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

医生有没有进行非法寻租行为？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收费服务计划获得报酬，该计划鼓励患者快速就诊，并提供更密集或更复杂的治疗。这一激励计划对加拿大纳税人的医疗保健总成本有何影响？在美国医疗保健私有化的背景下，人们对错位的激励和市场低效进行了深入研究，但据我所知，还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这一问题。利用丰富的患者层面数据，我利用政府要求医生报告治疗方法的准外生变化，以辨别医生寻租行为给加拿大纳税人造成的总经济损失。这项研究的结果可能对设计有效的公共卫生保健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.