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Nonprofit Production and Competition

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Author Info
Darius Lakdawalla
Tomas Philipson

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Abstract

Industries in which private nonprofit production is present and significant, such as health care and education, account for more than one-fifth of US economic activity. This paper argues that previous analysis of nonprofits has not separated profit-deviating preferences from the state-defined regulatory status of nonprofit production. We argue that this separation is crucial in providing predictions about the underlying forces which allow the coexistence of nonprofit and for-profit production in an industry, as well as predictions about such fundamental matters as the share of nonprofit activity. By separating choice of nonprofit status from profit-deviating preferences, the paper provides predictions about the forces which determine the share of nonprofit production in an industry. We argue that this share falls with the share of the demand that is publicly subsidized, rises with the total number of firms in the industry, and rises with growth in the pace or extent of cost-reductions resulting from learning-by-doing. These predictions stem from a basic aspect of regulatory nonprofit choice which links the degree of competition in a market with the share of nonprofits: the availability of economic profits under for-profit status raises the cost of choosing nonprofit status when such a status is associated with a distribution constraint. Empirical evidence using panel data on US states in the long-term care industry from 1989 to 1994 suggests the presence of the discussed predictions in this industry.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 6377.

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Date of creation: Jan 1998
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Handle: RePEc:nbr:nberwo:6377

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I1 - Health, Education, and Welfare - - Health

References listed on IDEAS
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  1. Wedig, Gerard, et al, 1988. " Capital Structure, Ownership, and Capital Payment Policy: The Case of Hospitals," Journal of Finance, American Finance Association, vol. 43(1), pages 21-40, March. [Downloadable!] (restricted)
  2. Susan Rose-Ackerman, 1996. "Altruism, Nonprofits, and Economic Theory," Journal of Economic Literature, American Economic Association, vol. 34(2), pages 701-728, June. [Downloadable!] (restricted)
  3. Paul J. Gertler & Donald M. Waldman, 1990. "Quality Adjusted Cost Functions," NBER Working Papers 3567, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  4. Tomas J. Philipson & Gary S. Becker, 1998. "Old-Age Longevity and Mortality-Contingent Claims," Journal of Political Economy, University of Chicago Press, vol. 106(3), pages 551-573, June. [Downloadable!] (restricted)
  5. Wedig, Gerard J & Hassan, Mahmud & Sloan, Frank A, 1989. "Hospital Investment Decisions and the Cost of Capital," Journal of Business, University of Chicago Press, vol. 62(4), pages 517-37, October. [Downloadable!] (restricted)
  6. Gertler, Paul J., 1989. "Subsidies, quality, and the regulation of nursing homes," Journal of Public Economics, Elsevier, vol. 38(1), pages 33-52, February. [Downloadable!] (restricted)
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Cited by:
(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

  1. David M. Blau & H. Naci Mocan, 1999. "The Supply of Quality in Child Care Centers," NBER Working Papers 7225, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
  2. Karen Eggleston & Yu-Chu Shen & Joseph Lau & Christopher H. Schmid & Jia Chan, 2008. "Hospital ownership and quality of care: what explains the different results in the literature?," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1345-1362. [Downloadable!]
  3. Anup Malani & Tomas Philipson & Guy David, 2003. "Theories of Firm Behavior in the Nonprofit Sector. A Synthesis and Empirical Evaluation," NBER Chapters, in: The Governance of Not-for-Profit Organizations, pages 181-216 National Bureau of Economic Research, Inc. [Downloadable!]
  4. Henry Hansmann & Daniel Kessler & Mark McClellan, 2002. "Ownership Form and Trapped Capital in the Hospital Industry," NBER Working Papers 8989, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  5. Martin Gaynor, 2006. "What Do We Know About Competition and Quality in Health Care Markets?," NBER Working Papers 12301, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
  6. Fiona M. Scott Morton & Joel M. Podolny, 1998. "Love or Money? The Effects of Owner Motivation in the California Wine Industry," NBER Working Papers 6743, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  7. Haruko Noguchi & Satoshi Shimizutani, 2005. "Nonprofit/For-Profit Status and Earning Differentials in the Japanese At-home Elderly Care Industry: Evidence from Micro-level Data on Home Helpers and Staff Nurses," Hi-Stat Discussion Paper Series d04-76, Institute of Economic Research, Hitotsubashi University. [Downloadable!]
    Other versions:
  8. Nolan Miller & Karen Eggleston & Richard Zeckhauser, 2006. "Provider choice of quality and surplus," International Journal of Health Care Finance and Economics, Springer, vol. 6(2), pages 103-117, June. [Downloadable!] (restricted)
    Other versions:
  9. Al Slivinski, 1999. "Team Incentives and Organizational Form," UWO Department of Economics Working Papers 9916, University of Western Ontario, Department of Economics. [Downloadable!]
    Other versions:
  10. Sujoy Chakravarty & Martin Gaynor & Steven Klepper & William B. Vogt, 2006. "Does the profit motive make Jack nimble? Ownership form and the evolution of the US hospital industry," Health Economics, John Wiley & Sons, Ltd., vol. 15(4), pages 345-361. [Downloadable!]
    Other versions:
  11. Edward Schumacher, 2009. "Does Public or Not-for-Profit Status Affect the Earnings of Hospital Workers?," Journal of Labor Research, Springer, vol. 30(1), pages 9-34, March. [Downloadable!] (restricted)
  12. Yu-Chu Shen & Karen Eggleston & Joseph Lau & Christopher Schmid, 2005. "Hospital Ownership and Financial Performance: A Quantitative Research Review," NBER Working Papers 11662, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  13. Rexford E. Santerre & John A. Vernon, 2005. "Testing for Ownership Mix Efficiency: The Case of the Nursing Home Industry," NBER Working Papers 11115, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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