A Model for Dual Healthcare Market with Congestion Differentiation

Damien Besancenot (1, 2) , Karine Lamiraud (3, 4) , Radu Vranceanu (3, 4)

1 UPCité - Université Paris Cité
2 LIRAES (URP_ 4470) - Laboratoire Interdisciplinaire de Recherche Appliquée en Economie de la Santé
3 ESSEC Business School
4 THEMA - Théorie économique, modélisation et applications

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.

Mots clés: Dual market; Congestion; Regulation; Balance billing

Domaines: Sciences de l'Homme et Société; Economies et finances

Damien Besancenot, Karine Lamiraud, Radu Vranceanu. A Model for Dual Healthcare Market with Congestion Differentiation. 2020. ⟨hal-03028437⟩