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Quality Competition in Regulated Markets.
紀錄類型:
書目-語言資料,手稿 : Monograph/item
正題名/作者:
Quality Competition in Regulated Markets./
作者:
Ghandour, Ziad Rabih.
面頁冊數:
1 online resource (145 pages)
附註:
Source: Dissertations Abstracts International, Volume: 84-01, Section: A.
Contained By:
Dissertations Abstracts International84-01A.
標題:
Competition. -
電子資源:
click for full text (PQDT)
ISBN:
9798835532759
Quality Competition in Regulated Markets.
Ghandour, Ziad Rabih.
Quality Competition in Regulated Markets.
- 1 online resource (145 pages)
Source: Dissertations Abstracts International, Volume: 84-01, Section: A.
Thesis (Ph.D.)--Universidade do Minho (Portugal), 2021.
Includes bibliographical references
This doctoral thesis studies quality competition in regulated markets, such as health care and education. The three essays are based on theoretical contributions using a spatial competition framework. The first essay analyses the effect of competition on quality provision in mixed markets, where public and private providers coexist. We make two key assumptions about the public provider in such markets, namely that it faces a regulated price and is (partly) motivated. We find that increased competition has an a priori ambiguous effect on quality provided by the public provider, while the scope for a quality reduction by the private provider is larger. We also derive the first-best solution and show how it coincides with the Nash equilibrium of a private (symmetric) duopoly. The second essay extends the analysis to more than two competitors to study quality competition in a mixed oligopoly. We consider a welfare-maximising public provider competing with two profit-maximising private providers that differ with respect to the regulatory regime they face, with only one of the private providers being included in the public funding scheme. We find that changes in the funding scheme or in the degree of competition have differential effects on quality provision across the different types of providers and thus generally ambiguous effects on average quality provision. In terms of social welfare, we find that the two policy instruments in the funding scheme, price and copayment, are policy complements (substitutes) for sufficiently low (high) levels of the copayment rate. We also identify a welfare trade-off between the public funding scheme's generosity (price level) and its extent (number of private providers included). The third essay studies the strategic relationship between hospital investment in health technologies and provision of service quality. We assume providers are altruistic and allow for hospital investment and quality provision to be either complements or substitutes in the patient health benefit and provider cost functions. We assume that each hospital commits to a certain investment level before deciding on the provision of service quality. We show that, compared to a simultaneous-move benchmark, providers' lack of ability to commit to a particular quality level generally leads to either under- or overinvestment. Underinvestment arises when the price-cost margin is positive and when quality and investments are strategic complements. In turn, this has implications for the optimal design of hospital payment contracts. We show that, differently from the simultaneous-move case, the first-best solution is generally not attainable by setting the fixed price at the appropriate level, but the regulator must complement the payment contract with at least one more instrument to address under- or overinvestment. We also analyse the welfare effects of different policy options (separate payment for investment, through a higher per-treatment price, or refinement of pricing) to reimburse hospitals for their investments.
Electronic reproduction.
Ann Arbor, Mich. :
ProQuest,
2024
Mode of access: World Wide Web
ISBN: 9798835532759Subjects--Topical Terms:
559988
Competition.
Index Terms--Genre/Form:
554714
Electronic books.
Quality Competition in Regulated Markets.
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This doctoral thesis studies quality competition in regulated markets, such as health care and education. The three essays are based on theoretical contributions using a spatial competition framework. The first essay analyses the effect of competition on quality provision in mixed markets, where public and private providers coexist. We make two key assumptions about the public provider in such markets, namely that it faces a regulated price and is (partly) motivated. We find that increased competition has an a priori ambiguous effect on quality provided by the public provider, while the scope for a quality reduction by the private provider is larger. We also derive the first-best solution and show how it coincides with the Nash equilibrium of a private (symmetric) duopoly. The second essay extends the analysis to more than two competitors to study quality competition in a mixed oligopoly. We consider a welfare-maximising public provider competing with two profit-maximising private providers that differ with respect to the regulatory regime they face, with only one of the private providers being included in the public funding scheme. We find that changes in the funding scheme or in the degree of competition have differential effects on quality provision across the different types of providers and thus generally ambiguous effects on average quality provision. In terms of social welfare, we find that the two policy instruments in the funding scheme, price and copayment, are policy complements (substitutes) for sufficiently low (high) levels of the copayment rate. We also identify a welfare trade-off between the public funding scheme's generosity (price level) and its extent (number of private providers included). The third essay studies the strategic relationship between hospital investment in health technologies and provision of service quality. We assume providers are altruistic and allow for hospital investment and quality provision to be either complements or substitutes in the patient health benefit and provider cost functions. We assume that each hospital commits to a certain investment level before deciding on the provision of service quality. We show that, compared to a simultaneous-move benchmark, providers' lack of ability to commit to a particular quality level generally leads to either under- or overinvestment. Underinvestment arises when the price-cost margin is positive and when quality and investments are strategic complements. In turn, this has implications for the optimal design of hospital payment contracts. We show that, differently from the simultaneous-move case, the first-best solution is generally not attainable by setting the fixed price at the appropriate level, but the regulator must complement the payment contract with at least one more instrument to address under- or overinvestment. We also analyse the welfare effects of different policy options (separate payment for investment, through a higher per-treatment price, or refinement of pricing) to reimburse hospitals for their investments.
