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The political economy of corporatism in medicine: Self-regulation or cartel management?

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Abstract

This paper seeks to explain why delegation of regulatory authority to medical associations (“medical Corporatism”) is so prominent in health care. It argues that the interests of politicians and physicians in limiting access to medical markets rather than the interests of patients in the control of quality of medical care determines this delegation. Recent trends in physician densities, their impacts on physician incomes, and rates of return to a medical career in several industrialized countries are adduced as evidence to support this claim.

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References

  • Allianz-Versicherung. 1985. Lebenserwartung nach Berufen (Life expectancy according to profession.) Capital 4.

  • American Medical Association. 1984. International Lessons. Medical Societies and Health Policy. Chicago.

  • Becker, G. 1986. The Public Interest Hypothesis Revisited: A New Test of Peltzman's Theory of Regulation. Public Choice 49:223–234.

    Google Scholar 

  • Benham, L. 1991. Licensure and Competition in Medical Markets. In Regulating Doctor's Fees: Competition, Benefits and Controls under Medicare, edited by H.E. Frech III, 75–90. Washington, DC: The AEI Press.

    Google Scholar 

  • Beske, F. 1982. Expenditures and Attempts of Cost Containment in the Statutory Health Insurance System of the Federal Republic of Germany. In The Public/Private Mix for Health - The Relevance and Effects of Change, edited by Nuffield Provincial Hospitals Trust, 233–351. London.

  • Blankart, C.B. 1987. Limits to Privatization. European Economic Review 31:346–351.

    Google Scholar 

  • Burstein, P.L., and J. Cromwell. 1985. Relative Incomes and Rates of Return for U.S. Physicians. Journal of Health Economics 4:63–78.

    Google Scholar 

  • Cawson, A. 1986. Corporatism and Political Theory. Oxford: Blackwell.

    Google Scholar 

  • Chester, T.E. 1986. Rationing Health Care: The British Experience in the 1980s. Frontiers of Health Services Management 3(3): 4–30.

    Google Scholar 

  • Eisen, R. and Schrüfer, K. 1986. Gesundheitsleistungen: Märkte. Wahlen oder Bürokraten (Health Care Services: Markets, Elections, or Bureaucrats.) In Oekonomie des Gesundheitswesens, edited by G. Gäfgen, 207–222. Berlin: Dunker & Humblot.

    Google Scholar 

  • Enthoven, A.C. 1978. Consumer-choice Health Plan: Parts I and II. New England Journal of Medicine 298: 650–658, 709–720.

    Google Scholar 

  • Enthoven, A.C. 1980. Health Plan: The Only Practical Solution to the Soaring Cost of Medical Care. Reading, MA: Addison-Wesley.

    Google Scholar 

  • Fausto, D., and M. Lecisotti. 1981. An Interpretation of Government Intervention in Health: The Italian Case. In Health, Economics, and Health Economics, edited by J. Van der Gaag and M. Perlman, 33–44. New York: North Holland.

    Google Scholar 

  • Feige, L. 1982. Neue Politische Oekonomie als Erklärungsansatz der Entstehung und Entwicklung von Zwangsinstitutionen am Beispiel der Gesetzlichen Krankenversicherung (Economic Theory of Democracy as an Attempt at Explaining the Rise and Development of Compulsory Institutions - the Case of Social Health Insurance.) Jahrbuch für Neue Politische Oekonomie 2:306–322.

    Google Scholar 

  • Frech, H.E. III. 1990. Comparative Health Systems: The United States. In Advances in Health Economics and Health Services Research, Suppl. 1, edited by J.J. Rosa, 43–76. Greenwich CT: JAI Press.

    Google Scholar 

  • Gäfgen, G. 1988a. Kollektivverhandlungen als Konstitutiver Allokationsmechanismus korporatistischer Ordnungen. (Collective Bargaining as the Essential Allocation Mechanism of Corporatist Systems.) In Neokorporatismus und Gesundheitswesen, edited by G. Gäfgen, 61–89. Baden-Baden: Nomos.

