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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
Contact details of provider: Postal: 200 Avenue de la République, Bât. G - 92001 Nanterre Cedex
Web page: http://economix.fr
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  1. Chandra, Amitabh & Gruber, Jonathan & McKnight, Robin, 2009. "Patient Cost-Sharing and Hospitalization Offsets in the Elderly," Scholarly Articles 8058412, Harvard Kennedy School of Government.
  2. 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.
  3. Fantin, Romain & Jusot, Florence & Dourgnon, Paul, 2011. "Payer peut nuire à votre santé : une étude de l’impact du renoncement financier aux soins sur l’état de santé," Economics Papers from University Paris Dauphine 123456789/9215, Paris Dauphine University.
  4. Trannoy, Alain & Tubeuf, Sandy & Jusot, Florence, 2009. "Tel père, tel fils : l’influence de l'origine sociale et familiale sur la santé des descendants en Europe," Economics Papers from University Paris Dauphine 123456789/7044, Paris Dauphine University.
  5. 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.
  6. Amy Finkelstein & Sarah Taubman & Bill Wright & Mira Bernstein & Jonathan Gruber & Joseph P. Newhouse & Heidi Allen & Katherine Baicker & The Oregon Health Study Group, 2011. "The Oregon Health Insurance Experiment: Evidence from the First Year," NBER Working Papers 17190, National Bureau of Economic Research, Inc.
  7. Chiappori, P.A. & Durand, F. & Geoffard, P.Y., 1998. "Moral Hazard and the Demand for Physician Services: First Lessons from a French Natural Experiment," DELTA Working Papers 98-05, DELTA (Ecole normale supérieure).
  8. Nyman, John A., 1999. "The value of health insurance: the access motive," Journal of Health Economics, Elsevier, vol. 18(2), pages 141-152, April.
  9. 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.
  10. David BARDEY & Romain LESUR, 2006. "Optimal regulation of health system with induced demand and 'ex post' moral hazard," Annales d'Economie et de Statistique, ENSAE, issue 83-84, pages 279-293.
  11. Michel Grignon & Agnès Couffinhal & David Bardey, 2003. "Efficacité et risque moral ex post en assurance maladie," Revue Française d'Économie, Programme National Persée, vol. 18(2), pages 165-197.
  12. Stéphane Jacobzone & Lise Rochaix, 1997. "L'hypothèse de demande induite : un bilan économique," Économie et Prévision, Programme National Persée, vol. 129(3), pages 25-36.
  13. 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.
  14. 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.
  15. 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.
  16. Nyman, John A., 1999. "The economics of moral hazard revisited," Journal of Health Economics, Elsevier, vol. 18(6), pages 811-824, December.
  17. Philippe Batifoulier & Jean-Paul Domin & Maryse Gadreau, 2011. "Market Empowerment of the Patient: The French Experience," Review of Social Economy, Taylor & Francis Journals, vol. 69(2), pages 143-162.
  18. 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.
  19. 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.
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