Exploring physician agency under demand‐side cost sharing—An experimental approach

Abstract

Demand-side cost sharing in the health sector occurs when a patient is required to pay for a portion of medical treatment costs. Out-of-pocket payments by patients can take the form of co-payments according to a fixed fee schedule or specific co-insurance rates. Demand-side cost sharing can be the result of national policy in single-payer systems such as in the Scandinavian countries, where out-of pocket payments for various health services are set by the government. In markets where consumers may choose from several health insurance plans, the amount and specific features of demand-side cost sharing will typically vary substantially between plans, and plans with less cost sharing will necessarily imply higher premiums. Consumers purchasing health insurance in the United States can choose between alternative health insurance plans with different levels of demand-side cost sharing, and consumers may acquire health insurance with relatively low premiums in exchange for greater cost sharing (Pauly, 2017).The aim of our study is to contribute to knowledge on physician behavior in the context of demand-side cost sharing. Under demand-side cost sharing, the choice of treatment will influence both health benefits and consumption opportunities for patients. The optimal calibration of supply-and demand-side cost sharing has been shown to depend on physician preferences. This paper contributes to the literature on physician preferences in several respects: We acquire data by conducting a laboratory experiment where we attach real monetary incentives to three separate choice attributes. In addition to determining subjects' profit, the choices in the experiment determine the health benefits and the future consumption opportunity of a real patient admitted to the nearest hospital. To the best of our knowledge, this is the first

Medical occupation preference under the influence of the COVID‐19 pandemic: The role of risk and altruistic preferences

“…More generally, our experimental method and findings contribute to a growing economic literature on measuring altruistic preference among medical students and physicians (e.g., Attema et al., 2023; Ge et al., 2022; Hennig‐Schmidt et al., 2011; Hennig‐Schmidt & Wiesen, 2014; Li et al., 2017; Wang et al., 2020). Using a modified dictator game, developed by Andreoni and Miller (2002) and refined by Fisman et al.…”

“…Consequently, we suggest the pandemic is the more likely explanation for reduced levels of altruism among medical students who enrolled before the pandemic. 16 More generally, our experimental method and findings contribute to a growing economic literature on measuring altruistic preference among medical students and physicians (e.g., Attema et al, 2023;Ge et al, 2022;Hennig-Schmidt et al, 2011;Hennig-Schmidt & Wiesen, 2014;Li et al, 2017;Wang et al, 2020). Using a modified dictator game, developed by Andreoni and Miller (2002) and refined by Fisman et al (2007), Li et al (2017) and Li (2018) structurally estimate the altruistic preference of medical students and found that they are less altruistic than the general US population.…”

Does gender affect medical decisions?

“…The parametern denotes the relative valuation of the health benefit in n's preference function. Specifying physician preferences to comprise a combination of profit and patient benefit has been shown to fit well to experimental data (Godager & Wiesen 2013, Li et al 2017, Li 2018, Wang et al 2020, Ge & Godager 2021a, Ge et al 2022, Li et al 2022. Since our data is from a controlled experiment guaranteeing that females and males face exactly the same values of fi B , and since MRS n (B, fi) in (4) increases monotonously withn , we may conclude on the question of gender differences in patient-regarding preferences by testing the null hypothesis that -FEMALE = -MALE .…”

“… See, e.g., Hennig-Schmidt et al (2011),Godager and Wiesen (2013), Hennig-Schmidt and Wiesen (2014),Godager et al (2016),Brosig-Koch et al (2016,Wang et al (2020),Ge & Godager (2021b) andGe et al (2022) …”

Physician beneficence and profit-taking among private for-profit clinics in China: A field study using a mystery shopper audit

“…Other studies show how the risk attitudes (Martinsson and Persson, 2019) and altruistic tendencies of physicians (Brosig-Koch et al, 2017;Godager and Wiesen, 2013;Martinsson and Persson, 2019) might mitigate this profit-taking motive or under-provision of medical care due to a lack of monetary incentives. Our paper adds to the growing literature measuring physician altruism (Attema et al, 2023;Byambadalai et al, 2023;Ge et al, 2022;Ge and Godager, 2021;Li, 2018;Li et al, 2017) and determining whether such measures promote patient welfare at the cost of the physician's profit 1 . Previous research on hospital care have shown that prosocial doctors are less likely to be concerned with profit and more for the welfare of the patient.…”