting lists and patient selection [J].
Barros, PP ;
Olivella, P .
JOURNAL OF ECONOMICS & MANAGEMENT STRATEGY, 2005, 14 (03) :623-646
[2]  
BESLEY T, 1991, AM ECON REV, V81, P979
[3]   Does public insurance crowd out private insurance? [J].
Cutler, DM ;
Gruber, J .
QUARTERLY JOURNAL OF ECONOMICS, 1996, 111 (02) :391-430
[4]   Creaming, skimping and dumping: provider competition on the intensive and extensive margins [J].
Ellis, RP .
JOURNAL OF HEALTH ECONOMICS, 1998, 17 (05) :537-555
[5]   Public provision of private goods [J].
Epple, D ;
Romano, RE .
JOURNAL OF POLITICAL ECONOMY, 1996, 104 (01) :57-84
[6]   Economic foundations of cost-effectiveness analysis [J].
Garber, AM ;
Phelps, CE .
JOURNAL OF HEALTH ECONOMICS, 1997, 16 (01) :1-31
[7]  
Grassi S., 2009, BOSTON U EC WORKING
[8]  
Grassi S, 2010, J PUBLIC EC IN PRESS
[9]   Ramsey waits: Allocating public health service resources when there is rationing by waiting [J].
Gravelle, Hugh ;
Siciliani, Luigi .
JOURNAL OF HEALTH ECONOMICS, 2008, 27 (05) :1143-1154
[10]   THIRD DEGREE WAITING TIME DISCRIMINATION: OPTIMAL ALLOCATION OF A PUBLIC SECTOR HEALTHCARE TREATMENT UNDER RATIONING BY WAITING [J].
Gravelle, Hugh ;
Siciliani, Luigi .
HEALTH ECONOMICS, 2009, 18 (08) :977-986