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The Ban on Extra-Fees for Beneficiaries of the CMU-C Health Cover: What Consequences for Physicians and Dentists in Private Practice?

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  • Brigitte Dormont
  • Cécile Gayet

Abstract

[eng] Whilst it is forbidden to charge patients with CMU-C health cover fees in excess of the reimbursable regulated fee (or extra fees), so as to make their access to care easier, field experiment studies report discrimination against the latter by physicians. This issue is approached here from the angle of healthcare supply, using four waves of longitudinal administrative data on physicians in private practice between 2005 and 2014. We examine whether this ban on excess fees for CMU-C beneficiaries, i.e. charging them fees in excess of the standard social security-negotiated fees agreed under the public health insurance scheme, generates a real financial constraint for Sector 2 physicians (those who charge extra-fees) and dentists in private practice. Estimates show a significant drop in the average extra-fees per procedure when physicians accept more CMU-C patients in their practice. Even if costs are transferred (cost-shifting), with other patients being charged higher extra-fees, this is not enough to offset the financial impact. However, this restriction does not have a negative impact on total fees for Sector 2 specialists, general practitioners and dentists, as they increase their volume of activity at the same time.

Suggested Citation

  • Brigitte Dormont & Cécile Gayet, 2021. "The Ban on Extra-Fees for Beneficiaries of the CMU-C Health Cover: What Consequences for Physicians and Dentists in Private Practice?," Economie et Statistique / Economics and Statistics, Institut National de la Statistique et des Etudes Economiques (INSEE), issue 524-525, pages 31-47.
    • Handle: RePEc:nse:ecosta:ecostat_2021_524d_3
    DOI: https://doi.org/10.24187/ecostat.2021.524d.2046
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    References listed on IDEAS

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    1. Frank Sloan & Janet Mitchell & Jerry Cromwell, 1978. "Physician Participation in State Medicaid Programs," NBER Chapters, in: The Economics of Physician and Patient Behavior, pages 211-245, National Bureau of Economic Research, Inc.
    2. Olivier Chanel & Alain Paraponaris & Christel Protière & Bruno Ventelou, 2017. "Take the Money and Run? Hypothetical Fee Variations and French GPs’ Labour Supply," Revue économique, Presses de Sciences-Po, vol. 68(3), pages 357-377.
    3. Mark H. Showalter, 1997. "Physicians' Cost Shifting Behavior: Medicaid Versus Other Patients," Contemporary Economic Policy, Western Economic Association International, vol. 15(2), pages 74-84, April.
    4. Diane Alexander & Molly Schnell, 2024. "The Impacts of Physician Payments on Patient Access, Use, and Health," American Economic Journal: Applied Economics, American Economic Association, vol. 16(3), pages 142-177, July.
    5. repec:dau:papers:123456789/9221 is not listed on IDEAS
    6. repec:dau:papers:123456789/9219 is not listed on IDEAS
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    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models

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