IDEAS home Printed from https://ideas.repec.org/p/drm/wpaper/2014-9.html
   My bibliography  Save this paper

The economic behaviour of doctors: medical altruism without an ethic?

Author

Listed:
  • Philippe Batifoulier
  • Nicolas Da Silva

Abstract

Health economics appears to have difficulty in taking medical ethics into consideration because of the standard figure of homo economicus. In main stream economics, the ethical attitude of a physician is then formalized in terms of “medical altruism”. This paper seeks to highlight the advantages and the contradictions of this medical altruism. We can identify several levels of problems raised by this medical altruism: theoretical paradoxes and economic policy problems for the regulator. The interest of the concept of medical altruism is to save or improve the economic theory with a more realistic assumption. However, if this assumption is more realistic, it induces paradoxes of economic theory. The misfortune for economists is that this theoretical inconstancy is lined with economic policy issues. These remain unresolved and we do not know what to do. In conclusion, we think that it becomes crucial to consider seriously medical ethics.

Suggested Citation

  • Philippe Batifoulier & Nicolas Da Silva, 2014. "The economic behaviour of doctors: medical altruism without an ethic?," EconomiX Working Papers 2014-9, University of Paris Nanterre, EconomiX.
    • Handle: RePEc:drm:wpaper:2014-9
    as

