IDEAS home Printed from https://ideas.repec.org/p/hal/wpaper/hal-03028437.html

A Model for Dual Healthcare Market with Congestion Differentiation

Author

Listed:
  • Damien Besancenot

    (UPCité - Université Paris Cité, LIRAES (URP_ 4470) - Laboratoire Interdisciplinaire de Recherche Appliquée en Economie de la Santé - UPCité - Université Paris Cité)

  • Karine Lamiraud

    (ESSEC Business School, THEMA - Théorie économique, modélisation et applications - CNRS - Centre National de la Recherche Scientifique - CY - CY Cergy Paris Université)

  • Radu Vranceanu

    (ESSEC Business School, THEMA - Théorie économique, modélisation et applications - CNRS - Centre National de la Recherche Scientifique - CY - CY Cergy Paris Université)

Abstract

The French market for specialist physician care has a dual legal structure: physicians must exclusively work in sector 1 and charge regulated fees or in sector 2, where they can freely set their fees. Patient out-of-pocket payments in sector 2 are partially covered by private insurance. The primary differentiating factor between both sectors is the number of patients per specialist, which in turn directly affects the overall quality of the service provided. We built an equilibrium model to analyse both specialists decisions about which sector to work in, and patients choice of physician and therefore sector. More specifically, the model allowed us to study the effect of changes in prices and economy-wide patient-to-specialist ratios on profits and patients utility associated with the services provided in each sector.

Suggested Citation

  • Damien Besancenot & Karine Lamiraud & Radu Vranceanu, 2020. "A Model for Dual Healthcare Market with Congestion Differentiation," Working Papers hal-03028437, HAL.
    • Handle: RePEc:hal:wpaper:hal-03028437
    Note: View the original document on HAL open archive server: https://essec.hal.science/hal-03028437
    as

