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| Tekijä: | March, M. Schroyen, F. |
| Otsikko: | Can a mixed health care system be desirable on equity grounds? |
| Lehti: | Scandinavian Journal of Economics
2005 : VOL 107:1, p. 1-23 |
| Asiasana: | Health service Health insurance Health economics Models |
| Kieli: | eng |
| Tiivistelmä: | Should health care (henceforth as: h-c.) provision be public, private, or both? This paper considers the question in a setting where people differ in their earnings capacity and face some illness risk. It is assumed that illness reduces an individual's time endowment when waiting for treatment. Treatment can be obtained in a competitive private sector (through private insurance) or in the National Health Service(NHS) where it is provided free of charge but after some (endogenous) waiting time. The equilibrium in the h-c. sector consists of a waiting time in the NHS such that no patient wants to switch h-c. provider. This equilibrium is governed by two public policies: the income tax system and the size of the NHS. It is found that: i. a mixed system with a small NHS is never desirable, ii. actuarially fair sickness insurance is never desirable either, iii. a mixed system with a sufficiently large NHS may improve on a pure public system if the dispersion of earnings capacities is large enough, and iv. the welfare gains from such a mixed system are not likely to be significant. |
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