    Google Scholar 

  • Gäfgen, G. 1988b. Kooperative Wirtschaftspolitik, neuer Korporatismus und Wirtschaftsordnung (Co-operative Economic Policy, New Corporatism, and the Economic Order.) In Wirtschaftliche Strukturprobleme und soziale Fragen, edited by J. Klaus and P. Klemmer. Berlin: Duncker & Humblot.

    Google Scholar 

  • Gisler, U. 1986. Einkommen der Aerzte aus Belgien, Grossbritannien und Deutschland im Vergleich (Comparing Physician Incomes in Belgium, Great Britain, and Germany.) Zurich: University of Zurich (mimeo).

    Google Scholar 

  • Goldberger, A.S. 1974. Unobservable Variables in Econometrics. In Frontiers in Econometrics, edited by P. Zarembka, 192–213. New York: Academic Press.

    Google Scholar 

  • Gravelle, H.S.E. 1985. Economic Analysis of Health Service Professions: A Survey. Social Science and Medicine 20 (10): 1049–1061.

    Google Scholar 

  • Havighurst, C.C. 1988. The Questionable Cost-Containment Record of Commercial Health Insurers. In Health Care in America, edited by H.E. Frech III, 221–258. San Fransisco, CA: Pacific Research Institute.

    Google Scholar 

  • Heller, P.S., R. Hemming, P.W. Kohnert, et al. 1986. Aging and Social Expenditure in the Major Industrial Countries 1980–2025. Washington, DC: International Monetary Fund.

    Google Scholar 

  • Kessel, R.A. 1958. Price Discrimination in Medicine. Journal of Law and Economics 1:20–23.

    Google Scholar 

  • Klein, B., and K.B. Leffler. 1981. The Role of Market Forces in Assuring Contractual Performance. Journal of Political Economy 89:615–641.

    Google Scholar 

  • Kleindorfer, P.R., and J.-M. von der Schulenburg. 1986. Intergenerational Equity and Fund Balances for Statutory Health Insurance. In Essays in Social Security Economics, edited by J.-M. von der Schulenburg, 108–129. New York: Springer.

    Google Scholar 

  • Launois, R.J., and J.J. Rosa. 1990. The Health Care System of France. In Advances in Health Economics and Health Services Research, edited by J.J. Rosa, R.M. Scheffler, and L.F. Rossiter, 179–195. London: JAI Press.

    Google Scholar 

  • Leenen, H.J.J., G. Pinet, and A.V. Prims. 1986. Trends in Health Legislation in Europe. Paris: Masson.

    Google Scholar 

  • Lévy, D. 1988. La démographie médicale dans l'analyse du système de santé. In La société inquiète de la santé, edited by G. Duru et M. Tachon, 12–32. Toulouse: Ed. Ers.

    Google Scholar 

  • Marmor, T.R., and J.B. Christianson. 1982. Health Care Policy: A Political Economy Approach. Beverly Hills, CA: Sage.

    Google Scholar 

  • Maynard, A. 1975. Health Care in the European Community. London: Croom Helm.

    Google Scholar 

  • Maynard, A., and A. Walker. 1978. Doctor Manpower 1975–2000: Alternative Forecasts and their Resource Implications. In Research Paper Nr. 4 for the Royal Commission on the NHS. London: HMSO.

    Google Scholar 

  • Nelson, P. 1970. Information and Consumer Behavior. Journal of Political Economy 78 (2): 311–329.

    Google Scholar 

  • Nonneman, W., and E.K.A. van Doorslaer. 1985. “Een model van de arbeidsmarkt voor artsen (A Model of the Market for Physicians.)” In Concurrentie in de Nederlandse Gesondheitdszorg, De Tijdstroom, edited by H. Hagen. Cited in: Rutten, F.F.H. 1987. “Market Strategies for Publicly Financed Health Care Systems.” Health Policy 7:135–148.

