Faculty of Business and Economics, Department of Economics and Econometrics and Institut d'Economie et de Management de la Santé, University of Lausanne, Building Internef, CH-1015 Lausanne, Switzerland.
J Health Econ. 2011 Dec;30(6):1197-206. doi: 10.1016/j.jhealeco.2011.08.011. Epub 2011 Sep 3.
We study optimal public health care rationing and private sector price responses. Consumers differ in their wealth and illness severity (defined as treatment cost). Due to a limited budget, some consumers must be rationed. Rationed consumers may purchase from a monopolistic private market. We consider two information regimes. In the first, the public supplier rations consumers according to their wealth information (means testing). In equilibrium, the public supplier must ration both rich and poor consumers. Rationing some poor consumers implements price reduction in the private market. In the second information regime, the public supplier rations consumers according to consumers' wealth and cost information. In equilibrium, consumers are allocated the good if and only if their costs are below a threshold (cost effectiveness). Rationing based on cost results in higher equilibrium consumer surplus than rationing based on wealth.
我们研究了最优的公共卫生保健配给和私营部门价格反应。消费者在财富和疾病严重程度（定义为治疗成本）方面存在差异。由于预算有限，一些消费者必须配给。配给的消费者可以从垄断的私人市场购买。我们考虑两种信息制度。在第一种制度下，公共供应商根据消费者的财富信息（收入调查）对消费者进行配给。在均衡状态下，公共供应商必须对富人和穷人进行配给。对一些贫困消费者进行配给会导致私人市场的价格下降。在第二种信息制度下，公共供应商根据消费者的财富和成本信息对消费者进行配给。在均衡状态下，只有当消费者的成本低于一个阈值（成本效益）时，他们才会被分配到这种药物。基于成本的配给比基于财富的配给产生更高的均衡消费者剩余。