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Esta tese de doutoramento estuda a concorrencia pela qualidade em mercados regulados, tais como os mercados de cuidados de saude ou de ensino. Os tres ensaios que a constituem baseiam-se em contributos teoricos do ambito da concorrencia espacial. O primeiro ensaio analisa o efeito da concorrencia na qualidade oferecida em mercados mistos, aqueles em que prestadores publicos e privados coexistem. Adotamos dois pressupostos fundamentais acerca do prestador publico nestes mercados; nomeadamente, que e alvo de um preco regulado e que e (parcialmente) "motivado". Concluimos que maior intensidade da concorrencia tem um efeito a priori ambiguo na qualidade oferecida pelo prestador publico, enquanto existe maior margem para um efeito negativo na qualidade oferecida pelo prestador privado. Tambem calculamos a solucao otima e demonstramos que esta coincide com o Equilibrio de Nash num oligopolio privado (e simetrico). O segundo ensaio estende a analise a mais de dois prestadores para analisar a concorrencia pela qualidade em oligopolios mistos. Analisamos a concorrencia entre um prestador publico cujo objetivo e maximizar o bem-estar social e dois prestadores privados cujo objetivo e maximizar o maximizar o lucro. Estes distinguem-se entre si pela regulacao de que sao alvo: apenas um deles e incluido no esquema de financiamento publico. Demonstramos que alteracoes neste esquema ou na intensidade da concorrencia afetam a qualidade oferecida pelos tres prestadores diferentemente, resultando em efeitos geralmente ambiguos na qualidade media do mercado. Relativamente ao bem-estar social, demonstramos que os dois instrumentos regulatorios, o preco e o copagamento, sao complementos (substitutos) de politica publica se o nivel da taxa de copagamento for suficientemente baixo (alto). Tambem identificamos um compromisso entre a prodigalidade do esquema de financiamento publico (o preco) e a extensao da sua aplicacao (o numero de prestadores privados nele incluidos). O terceiro ensaio estuda a relacao estrategica entre investimentos hospitalares em tecnologias de saude e a qualidade do servico prestado. Assumimos que os prestadores (hospitais) sao "altruistas" e consideramos simultaneamente a possibilidade de o investimento e a qualidade serem complementos ou substitutos na funcao-beneficio dos utentes e na funcao-custo dos prestadores. Assumimos tambem que os hospitais comprometem-se a realizar um determinado nivel de investimento antes de escolher a qualidade oferecida. Mostramos que, em comparacao com um jogo simultaneo, a ausencia de compromisso sobre a qualidade resulta geralmente em sub- ou sobreinvestimento. Subinvestimento ocorre quando a diferenca preco-custo e positiva e quando qualidade e investimento sao complementos estrategicos. Isto tem implicacoes para o desenho otimo dos contratos de financiamento hospitalar. Ao contrario do que acontece num jogo simultaneo, a solucao otima nao e geralmente atingida pela fixacao do preco no valor adequado, devendo o regulador complementar o contrato de financiamento com pelo menos mais um instrumento para lidar com o sub- ou o sobreinvestimento. Tambem analisamos o efeito no bem-estar de duas politicas publicas de reembolso do investimento hospitalar, o financiamento independente do investimento atraves um preco por tratamento mais elevado ou um esquema de precos mais sofisticado.
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