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Provider and consumer preferences in health care markets


Rischatsch, Maurus. Provider and consumer preferences in health care markets. 2012, University of Zurich, Faculty of Economics.

Abstract

This dissertation investigates provider and consumer preferences in health care mar- kets as they pertain to policy decisions and shows that, if placing priority on a na- tion’s welfare, policy makers would do well to design reforms that not only address, but also, are largely informed by, provider and consumer feedback. For example, if citizens’ preferences point to a willingness to pay high insurance premiums (or taxes) for health care consumption, reforms to cut cost through rationing health care provision may actually decrease a nation’s welfare. Each chapter of this dissertation can be considered as self-contained. Following a brief discussion of the relevance of preference measurement, this dissertation first analyzes what it is that physicians dislike about Managed Care (MC). Supported by evidence drawn from a discrete choice experiment conducted with Swiss ambu- latory care physicians, findings demonstrate that private health insurers must be able to achieve substantial savings in order to create sufficient incentives for physi- cians to participate voluntarily in MC. The same is true for accepting budgetary co-responsibility investigated in Chapter 3. The results show that, as long as the alternative of conventional private practice exists, physicians are less likely to join physician networks and accept budgetary responsibility unless they are highly com- pensated for the additional financial risk. Chapter 4 compares consumer preferences for health insurance in Germany and the Netherlands. Using two discrete choice experiments, this chapter compares con- sumer willingness to pay for health insurance attributes. While the two populations agree in their resistance against MC-type attributes, German respondents required much higher compensation in order to give up free physician choice and instead accept a physician list. Chapters 5 and 6 examine physicians’ preferences for drug versions and package sizes. Chapter 5 tests physicians’ imperfect agency and reveals a significant positive association between physician dispensing and the use of generic drugs. Chapter 6 explores whether or not dispensing physicians optimize their own drug margins by prescribing margin-optimizing package sizes. Findings suggest that dispensing physicians achieve higher drug margins than pharmacies, which results in higher drug costs and inefficient package choices for patients.

Abstract

This dissertation investigates provider and consumer preferences in health care mar- kets as they pertain to policy decisions and shows that, if placing priority on a na- tion’s welfare, policy makers would do well to design reforms that not only address, but also, are largely informed by, provider and consumer feedback. For example, if citizens’ preferences point to a willingness to pay high insurance premiums (or taxes) for health care consumption, reforms to cut cost through rationing health care provision may actually decrease a nation’s welfare. Each chapter of this dissertation can be considered as self-contained. Following a brief discussion of the relevance of preference measurement, this dissertation first analyzes what it is that physicians dislike about Managed Care (MC). Supported by evidence drawn from a discrete choice experiment conducted with Swiss ambu- latory care physicians, findings demonstrate that private health insurers must be able to achieve substantial savings in order to create sufficient incentives for physi- cians to participate voluntarily in MC. The same is true for accepting budgetary co-responsibility investigated in Chapter 3. The results show that, as long as the alternative of conventional private practice exists, physicians are less likely to join physician networks and accept budgetary responsibility unless they are highly com- pensated for the additional financial risk. Chapter 4 compares consumer preferences for health insurance in Germany and the Netherlands. Using two discrete choice experiments, this chapter compares con- sumer willingness to pay for health insurance attributes. While the two populations agree in their resistance against MC-type attributes, German respondents required much higher compensation in order to give up free physician choice and instead accept a physician list. Chapters 5 and 6 examine physicians’ preferences for drug versions and package sizes. Chapter 5 tests physicians’ imperfect agency and reveals a significant positive association between physician dispensing and the use of generic drugs. Chapter 6 explores whether or not dispensing physicians optimize their own drug margins by prescribing margin-optimizing package sizes. Findings suggest that dispensing physicians achieve higher drug margins than pharmacies, which results in higher drug costs and inefficient package choices for patients.

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Additional indexing

Item Type:Dissertation (monographical)
Referees:Zweifel Peter, Hopkins Sandra
Communities & Collections:UZH Dissertations
Dewey Decimal Classification:Unspecified
Language:English
Place of Publication:Zürich
Date:2012
Deposited On:16 Apr 2019 13:11
Last Modified:07 Apr 2020 07:17
Number of Pages:169
Additional Information:Enthält Sonderdrucke
OA Status:Green
Related URLs:https://www.recherche-portal.ch/primo-explore/fulldisplay?docid=ebi01_prod007330564&context=L&vid=ZAD&search_scope=default_scope&tab=default_tab&lang=de_DE (Library Catalogue)

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