Competition and Coordination in Two‐tier Public Service Systems Under Government Fiscal Policy

As a result of government budgetary limits and rapid market growth, many public service systems—such as healthcare—are characterized by extensive customer wait times that have become a serious problem. This problem might be solved by allowing private firms to enter these markets, which would provide customers with a choice between a free (governmental) public service provider and a fee-charging (or “toll”) private service provider. In such a two-tier service system, the two service providers are differentiated by service quality and cost efficiency. This paper focuses on the competition and coordination issues for two-tier service systems with customers who are sensitive to both service quality and delay. The free system attempts to maximize its expected total customer utility with limited capacity, whereas the toll system attempts to maximize its profit. Neither goal is aligned with the social welfare goal of the public service. To achieve the social welfare goal, the government plays a crucial role in coordinating the two-tier service system via the budget, the tradeoff of social members’ goals, and tax-subsidy policies. Using a mixed duopoly game, we establish Nash equilibrium strategies and identify the conditions for the existence of the two-tier service system. We employ several interesting and counter-intuitive managerial insights generated by the model to show that the public service can be delivered more efficiently via customer choice and service provider competition. In addition, we show that a relatively low tax-subsidy rate can almost perfectly coordinate the two service providers to achieve most of the maximum possible benefit of the two-tier service system.

[1]  Israel Luski,et al.  Duopoly pricing and waiting lines , 1978 .

[2]  James F. Burgess,et al.  Quality competition, welfare, and regulation , 1993 .

[3]  M. Keen,et al.  Fiscal competition and the pattern of public spending , 1997 .

[4]  Phillip J. Lederer,et al.  Pricing, Production, Scheduling, and Delivery-Time Competition , 1997, Oper. Res..

[5]  C. Bode,et al.  Long term outcome after out-of-hospital cardiac arrest with physician staffed emergency medical services: the Utstein style applied to a midsized urban/suburban area , 1999, Heart.

[6]  Kut C. So,et al.  Price and Time Competition for Service Delivery , 2000, Manuf. Serv. Oper. Manag..

[7]  O. Hart Incomplete Contracts and Public Ownership: Remarks, and an Application to Public-Private Partnerships , 2002 .

[8]  Patrick T. Harker,et al.  Competition and Outsourcing with Scale Economies , 2002, Manag. Sci..

[9]  Moshe Haviv,et al.  Price and delay competition between two service providers , 2003, Eur. J. Oper. Res..

[10]  Edieal J. Pinker,et al.  Gatekeepers and Referrals in Services , 2003, Manag. Sci..

[11]  Arantza Beitia,et al.  Hospital quality choice and market structure in a regulated duopoly. , 2003, Journal of health economics.

[12]  Yat-wah Wan,et al.  Price Competition of Make-to-Order Firms , 2003 .

[13]  M. Stabile,et al.  How Does Private Finance Affect Public Health Care Systems? Marshaling the Evidence from OECD Nations , 2004, Journal of health politics, policy and law.

[14]  Gérard P. Cachon,et al.  Supply Chain Coordination with Revenue-Sharing Contracts: Strengths and Limitations , 2005, Manag. Sci..

[15]  Fernando Bernstein,et al.  Decentralized Supply Chains with Competing Retailers Under Demand Uncertainty , 2005, Manag. Sci..

[16]  Edieal J. Pinker,et al.  Staffing and routing in a two-tier call centre , 2005 .

[17]  Hai Yang,et al.  Equilibrium properties of the morning peak-period commuting in a many-to-one mass transit system , 2007 .

[18]  Awi Federgruen,et al.  Service Competition with General Queueing Facilities , 2006, Oper. Res..

[19]  Francis de Véricourt,et al.  Resource and Revenue Management in Nonprofit Operations , 2009, Oper. Res..

[20]  Yuri Levin,et al.  Dynamic Pricing in the Presence of Strategic Consumers and Oligopolistic Competition , 2009, Manag. Sci..

[21]  A. Nichols,et al.  Hospital ownership and medical services: market mix, spillover effects, and nonprofit objectives. , 2009, Journal of health economics.

[22]  Gérard P. Cachon,et al.  Competing Manufacturers in a Retail Supply Chain: On Contractual Form and Coordination , 2010, Manag. Sci..

[23]  Proper Welfare Weights for Social Optimization Problems , 2010 .

[24]  Annika Herr,et al.  Quality and Welfare in a Mixed Duopoly with Regulated Prices: The Case of a Public and a Private Hospital , 2011 .

[25]  Haim Mendelson,et al.  Service Provider Competition: Delay Cost Structure, Segmentation, and Cost Advantage , 2010, Manuf. Serv. Oper. Manag..

[26]  R. Feachem,et al.  Public-private integrated partnerships demonstrate the potential to improve health care access, quality, and efficiency. , 2011, Health affairs.

[27]  H. Campbell,et al.  Public investment, taxation, and long-run output in economies with multi-level governments , 2012 .

[28]  Zhe George Zhang,et al.  On the Downs-Thomson Paradox in a Self-Financing Two-Tier Queuing System , 2014, Manuf. Serv. Oper. Manag..

[29]  Anming Zhang,et al.  Would Allowing Privately Funded Health Care Reduce Public Waiting Time? Theory and Empirical Evidence from Canadian Joint Replacement Surgery Data , 2015 .