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This paper studies the interaction of private & public health care providers. I present a model acknowledging that consumers differ in their income levels. Health care is provided by a public firm maximizing social welfare &/or private providers maximizing profits. The decision process of firms consists of three stages: entry choice, selection of health care quality, & quantity produced. With mixed provision, in equilibrium, the private provider serves the high-quality demand, & the public supplier serves the low-quality demand. Mixed provision results in a welfare improvement compared to the strictly private regime, & is less costly than a purely public regime. 3 Tables, 1 Figure, 16 References. Adapted from the source document.

We study how the optimal public provision of health care depends on whether or not individuals have an option to seek publicly financed treatment in other regions. We find that, relative to the first-best solution, the government has an incentive to over-provide health care to low-income individuals. When cross-border health care takes place, this incentive is solely explained by that over-provision facilitates redistribution. The reason why more health care facilitates redistribution is that high-ability individuals mimicking low-ability individuals benefit the least from health care when health and labor supply are complements. Without cross-border health care, higher demand for health care among high-income individuals also contributes to the over-provision given that high-income individuals do not work considerably less than low-income individuals and that the government cannot discriminate between the income groups by giving them different access to health care.

One of the mechanisms that is implemented in the cost containment wave in the health care sectors in western countries is the definition, by the third-party payer, of a set of preferred providers. The insured patients have different access rules to such providers when ill. The rules specify the co-payments and the indemnity the patient obtains if patronizing an out-of-plan care provider. We propose to study the competitive process among providers in terms of both prices and qualities. Competition is influenced among other factors by the status of providers as in-plan or out-of-plan care providers. Also, we face a moral hazard of provider choice related to the trade-off between freedom to choose and the need to hold down costs. Our main findings are that we can define a reimbursement scheme when decisions on prices and qualities are taken simultaneously (that we relate to primary health care sectors) such that the first-best allocation is achieved. In contrast, some type of regulation is needed to achieve the optimal solution when decisions are sequential (specialized health care sector). We also derive some normative conclusions on the way price controls should be implemented in some European Union Member States.

One of the mechanisms that is implemented in the cost containment wave in the health care sectors in western countries is the definition, by the third-party payer, of a set of preferred providers. The insured patients have different access rules to such providers when il. The rules specify the co-payments and the indemnity the patient obtains if patronizing an out-of-plan care provider. We propose to study the competitive process among providers in terms of both prices and qualities. Competition is influenced among other factors by the status of providers as in-plan or out-of-plan care providers. Also, we face a moral hazard of provider choice related to the trade-off between freedom to choose and the need to hold down costs. Our main findings are that we can define a reimbursement scheme when decisions on prices and qualities are taken simultaneously (that we relate to primary health care sectors) such that the first-best alocation is achieved. In contrast, some type of regulation is needed to achieve the optimal solution when decisions are sequential (specialized health care sector). We also derive some normative conclusions on the way price controls should be implemented in some European Union Member States.

Nonprofit hospitals receive significant federal, state, and local tax exemptions, partly based on the rationale that nonprofit hospitals provide public goods and services. Through Minimum Charity Care Provision (MCCP) requirements, nonprofit hospitals are required to spend a certain percentage of their revenues on charity care. However, it is not clear whether these requirements increase spending on charity care. This brief summarizes findings from research examining the differences in provisions of charity care across different hospital market sectors – non-profit, for-profit, and government. Findings suggest that MCCP requirements for nonprofit hospitals do not lead to more charity care. If anything, targeting policies that use external incentives may have crowded out some organizations' internal motivations to provide public goods and services.

Hospital provision of uncompensated care is partly a function of insurance coverage of state populations. As states expand insurance coverage options and reduce the number of uninsured, hospital provision of uncompensated care should also decrease. Controlling for hospital characteristics and market factors, the authors estimate that increases in MinnesotaCare (a state-subsidized health insurance program for the working poor) enrollment resulted in a 5-year cumulative savings of $58.6 million in hospital uncompensated care costs. Efforts to evaluate access expansions should take into account the costs of the program and the savings associated with reductions in hospital uncompensated care.

This paper analyzes public intervention in the market for specialized medical care in a model where public & private provision of health care coexist, & physicians offer their services in both systems. The analysis shows that, for a wide range of the public decision-maker's preferences, which include biases in favor of consumers at the expense of physician revenues, full public subsidization of physicians' specialization costs can be socially desirable. The analysis also provides insights into the role of general practitioners (GPs) as providers of information in the market for medical care. 1 Appendix, 24 References. [Copyright 2005 Elsevier B.V.]

We present an analysis of the main orientations that have guided the introduction of the New Public Management principles in the Portuguese health sector. Despite of being a result of international dynamics we also equate some national institutional characteristics such as a delayed and unfinished Welfare State and a centralized structure in political decision making that configures in a particular way the Portuguese health sector reform. Five main dynamics are here identified: dece ntralization of competences, financing and accountability, rationalization of expenses, deregulation of the labour market and internal competition and differentiation in the NHS. One of the most important arguments that we stress is that the health reform pursued in Portugal over the last decades has followed an ideological convergence despite today's growing uncertainties about the f uture of the Portuguese NHS, moving between Beveridge and Bismarck principles and dealing with an emergent for-profit sector that is allowed to act in competition with public sector.