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GP responses to price regulation: evidence from a French nationwide reform

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  • Elise Coudin
  • Anne Pla
  • Anne‐Laure Samson

Abstract

This paper uses a French reform to evaluate the impacts of overbilling restrictions on general practitioner (GP) care provision, fees and incomes. Since 1990, this reform has introduced conditions self‐employed GPs must fulfil to be permitted to bill freely. We exploit 2005 and 2008 public health insurance administrative data on GP activity and fees. We use fuzzy regression discontinuity techniques to estimate local causal impacts for GPs who established practices in 1990 and who were constrained by the new regulation to charge regulated prices (compliers). We find that those GPs practices to income effects. In the regulated fee regime, GPs face prices lower by 42% and provide 50% more care than they would do in the unregulated fee regime. Male care provision increasing reaction is larger than the female one, which results in a higher male labour income in the regulated fee regime than with unregulated fees, whereas it is the opposite for women. With regulated fees, GPs limit side‐salaried activities, use more lump‐sum payment schemes and occupy more often gatekeeper positions. Copyright © 2015 John Wiley & Sons, Ltd.

Suggested Citation

  • Elise Coudin & Anne Pla & Anne‐Laure Samson, 2015. "GP responses to price regulation: evidence from a French nationwide reform," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1118-1130, September.
  • Handle: RePEc:wly:hlthec:v:24:y:2015:i:9:p:1118-1130
    DOI: 10.1002/hec.3216
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    2. Damien Besancenot & Karine Lamiraud & Radu Vranceanu, 2023. "A model for dual health care market with congestion differentiation," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 32(2), pages 400-423, April.
    3. Benjamin Montmartin & Mathieu Escot, 2017. "Local Competition and Physicians’ Pricing Decisions: New Evidence from France," GREDEG Working Papers 2017-31, Groupe de REcherche en Droit, Economie, Gestion (GREDEG CNRS), Université Côte d'Azur, France.
    4. Aleksandr Proshin & Alexandre Cazenave-Lacroutz & Zeynep Or & Lise Rochaix, 2018. "Impact of Diagnosis Related Group Refinement on the Choice Between Scheduled Caesarean Section and Normal Delivery: Recent Evidence from France," Working Papers halshs-01812107, HAL.
    5. Benjamin Montmartin & Marcos Herrera-Gomez, 2022. "Imitative Pricing: The Importance of Neighborhood Effects in Physicians' Consultation Prices," GREDEG Working Papers 2022-02, Groupe de REcherche en Droit, Economie, Gestion (GREDEG CNRS), Université Côte d'Azur, France.
    6. Mikol, Fanny & Franc, Carine, 2019. "Gender differences in the incomes of self-employed French physicians: The role of family structure," Health Policy, Elsevier, vol. 123(7), pages 666-674.
    7. Fu, Hongqiao & Li, Ling & Yip, Winnie, 2018. "Intended and unintended impacts of price changes for drugs and medical services: Evidence from China," Social Science & Medicine, Elsevier, vol. 211(C), pages 114-122.
    8. Montmartin, Benjamin & Herrera-Gómez, Marcos, 2023. "Spatial dependence in physicians’ prices and additional fees: Evidence from France," Journal of Health Economics, Elsevier, vol. 88(C).
    9. Choné, Philippe, 2017. "Competition policy for health care provision in France," Health Policy, Elsevier, vol. 121(2), pages 111-118.

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