    Download full text from publisher

    File URL: http://economix.fr/pdf/dt/2014/WP_EcoX_2014-09.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Louis F. Rossiter & Gail R. Wilensky, 1984. "Identification of Physician-Induced Demand," Journal of Human Resources, University of Wisconsin Press, vol. 19(2), pages 231-244.
    2. Levy-Garboua, Louis & Meidinger, Claude & Rapoport, Benoit, 2006. "The Formation of Social Preferences: Some Lessons from Psychology and Biology," Handbook on the Economics of Giving, Reciprocity and Altruism, in: S. Kolm & Jean Mercier Ythier (ed.), Handbook of the Economics of Giving, Altruism and Reciprocity, edition 1, volume 1, chapter 7, pages 545-613, Elsevier.
    3. Susan Rose-Ackerman, 1996. "Altruism, Nonprofits, and Economic Theory," Journal of Economic Literature, American Economic Association, vol. 34(2), pages 701-728, June.
    4. Lise Rochaix & Stéphane Jacobzone, 1997. "L'hypothèse de demande induite : un bilan économique," Économie et Prévision, Programme National Persée, vol. 129(3), pages 25-36.
    5. Olivier Favereau, 1989. "Marchés internes, marchés externes," Revue Économique, Programme National Persée, vol. 40(2), pages 273-328.
    6. Lien, Hsien-Ming & Albert Ma, Ching-To & McGuire, Thomas G., 2004. "Provider-client interactions and quantity of health care use," Journal of Health Economics, Elsevier, vol. 23(6), pages 1261-1283, November.
    7. Philippe Batifoulier & Jean-Paul Domin & Maryse Gadreau, 2008. "Mutation du patient et construction d'un marché de la santé. L'expérience française," Revue française de socio-Economie, La découverte, vol. 0(1), pages 27-46.
    8. Nicolas da Silva, 2013. "Faut-il intéresser les médecins pour les motiver? Une analyse critique du paiement à la performance médicale," Post-Print hal-01480859, HAL.
    9. Woodward, Robert S. & Warren-Boulton, Frederick, 1984. "Considering the effects of financial incentives and professional ethics on `appropriate' medical care," Journal of Health Economics, Elsevier, vol. 3(3), pages 223-237, December.
    10. David Bardey, 2002. "Demande induite et réglementation de médecins altruistes," Revue économique, Presses de Sciences-Po, vol. 53(3), pages 581-588.
    11. Mark V. Pauly & Mark A. Satterthwaite, 1981. "The Pricing of Primary Care Physicians' Services: A Test of the Role of Consumer Information," Bell Journal of Economics, The RAND Corporation, vol. 12(2), pages 488-506, Autumn.
    12. Mandy Ryan, 1994. "Agency in Health Care: Lessons for Economists from Sociologists," American Journal of Economics and Sociology, Wiley Blackwell, vol. 53(2), pages 207-217, April.
    13. Nicolas da Silva, 2012. "Quelle éthique médicale ? Une relecture à partir de l'hypothèse de « crowding out effect »," Post-Print hal-01480861, HAL.
    14. repec:adr:anecst:y:2006:i:83-84:p:11 is not listed on IDEAS
    15. Bruno S. Frey, 1997. "Not Just for the Money," Books, Edward Elgar Publishing, number 1183.
    16. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    17. Robert G. Evans, 1974. "Supplier-Induced Demand: Some Empirical Evidence and Implications," International Economic Association Series, in: Mark Perlman (ed.), The Economics of Health and Medical Care, chapter 10, pages 162-173, Palgrave Macmillan.
    18. Hausman, Daniel M & McPherson, Michael S, 1993. "Taking Ethics Seriously: Economics and Contemporary Moral Philosophy," Journal of Economic Literature, American Economic Association, vol. 31(2), pages 671-731, June.
    19. Rochaix, Lise, 1989. "Information asymmetry and search in the market for physicians' services," Journal of Health Economics, Elsevier, vol. 8(1), pages 53-84, March.
    20. Jérôme Ballet & Sébastien Barillot & Damien Bazin & François-Régis Mahieu, 2005. "Taking Moral Motivations into Consideration: An Internalist Point of View," Journal of Interdisciplinary Economics, , vol. 16(3), pages 271-287, April.
    21. Stano, Miron, 1987. "A further analysis of the physician inducement controversy," Journal of Health Economics, Elsevier, vol. 6(3), pages 227-238, September.
    22. Damien Bazin & Jérôme Ballet, 2004. "Taking Moral Motivations into Consideration," Post-Print halshs-00727579, HAL.
    23. Jon Elster, 1998. "Emotions and Economic Theory," Journal of Economic Literature, American Economic Association, vol. 36(1), pages 47-74, March.
    24. Carlsen, Fredrik & Grytten, Jostein, 2000. "Consumer satisfaction and supplier induced demand," Journal of Health Economics, Elsevier, vol. 19(5), pages 731-753, September.
    25. Khalil, Elias L., 2004. "What is altruism? A reply to critics," Journal of Economic Psychology, Elsevier, vol. 25(1), pages 141-143, February.
    26. Nicolas Dasilva, 2011. "Motivations médicales et politiques d'incitations. La motivation intrinsèque contre la théorie de l'agence?," Post-Print hal-01480862, HAL.
    27. Khalil, Elias L., 2004. "What is altruism?," Journal of Economic Psychology, Elsevier, vol. 25(1), pages 97-123, February.
    28. Philippe Batifoulier & Jean-Paul Domin & Maryse Gadreau, 2007. "La gouvernance de l'assurance maladie au risque d'un Etat social marchand," Post-Print halshs-00202861, HAL.
    29. Olivier Thevenon & Philippe Batifoulier, 2003. "L'éthique (médicale) est elle soluble dans le calcul économique?," Post-Print hal-00442960, HAL.
    30. Eric Delattre & Brigitte Dormont, 2003. "Fixed fees and physician‐induced demand: A panel data study on French physicians," Health Economics, John Wiley & Sons, Ltd., vol. 12(9), pages 741-754, September.
    31. Philippe Batifoulier, 2012. "Le marché de la santé et la reconstruction de l'interaction patient-médecin," Revue française de socio-Economie, La découverte, vol. 0(2), pages 155-174.
    32. Géraldine Bloy, 2005. "La transmission des savoirs professionnels en médecine générale : le cas du stage chez le praticien," Post-Print halshs-00111983, HAL.
    33. David Bardey & Romain Lesur, 2006. "Optimal regulation of health system with induced demand and 'ex post' moral hazard," Annals of Economics and Statistics, GENES, issue 83-84, pages 279-293.
    34. De Jaegher, Kris & Jegers, Marc, 2000. "A model of physician behaviour with demand inducement," Journal of Health Economics, Elsevier, vol. 19(2), pages 231-258, March.
    35. Nicolas Da Silva, 2011. "Motivations médicales et politiques d’incitations," EconomiX Working Papers 2011-35, University of Paris Nanterre, EconomiX.