  • OECD. 1985a. Social Expenditure 1960–1990. Paris: OECD.

    Google Scholar 

  • OECD. 1985. Measuring Health Care 1960–1983. Paris: OECD.

    Google Scholar 

  • OECD. 1987. Financing and Delivering Health Care. Paris: OECD.

    Google Scholar 

  • OECD. 1990. Health Care Systems in Transition. Paris: OECD.

    Google Scholar 

  • Olson, M. 1965. The Logic of Collective Action. Cambridge: Harvard University Press.

    Google Scholar 

  • Pauly, M.V. 1986. Taxation, Health Insurance, and Market Failure in the Medical Economy. Journal of Economic Literature XXIC (June): 629–675.

    Google Scholar 

  • Roos, N.P., L.L. Roos, and P.D. Henteleff. 1977. Elective Surgical Rates - Do High Rates Mean Lower Standards? New England Journal of Medicine 297, 360–365.

    Google Scholar 

  • Roos, N.P., and L.L. Roos. 1981. High and Low Surgical Rates: Risk Factors For Area Residents. American Journal of Public Health 71:591–600.

    Google Scholar 

  • Rowley, C.K., R.D. Tollison, and G. Tullock. 1988. The Political Economy of Rent-Seeking. Boston: Kluwer.

    Google Scholar 

  • Satterthwaite, M.A. 1979. Consumer Information, Equilibrium Industry Price and the Number of Sellers. Bell Journal of Economics 10(2): 483–202.

    Google Scholar 

  • Schulenburg von der, J.-M. 1987. Verbände als Interessenwahrer von Berufsgruppen im Gesundheitswesen (Associations as Agents of Health Care Professionals.) In Der Arbeitsmarkt im Gesundheitswesen, edited by L. Männer and G. Sieben, 373–418. Gerlingen: Bleicher.

    Google Scholar 

  • Svorny, S.V. 1987. Physician Licensure: A New Approach to Examining the Role of Professional Interests. Economic Inquiry 25 (July): 497–509.

    Google Scholar 

  • Swennen, H. 1989. Concurrentie in het medisch beroep (Competition in the Medical Profession.) Juridische Aspecten van den Geneeskunde, edited by A. Heyvaert, et al., 93–162. Antwerp: Kluwer.

    Google Scholar 

  • Ware, J.E. Jr., A. Davies-Avery, and R.H. Brook. 1980. Conceptualization and Measurement of Health for Adults in the Health Insurance Study. In Analysis of Relationships among Health Status Measures, Vol. VI, R-1987/6-HEW. Santa Monica, CA: Rand.

    Google Scholar 

  • Williamson, O.E. 1983. Credible Commitments: Using Hostages to Support Exchange. American Economic Review 73: 519–540.

    Google Scholar 

  • Wilson, R.A. 1987. Returns to Entering the Medical Profession in the U.K. Journal of Health Economics 6(4): 339–364.

    Google Scholar 

  • Zohlnhöfer, W., and P.G. Schmidt. 1985. Preisbildung für kassenärztliche Leistungen im ambulanten Bereich in der Bundesrepublik Deutschland (Price Formation for Medical Services in the German Ambulatory Care Sector.) In Preisbildung im Gesundheitswesen, edited by D. Adam and P. Zweifel, 101–133. Gerlingen: Bleicher.

    Google Scholar 

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  1. University of Zurich Institute for Empirical Research in Economics, Kleinstrasse 15, CH-8008, Zurich, Switzerland

    Peter Zweifel & Reiner Eichenberger

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  1. Peter Zweifel
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  2. Reiner Eichenberger
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Zweifel, P., Eichenberger, R. The political economy of corporatism in medicine: Self-regulation or cartel management?. J Regul Econ 4, 89–108 (1992). https://doi.org/10.1007/BF00134221

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