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Public health care with waiting time: the role of supplementary private health care

  • Hoel, Michael
  • Saether, Erik Magnus

We consider an economy where most of the health care is publicly provided,and where there is waiting time for several types of treatments. Privatehealth care without waiting time is an option for the patients in the publichealth queue. We show that although patients with low waiting costs willchoose public treatment, they may be better off with waiting time thanwithout. The reason is that waiting time induces patients with high waitingcosts to choose private treatment, thus reducing the cost of public healthcare that everyone pays for. Even if higher quality (i.e. zero waiting time) canbe achieved at no cost, the self-selection induced redistribution may implythat it is socially optimal to provide health care publicly and at an inferiorquality level. We give a detailed discussion of the circumstances in which it isoptimal to have waiting time for public health treatment. Moreover, we studythe interaction between this quality decision and the optimal tax/subsidy onprivate health care.

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Article provided by Elsevier in its journal Journal of Health Economics.

Volume (Year): 22 (2003)
Issue (Month): 4 (July)
Pages: 599-616

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Handle: RePEc:eee:jhecon:v:22:y:2003:i:4:p:599-616
Contact details of provider: Web page: http://www.elsevier.com/locate/inca/505560

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  1. Blomquist, Sören & Christiansen, Vidar, 1997. "Price Subsidies versus Public Provision," Working Paper Series 1997:12, Uppsala University, Department of Economics.
  2. Boadway, R. & Marchand, M., . "The use of public expenditures for redistributive purposes," CORE Discussion Papers RP -1131, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  3. Besley, Timothy & Coate, Stephen, 1991. "Public Provision of Private Goods and the Redistribution of Income," American Economic Review, American Economic Association, vol. 81(4), pages 979-84, September.
  4. Sam Bucovetsky, 1984. "On the Use of Distributional Waits," Canadian Journal of Economics, Canadian Economics Association, vol. 17(4), pages 699-717, November.
  5. BOADWAY, Robin & MARCHAND, Maurice & SATO, Motohiro, 1997. "Subsidies versus public provision of private goods as instruments for redistibution," CORE Discussion Papers 1997071, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  6. Hamilton, Barton H. & Hamilton, Vivian H. & Mayo, Nancy E., 1996. "What are the costs of queuing for hip fracture surgery in Canada?," Journal of Health Economics, Elsevier, vol. 15(2), pages 161-185, April.
  7. Hoel, Michael & Sæther, Erik Magnus, 2009. "Private health care as a supplement to a public health system with waiting time for treatment," HERO On line Working Paper Series 2000:9, Oslo University, Health Economics Research Programme.
  8. Blomquist, Suren & Christiansen, Vidar, 1995. " Public Provision of Private Goods as a Redistributive Device in an Optimum Income Tax Model," Scandinavian Journal of Economics, Wiley Blackwell, vol. 97(4), pages 547-67, December.
  9. Cullis, John G. & Jones, Philip R., 1985. "National health service waiting lists : A discussion of competing explanations and a policy proposal," Journal of Health Economics, Elsevier, vol. 4(2), pages 119-135, June.
  10. Michael Hoel & Erik Magnus Sæther, 2001. "Public Health Care with Waiting Time: The Role of Supplementary Private Health Care," CESifo Working Paper Series 562, CESifo Group Munich.
  11. Brekke, K.R. & Sorgard, L., 2000. "Where are all the Physicans? Private vs. Public Health Care," Norway; Department of Economics, University of Bergen 1800, Department of Economics, University of Bergen.
  12. Alistair Munro, 1990. "Self-Selection and Optimal In-Kind Transfers," Working Papers Series 90/3, University of Stirling, Division of Economics.
  13. Blackorby, Charles & Donaldson, David, 1988. "Cash versus Kind, Self-selection, and Efficient Transfers," American Economic Review, American Economic Association, vol. 78(4), pages 691-700, September.
  14. Iversen, Tor, 1997. "The effect of a private sector on the waiting time in a national health service," Journal of Health Economics, Elsevier, vol. 16(4), pages 381-396, August.
  15. Lindsay, Cotton M & Feigenbaum, Bernard, 1984. "Rationing by Waiting Lists," American Economic Review, American Economic Association, vol. 74(3), pages 404-17, June.
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