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The Market for Paid Sick Leave

Author

Listed:
  • Markussen, Simen

    () (Ragnar Frisch Centre for Economic Research)

  • Røed, Knut

    () (Ragnar Frisch Centre for Economic Research)

Abstract

In many countries, general practitioners (GPs) are assigned the task of controlling the validity of their own patients' insurance claims. At the same time, they operate in a market where patients are customers free to choose their GP. Are these roles compatible? Can we trust that the gatekeeping decisions are untainted by private economic interests? Based on administrative registers from Norway with records on sick pay certification and GP-patient relationships, we present evidence to the contrary: GPs are more lenient gatekeepers the more competitive is the physician market, and a reputation for lenient gatekeeping increases the demand for their services.

Suggested Citation

  • Markussen, Simen & Røed, Knut, 2016. "The Market for Paid Sick Leave," IZA Discussion Papers 9825, Institute of Labor Economics (IZA).
  • Handle: RePEc:iza:izadps:dp9825
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    References listed on IDEAS

    as
    1. Gravelle, Hugh S & Propper, Carol & Santos, Rita, 2013. "Does quality affect patients’ choice of doctor? Evidence from the UK," CEPR Discussion Papers 9534, C.E.P.R. Discussion Papers.
    2. Mark McClellan, 2011. "Reforming Payments to Healthcare Providers: The Key to Slowing Healthcare Cost Growth While Improving Quality?," Journal of Economic Perspectives, American Economic Association, vol. 25(2), pages 69-92, Spring.
    3. Lusine Lusinyan & Leo Bonato, 2007. "Work Absence in Europe," IMF Staff Papers, Palgrave Macmillan, vol. 54(3), pages 475-538, July.
    4. Godager, Geir & Iversen, Tor & Ma, Ching-to Albert, 2015. "Competition, gatekeeping, and health care access," Journal of Health Economics, Elsevier, vol. 39(C), pages 159-170.
    5. Markussen, Simen & Mykletun, Arnstein & Røed, Knut, 2012. "The case for presenteeism — Evidence from Norway's sickness insurance program," Journal of Public Economics, Elsevier, vol. 96(11), pages 959-972.
    6. Tor Iversen & Ching-to Ma, 2011. "Market conditions and general practitioners’ referrals," International Journal of Health Economics and Management, Springer, vol. 11(4), pages 245-265, December.
    7. Carlsen, Benedicte & Nyborg, Karine, 2009. "The Gate is Open: Primary Care Physicians as Social Security Gatekeepers," Memorandum 07/2009, Oslo University, Department of Economics.
    8. Iversen, Tor & Luras, Hilde, 2000. "Economic motives and professional norms: the case of general medical practice," Journal of Economic Behavior & Organization, Elsevier, vol. 43(4), pages 447-470, December.
    9. Iversen, Tor & Lurås, Hilde, 2011. "Patient switching in general practice," Journal of Health Economics, Elsevier, vol. 30(5), pages 894-903.
    10. Grytten, Jostein & Sorensen, Rune, 2003. "Practice variation and physician-specific effects," Journal of Health Economics, Elsevier, vol. 22(3), pages 403-418, May.
    11. Iversen, Tor, 2004. "The effects of a patient shortage on general practitioners' future income and list of patients," Journal of Health Economics, Elsevier, vol. 23(4), pages 673-694, July.
    12. Markussen, Simen & Røed, Knut & Røgeberg, Ole J. & Gaure, Simen, 2011. "The anatomy of absenteeism," Journal of Health Economics, Elsevier, vol. 30(2), pages 277-292, March.
    13. Gowrisankaran, Gautam & Town, Robert J., 1999. "Estimating the quality of care in hospitals using instrumental variables," Journal of Health Economics, Elsevier, vol. 18(6), pages 747-767, December.
    14. Dusheiko, Mark & Gravelle, Hugh & Jacobs, Rowena & Smith, Peter, 2006. "The effect of financial incentives on gatekeeping doctors: Evidence from a natural experiment," Journal of Health Economics, Elsevier, vol. 25(3), pages 449-478, May.
    15. Gaure, Simen, 2013. "OLS with multiple high dimensional category variables," Computational Statistics & Data Analysis, Elsevier, vol. 66(C), pages 8-18.
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    Cited by:

    1. Brekke, Kurt R. & Holmås, Tor Helge & Monstad, Karin & Straume, Odd Rune, 2019. "Competition and physician behaviour: Does the competitive environment affect the propensity to issue sickness certificates?," Journal of Health Economics, Elsevier, vol. 66(C), pages 117-135.
    2. Beckert, Walter, 2018. "Choice in the presence of experts: The role of general practitioners in patients’ hospital choice," Journal of Health Economics, Elsevier, vol. 60(C), pages 98-117.
    3. repec:eee:jhecon:v:62:y:2018:i:c:p:60-68 is not listed on IDEAS
    4. Hernæs, Øystein, 2018. "Activation against absenteeism – Evidence from a sickness insurance reform in Norway," Journal of Health Economics, Elsevier, vol. 62(C), pages 60-68.
    5. Francisco Gomez Martinez & Sander Onderstal & Maarten Pieter Schinkel, 2019. "Can Collusion Promote Corporate Social Responsibility? Evidence from the Lab," Tinbergen Institute Discussion Papers 19-034/VII, Tinbergen Institute, revised 03 Oct 2019.
    6. Dietrichson, Jens & Ellegård, Lina Maria & Kjellsson, Gustav, 2016. "Patient Choice, Entry, and the Quality of Primary Care: Evidence from Swedish Reforms," Working Papers 2016:36, Lund University, Department of Economics, revised 27 Jun 2018.
    7. repec:eee:pubeco:v:167:y:2018:i:c:p:190-204 is not listed on IDEAS
    8. Brekke, Kurt R. & Holmås, Tor Helge & Monstad, Karin & Straume, Odd Rune, 2017. "Competition and physician behaviour: Does the competitive environment the propensity to issue sickness certificates?," Discussion Paper Series in Economics 3/2017, Norwegian School of Economics, Department of Economics.

    More about this item

    Keywords

    absenteeism; gatekeeping; competition; role-conflicts;

    JEL classification:

    • H55 - Public Economics - - National Government Expenditures and Related Policies - - - Social Security and Public Pensions
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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