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Patients' free choice of physicians is not always good

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  • Xinyu Li
  • Christian Waibel

Abstract

We present a model of learning in healthcare markets. Hospitals have junior physicians with low and senior physicians with high ability. Junior physicians turn senior if they treat enough patients. Patients face heterogeneous costs for waiting if a physician's capacity is utilized. Hospitals choose to either allocate patients to physicians randomly or let patients choose their physicians. In a monopolistic market, the hospital always chooses the welfare‐maximizing allocation system. In a competitive market, inefficiencies may arise due to two externalities. If patients are free to choose their physician, the marginal patient neither internalizes her impact on other patients' waiting costs nor the learning of junior physicians.

Suggested Citation

  • Xinyu Li & Christian Waibel, 2021. "Patients' free choice of physicians is not always good," Health Economics, John Wiley & Sons, Ltd., vol. 30(11), pages 2751-2765, November.
    • Handle: RePEc:wly:hlthec:v:30:y:2021:i:11:p:2751-2765
    DOI: 10.1002/hec.4407
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    References listed on IDEAS

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    1. Kurt R. Brekke & Hugh Gravelle & Luigi Siciliani & Odd Rune Straume, 2014. "Patient Choice, Mobility and Competition Among Health Care Providers," Developments in Health Economics and Public Policy, in: Rosella Levaggi & Marcello Montefiori (ed.), Health Care Provision and Patient Mobility, edition 127, pages 1-26, Springer.
    2. Canice Prendergast, 1999. "The Provision of Incentives in Firms," Journal of Economic Literature, American Economic Association, vol. 37(1), pages 7-63, March.
    3. Brekke, Kurt R. & Nuscheler, Robert & Straume, Odd Rune, 2007. "Gatekeeping in health care," Journal of Health Economics, Elsevier, vol. 26(1), pages 149-170, January.
    4. Kurt R. Brekke & Luigi Siciliani & Odd Rune Straume, 2011. "Hospital Competition and Quality with Regulated Prices," Scandinavian Journal of Economics, Wiley Blackwell, vol. 113, pages 444-469, June.
    5. Zack Cooper & Stephen Gibbons & Simon Jones & Alistair McGuire, 2011. "Does Hospital Competition Save Lives? Evidence From The English NHS Patient Choice Reforms," Economic Journal, Royal Economic Society, vol. 121(554), pages 228-260, August.
    6. Brekke, Kurt R. & Siciliani, Luigi & Straume, Odd Rune, 2008. "Competition and waiting times in hospital markets," Journal of Public Economics, Elsevier, vol. 92(7), pages 1607-1628, July.
    7. Varkevisser, Marco & van der Geest, Stéphanie A. & Schut, Frederik T., 2012. "Do patients choose hospitals with high quality ratings? Empirical evidence from the market for angioplasty in the Netherlands," Journal of Health Economics, Elsevier, vol. 31(2), pages 371-378.
    8. Sá, Luís & Siciliani, Luigi & Straume, Odd Rune, 2019. "Dynamic hospital competition under rationing by waiting times," Journal of Health Economics, Elsevier, vol. 66(C), pages 260-282.
    9. Hehenkamp, Burkhard & Kaarbøe, Oddvar M., 2020. "Location choice and quality competition in mixed hospital markets," Journal of Economic Behavior & Organization, Elsevier, vol. 177(C), pages 641-660.
    10. Neil J. Buckley & Katherine Cuff & Jeremiah Hurley & Logan McLeod & Robert Nuscheler & David Cameron, 2012. "Willingness‐to‐pay for parallel private health insurance: evidence from a laboratory experiment," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 45(1), pages 137-166, February.
    11. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    12. Rosella Levaggi & Marcello Montefiori (ed.), 2014. "Health Care Provision and Patient Mobility," Developments in Health Economics and Public Policy, Springer, edition 127, number 978-88-470-5480-6, December.
    13. Rebitzer, James B. & Taylor, Lowell J., 2011. "Extrinsic Rewards and Intrinsic Motives: Standard and Behavioral Approaches to Agency and Labor Markets," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 4, chapter 8, pages 701-772, Elsevier.
    14. Sridhar Narayanan & Puneet Manchanda, 2009. "Heterogeneous Learning and the Targeting of Marketing Communication for New Products," Marketing Science, INFORMS, vol. 28(3), pages 424-441, 05-06.
    15. Katherine Cuff & Jeremiah Hurley & Stuart Mestelman & Andrew Muller & Robert Nuscheler, 2012. "Public and private health‐care financing with alternate public rationing rules," Health Economics, John Wiley & Sons, Ltd., vol. 21(2), pages 83-100, February.
    16. Beitia, Arantza, 2003. "Hospital quality choice and market structure in a regulated duopoly," Journal of Health Economics, Elsevier, vol. 22(6), pages 1011-1036, November.
    17. Tay, Abigail, 2003. "Assessing Competition in Hospital Care Markets: The Importance of Accounting for Quality Differentiation," RAND Journal of Economics, The RAND Corporation, vol. 34(4), pages 786-814, Winter.
    18. 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.
    19. Ma, Ching-to Albert, 1994. "Health Care Payment Systems: Cost and Quality Incentives," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 3(1), pages 93-112, Spring.
    20. David M. Cutler, 1996. "Public Policy for Health Care," NBER Working Papers 5591, National Bureau of Economic Research, Inc.
    21. Sobel, Joel, 2000. "Economists' Models of Learning," Journal of Economic Theory, Elsevier, vol. 94(2), pages 241-261, October.
    22. Howard David H, 2006. "Quality and Consumer Choice in Healthcare: Evidence from Kidney Transplantation," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 5(1), pages 1-22, January.
    23. repec:bla:jemstr:v:3:y:1994:i:1:p:93-112:a is not listed on IDEAS
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