We examine the strategic interaction in the market for physician services when the total budget for reimbursement is fixed. We show that this prospective payment system involves compared to a fee-for-service remuneration system a severe coordination problem, which potentially leads to the...

Abstract: Regelmäßig wird behauptet, in Deutschland gäbe es zu viele Ärzte, insbesondere zu viele niedergelassene Fachärzte. Namentlich die „doppelte Facharztschiene“ in Klinik und Praxis sei ein wichtiger Grund für Ressourcenverschwendung und Unwirtschaftlichkeit des deutschen...

This paper analyses the potential costs and benefits from patient driven competition between GPs and specialists by comparing gate-keeping with direct access to specialist care. The two access rules are compared under fee-for-service and capitation, on their performance at minimizing both total...

The questions addressed in this paper are related to access rules to primary care services and the potential for patient driven competition between GPs and specialists. Most of the literature on the performance of primary care has dealt with reforming payment schemes, little attention being paid...

We examine the strategic interaction in the market for physician services when the total budget for reimbursement is fixed. We show that this prospective payment system involves - compared to a fee-for-service remuneration system - a severe coordination problem, which potentially leads to the...