An alternative way of understanding exit,voice and loyalty: the case of informal payments for health care in Israel |
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Authors: | Nissim Cohen Dani Filc |
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Affiliation: | Department of Public Administration and Policy, School of Political Sciences, The University of Haifa, Haifa, IsraelBoth authors contributed equally to this article. |
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Abstract: | This study examines Hirschman's model of exit, voice and loyalty with regard to informal payments in the Israeli healthcare system. Based on a national survey, we investigate the extent of “black” payments, its characteristics and its correlated factors. We find that informal payments do exist in Israel—although it seems that there has been a decline in the phenomenon. Contrary to the literature, we find no relationship between the option of voice or dissatisfaction with healthcare services and informal payments. However, we do find a negative correlation between trust and the use of such payments. This finding is consistent with Hirschman's insight that a lack of loyalty may lead people to strategies of exit. We suggest that given the fact that health care in Israel is a public service, the exit option may actually be a quasi‐exit behavior. Copyright © 2015 John Wiley & Sons, Ltd. |
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Keywords: | informal payments black market medicine exit voice loyalty |
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