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Strategic sorting: the role of ordeals in health care

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  • Zeckhauser, Richard

Abstract

Ordeals are burdens placed on individuals that yield no benefits to others; hence they represent a dead-weight loss. Ordeals – the most common is waiting time – play a prominent role in rationing health care. The recipients most willing to bear them are those receiving the greatest benefit from scarce health-care resources. Health care is heavily subsidized; hence, moral hazard leads to excess use. Ordeals are intended to discourage expenditures yielding little benefit while simultaneously avoiding the undesired consequences of rationing methods such as quotas or pricing. This analysis diagnoses the economic underpinnings of ordeals. Subsidies for nursing-home care versus home care illustrate.

Suggested Citation

  • Zeckhauser, Richard, 2021. "Strategic sorting: the role of ordeals in health care," Economics and Philosophy, Cambridge University Press, vol. 37(1), pages 64-81, March.
    • Handle: RePEc:cup:ecnphi:v:37:y:2021:i:1:p:64-81_6
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    Citations

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    Cited by:

    1. Piotr Dworczak, 2022. "Equity-efficiency trade-off in quasi-linear environments," GRAPE Working Papers 70, GRAPE Group for Research in Applied Economics.
    2. Frank Yang, 2021. "Costly Multidimensional Screening," Papers 2109.00487, arXiv.org, revised Sep 2025.
    3. Madsen, Jonas Krogh & Mikkelsen, Kim Sass & Moynihan, Donald, 2020. "Burdens, Sludge, Ordeals, Red Tape, Oh My! A User’s Guide to the Study of Frictions," SocArXiv qfykb, Center for Open Science.
    4. Oren Ginzburg & Stefanie Weil & Arjen Witteloostuijn, 2024. "Unnecessary organizational burden: a conceptual framework," Future Business Journal, Springer, vol. 10(1), pages 1-16, December.
    5. Joan Costa‐Font & Nilesh Raut, 2025. "Long‐Term Care Partnership Effects on Medicaid and Private Insurance," Health Economics, John Wiley & Sons, Ltd., vol. 34(6), pages 1171-1187, June.
    6. Costa-Font, Joan & Raut, Nilesh, 2025. "Long-term care partnership effects on Medicaid and private insurance," LSE Research Online Documents on Economics 127078, London School of Economics and Political Science, LSE Library.
    7. Caspari, Gian, 2025. "Bidding for subsidies with one's patience," ZEW Discussion Papers 25-009, ZEW - Leibniz Centre for European Economic Research.
    8. Atayev Atabek & Caspari Gian & Hillenbrand Adrian & Klein Thilo, 2025. "Mit Ungeduld zu besseren Subventionen für umweltfreundliche Produkte," Wirtschaftsdienst, Sciendo, vol. 105(6), pages 466-470.

    More about this item

    JEL classification:

    • H21 - Public Economics - - Taxation, Subsidies, and Revenue - - - Efficiency; Optimal Taxation
    • H24 - Public Economics - - Taxation, Subsidies, and Revenue - - - Personal Income and Other Nonbusiness Taxes and Subsidies
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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