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

33 Pages Posted: 8 Dec 2006

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: May 2007

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 own price elasticity of the demand for public specialist consultation is about -0.3, while administrative waiting time plays a less important role. 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, 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 (May 2007). Available at SSRN: https://ssrn.com/abstract=950249 or http://dx.doi.org/10.2139/ssrn.950249

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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