Rationing the Public Provision of Healthcare in the Presence of Private Supplements: Evidence from the Italian NHS

Posted: 6 Jun 2009

See all articles by Daniele Fabbri

Daniele Fabbri

University of Bologna - Department of Economics

Chiara Monfardini

University of Bologna - Department of Economics; IZA Institute of Labor Economics

Multiple version iconThere are 2 versions of this paper

Date Written: december 3, 2008

Abstract

In this paper we assess the relative effectiveness of user charges and administrative waiting times as a tool for rationing public healthcare in Italy. We measure demand elasticities by estimating a simultaneous equation model of GP primary care visits, public specialist consultations and private specialist consultations, as if they were part of an incomplete system of demand. We find that for public specialist consultations, own price elasticity of demand is about -0.3, while elasticity to administrative waiting time is about -.04. No substitution exists between the demand for public and private specialists, so that user charges act as a net deterrent for over-consumption. The public provision of healthcare does not induce the wealthy to opt out. Moreover our evidence suggests that user charges and waiting lists do not serve redistributive purposes.

Keywords: Healthcare demand elasticities, User charges, Waiting lists, Multivariate count data model

JEL Classification: C34, C35, C35, C51, D12, I11

Suggested Citation

Fabbri, Daniele and Monfardini, Chiara, Rationing the Public Provision of Healthcare in the Presence of Private Supplements: Evidence from the Italian NHS (december 3, 2008). Journal of Health Economics, Vol. 28, No. 2, 2009, Available at SSRN: https://ssrn.com/abstract=1399329

Daniele Fabbri (Contact Author)

University of Bologna - Department of Economics ( email )

Piazza Scaravilli 2
Bologna, 40126
Italy

Chiara Monfardini

University of Bologna - Department of Economics ( email )

Piazza Scaravilli 2
Bologna, 40126
Italy
0039 51 2098148 (Phone)
0039 51 221968 (Fax)

IZA Institute of Labor Economics

P.O. Box 7240
Bonn, D-53072
Germany

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