【本期主题】Moral Hazard in Expert Services:Evidence from an Intervention to Reduce Health Care Spending in China
This paper examines how physicians respond to financial incentives when there are conflicts of interest using a quasi-experimental approach in a unique setting—the health services market in China. In recent years, drug expenditures in China have accounted for nearly 50% of total health expenditures, which is much higher than the world average. Hospitals own pharmacies and generate revenue from drug sales. Physicians are salaried and may receive under-the-counter commissions from drug manufacturers for prescribing particular drugs. To reduce drug expen- ditures, China imposed a policy that penalized hospitals with high drug percentages (i.e., drug sales as a percentage of total revenue). This paper studies one hospital that responded by instituting a compensation scheme that punished physicians whose drug percentages exceeded a specialty-specific threshold. Using a unique transaction-level dataset, I find that the com- pensation scheme resulted in unintended consequences: rather than decreasing drug utilization, physicians responded by increasing the utilization of non-drug services, especially for diagnostic tests. Because the policy had no significant effect in reducing drug expenditures, its overall effect was to increase total expenditures. This finding is consistent with the inducement hy-pothesis predicted by agency theory. I also find that increased non-drug expenditures were concentrated among insured patients, suggesting that physicians have stronger incentives to act in the patients’interests than in the interests of the third-party payer.
【报告人】吴冰晓 西北大学凯洛格商学院
【时 间】2月23日（周四）中午12：00
【地 点】中国人民大学明德主楼714室
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报告人简介：
吴冰晓，即将在2012年获得西北大学凯洛格商学院博士学位。主要研究领域：健康经济学、产业组织理论、应用微观经济学。教学领域：微观经济学、卫生经济学、产业组织理论、应用计量经济学等。
财政金融学院
梁晶工作室
二零一二年二月二十日