    Download full text from publisher

    File URL: https://essec.hal.science/hal-03028437/document
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Damien Besancenot & Karine Lamiraud & Radu Vranceanu, 2021. "Balance Billing as an Adherence-to-Treatment Signalling Device," Journal of Institutional and Theoretical Economics (JITE), Mohr Siebeck, Tübingen, vol. 177(3), pages 359-390.
    2. George J. Mailath, 1998. "Do People Play Nash Equilibrium? Lessons from Evolutionary Game Theory," Journal of Economic Literature, American Economic Association, vol. 36(3), pages 1347-1374, September.
    3. Hoel, Michael & Saether, Erik Magnus, 2003. "Public health care with waiting time: the role of supplementary private health care," Journal of Health Economics, Elsevier, vol. 22(4), pages 599-616, July.
    4. Pita Barros, Pedro & Siciliani, Luigi, 2011. "Public and Private Sector Interface," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 927-1001, Elsevier.
    5. Besancenot, Damien & Vranceanu, Radu, 2004. "Quality and price dispersion in an equilibrium search model," Journal of Economics and Business, Elsevier, vol. 56(2), pages 99-116.
    6. Izabela Jelovac, 2015. "Physicians’ balance billing, supplemental insurance and access to health care," International Journal of Health Economics and Management, Springer, vol. 15(2), pages 269-280, June.
    7. Godager, Geir & Wiesen, Daniel, 2013. "Profit or patients’ health benefit? Exploring the heterogeneity in physician altruism," Journal of Health Economics, Elsevier, vol. 32(6), pages 1105-1116.
    8. Brekke, Kurt R. & Siciliani, Luigi & Straume, Odd Rune, 2012. "Quality competition with profit constraints," Journal of Economic Behavior & Organization, Elsevier, vol. 84(2), pages 642-659.
    9. Mitchell, Janet B. & Cromwell, Jerry, 1982. "Physician behavior under the medicare assignment option," Journal of Health Economics, Elsevier, vol. 1(3), pages 245-264, December.
    10. repec:bla:ausecr:v:37:y:2004:i:1:p:31-40 is not listed on IDEAS
    11. Mathias Kifmann & Florian Scheuer, 2011. "Balance billing: the patients' perspective," Health Economics Review, Springer, vol. 1(1), pages 1-14, December.
    12. 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.
    13. Isabelle Clerc & Olivier L’Haridon & Alain Paraponaris & Camelia Protopopescu & Bruno Ventelou, 2012. "Fee-for-service payments and consultation length in general practice: a work--leisure trade-off model for French GPs," Applied Economics, Taylor & Francis Journals, vol. 44(25), pages 3323-3337, September.
    14. Siciliani, Luigi & Hurst, Jeremy, 2005. "Tackling excessive waiting times for elective surgery: a comparative analysis of policies in 12 OECD countries," Health Policy, Elsevier, vol. 72(2), pages 201-215, May.
    15. Elise Coudin & Anne Pla & Anne-Laure Samson, 2014. "GPs' Response to Price Regulation : Evidence from a Nationwide French Reform," Working Papers 2014-14, Center for Research in Economics and Statistics.
    16. Michael Kuhn & Robert Nuscheler, 2020. "Saving the public from the private? Incentives and outcomes in dual practice," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 22(4), pages 1120-1150, August.
    17. Liran Einav & Amy Finkelstein & Heidi Williams, 2016. "Paying on the Margin for Medical Care: Evidence from Breast Cancer Treatments," American Economic Journal: Economic Policy, American Economic Association, vol. 8(1), pages 52-79, February.
    18. Brigitte Dormont & Mathilde Péron, 2016. "Does Health Insurance Encourage the Rise in Medical Prices? A Test on Balance Billing in France," Health Economics, John Wiley & Sons, Ltd., vol. 25(9), pages 1073-1089, September.
    19. Glazer, Jacob & Glazer, Jacob & McGuire, Thomas G., 1993. "Should physicians be permitted to 'balance bill' patients?," Journal of Health Economics, Elsevier, vol. 12(3), pages 239-258, October.
    20. Damien Besancenot & Radu Vranceanu, 2017. "An equilibrium search model of the French dual market for medical services," Working Papers hal-01574648, HAL.
    21. Pedro Pita Barros & Xavier Martinez‐Giralt, 2002. "Public and Private Provision of Health Care," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 11(1), pages 109-133, March.
    22. Olivella, Pau, 2003. "Shifting public-health-sector waiting lists to the private sector," European Journal of Political Economy, Elsevier, vol. 19(1), pages 103-132, March.
    23. Chunzhou Mu & Richard De Abreu Lourenco & Kees van Gool & Jane Hall, 2018. "Is low-priced primary care bad for quality? Evidence from Australian general practice," Applied Economics, Taylor & Francis Journals, vol. 50(5), pages 475-491, January.
    24. Eggleston, Karen & Bir, Anupa, 2006. "Physician dual practice," Health Policy, Elsevier, vol. 78(2-3), pages 157-166, October.
    25. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    26. Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), 2011. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, volume 2, number 2.
    27. Lecluyse, Ann & Van de Voorde, Carine & De Graeve, Diana & Schokkaert, Erik & Van Ourti, Tom, 2009. "Hospital supplements in Belgium: Price variation and regulation," Health Policy, Elsevier, vol. 92(2-3), pages 276-287, October.
    28. Socha, Karolina Z. & Bech, Mickael, 2011. "Physician dual practice: A review of literature," Health Policy, Elsevier, vol. 102(1), pages 1-7, September.
    29. Calcoen, Piet & van de Ven, Wynand P. M. M., 2019. "Supplementary physicians’ fees: a sustainable system?," Health Economics, Policy and Law, Cambridge University Press, vol. 14(1), pages 40-60, January.
