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Letter: Closed shop.

J R Lang·G W Burgess
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Fees and ChargesLabor UnionsSocieties, MedicalUnited KingdomJournal Article

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J R Lang, G W Burgess. 1975-01-04. Letter: Closed shop.. https://doi.org/10.1136/bmj.1.5948.42-a

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Two-tier charging strategies in public hospitals: implications for intra-hospital resource allocation and equity of access to hospital services.

Two-tier charging, the practice of offering separate qualities of service at different prices, is a growing practice in public hospitals internationally. This paper models two-tier charging as a Stackelberg game in which the Ministry of Health leads by setting prices and a representative hospital follows by setting quality levels to maximise surplus in response. Whether or not two-tier charging will secure cross-subsidy from superior to basic service users depends on the own and cross-quality effects of the demand functions for the two services. Under a range of assumptions, the policy will evoke cross-subsidy from basic to superior services.

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