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Bureaucracy Versus Markets in Hospital Care: The Dutch Case

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Abstract

In this paper we analyze the bureaucratic negotiation processthat is implied by the budgeting system applied in Dutchhospital care. This system is based on centralized pricesetting while simultaneously allowing for decentralizednegotiations on volumes. We apply a variant of the bureaucracytheory, according to which the bureaucratic agency (in ourcase the joint hospitals) are not allowed to pricediscriminate, but will receive a flat price per unit ofoutput. We find that central price setting, where the insurercannot exploit its information on hospital costs, leads to asuboptimal supply of hospital care.

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References

  • Arrow, K.J. (1963). Uncertainty and the welfare economics of medical care. American Economic Review 53: 941-973.

    Google Scholar 

  • Breton, A. and Wintrobe, R. (1975). The equilibrium size of a budget maximizing bureau. Journal of Political Economy 83: 195-207.

    Google Scholar 

  • Janssen, R. (1993). Cost containment in the Netherlands, success and failure. In: Report on the WHO-meeting on the future of health care financing: increasing demand and limited resources, 171-188. WHO-Centre for Public Health Research. Kiel, Germany.

    Google Scholar 

  • Janssen, R. and Hartog, M. den (1993). More market, less competition and more strategy. In: M. Malek, J. Rasquinha and P. Vacani (Eds.), Strategic issues in health care management, 189-209. Chichester: John Wiley and Sons.

    Google Scholar 

  • Mueller, D.C. (1989). Public choice II. Cambridge: Cambridge University Press.

    Google Scholar 

  • Niskanen, W.A. (1971). Bureaucracy and representative government. Chicago: Aldine Atherton.

    Google Scholar 

  • Schut, F. (1995). Competition in the Dutch health care sector. Rotterdam: PhD-thesis, Erasmus University.

    Google Scholar 

  • Staten, M.(1987). Marketshare and the illusion of power. Journal of Health Economics 7: 43-56.

    Google Scholar 

  • Zorgnota 2001 (2000). Memorandum on the care sector. The Hague: SDU publishers (in Dutch).

    Google Scholar 

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Authors and Affiliations

  1. Department of Economics and CentER, Tilburg University, 5000 LE, Tilburg, The Netherlands

    Richard T.J.M. Janssen, Theo Leers, Lex C. Meijdam & Harrie A.A. Verbon

Authors
  1. Richard T.J.M. Janssen
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  2. Theo Leers
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  3. Lex C. Meijdam
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  4. Harrie A.A. Verbon
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Janssen, R.T., Leers, T., Meijdam, L.C. et al. Bureaucracy Versus Markets in Hospital Care: The Dutch Case. Public Choice 114, 477–489 (2003). https://doi.org/10.1023/A:1022646231170

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  • DOI: https://doi.org/10.1023/A:1022646231170

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