    36. Labelle, Roberta & Stoddart, Greg & Rice, Thomas, 1994. "A re-examination of the meaning and importance of supplier-induced demand," Journal of Health Economics, Elsevier, vol. 13(3), pages 347-368, October.
    37. Philippe Batifoulier & Franck Bessis & Olivier Biencourt, 2011. "La déontologie médicale face aux impératifs de marché," Post-Print halshs-00603354, HAL.
    38. Jean-Paul Domin, 2004. "Famille, communauté et prise en charge de la maladie : une analyse des expériences en cours," Post-Print hal-02071636, HAL.
    39. Roy J. Ruffin & Duane E. Leigh, 1973. "Charity, Competition, and the Pricing of Doctors' Services," Journal of Human Resources, University of Wisconsin Press, vol. 8(2), pages 212-222.
    40. Lise Rochaix, 2004. "Concurrence et assurance santé. Entre vœux pieux et vieux démons," Revue d'économie politique, Dalloz, vol. 114(5), pages 575-576.
    41. Mooney, Gavin & Ryan, Mandy, 1993. "Agency in health care: Getting beyond first principles," Journal of Health Economics, Elsevier, vol. 12(2), pages 125-135, July.
    42. John C. Harsanyi, 1955. "Cardinal Welfare, Individualistic Ethics, and Interpersonal Comparisons of Utility," Journal of Political Economy, University of Chicago Press, vol. 63(4), pages 309-309.
    43. A. J. Culyer & J. P. Newhouse (ed.), 2000. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, edition 1, volume 1, number 1.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Philippe Batifoulier & Nicolas Da Silva, 2014. "Medical Altruism in Mainstream Health Economics: Theoretical and Political Paradoxes," Review of Social Economy, Taylor & Francis Journals, vol. 72(3), pages 261-279, September.
    2. Jeanne Lievaut & Philippe Batifoulier, 2011. "La transformation des actes gratuits en actes payants en médecine libérale. Une étude micro-économétrique longitudinale," EconomiX Working Papers 2011-12, University of Paris Nanterre, EconomiX.
    3. E. Delattre & B. Dormont, 2000. "Testing for supplier-induced demand behavior : A panel data study on French physicians," THEMA Working Papers 2000-42, THEMA (THéorie Economique, Modélisation et Applications), Université de Cergy-Pontoise.
    4. Bernard Fortin & Nicolas Jacquemet & Bruce Shearer, 2008. "Policy Analysis in Health-Services Market: Accounting for Quality and Quantity," Annals of Economics and Statistics, GENES, issue 91-92, pages 293-319.
    5. Martin Gaynor, 1994. "Issues in the Industrial Organization of the Market for Physician Services," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 3(1), pages 211-255, March.
    6. Thomas Rice, 2012. "The Physician as the Patient’s Agent," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 25, Edward Elgar Publishing.
    7. Winand Emons, 2013. "Incentive-Compatible Reimbursement Schemes for Physicians," Journal of Institutional and Theoretical Economics (JITE), Mohr Siebeck, Tübingen, vol. 169(4), pages 605-620, December.
    8. Benjamin Montmartin & Marcos Herrera-Gómez, 2022. "Imitative Pricing: the Importance of Neighborhood Effects in Physicians’ Consultation Prices," Working Papers 123, Red Nacional de Investigadores en Economía (RedNIE).
    9. Pedersen, Line Bjørnskov & Hess, Stephane & Kjær, Trine, 2016. "Asymmetric information and user orientation in general practice: Exploring the agency relationship in a best–worst scaling study," Journal of Health Economics, Elsevier, vol. 50(C), pages 115-130.
    10. Éric Delattre & Brigitte Dormont, 2000. "Induction de la demande de soins par les médecins libéraux français. Étude micro-économétrique sur données de panel," Économie et Prévision, Programme National Persée, vol. 142(1), pages 137-161.
    11. Schuster, Stephan, 2012. "Applications in Agent-Based Computational Economics," MPRA Paper 47201, University Library of Munich, Germany.
    12. Haruko Noguchi & Satoshi Shimizutani & Yuichiro Masuda, 2008. "Regional variations in medical expenditure and hospitalization days for heart attack patients in Japan: evidence from the Tokai Acute Myocardial Study (TAMIS)," International Journal of Health Economics and Management, Springer, vol. 8(2), pages 123-144, June.
    13. Philippe Batifoulier, 2014. "De l’aléa moral du patient aux inégalités d’accès aux soins," Working Papers hal-04141361, HAL.
    14. Barigozzi, Francesca & Levaggi, Rosella, 2008. "Emotions in physician agency," Health Policy, Elsevier, vol. 88(1), pages 1-14, October.
    15. Elias Asproudis, 2011. "Revisiting environmental groups and members’ behaviour: budget, size and (im)pure altruism," Environmental Economics and Policy Studies, Springer;Society for Environmental Economics and Policy Studies - SEEPS, vol. 13(2), pages 139-156, June.
    16. Christian Schmid, 2015. "Consumer Health Information and the Demand for Physician Visits," Health Economics, John Wiley & Sons, Ltd., vol. 24(12), pages 1619-1631, December.
    17. Benjamin Montmartin & Mathieu Escot, 2017. "Local Competition and Physicians’ Pricing Decisions: New Evidence from France," GREDEG Working Papers 2017-31, Groupe de REcherche en Droit, Economie, Gestion (GREDEG CNRS), Université Côte d'Azur, France.
    18. Lise Rochaix, 1997. "Asymétries d'information et incertitude en santé : les apports de la théorie des contrats," Économie et Prévision, Programme National Persée, vol. 129(3), pages 11-24.
    19. De Jaegher, Kris & Jegers, Marc, 2000. "A model of physician behaviour with demand inducement," Journal of Health Economics, Elsevier, vol. 19(2), pages 231-258, March.
    20. Philippe Batifoulier, 1999. "Éthique professionnelle et activité médicale: une analyse en termes de conventions," Revue Finance Contrôle Stratégie, revues.org, vol. 2(2), pages 5-24, June.

    More about this item

    Keywords

    healthcare; altruism; professional ethics; instrumental rationality; intrinsic motivation;
    All these keywords.

    JEL classification:

    • B41 - Schools of Economic Thought and Methodology - - Economic Methodology - - - Economic Methodology
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:drm:wpaper:2014-9. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Valerie Mignon (email available below). General contact details of provider: https://edirc.repec.org/data/modemfr.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.