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Bargaining and the Provision of Health Services

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Author Info
Luigi Siciliani
Anderson Stanciol

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Abstract

We model and compare the bargaining process between a purchaser of health services, such as a health authority, and a provider (the hospital) in three plausible scenarios: a) the purchaser sets the price, and activity is bargained between the purchaser and the provider: activity bargaining; b) the price is bargained between the purchaser and the provider, but activity is chosen unilaterally by the provider: price bargaining; c) price and activity are simultaneously bargained between the purchaser and the provider: efficient bargaining. We show that: 1) if the bargaining power of the purchaser is high (low), efficient bargaining leads to higher (lower) activity and purchaser's utility, and lower (higher) prices and provider's utility compared to price bargaining. 2) In activity bargaining, prices are lowest, the purchaser's utility is highest and the provider's utility is lowest; activity is generally lowest, but higher than in price bargaining for high bargaining power of the purchaser. 3) If the purchaser has higher bargaining power, this reduces prices and activity in price bargaining, it reduces prices but increases activity in activity bargaining, and it reduces prices but has no effect on activity in efficient bargaining.

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Paper provided by Department of Economics, University of York in its series Discussion Papers with number 08/28.

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Date of creation: Oct 2008
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Handle: RePEc:yor:yorken:08/28

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Related research
Keywords: bargaining. negotiation. purchasing.;

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Find related papers by JEL classification:
I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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  1. Chalkley, Martin & Malcomson, James M, 1998. "Contracting for Health Services with Unmonitored Quality," Economic Journal, Royal Economic Society, vol. 108(449), pages 1093-1110, July. [Downloadable!] (restricted)
    Other versions:
  2. Ellis, Randall P. & McGuire, Thomas G., 1990. "Optimal payment systems for health services," Journal of Health Economics, Elsevier, vol. 9(4), pages 375-396, December. [Downloadable!] (restricted)
  3. Chalkley, Martin & Malcomson, James M., 1998. "Contracting for health services when patient demand does not reflect quality," Journal of Health Economics, Elsevier, vol. 17(1), pages 1-19, January. [Downloadable!] (restricted)
    Other versions:
  4. Clark, Derek, 1995. "Priority setting in health care: An axiomatic bargaining approach," Journal of Health Economics, Elsevier, vol. 14(3), pages 345-360, August. [Downloadable!] (restricted)
  5. Xavier Martinez-Giralt & Pedro Pita Barros, 2000. "Selecting Negotiation Processes with Health Care," UFAE and IAE Working Papers 467.00, Unitat de Fonaments de l'Anàlisi Econòmica (UAB) and Institut d'Anàlisi Econòmica (CSIC). [Downloadable!]
  6. Xavier Martinez-Giralt & Pedro Pita Barros, 2000. "Negotiation Advantages of Professional Associations in Health Care," UFAE and IAE Working Papers 466.00, Unitat de Fonaments de l'Anàlisi Econòmica (UAB) and Institut d'Anàlisi Econòmica (CSIC). [Downloadable!]
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  7. Bulkley, George & Myles, Gareth D., 1997. "Bargaining over effort," European Journal of Political Economy, Elsevier, vol. 13(2), pages 375-384, May. [Downloadable!] (restricted)
  8. Brooks, John M. & Dor, Avi & Wong, Herbert S., 1997. "Hospital-insurer bargaining: An empirical investigation of appendectomy pricing," Journal of Health Economics, Elsevier, vol. 16(4), pages 417-434, August. [Downloadable!] (restricted)
  9. Aronsson, Thomas & Lofgren, Karl-Gustaf & Wikstrom, Magnus, 1993. "Monopoly union versus efficient bargaining : Wage and employment determination in the Swedish construction sector," European Journal of Political Economy, Elsevier, vol. 9(3), pages 357-370, August. [Downloadable!] (restricted)
  10. Barros Pedro Pita & Xavier Martinez-Giralt, 2005. "Bargaining and idle public sector capacity in health care," Economics Bulletin, Economics Bulletin, vol. 9(5), pages 1-8. [Downloadable!]
  11. De Fraja, Gianni, 2000. "Contracts for health care and asymmetric information," Journal of Health Economics, Elsevier, vol. 19(5), pages 663-677, September. [Downloadable!] (restricted)
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