LOZACHMEUR Jean Marie

This thesis consists of three essays in public economics. They study public intervention in markets where there are health-harming goods. The first chapter considers a situation where consumers can acquire two types of goods, each harmful to health but differing in their observability by the government (taxable or not). First, considering homogeneous individuals, the optimal taxes for these taxable and non-taxable harmful goods are calculated. Then, when the observability of consumption is limited, it is shown that the second optimal taxation rule depends on the degree of complementarity or substitutability between the two goods, observable and unobservable. Finally, redistributive issues are analyzed by considering on the one hand wealth inequalities and on the other hand differences in the perception of the damage caused by the consumption of harmful goods. Policy recommendations are proposed by considering physical inactivity and illegal drugs as harmful goods that cannot be taxed, and alcohol, tobacco and fatty and sugary products as harmful goods that can be. The second chapter focuses on the optimal policies for legalizing cannabis. Consumers differ in the utility they derive from the use of THC, the psychoactive component of cannabis, and have a misperception of the harm to their health from its use. The problem is analyzed using a vertical differentiation model where two firms, one public and one black market, compete on price and quality (THC content). A paternalistic government would like to correct, on the one hand, the excess of consumption linked to the bad perception of consumers of the damage caused by cannabis and, on the other hand, to reduce the size of the black market. We show that it is the desire to reduce the profits of the black market, rather than the lack of consumer perception, that explains why the optimal first-order consumption is not attainable in a decentralized market. We find two possible equilibria, where the public firm serves only those consumers with the highest or lowest propensity to pay for (cannabis) quality. Allowing the public firm to act first does not provide any benefit to the public firm and therefore does not improve social welfare. The third chapter analyzes how the policy of a neighboring jurisdiction, with the same characteristics as the domestic jurisdiction, affects the optimal domestic drug policy. Competition in the drug market is assumed to be imperfect, a black market is present, and consumers may make cross-border purchases. We consider that a drug policy consists of a choice between legalization and prohibition of drug sales on the one hand, and the intensity of investments to fight illegal production on the other. We assume that both drug use and black market profits have a negative social value. In equilibrium, if concern for drug use is low (high), then both jurisdictions adopt a policy of drug legalization (prohibition). More interestingly, for intermediate levels of the social value of drug use, the equilibria are asymmetric, which could explain, for example, why two symmetric jurisdictions adopt opposite policies in the fight against drugs. Moreover, in some circumstances, governments face a prisoner's dilemma. In the equilibrium, both jurisdictions legalize the sale of harmful drugs even though maintaining two prohibition policies would be socially preferable.

This paper considers an e-commerce market wherein a vertically integrated marketplace competes downstream with a single retailer and upstream with an independent parcel delivery operator. Because of the information collected by the marketplace on customersíhabits and preferences, the integrated parcel delivery operator has lower delivery costs than its competitor. Products are di§erentiated according to the retailer and the parcel operator who delivers them. The representation of product di§erentiation is inspired by the Anderson, De Palma and Thisse (2002) discrete choice model. We study several scenarios each representing a speciÖc policy implemented to regulate the marketplace. The Örst one is a data sharing policy. The integrated marketplace has to share its information with the other delivery operator which in turn will lower this operatorís cost of delivering the marketplaceís product. The second one is vertical separation under which the parcel delivery operator previously owned and managed by the marketplace becomes independent. Finally we consider a full dismantlement scenario under which there is both vertical and horizontal separation. We show that the optimal policy is either complete dismantlement or data sharing. The relative impacts on consumer surplus and total welfare of these two options involve a tradeo§ between the increased competition implied by complete dismantling and the data related delivery cost advantage achieved under data sharing. When this cost advantage is small, completely dismantling dominates, while data sharing is the best policy when the cost advantage is large.

The significant development of e-commerce and Internet marketplaces has provided numerous benefits to both retailers and customers. In addition, it has been a boon for delivery operators, allowing postal services to compensate at least in part revenue losses due to declining mail volumes. However, increasing concentration in e-commerce and the worry that market power may be extended into adjacent markets has turned into a major concern of policy makers and competition authorities. While many argue that traditional regulatory or competition policy may have to be amended within the context of platforms, there are so far few rigorous studies that can provide guidance.

We study optimal commodity taxes under household bargaining. We focus on the taxation of ‘female’ and ‘male’ products. The expressions for the tax rates include Pigouvian and incentive terms. When the female spouse has the lower bargaining weight, the Pigouvian term calls for a subsidization of the ‘female good’, and a taxation of the ‘male good’. The incentive term depends on the distribution of bargaining weights across couples. When the bargaining weight of the female spouse increases with wages, the female good will be consumed in larger proportion by more productive couples. In this case the Pigouvian term is mitigated.

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The French abstract was not provided by the author.

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We determine the optimal health policy mix when the average utility of patients increases with the supply of drugs available in a therapeutic class. Health risk coverage relies on two instruments, copayment and reference pricing, both of which affect the risk associated with health expenses and diversity of treatment. For a fixed supply of drugs, the reference pricing policy aims at minimizing expenses, in which case the equilibrium price of drugs is independent of the copayment rate. However, with an endogenous supply of drugs, diversity of treatment may susbtitute for insurance so that the reference pricing may depart from maximal cost-containment in order to promote entry. We next analyze the determinants of the optimal policy. While an increase in risk aversion, or in the side effect loss, increases diversity and decreases the copayment rate, an increase in entry cost decreases both diversity and the copayment rate.

