Public and Private Health Care Financing with Alternate Public Rationing
AbstractWe develop a model to analyze health care nancing arrangements and under alternative public sector rationing rules. Health care is demanded by individuals varying in income and severity of illness. There is a limited supply of health care resources used to treat individuals, causing some individuals to go untreated. We examine outcomes under full public finance, full private finance, and mixed, parallel public and private finance under two rationing rules for the public sector: needs-based rationing and random rationing. Insurers (both public and private) must bid to obtain the necessary health care resources to treat their beneficiaries. While the public insurer's ability-to-pay is limited by its (fixed) budget, the private insurer's willingness-to-pay re ects the individuals' willingness-to-pay for care. When permitted, the private sector supplies supplementary health care to those willing and able to pay. The introduction of private insurance diverts treatment from relatively poor to relatively rich individuals. Moreover, if the public insurer allocates care according to need, the average severity of the untreated is higher in a mixed system than in a pure public system. While we can unambiguously sign most comparative static effects for a general set of distribution functions for income and severity, a complete analysis of the relationship between public sector rationing and the scope for a private health insurance market requires distributional assumptions. For a bivariate uniform distribution function we nd that the private health insurance market is smaller when the public sector rations according to need as compared to random allocation of health care.
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Bibliographic InfoPaper provided by McMaster University in its series Department of Economics Working Papers with number 2007-07.
Length: 44 pages
Date of creation: Nov 2007
Date of revision:
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health care financing; rationing rules;
Find related papers by JEL classification:
- I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
This paper has been announced in the following NEP Reports:
- NEP-ALL-2007-11-24 (All new papers)
- NEP-HEA-2007-11-24 (Health Economics)
- NEP-IAS-2007-11-24 (Insurance Economics)
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- Fabbri, Daniele & Monfardini, Chiara, 2011.
"Opt Out or Top Up? Voluntary Healthcare Insurance and the Public vs. Private Substitution,"
IZA Discussion Papers
5952, Institute for the Study of Labor (IZA).
- D. Fabbri & C. Monfardini, 2011. "Opt Out Or Top Up? Voluntary Healthcare Insurance And The Public Vs. Private Substitution," Working Papers wp780, Dipartimento Scienze Economiche, Universita' di Bologna.
- D. Fabbri ; & C. Monfardini ;, 2011. "Opt Out Or Top Up? Voluntary Healthcare Insurance And The Public Vs. Private Substitution," Health, Econometrics and Data Group (HEDG) Working Papers 11/28, HEDG, c/o Department of Economics, University of York.
- Neil J. Buckley & Katherine Cuff & Jeremiah Hurley & Logan McLeod & Stuart Mestelman & David Cameron, 2012.
"An Experimental Investigation of Mixed Systems of Public and Private Health Care Finance,"
Department of Economics Working Papers
2012-02, McMaster University.
- Buckley, Neil J. & Cuff, Katherine & Hurley, Jeremiah & McLeod, Logan & Mestelman, Stuart & Cameron, David, 2012. "An experimental investigation of mixed systems of public and private health care finance," Journal of Economic Behavior & Organization, Elsevier, vol. 84(3), pages 713-729.
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