GPs’ response to price regulation: evidence from a nationwide French reform

This paper uses a French reform to evaluate the impacts of price regulation on general practitioners (GP) care provision, fees, and income. This reform has restricted, since 1990, the conditions self-employed GPs have to fulfill to be allowed to over-bill. We exploit 2005 and 2008 Public Health insurance administrative data on GPs activity and fees. We use regression discontinuity techniques in a fuzzy design to estimate causal impacts for GPs who set up practice in 1990 and were constrained to charge regulated prices. Our results suggest that GPs react to income effects. Under price regulation, facing prices lower of 42%, GPs provide 50% of more care than if they could overbill. Male GPs react more than female GPs, which leads to opposite effects on their labor income. GPs are more accessible to patients but may also induce demand. They reduce aside salaried activities, use more lump-sum payment schemes, and occupy more often gate-keeper positions. A complementary analysis at dates closer to the reform suggests that these figures may underestimate the short-term effects of price regulation.