Should we be afraid of managed care?: a theoretical assessment

Managed caIe capitation contracts provide monetary incentives for doctoIs to save medical costs while standard health insurance contracts do noto The papeI proposes an alternative model for insurance markets which is used to analyze managed caIe contracts. In our model, households would like to buy insurance for the possible need of a service. The distinctive aspect of our model is that providers of service have privileged information on the most appropriate procedure to be followed. In the managed care application of the model, doctors are the providers of the service and through a diagnosis have better information of the patient's health condition. Equilibrium in our model is always constrained eflicient. A partial capitation contract arises when both the cost and net benefits of treatment are high enough. We show that a capitation contract provides incentives for doctors: i) to care about the likelihood households will obtain the good state of nature (altruistic behamor); and ii) to save medical costs (managed care behamor). Doctors, in this case, choose less medically eflicient treatments as they would choose under a standard health insurance contract. Besides this, household' welfare is increased in comparison to the standard contract. This increased welfare translates into a revealed preference for the capitation contract.

Using consumer search cost and loyalty to explain dispersion in banking fees

Pode-se observar uma considerável dispersão entre os preços que diferentes bancos comerciais no Brasil cobram por um mesmo pacote homogêneo de serviços— dispersão esta que é sustentada ao longo do tempo. Em uma tentativa de replicar esta observação empírica, foi desenvolvido um simples modelo que lança mão do arcabouço da literatura de custos de procura (search costs) e que baseia-se também na lealdade por parte dos consumidores. Em seguida, dados de preços referentes ao setor bancário brasileiro são aplicados ao modelo desenvolvido e alguns exercícios empíricos são então realizados. Esses exercícios permitem que: (i) os custos de procura incorridos pelos consumidores sejam estimados, ao fixar-se os valores dos demais parâmetros e (ii) as correspondentes perdas de peso-morto que surgem como consequência dos custos de procura incorridos pelos consumidores sejam também estimadas. Quando apenas 80% da população é livre para buscar por bancos que cobrem menores tarifas, à taxa de juros mensal de 0,5%, o valor estimado do custo de procura médio incorrido pelos consumidores chega a 1805,80 BRL, sendo a correspondente perda de peso-morto média na ordem de 233,71 BRL por consumidor.

Bias from ignoring price dispersion in demand estimation

Consumers often pay different prices for the same product bought in the same store at the same time. However, the demand estimation literature has ignored that fact using, instead, aggregate measures such as the “list” or average price. In this paper we show that this will lead to biased price coefficients. Furthermore, we perform simple comparative statics simulation exercises for the logit and random coefficient models. In the “list” price case we find that the bias is larger when discounts are higher, proportion of consumers facing discount prices is higher and when consumers are more unwilling to buy the product so that they almost only do it when facing discount. In the average price case we find that the bias is larger when discounts are higher, proportion of consumers that have access to discount are similar to the ones that do not have access and when consumers willingness to buy is very dependent on idiosyncratic shocks. Also bias is less problematic in the average price case in markets with a lot of bargain deals, so that prices are as good as individual. We conclude by proposing ways that the econometrician can reduce this bias using different information that he may have available.