OBJECTIVE This paper uses an economic model to compare three methods for stimulating quality improvement: payment incentives, competition for patients, and emphasis on professional ethics. DESIGN Use an economic model to simulate the impact on quality distortions (risk selection) of differences in payment incentives, competition for patients, and emphasis on professional ethics. SETTING Hea...

In the light of policy interest in measures to improve public school performance, this paper studies the e ects of collective parental pressure and competition from private schools on public school quality. It sets out a new empirical model for understanding school quality determination which makes explicit the inter-connections among public school quality setting, parental pressure, and privat...

Under most conceivable scenarios of expanded choice, even with private school vouchers, the public school system will still remain the majority supplier of schooling. Therefore, it is important to know what might happen to quality and outcomes in the remaining public schools. This paper examines the effect of public school competition on academic achievement. The empirical analysis has two majo...

Abstract: We analyze the effect that competition between HMOs has on the cost and quality of medical services. Our key result is that increasing competition enhances consumer utility while also moderating the impact of managed care on quality and costs. Indeed, we find that heightened competition between HMOs can cause an overall increase in care quality and costs. This result derives from an i...

We analytically characterize the effects of ownership and competition in the health care industry on quality provision, market coverage and optimal co-payment policy. A private monopoly selects a lower quality than a public supplier, and the socially optimal co-payment rate with a private monopoly exceeds that with a public monopoly. We establish that the optimal co-payment policy is invariant ...