    30. David Bardey & Helmuth Cremer & Jean-Marie Lozachmeur, 2014. "Competition in Two-Sided Markets with Common Network Externalities," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 44(4), pages 327-345, June.
    31. Hugh Gravelle & Anthony Scott & Peter Sivey & Jongsay Yong, 2016. "Competition, prices and quality in the market for physician consultations," Journal of Industrial Economics, Wiley Blackwell, vol. 64(1), pages 135-169, March.
    32. 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.
    33. George J. Mailath, 1998. "Do People Play Nash Equilibrium? Lessons from Evolutionary Game Theory," Journal of Economic Literature, American Economic Association, vol. 36(3), pages 1347-1374, September.
    34. Kurt R. Brekke & Lars Sørgard, 2007. "Public versus private health care in a national health service," Health Economics, John Wiley & Sons, Ltd., vol. 16(6), pages 579-601, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Indranil Dutta & Mario Pezzino & Yan Song, 2022. "Should developing countries ban dual practice by physicians? Analysis under mixed hospital competition," Health Economics, John Wiley & Sons, Ltd., vol. 31(11), pages 2289-2310, November.
    2. Michael Kuhn & Robert Nuscheler, 2020. "Saving the public from the private? Incentives and outcomes in dual practice," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 22(4), pages 1120-1150, August.
    3. Brigitte Dormont & Mathilde Péron, 2016. "Does Health Insurance Encourage the Rise in Medical Prices? A Test on Balance Billing in France," Health Economics, John Wiley & Sons, Ltd., vol. 25(9), pages 1073-1089, September.
    4. 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.
    5. Xidong Guo & Sarah Parlane, 2023. "Private Practice in Public Hospitals: Should Senior Consultants Be Prioritized?," Working Papers 202301, Geary Institute, University College Dublin.
    6. Cristina Pardo-Garcia & Jose J. Sempere-Monerris, 2018. "Mixed provision of health care services with double coverage," Journal of Economics, Springer, vol. 123(1), pages 49-70, January.
    7. repec:dau:papers:123456789/15235 is not listed on IDEAS
    8. Huw Dixon & Luigi Siciliani, 2009. "Waiting Time Targets in Healthcare Markets: How Long Are We Waiting?," Discussion Papers 09/05, Department of Economics, University of York.
    9. González, Paula & Macho-Stadler, Inés, 2013. "A theoretical approach to dual practice regulations in the health sector," Journal of Health Economics, Elsevier, vol. 32(1), pages 66-87.
    10. Dormont, B. & Péron, M., 2015. "Does health insurance encourage the rise in medical prices?," Health, Econometrics and Data Group (HEDG) Working Papers 15/16, HEDG, c/o Department of Economics, University of York.
    11. Domenico Lisi & Giacomo Pignataro, 2021. "A note on the trade‐off between waiting times and quality in a constrained hospital market," Health Economics, John Wiley & Sons, Ltd., vol. 30(1), pages 180-185, January.
    12. Mario Pezzino, 2010. "Hospital competition when patients have different willingness to pay for quality," Economics Discussion Paper Series 1014, Economics, The University of Manchester.
    13. Andritsos, Dimitrios A. & Tang, Christopher S., 2014. "Introducing competition in healthcare services: The role of private care and increased patient mobility," European Journal of Operational Research, Elsevier, vol. 234(3), pages 898-909.
    14. Bisceglia, Michele & Padilla, Jorge & Piccolo, Salvatore & Sääskilahti, Pekka, 2023. "On the bright side of market concentration in a mixed-oligopoly healthcare industry," Journal of Health Economics, Elsevier, vol. 90(C).
    15. Hugh Gravelle & Rita Santos & Luigi Siciliani & Rosalind Goudie, 2012. "Hospital Quality Competition Under Fixed Prices," Working Papers 080cherp, Centre for Health Economics, University of York.
    16. Kurt R. Brekke & Luigi Siciliani & Odd Rune Straume, 2015. "Hospital Competition with Soft Budgets," Scandinavian Journal of Economics, Wiley Blackwell, vol. 117(3), pages 1019-1048, July.
    17. Paula González & Gabriel Montes-Rojas & Sarmistha Pal, 2017. "Dual Practice by Health Workers: Theory and Evidence from Indonesia," Working Papers 17.12, Universidad Pablo de Olavide, Department of Economics.
    18. Guccio, Calogero & Lisi, Domenico & Pignataro, Giacomo, 2014. "Readmission and Hospital Quality under Prospective Payment System," MPRA Paper 56490, University Library of Munich, Germany.
    19. Kurt R. Brekke & Lars Sørgard, 2007. "Public versus private health care in a national health service," Health Economics, John Wiley & Sons, Ltd., vol. 16(6), pages 579-601, June.
    20. Katherine Cuff & Jeremiath Hurley & Stuart Mestelman & Andrew Muller & Robert Nuscheler, 2007. "Public and Private Health Care Financing with Alternate Public Rationing," Department of Economics Working Papers 2007-07, McMaster University.
    21. Dixon, Huw & Siciliani, Luigi, 2009. "Waiting-time targets in the healthcare sector: How long are we waiting?," Journal of Health Economics, Elsevier, vol. 28(6), pages 1081-1098, December.

    More about this item

    Keywords

    ;
    ;
    ;
    ;

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:hal:wpaper:hal-03028437. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: CCSD (email available below). General contact details of provider: https://hal.archives-ouvertes.fr/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.