Women represent a growing proportion of the physician workforce, worldwide. Therefore, for the purposes of workforce planning, it is increasingly important to understand differences in how male and female physicians work and might respond to financial incentives. A recent survey allowed us to determine whether sex-based differences in either physician income or responses to a hypothetical increase in reimbursement exist among French General Practitioners (GPs). Our analysis of 828 male and 244 female GPs' responses showed that females earned 35% less per year from medical practice than their male counterparts. After adjusting for the fact that female GPs had practiced medicine fewer years, worked 11% fewer hours per year, and spent more time with each consultation, female GPs earned 11,194euro, or 20.6%, less per year (95% CI: 7085euro-15,302euro less per year). Male GPs were more likely than female GPs to indicate that they would work fewer hours if consultation fees were to be increased. Our findings suggest that, as the feminization of medicine increases, the need to address gender-based income disparities increases and the tools that French policymakers use to regulate the physician supply might need to change.

Despite the remarkable progress in expanding the coverage of social protection mechanisms in health, the Tunisian healthcare system is still largely funded through direct out-of-pocket payments. This paper seeks to assess financial protection in health in the particular policy and epidemiological transition of Tunisia using nationally representative survey data on healthcare expenditure, utilization and morbidity. The extent to which the healthcare system protects people against the financial repercussions of ill-health is assessed using the catastrophic and impoverishing payment approaches. The characteristics associated with the likelihood of vulnerability to catastrophic health expenditure (CHE) are examined using multivariate logistic regression technique. Results revealed that non-negligible proportions of the Tunisian population (ranging from 4.5 % at the conservative 40 % threshold of discretionary nonfood expenditure to 12 % at the 10 % threshold of total expenditure) incurred CHE. In terms of impoverishment, results showed that health expenditure can be held responsible for about 18 % of the rise in the poverty gap. These results appeared to be relatively higher when compared with those obtained for other countries with similar level of development. Nonetheless, although households belonging to richer quintiles reported more illness episodes and received more treatment than the poor households, the latter households were more likely to incur CHE at any threshold. Amongst the correlates of CHE, health insurance coverage was significantly related to CHE regardless of the threshold used. Some implications and policy recommendations, which might also be useful for other similar countries, are advanced to enhance the financial protection capacity of the Tunisian healthcare system.

This paper examines the possible reform of the system of aid to dependent individuals (apa), a reform aimed at recovering the subsidies awarded from the individual?s bequest. We develop a theoretical model with a dependent parent and an offspring that can potentially act as informal carer. The parent decides how much formal aid to buy, while the offspring decides how much informal care to provide to her parent. The model is solved for three cases: no altruism, altruism from bequests (towards a surviving spouse or offspring), and altruism towards the parent. We show that recovering the subsidy from the bequest increases the amount of informal aid supplied by a non-altruist offspring, while the versions with altruism yield ambiguous results. Classification JEL : D11, D3

This article investigates whether a cancer diagnosis can cause a permanent loss in employability. In this regard, we evaluate the impact of cancer on labor market conditions by constructing transition matrices to compare the transitions between occupational states. We obtain a set of statistics based on our estimations by using continuous-time Markov transition processes to study and compare the labor market dynamics in two populations: 1) individuals diagnosed with cancer and 2) individuals free of cancer in the general population. The consequences of cancer diagnosis were measured by the significant deviation in the transition matrix for cancer survivors in comparison to the prior matrix standardized according to the general population. We accounted for the probability that some individuals in the control group (i.e., the general population) could be diagnosed with cancer which is a key-issue in case-control studies. The absence of detailed information about the health statuses of the individuals in the control group required the implementation of the EM algorithm for maximizing the adapted likelihood function. We jointly estimated the probability of being diagnosed with cancer in the control group and the parameters of our model. Given that individuals are exposed differently to cancer depending on their activities, we stratified the dataset by socioeconomic status (SES) for two reasons: 1) to clearly distinguish between the cancer-specific effects and 2) to account for the other stigmatizing factors in the labor market that are inherent to the examined subpopulations (i.e., low- and high-SES groups). We also considered the systematic differences in the subjects' socioeconomic statuses and their abilities to return to work. We determined whether these differences are related to illness (e.g., cancer sites or prognosis) or occupation (e.g., physical demands).