Institute of Economics and Finance, Nanjing Audit University, Nanjing, China.
Department of Economics, University of Los Andes, Bogotá, Colombia.
Health Econ. 2021 Mar;30(3):525-543. doi: 10.1002/hec.4206. Epub 2020 Dec 17.
This article explores a three-party contracting problem when the patient and the provider possess private information that is unobservable to the insurer. We show that for an insurance mechanism to be collusion-proof, it suffices for the insurer to rely on the incentive for one side of the patient-provider coalition. If the risk premium for the patient is smaller than the provider's informational rent, placing the incentive on the patient generates a lower social cost than placing the incentive on the provider. We show that if the provider's effort is highly valued by the patient, the insurer should rely on the patient's incentive to implement a collusion-proof second-best insurance. Interestingly, an altruistic provider may lead to a higher social cost than a self-interested provider. However, even if the insurer does not know the degree of provider altruism, it may still achieve the second-best outcome by assuming that the provider is self-interested. The model can be further extended to allow for different objective of the insurer, provider's informational advantage over patient, and auditing.
本文探讨了在患者和提供者拥有保险公司无法观察到的私人信息的情况下的三方承包问题。我们表明，为了使保险机制具有防共谋性，保险公司只需要依赖于患者-提供者联盟一方的激励。如果患者的风险溢价低于提供者的信息租金，那么对患者进行激励会比对提供者进行激励产生更低的社会成本。我们表明，如果提供者的努力受到患者的高度重视，那么保险公司应该依赖患者的激励来实施防共谋的第二佳保险。有趣的是，一个利他主义的提供者可能会导致比自利的提供者更高的社会成本。然而，即使保险公司不知道提供者利他主义的程度，它也可以通过假设提供者是自利的来实现第二佳结果。该模型可以进一步扩展到允许不同的保险公司目标、提供者相对于患者的信息优势和审计。
