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The Changing of the Guards: Can Physicians Contain Social Insurance Costs?

Author

Listed:
  • Markussen, Simen

    (Ragnar Frisch Centre for Economic Research)

  • Røed, Knut

    (Ragnar Frisch Centre for Economic Research)

  • Røgeberg, Ole J.

    (Ragnar Frisch Centre for Economic Research)

Abstract

Based on administrative data from Norway, we examine the extent to which family doctors influence their clients' propensity to claim sick pay and disability benefits. The analysis is based on exogenous shifts of family doctors occurring when physicians quit, retire, or for other reasons sell their patient lists to other doctors. Our key finding is that family doctors have significant influence on their clients' benefit claims. We conclude that it is possible for family doctors to contain social insurance costs to some extent, and that there is a significant variation across doctors in the way they do so.

Suggested Citation

  • Markussen, Simen & Røed, Knut & Røgeberg, Ole J., 2013. "The Changing of the Guards: Can Physicians Contain Social Insurance Costs?," IZA Discussion Papers 7122, Institute of Labor Economics (IZA).
  • Handle: RePEc:iza:izadps:dp7122
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    References listed on IDEAS

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    1. Duggan, Mark, 2005. "Do new prescription drugs pay for themselves?: The case of second-generation antipsychotics," Journal of Health Economics, Elsevier, vol. 24(1), pages 1-31, January.
    2. Brekke, Kurt R. & Nuscheler, Robert & Straume, Odd Rune, 2007. "Gatekeeping in health care," Journal of Health Economics, Elsevier, vol. 26(1), pages 149-170, January.
    3. Markussen, Simen, 2009. "The Effects of Sick-Leaves on Earnings," Memorandum 20/2009, Oslo University, Department of Economics.
    4. Grytten, Jostein & Sorensen, Rune, 2003. "Practice variation and physician-specific effects," Journal of Health Economics, Elsevier, vol. 22(3), pages 403-418, May.
    5. Dusheiko, Mark & Gravelle, Hugh & Jacobs, Rowena & Smith, Peter, 2006. "The effect of financial incentives on gatekeeping doctors: Evidence from a natural experiment," Journal of Health Economics, Elsevier, vol. 25(3), pages 449-478, May.
    6. Nicole Maestas & Kathleen J. Mullen & Alexander Strand, 2013. "Does Disability Insurance Receipt Discourage Work? Using Examiner Assignment to Estimate Causal Effects of SSDI Receipt," American Economic Review, American Economic Association, vol. 103(5), pages 1797-1829, August.
    7. Blomqvist, Ake, 1991. "The doctor as double agent: Information asymmetry, health insurance, and medical care," Journal of Health Economics, Elsevier, vol. 10(4), pages 411-432.
    8. Scott, Anthony, 2000. "Economics of general practice," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 22, pages 1175-1200, Elsevier.
    9. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    10. Nicole Maestas & Kathleen J. Mullen & Alexander Strand, 2013. "Does Disability Insurance Receipt Discourage Work? Using Examiner Assignment to Estimate Causal Effects of SSDI Receipt," American Economic Review, American Economic Association, vol. 103(5), pages 1797-1829, August.
    11. Carlsen, Benedicte & Nyborg, Karine, 2009. "The Gate is Open: Primary Care Physicians as Social Security Gatekeepers," Memorandum 07/2009, Oslo University, Department of Economics.
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    Cited by:

    1. Gerard J Van Den Berg & Barbara Hofmann & Arne Uhlendorff, 2016. "The Role of Sickness in the Evaluation of Job Search Assistance and Sanctions," Working Papers 2016-17, Center for Research in Economics and Statistics.
    2. Nordström Skans, Oskar & Vikström, Johan & Lombardi, Stefano, 2018. "Wage subsidies, job-displacement and Swedish firms: A comparison between policy systems," Working Paper Series 2018:6, IFAU - Institute for Evaluation of Labour Market and Education Policy.
    3. Patrick Arni & Gerard J. van den Berg & Rafael Lalive, 2022. "Treatment Versus Regime Effects of Carrots and Sticks," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 40(1), pages 111-127, January.
    4. Lombardi, Stefano & Skans, Oskar Nordström & Vikström, Johan, 2018. "Targeted wage subsidies and firm performance," Labour Economics, Elsevier, vol. 53(C), pages 33-45.
    5. Markussen, Simen & Røed, Knut & Røgeberg, Ole, 2013. "The changing of the guards," Journal of Health Economics, Elsevier, vol. 32(6), pages 1230-1239.

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    More about this item

    Keywords

    disability insurance; absence certification; gatekeepers; sick pay;
    All these keywords.

    JEL classification:

    • H55 - Public Economics - - National Government Expenditures and Related Policies - - - Social Security and Public Pensions
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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