Les honoraires libres en médecine ambulatoire : une lecture par la théorie des conventions

Batifoulier, Philippe; Bien, Franck

doi:10.3406/sosan.2000.1479

Cited by 3 publications

(2 citation statements)

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“…Apart from this, patients have no other information on differences in quality of care provided by physicians. In this context, a physician's choice to belong to Sector 2 can be seen as a signal about skill (Spence, ), and patients might prefer to consult a Sector 2 physician in order to have a better chance of attaining high‐quality care (Batifoulier and and Bien, ). Nevertheless, beyond the issue of care quality, other potential differences between Sectors 1 and 2 specialists are observable: if there is a local shortage in Sector 1 specialists, consulting a Sector 1 specialist exposes the patient to search costs, waiting time and transportation costs, whereas Sector 2 specialists can be more readily accessible.…”

Section: French Regulation Of Ambulatory Care and Balance Billingmentioning

confidence: 99%

Does Health Insurance Encourage the Rise in Medical Prices? A Test on Balance Billing in France

Dormont

Péron

2016

Health Economics

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We evaluate the causal impact of an improvement in insurance coverage on patients' decisions to consult physicians who charge more than the regulated fee. We use a French panel data set of 43,111 individuals observed from 2010 to 2012. At the beginning of the period, none of them were covered for balance billing; by the end, 3819 had switched to supplementary insurance contracts that cover balance billing. Using instrumental variables to deal with possible non-exogeneity of the decision to switch, we find evidence that better coverage increases demand for specialists who charge high fees, thereby contributing to the rise in medical prices. People whose coverage improves increased their average amount of balance billing per consultation by 32%. However, the impact of the coverage shock depends on the supply of physicians. For people residing in areas where few specialists charge the regulated fee, better coverage increases not only prices but also the number of consultations, a finding that suggests that balance billing might limit access to care. Conversely, in areas where patients have a genuine choice between specialists who balance bill and those who do not, we find no evidence of a response to better coverage. Copyright © 2016 John Wiley & Sons, Ltd.

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Section: French Regulation Of Ambulatory Care and Balance Billingmentioning

confidence: 99%

Does Health Insurance Encourage the Rise in Medical Prices? A Test on Balance Billing in France

Dormont

Péron

2016

Health Economics

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show abstract

“…Apart from this fact, patients have no information on possible dierences in quality of care provided by physicians. In this context, physician's choice to belong to Sector 2 can be seen as a signal about his ability (Spence (1973)) and patients might prefer to consult a Sector 2 physician to have a better chance to get high quality of care (see also Batifoulier and Bien (2000)). Nevertheless, besides the issue of care quality, other potential dierences between Sector 1 and 2 specialists are observable: if there is a local shortage in Sector 1 specialists, consulting a sector 1 specialist expose the patient to seeking costs, waiting time and transportation costs, whereas Sector 2 specialists can be more accessible.…”

Section: The Decision To Consult a Sector 2 Specialistmentioning

confidence: 99%

Does Health Insurance Encourage the Rise in Medical Prices? A Test on Balance Billing in France

Dormont

Péron

2014

SSRN Journal

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SUMMARYWe evaluate the causal impact of an improvement in insurance coverage on patients' decisions to consult physicians who charge more than the regulated fee. We use a French panel data set of 43,111 individuals observed from 2010 to 2012. At the beginning of the period, none of them were covered for balance billing; by the end, 3819 had switched to supplementary insurance contracts that cover balance billing. Using instrumental variables to deal with possible non-exogeneity of the decision to switch, we find evidence that better coverage increases demand for specialists who charge high fees, thereby contributing to the rise in medical prices. People whose coverage improves increased their average amount of balance billing per consultation by 32%. However, the impact of the coverage shock depends on the supply of physicians. For people residing in areas where few specialists charge the regulated fee, better coverage increases not only prices but also the number of consultations, a finding that suggests that balance billing might limit access to care. Conversely, in areas where patients have a genuine choice between specialists who balance bill and those who do not, we find no evidence of a response to better coverage.

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L'émergence du référentiel marchand dans la tarification des cliniques privées algériennes : privatisation du financement et changement de paradigme

Zehnati

2021

agr

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Tariff convergence is part of the gradual privatization of the Algerian health care system that began in the late 1980s. The transition from a logic of free access to health care to a market logic represents an upheaval for patients. In order to understand the formation of tariffs in the private healthcare, we mixed a qualitative survey by semi-structured interviews with 16 founders of the clinics and the administration of a questionnaire to 40 permanent doctors of these clinics with a full-time activity. Our results show that the absence of an official tariff scheme in the Algerian private clinics has promoted the establishment of conventional tariff and remuneration systems, adopted by different actors especially to overcome the lack of regulation of the private healthcare. We observe a strong collective commitment to tariff devices, without sacrificing freedom of doctors as autonomous professionals on fixing their own tariff according to their own criteria. The emerging privatization of the Algerian health system is part of an overall international dynamic that would require a gradual change in the paradigm of public action.

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Les honoraires libres en médecine ambulatoire : une lecture par la théorie des conventions

Cited by 3 publications

References 0 publications

Does Health Insurance Encourage the Rise in Medical Prices? A Test on Balance Billing in France

Does Health Insurance Encourage the Rise in Medical Prices? A Test on Balance Billing in France

Does Health Insurance Encourage the Rise in Medical Prices? A Test on Balance Billing in France

L'émergence du référentiel marchand dans la tarification des cliniques privées algériennes : privatisation du financement et changement de paradigme

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