Informal payments in developing countries' public health sector

Liu, Ting and Sun, Jiayin (2007): Informal payments in developing countries' public health sector.

Abstract

In China and some other developing countries' public health sectors, many patients give their doctors a payment outside the official channel before a major treatment. This secret payment has been documented as informal payment in the literature. We argue that the fundamental cause for informal payments is that patients have more information about doctors' skill than the government does. The price, set by the government, for services offered by doctors cannot fully differentiate patients' various needs. As a consequence, informal payment rises as a tool for patients to compete for the skillful doctor. We study the welfare implications of different policies that can potentially be used to regulate such payments. Patient heterogeneity plays a central role in welfare implications of different policies: when patients' willingness-to-pay differs a lot, informal payments should be allowed and when it differs little, informal payments should be banned. Also we show that selling the right to choose physicians publicly always improves social welfare.

• Item Type: MPRA Paper
• Language: English
• Keywords: informal payments; public health sector; welfare; efficiency
• Subjects: I - Health, Education, and Welfare > I1 - Health > I18 - Government Policy ; Regulation ; Public Health; O - Economic Development, Innovation, Technological Change, and Growth > O1 - Economic Development > O17 - Formal and Informal Sectors ; Shadow Economy ; Institutional Arrangements; H - Public Economics > H4 - Publicly Provided Goods > H44 - Publicly Provided Goods: Mixed Markets

References

Acemoglu, D., and T. Verdier (1998): "Property Rights, Corruption and the Location of Talent: a General Equilibrium Approach," Economic Journal, Vol. 108(No. 450), 1381- 1403. ----(2000): "The Choice between Market Failures and Corruption," American Economics Review, Vol. 90(No. 1), 194-211. Bardhand, P. (1997): "Corruption and Development: A Review of Issues," Journal of Eco- nomics Literature, Vol. 35(No. 3), 1320-1346. Bernheim, B. D., and M. Whinston (1986): "Menu Auctions, Resource Allocation, and Economic Influence," Quarterly Journal of Economics, 101, 1-31. Biglaiser, G., and A. C. Ma (2003): "Moonlighting: Public Service and Private Practice," forthcoming, Rand Journal of Economics. Garcia-Prado, A. (2005): "An Analysis of Under-reporting and Informal Payments among Physicians," Unpublished working paper, Vol. 8(No. 5), 67-98. Gonzalez, P. (2004): "Should Physicians' Dual Practice be Limited? An Incentive Approach," Health Economics, 13, 505-524. Grossman, G., and E. Helpman (1994): "Protection for Sale," American Economic Review, 84, 833-850. Lewis, M. (2000): "Who is Paying for Health Care in Europe and Central China?," The World Bank. Lui, F. T. (1985): "An Equilibrium Queueing Model of Bribery," Journal of Political Economy,Vol. 93(No. 4), 760-781. Riley, J., and A. Hillman (1989): "Politically Contestable Rents and Transfers," Economics and Politics, 1, 17-39. Shleifer, A., and R. Vishny (1992): "Pervasive Shortages under Socialism," RAND Journal of Economics, Vol. 23(No. 2), 237-246. --(1993): "Corruption," Quarterly Journal of Economics, Vol. 108(No. 3), 599-617.