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.

The experience of semi-formal infrastructure finance in developing countries: proposals for Brazil and Latin America

This paper has the purpose of analyzing the role of civil society in funding and providing nfrastructure projects in developing countries. Considering that local associations around the world have been directly engaged on some infrastructure projects – some scholars define it as “semi-formal finance” –, the intention is to demonstrate that the experiences on such arrangements in developing countries have been responsible for fostering infrastructure investments in the poorer regions where the government is more absent. Based upon legal, economic and social aspects, this paper aims to contribute to a broader debate for the development of infrastructure in emerging countries. The conclusion is that, under a more social approach, the legal and economic mechanisms in developing countries are able to consider such arrangements in the benefit of their development.