0000000000901372
AUTHOR
Sophie Bejean
Prevention of occupational injuries moral hazard and complex agency relationship
This paper exploits the results of agency theory with the aim of contributing a new viewpoint and a form for analysis of the current functioning of the occupational injury and disease section of the Social Security system in its mission of providing incentives for prevention. After outlining the organization and specific features of insurance against occupational risks, an initial level of analysis highlights the presence of moral hazard in relations between insurer and company and between company and employee. A second level of analysis and resort to complex agency relationship models, multitask model and third-party model, is necessary to take into account the consequences for occupationa…
Strategical behaviours in French ambulatory care (a theoretical and empirical study)
Specifying agency relationships between the different actors in ambulatory care - the patient, the physician, the insurance and public authorities - allows to render an account of the complexity and the specificity of the health system. After a presentation of the normative approach of the agency theory, we will focus on two agency relationships : the Relationship between the insurance and insured people and the relationship between the patient and the physician. The driving part of supply appears through the analysis of the relationship between the physician and the others : he is the agent of both the patient and public authorities. The issue is then the hypothesis of supplier induced dem…
Networks and health care systems
The network concept has been successful in the economic littérature and in the health care economics littérature. However the network concept is not easy to define. In the first part, this paper suggests a framework for network conceptions analysis :first, network can be conceived as a structure of economic organisation (such as infrastructure networks), or as a coordination mode, alternative and different from market or hierarchy coordination. In the second part, this paper analyses recent mutations in the health care system (such as cooperation relationships between several hospitals and private clinics, networks between hospitals and ambulatory medical care...) from the network concept a…
The foundations of the new theories in health economics
In health economics, theoretic approaches such as the theory of contracts, the economy of conventions, the theory of transaction costs and the evolutionary theory, have been applied recently. The present paper offers a classification of these different theories focusing on their epistemological foundations. The clarification of their assumptions about individual rationality (substantial or procedural rationality), about coordination modality (by inter-individual contracts or collective rules), about uncertainty (probabilistic risk or cognitive uncertainty), shows oppositions between these theories. Nevertheless, the application of these different theories in health economics shows that they…
Contribution à une nouvelle économie de la santé : asymétries d'information et régulation en médecine ambulatoire
Le fonctionnement de la médecine ambulatoire est analysé à travers la spécification de relations d'agence complexes qui s'instaurent entre les différents acteurs : le malade, le médecin, l'assurance, la tutelle. Après une approche conceptuelle et normative qui distingue relations d'agence "parfaites" et "imparfaites", l'accent est mis deux relations : la relation assurance-principal et assuré-agent sur le marché de l'assurance maladie, et la relation patient-principal et médecin-agent sur le marché des soins médicaux. Les "effets pervers" inhérents à l'asymétrie d'information sont étudiés en terme de sélection adverse et de risque moral. L'hypothèse d'une démarche induite par l'offre, consé…