NATIONAL BUREAU OF ECONOMIC RESEARCH
NATIONAL BUREAU OF ECONOMIC RESEARCH

Market Forces and the Public Good: Competition Among Hospitals and Provision of Indigent Care

Richard G. Frank, David S. Salkever, Jean Mitchell

NBER Working Paper No. 3136*
Issued in October 1989
NBER Program(s):   HE

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The research presented here focuses on the impact of competitive forces

on the provision of social or merit goods by non-profit hospitals. We

specifically examine the behavior of altruistic non-profit hospitals in the

supply of charity care. The effects of competitive pressures and past

charity care provision on the supply of philanthropic donations to nonprofit

hospitals are also examined. Empirical models of the supply of

donations and charity care are specified and estimated using data on nonprofit

hospitals in Florida for the years 1980-1984. The coefficient

estimates imply strong income effects in the charity care supply equations.

This raises the possibility that competitive pressures and limits on

hospital payments, under public insurance programs, may reduce the supply of

indigent care. The results from the supply of donations models suggest that

philanthropic donations will alleviate the competitive pressures to a small

degree.

*Published: R. M. Scheffler and L. F. Rossiter, editors. Advances in Health Economicsand Health Services Research, Volume 11, pp. 159-184. Greenwich, CT: JAI Press, 1990.

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