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Oligopolistic competition for the provision of hospital care

Author

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  • Laura Levaggi

    (Libera Università di Bolzano, Italy)

  • Rosella Levaggi

    (Università di Brescia, Italy)

Abstract

Competition in the market for health care has followed different patterns, and some health care systems have opted for mixed markets where public organisations compete alongside private ones. Empirical evidences on these market structures are however mixed. In this article we argue that public hospitals which have different objectives than private ones and faces different constraints, are also perceived differently by patients. For this reason we model the market for hospital care as Salop circle with a centre where the public hospital is located; private providers are located on the circle. We show that, depending on the difference in the productivity advantage, mixed markets may outperform both the benchmark (one public hospital at the centre) and private competition (N private providers competing along the circle), but the welfare distribution of these improvements should be carefully analysed. In some cases monopoly franchise on the mixed market should be introduced to redistribute these benefits.

Suggested Citation

  • Laura Levaggi & Rosella Levaggi, 2017. "Oligopolistic competition for the provision of hospital care," Working papers 57, Società Italiana di Economia Pubblica.
  • Handle: RePEc:ipu:wpaper:57
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    References listed on IDEAS

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    2. Gaynor, Martin & Vogt, William B, 2003. "Competition among Hospitals," RAND Journal of Economics, The RAND Corporation, vol. 34(4), pages 764-785, Winter.
    3. Laura Levaggi & Rosella Levaggi, 2011. "Welfare properties of restrictions to health care based on cost effectiveness," Health Economics, John Wiley & Sons, Ltd., vol. 20(1), pages 101-110, January.
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    5. Martin Gaynor & Kate Ho & Robert J. Town, 2015. "The Industrial Organization of Health-Care Markets," Journal of Economic Literature, American Economic Association, vol. 53(2), pages 235-284, June.
    6. Kurt R. Brekke & Luigi Siciliani & Odd Rune Straume, 2018. "Can Competition Reduce Quality?," Journal of Institutional and Theoretical Economics (JITE), Mohr Siebeck, Tübingen, vol. 174(3), pages 421-447, September.
    7. Brekke, Kurt R. & Siciliani, Luigi & Straume, Odd Rune, 2012. "Quality competition with profit constraints," Journal of Economic Behavior & Organization, Elsevier, vol. 84(2), pages 642-659.
    8. Herr Annika, 2011. "Quality and Welfare in a Mixed Duopoly with Regulated Prices: The Case of a Public and a Private Hospital," German Economic Review, De Gruyter, vol. 12(4), pages 422-437, December.
    9. Duggan, Mark, 2004. "Does contracting out increase the efficiency of government programs? Evidence from Medicaid HMOs," Journal of Public Economics, Elsevier, vol. 88(12), pages 2549-2572, December.
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    11. Rosella Levaggi, 2007. "Regulating internal markets for hospital care," Journal of Regulatory Economics, Springer, vol. 32(2), pages 173-193, October.
    12. Madden Paul & Pezzino Mario, 2011. "Oligopoly on a Salop Circle with Centre," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 11(1), pages 1-30, January.
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    Cited by:

    1. Levaggi, Laura & Levaggi, Rosella, 2020. "Is there scope for mixed markets in the provision of hospital care?," Social Science & Medicine, Elsevier, vol. 247(C).
    2. Berta, Paolo & Guerriero, Carla & Levaggi, Rosella, 2021. "Hospitals’ strategic behaviours and patient mobility: Evidence from Italy," Socio-Economic Planning Sciences, Elsevier, vol. 77(C).
    3. Paolo Berta & Carla Guerriero & Rosella Levaggi, 2018. "The dark side of fiscal federalism:evidence from hospital care in Italy," Working papers 72, Società Italiana di Economia Pubblica.

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    More about this item

    Keywords

    Private hospitals; Public hospitals; Salop competition;
    All these keywords.

    JEL classification:

    • D47 - Microeconomics - - Market Structure, Pricing, and Design - - - Market Design
    • H44 - Public Economics - - Publicly Provided Goods - - - Publicly Provided Goods: Mixed Markets
    • L51 - Industrial Organization - - Regulation and Industrial Policy - - - Economics of Regulation

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