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This thesis is devoted to the problems of old age dependency which is increasingly becoming a "hot" topic in today's aging societies. The thesis consists of three independent chapters that address different issues related to dependency by highlighting the interaction between three institutions: the family, the state, and the market. Chapter 1 focuses on the interaction between the family and the market by investigating intra-family moral hazard as one potential explanation for the "LTC insurance conundrum," namely the surprisingly low demand for private LTC insurance. The intrafamily moral hazard argument, proposed by Pauly (1990), is based on the idea that insurance induces children to favor formal help for their parents (and thus reduce their informal help) because the cost of formal help is (at least in part) covered by the insurer and thus reduces the parents' future inheritance less than in the case without insurance. Parents who value their children's help may therefore forgo purchasing insurance. The chapter proposes and formally investigates the idea that the magnitude of intra-family moral hazard and, therefore, of not purchasing LTC insurance may be different in the case where insurance benefits are lump sum and in the case where they are proportional to LTC expenses. The results not only formally confirm that lump sum benefits help to limit intra-family moral hazard but also demonstrate that in some cases they eliminate it completely, while the effect of proportional benefits is ambiguous at best. As a result, the chapter shows that a parent is more likely to decide to purchase LTC insurance when the benefits are lump sum than when they are proportional. Based on these results, the chapter also offers some observations about public policy. The role of public intervention is further explored in Chapter 2, which analyzes optimal LTC policy in the context of intra-family moral hazard. In addition to addressing the inefficiencies present in this context, the chapter addresses the redistributional issues associated with wealth heterogeneity. The analysis reveals that intra-family moral hazard is a sufficient justification for insurance-based public intervention: if not necessarily for the introduction of compulsory public insurance, at least for the taxation or subsidization of private insurance premiums. While the first two chapters study the family from the perspective of the parent-child relationship, Chapter 3 invites consideration of another important but so far much less analyzed context, namely the context of older spouses. The chapter proposes a theoretical model of the dependency-related problems faced by an elderly couple and explores the optimal public intervention in this context as well as providing interesting observations about private LTC insurance for both the wife and the man.

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The world spends a significative and steadily increasing share of its resources on health care. Debates about health care financing models and practitioner payment methods are taking place around the world. Nevertheless, there is still no consensus on the ideal choice of financing mechanisms. This thesis aims to contribute to the debates on health care financing and health services policy. Chapter 1 examines the optimal nonlinear practitioner compensation rule, the principle under pay-for-performance, fee-for-service, and capitation in the presence of both adverse selection and moral hazard at the offre level. We found that when moral hazard is the only problem, fee-for-service can only lead to substitution of treatment quantity for practitioner effort, which is inefficient. As a result, fee-for-service payment should not be used in this case. However, when moral hazard combines with the problem of adverse selection, efficacious screening requires continued use of the fee-for-service system for low-productivity practitioners and less use of the pay-for-performance system. The development of payment utilization improves screening. We provide arguments on critical analysis of fee-for-service weaknesses. And, most importantly, we establish the reasons for the continued use of fee-for-service despite the fact that serious problems with the system have been widely recognized. Chapter Two analyzes the problem of the trilateral contract between payer, patient, and practitioner, where the practitioner and patient can agree to exploit mutually beneficial opportunities. Assuming that a secondary transfer between the patient and the practitioner is excluded, we analyze the problem of setting up the mechanism where the practitioner and the patient submit the diagnosis claim to the payer through a declaration game. We also derive the optimal insurance and payment scheme for the patient and practitioner. The optimal scheme of insurance and payment that is collusion-proof (weak) is such that one of the two tells the truth . but the payer's trade-off is different depending on the different ways it chooses to allocate incentives between the patient and the practitioner. Furthermore, we show that if the payer is successful in having both parties present the diagnosis sequentially, the advantage of the second agent's veto power allows the payer to achieve the best outcome. My secondary area of study deals with development economics. The third chapter aims to examine whether migration from villages to cities leads to a crowding out of informal risk-sharing contracts and leads households to less (self-)insurance for consumption in Thai villages. In terms of theoretical motivation, our idea is that migration can be used as an investment contract made in advance between the household and the child. The household invests by paying in advance in exchange for future payments depending on circumstances, which changes the household income process. For estimation, we used the Townsend Thai Annual Surveys (1997-2010) table. The hypothesis of no selection bias is rejected at the village insurance market level, supporting our conjecture that migration changes the risk-sharing status of households within the village. When biases are corrected, our results show that migration leads to crowding out of informal risk sharing in the village and even leads to a decrease in Thai households' consumption (self-)insurance.

We study competition in two-sided markets with a common network externality rather those than with the standard inter-group effects. This type of externality occurs when both groups benefit, possibly with different intensities, from an increase in the size of one group and from a decrease in the size of the other. We explain why common externality is relevant for the health and education sectors. We focus on symmetric equilibrium and show that when the externality itself satisfies a homogeneity condition then platforms’ profits and price structures have some specific properties. Our results reveal how the rents coming from network externalities are shifted by platforms from one side to the other, according to the homogeneity degree. Prices are affected but in such a way that platforms only transfer rents from consumers to providers. In the specific but realistic case where the common network externality is homogeneous of degree zero, platforms’ profits do not depend on the intensity of the (common) network externality. This result differs from those of the two-sided models, which deal with standard positive inter-group network externality.

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