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De l’aléa moral du patient aux inégalités d’accès aux soins

  • Philippe Batifoulier

One of the most influential “lessons” of the moral hazard theory in health economics is that cost sharing can reduce health spending without damage on health status. This “lesson” has been enormously influential on policy makers. This paper shows that this theoretical and empirical background is deficient and leads to perverse effects: inducement of inequalities and increase in health spending.

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File URL: http://economix.fr/pdf/dt/2014/WP_EcoX_2014-07.pdf
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Paper provided by University of Paris West - Nanterre la Défense, EconomiX in its series EconomiX Working Papers with number 2014-7.

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Length: 22 pages
Date of creation: 2014
Date of revision:
Handle: RePEc:drm:wpaper:2014-7
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  1. Philippe Batifoulier & Jean-Paul Domin & Maryse Gadreau, 2011. "Market empowerment of the patient: the French experience," Post-Print halshs-01224922, HAL.
  2. Sandy Tubeuf & Alain Trannoy & Marion Devaux & Florence Jusot, 2008. "La santé des seniors selon leur origine sociale et la longévité de leurs parents," Économie et Statistique, Programme National Persée, vol. 411(1), pages 25-46.
  3. Eichner, Matthew J, 1998. "The Demand for Medical Care: What People Pay Does Matter," American Economic Review, American Economic Association, vol. 88(2), pages 117-21, May.
  4. David Rowell & Luke B. Connelly, 2012. "A History of the Term “Moral Hazard”," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 79(4), pages 1051-1075, December.
  5. De Jaegher, Kris & Jegers, Marc, 2000. "A model of physician behaviour with demand inducement," Journal of Health Economics, Elsevier, vol. 19(2), pages 231-258, March.
  6. Blomqvist, Ake, 2001. "Does the economics of moral hazard need to be revisited? A comment on the paper by John Nyman," Journal of Health Economics, Elsevier, vol. 20(2), pages 283-288, March.
  7. Gafni, Amiram & Charles, Cathy & Whelan, Tim, 1998. "The physician-patient encounter: The physician as a perfect agent for the patient versus the informed treatment decision-making model," Social Science & Medicine, Elsevier, vol. 47(3), pages 347-354, August.
  8. Paul Dourgnon & Florence Jusot & Romain Fantin, 2012. "Payer peut nuire à votre santé : une étude de l’impact du renoncement financier aux soins sur l’état de santé," Working Papers DT47, IRDES institut for research and information in health economics, revised Apr 2012.
  9. Chandra, Amitabh & Gruber, Jonathan & McKnight, Robin, 2009. "Patient Cost-Sharing and Hospitalization Offsets in the Elderly," Scholarly Articles 8058412, Harvard Kennedy School of Government.
  10. repec:adr:anecst:y:2006:i:83-84:p:11 is not listed on IDEAS
  11. Lise Rochaix & Stéphane Jacobzone, 1997. "L'hypothèse de demande induite : un bilan économique," Économie et Prévision, Programme National Persée, vol. 129(3), pages 25-36.
  12. Nyman, John A., 1999. "The value of health insurance: the access motive," Journal of Health Economics, Elsevier, vol. 18(2), pages 141-152, April.
  13. Chiappori, Pierre-Andre & Durand, Franck & Geoffard, Pierre-Yves, 1998. "Moral hazard and the demand for physician services: First lessons from a French natural experiment," European Economic Review, Elsevier, vol. 42(3-5), pages 499-511, May.
  14. Finkelstein, Amy, et al., 2011. "The Oregon Health Insurance Experiment: Evidence from the First Year," Working Paper Series rwp11-040, Harvard University, John F. Kennedy School of Government.
  15. repec:dau:papers:123456789/7044 is not listed on IDEAS
  16. Nyman, John A., 1999. "The economics of moral hazard revisited," Journal of Health Economics, Elsevier, vol. 18(6), pages 811-824, December.
  17. Laurent Caussat & Denis Raynaud, 2004. "La régulation de la demande de soins : le rôle de l’assurance maladie dans la formation de la consommation de biens et services de santé," Revue d'Économie Financière, Programme National Persée, vol. 76(3), pages 129-151.
  18. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-77, June.
  19. Philippe Batifoulier & Maryse Gadreau, 2006. "Comportement du médecin et politique économique de santé. Quelle rationalité pour quelle éthique ?," Post-Print halshs-00111914, HAL.
  20. David Bardey & Agnès Couffinhal & Michel Grignon, 2003. "Efficacité et risque moral ex post en assurance maladie," Revue Française d'Économie, Programme National Persée, vol. 18(2), pages 165-197.
  21. René C. J. A. van Vliet, 2004. "Deductibles and Health Care Expenditures: Empirical Estimates of Price Sensitivity Based on Administrative Data," International Journal of Health Care Finance and Economics, Springer, vol. 4(4), pages 283-305, December.
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