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Intergenerational inequalities in GPs' earnings : experience, time and cohort effects

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  • Brigitte Dormont
  • Anne-Laure Samson

Abstract

This paper analyses the regulation of ambulatory care and its impact on physicians careers, using a representative panel of 6016 French self-employed GPs over the years 1983 to 2004. The beginning of their activity is influenced by the regulated number of places in medical schools, named in France numerus clausus. We show that the policies aimed at manipulating the numerus clausus strongly affect physicians permanent level of earnings. Our empirical approach allows us to identify experience, time and cohort effects in GPs earnings. The estimated cohort effect is very large, revealing that intergenerational inequalities due to fluctuations in the numerus clausus are not negligible. GPs beginning during the eighties have the lowest permanent earnings: they faced the consequences of an unlimited number of places in medical schools in the context of a high density due to the baby-boom numerous cohorts. Conversely, the decrease in the numerus clausus led to an increase in permanent earnings of GPs who began their practice in the mid nineties. Overall, the estimated gap in earnings between "good" and "bad" cohorts may reach 25%. We performed a more thorough analysis of the earnings distribution to examine whether individual unobserved heterogeneity could compensate for average differences between cohorts. Our results about stochastic dominance between earnings distributions by cohort show that it is not the case.

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Bibliographic Info

Paper provided by University of Lausanne, Institute of Health Economics and Management (IEMS) in its series Working Papers with number 0704.

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Length: 26 pages
Date of creation: Nov 2007
Date of revision:
Handle: RePEc:hem:wpaper:0704

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Keywords: GPs; self-employed; longitudinal data; earnings; stochastic dominance;

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References

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  1. Brigitte Dormont & Carine Milcent, 2010. "Innovation Diffusion under Budget Constraints: Microeconometric Evidence on Heart Attack in France," NBER Chapters, in: Contributions in Memory of Zvi Griliches, pages 697-726 National Bureau of Economic Research, Inc.
  2. François Bourguignon & Francisco H. G. Ferreira & Phillippe G. Leite, 2002. "Beyond Oaxaca-Blinder : Accounting for Differences in Household Income Distributions Across Countries," DELTA Working Papers 2002-04, DELTA (Ecole normale supérieure).
  3. Malik Koubi, 2003. "Les trajectoires professionnelles : une analyse par cohorte," Économie et Statistique, Programme National Persée, vol. 369(1), pages 119-147.
  4. Eric Delattre & Brigitte Dormont, 2003. "Fixed fees and physician-induced demand: A panel data study on French physicians," Health Economics, John Wiley & Sons, Ltd., vol. 12(9), pages 741-754.
  5. Shorrocks, Anthony F, 1983. "Ranking Income Distributions," Economica, London School of Economics and Political Science, vol. 50(197), pages 3-17, February.
  6. McGuire, Thomas G., 2000. "Physician agency," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 9, pages 461-536 Elsevier.
  7. Nijman, T.E. & Verbeek, M.J.C.M., 1992. "Testing for selectivity in panel data models," Open Access publications from Tilburg University urn:nbn:nl:ui:12-153280, Tilburg University.
  8. Verbeek, Marno & Nijman, Theo, 1992. "Testing for Selectivity Bias in Panel Data Models," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 33(3), pages 681-703, August.
  9. Rizzo, John A. & Zeckhauser, Richard J., 2007. "Pushing incomes to reference points: Why do male doctors earn more?," Journal of Economic Behavior & Organization, Elsevier, vol. 63(3), pages 514-536, July.
  10. Russell Davidson & Jean-Yves Duclos, 2000. "Statistical Inference for Stochastic Dominance and for the Measurement of Poverty and Inequality," Econometrica, Econometric Society, vol. 68(6), pages 1435-1464, November.
  11. Milton Friedman & Simon Kuznets, 1954. "Income from Independent Professional Practice," NBER Books, National Bureau of Economic Research, Inc, number frie54-1, June.
  12. Finis Welch, 1979. "Effects of Cohort Size on Earnings: The Baby Boom Babies' Financial Bust," UCLA Economics Working Papers 146, UCLA Department of Economics.
  13. Welch, Finis, 1979. "Effects of Cohort Size on Earnings: The Baby Boom Babies' Financial Bust," Journal of Political Economy, University of Chicago Press, vol. 87(5), pages S65-97, October.
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Cited by:
  1. B. Dormont & A.-L. Samson, 2008. "Medical demography and intergenerational inequalities in general practitioners' earnings," Health Economics, John Wiley & Sons, Ltd., vol. 17(9), pages 1037-1055.
  2. Brigitte Dormont & Anne-Laure Samson, 2008. "Medical Demography and Intergenerational inequalities in GPs' earnings," Post-Print halshs-00351781, HAL.

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