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Soft Budget Constraints in Public Hospitals

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  • Donald J. Wright

Abstract

A soft budget constraint arises when a government is unable to commit to not ‘bailout’ a public hospital if the public hospital exhausts its budget before the end of the budget period. It is shown that if the political costs of a ‘bailout’ are relatively small, then the public hospital exhausts the welfare‐maximising budget before the end of the budget period and a ‘bailout’ occurs. In anticipation, the government offers a budget to the public hospital that may be greater than or less than the welfare‐maximising budget. In either case, the public hospital treats ‘too many’ elective patients before the ‘bailout’ and ‘too few’ after. The introduction of a private hospital reduces the size of any ‘bailout’ and increases welfare. Copyright © 2015 John Wiley & Sons, Ltd.

Suggested Citation

  • Donald J. Wright, 2016. "Soft Budget Constraints in Public Hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 25(5), pages 578-590, May.
    • Handle: RePEc:wly:hlthec:v:25:y:2016:i:5:p:578-590
    DOI: 10.1002/hec.3174
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    1. M. Dewatripont & E. Maskin, 1995. "Credit and Efficiency in Centralized and Decentralized Economies," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 62(4), pages 541-555.
    2. Eggleston, Karen & Shen, Yu-Chu, 2011. "Soft budget constraints and ownership: Empirical evidence from US hospitals," Economics Letters, Elsevier, vol. 110(1), pages 7-11, January.
    3. János Kornai, 2009. "The soft budget constraint syndrome in the hospital sector," Society and Economy, Akadémiai Kiadó, Hungary, vol. 31(1), pages 5-31, June.
    4. Yu-Chu Shen & Karen Eggleston, 2009. "The effect of soft budget constraints on access and quality in hospital care," International Journal of Health Economics and Management, Springer, vol. 9(2), pages 211-232, June.
    5. Robinson, James A. & Torvik, Ragnar, 2009. "A political economy theory of the soft budget constraint," European Economic Review, Elsevier, vol. 53(7), pages 786-798, October.
    6. János Kornai, 2014. "The soft budget constraint," Acta Oeconomica, Akadémiai Kiadó, Hungary, vol. 64(supplemen), pages 25-79, November.
    7. Kurt R. Brekke & Luigi Siciliani & Odd Rune Straume, 2015. "Hospital Competition with Soft Budgets," Scandinavian Journal of Economics, Wiley Blackwell, vol. 117(3), pages 1019-1048, July.
    8. Hagen, Terje P. & Kaarboe, Oddvar M., 2006. "The Norwegian hospital reform of 2002: Central government takes over ownership of public hospitals," Health Policy, Elsevier, vol. 76(3), pages 320-333, May.
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    Cited by:

    1. Berger, Michael & Sommersguter-Reichmann, Margit & Czypionka, Thomas, 2020. "Determinants of soft budget constraints: how public debt affects hospital performance in Austria," LSE Research Online Documents on Economics 116865, London School of Economics and Political Science, LSE Library.
    2. Weicun Ren & Yizhen Zhao & Huiliang Zhong & Xiaoli Fu & Jian Wu, 2021. "Exploring the Optimal Allocation Decision-Making of Expenditure Budget in Hospitals Under Multi-Objective Constraints: Evidence from Urban Public Hospitals, China," SAGE Open, , vol. 11(4), pages 21582440211, December.
    3. Berger, Michael & Sommersguter-Reichmann, Margit & Czypionka, Thomas, 2020. "Determinants of soft budget constraints: How public debt affects hospital performance in Austria," Social Science & Medicine, Elsevier, vol. 249(C).

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