Volume 13, (Supplement) 1978
Friedman, Bernard. 1978. "On the Rationing of Health Services and Resource Availability." Journal of Human Resources 13(S):57-75.
Government controls on availability of physicians and hospital resources can counteract some undesired aggregate consequences of reimbursement insurance. Given aggregate controls, many important questions arise concerning nonprice rationing of services by physicians. A theoretical model of rationing should be consistent with existing items of evidence on delays, disequilibrium, and "availability effects." The model discussed in this paper has a foundation in the mutual advantages of a long-term association between an individual client and physician; these advantages motivate an implicit contract for rationing with a variety of testable implications.
The author is with the Department of Economics and the Center for Health Services and Policy Research, Northwestern University. I must thank Joseph P. Newhouse for a detailed critique of the first draft, and other conference participants for insightful criticism and suggestions. Discussions with Mark Pauly and Edward F.X. Hughes, M.D., have been very helpful in developing an economic basis of long-term association between doctor and client.
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