Rent-Seeking in Public Fee-for-Service Health Care

医生是否有非法寻租行为？加拿大被认为拥有世界上最好的公共卫生保健系统之一。加拿大医生主要通过按服务收费的方案获得报酬，该方案鼓励病人快速就诊，并提供更密集或更复杂的治疗。这项激励计划如何影响加拿大纳税人的医疗保健总成本？在美国医疗保健私有化的背景下，已经深入研究了不一致的激励和市场效率低下，但据我所知，没有发表的经济学研究在加拿大公共医疗保健的背景下研究过这一点。利用丰富的患者层面数据，我利用了政府要求医生报告治疗方式的准外生变化，以区分医生寻租行为给加拿大纳税人带来的总经济损失。这项研究的结果可能对设计公共卫生保健提供的有效市场具有更广泛的影响。

Do doctors conduct illegal rent-seeking behaviour? Canada is thought to have one of the best public health care systems in the world. Canadian physicians are primarily paid through fee-for-service scheme, which incentivizes quick patient visits and providing more intensive or complex treatments. How does this incentive scheme impact the overall cost of health care to the Canadian taxpayer? Mis-aligned incentives and market inefficiencies have been studied in-depth in the context of privatized American health care, but to my knowledge no published economics research has studied this in context of publicly provided Canadian health care. Using rich patient-level data, I exploit quasi-exogenous changes to the way the government requires doctors to report their treatments in order to discern the gross economic loss to the Canadian taxpayer from physician rent-seeking behaviour. The outcome of this research potentially has broader implications for designing efficient markets for public health care provision.