Notebook per
Should Medicine be a Commodity?
David Friedman
Citation (APA): Friedman, D. (2016). Should Medicine be a Commodity? [Kindle Android version]. Retrieved from Amazon.com
Parte introduttiva
Evidenzia (giallo) - Posizione 2
Should Medicine be a Commodity? By David Friedman
Evidenzia (giallo) - Posizione 10
What are the alternatives? The two most important are household production--the way in which children are reared, homes cleaned, clothes washed, and most meals cooked--and political production.
Nota - Posizione 12
ALTERNATIVE AL MERCATO
Evidenzia (giallo) - Posizione 16
The meaning of market provision of medical services is fairly clear, although the form may vary; individual physicians, group practices, private hospitals, payment by individuals or by insurance companies, are all possible market arrangements.
Nota - Posizione 17
MERCATO NELLA SANIYÀ
Evidenzia (giallo) - Posizione 18
I include three different sorts of government intervention under the general category of government provision and allocation--production, payment, and regulation. An obvious example of governmental production of medical services is a state hospital, or, on a larger scale, the British National Health System. Government payment would include systems such as medicare,
Nota - Posizione 21
3 FORME DEL SOCIALISMO
Evidenzia (giallo) - Posizione 21
Regulation includes such widely accepted activities as licensing of physicians and control by the FDA over the introduction of new drugs.
Evidenzia (giallo) - Posizione 25
calling the alternatives "market" and "government" is itself somewhat misleading, since government can be viewed as merely a second and different market, a political market
Nota - Posizione 26
GOVERNO VS PRIVATO
Evidenzia (giallo) - Posizione 37
I. Apologia Pro Via Sua--A Philosophical Introduction
Nota - Posizione 37
T
Evidenzia (giallo) - Posizione 38
This section deals with the relation between the philosophical question of what is desirable and the economic question of what is efficient.
Nota - Posizione 39
EFFICIENZA ED ETICA
Evidenzia (giallo) - Posizione 47
The position in moral philosophy that I find least unsatisfactory is that there exist natural rights, that they can be described in terms of entitlements, and that to be entitled
Nota - Posizione 48
DIRITTI
Evidenzia (giallo) - Posizione 52
The rules of original entitlement and transfer that I find plausible correspond fairly closely to the laws of a pure free market society.
Nota - Posizione 53
MERCATO E DIRITTI
Evidenzia (giallo) - Posizione 57
the "coincidence" reflects some underlying connection between natural rights and utilitarian arguments.
Nota - Posizione 58
DIRITTI E UTILITÀ
Evidenzia (giallo) - Posizione 58
What is Efficiency Anyway?
Nota - Posizione 58
T
Evidenzia (giallo) - Posizione 59
economic efficiency, due to Pareto, is that a Pareto-improvement is a change that benefits someone and injures no one and a situation is efficient if it cannot be Pareto-improved.
Nota - Posizione 60
PARETO
Evidenzia (giallo) - Posizione 61
I therefore prefer to use a slightly different approach, due to Marshall. I define an improvement as a change such that the total benefit to the gainers, measured by the sum of the numbers of dollars each would, if necessary, pay for the benefit, is larger than the total loss to the losers, similarly measured.
Nota - Posizione 63
MARSCHALL
Evidenzia (giallo) - Posizione 81
Suppose there were a situation that was Pareto efficient (could not be Pareto improved) but not Marshall efficient. There would then be a possible Marshall improvement--a change that would benefit the gainers by more, measured in dollars, than it would injure the losers. A bureaucrat god could make that change and simultaneously transfer from gainers to losers a sum larger than the losses and less than the gains, taxing each gainer
Nota - Posizione 84
MARSHALL = PARETO MA PIÙ ONESTO
Evidenzia (giallo) - Posizione 89
is a way of making interpersonal utility comparisons while pretending not to; Marshall's approach makes the same comparisons but is honest
Nota - Posizione 90
ONESTÀ
Evidenzia (giallo) - Posizione 90
What justification can there be for making interpersonal utility comparisons in a way that, by comparing gains and losses as measured in dollars, implicitly assumes that the utility of a dollar is the same to everyone? Marshall's answer was that for most economic questions it does not much matter how you weight utilities. Most issues involve large and diverse groups of gainers and losers;
Nota - Posizione 93
CONFRONTABILITÀ DELLE UTILITÀ
Evidenzia (giallo) - Posizione 95
Utility measured in dollars is observable, since we can observe how much people are willing to pay to achieve their objectives; utility measured in utiles is not.
Nota - Posizione 96
PREF RIVELATE
Evidenzia (giallo) - Posizione 97
"O1 is more efficient that O2" means "going from O2 to O1 is a Marshall improvement" means "utility is (probably) higher in O1 than in O2."
Nota - Posizione 98
APPROSSIMAZIONE
Evidenzia (giallo) - Posizione 99
Why Bother With Efficiency?
Nota - Posizione 99
T
Evidenzia (giallo) - Posizione 101
more is known about economics than about moral philosophy, so we are more likely to reach true conclusions and be able to convince others of them through the former than through the latter.
Nota - Posizione 102
PER MOLTI MORAITÀ=UTILITARISMO=EFFICIENZA ECONOMICA
Evidenzia (giallo) - Posizione 109
If I am right, then political disagreement is fundamentally a disagreement about the economic question
Nota - Posizione 109
ECONOMY RULES
Evidenzia (giallo) - Posizione 121
Part II: Is The Best the Enemy of the Good? Efficiency Proofs
Nota - Posizione 122
T
Evidenzia (giallo) - Posizione 128
I. Perfect Knowledge:
Nota - Posizione 128
ASSUNTI X L EFFICIENZA
Evidenzia (giallo) - Posizione 130
II. Private Property:
Evidenzia (giallo) - Posizione 132
III. No Transaction Costs:
Evidenzia (giallo) - Posizione 134
IV. Perfect Competition:
Nota - Posizione 134
T
Evidenzia (giallo) - Posizione 136
V. Private Goods:
Nota - Posizione 136
T
Evidenzia (giallo) - Posizione 138
Assumption III substitutes for assumptions IV and V because of the Coase Theorem; under conditions of zero transaction costs all of the inefficiencies associated with imperfect competition, externalities, and public goods can be eliminated by appropriate bargains among the affected parties.[
Nota - Posizione 140
COASE ASSORBE
Evidenzia (giallo) - Posizione 143
market failure.
Nota - Posizione 144
FALLIMENTI
Evidenzia (giallo) - Posizione 144
The difficulty with such arguments is that there is no adequate theory of government behavior that implies that government would choose to do the right
Nota - Posizione 145
FALLIMENTI GOV
Evidenzia (giallo) - Posizione 160
although we do not have an economic theory of the political process as well worked out and broadly accepted as the theory of private markets, we do have enough of such a theory to have some idea of where and why the political market is likely to produce less efficient outcomes than the private market.
Nota - Posizione 162
DISTORSIONIBPOLITICHE
Evidenzia (giallo) - Posizione 165
there exists a large and growing body of empirical studies of the effects of government regulation,
Nota - Posizione 166
EMPIRIA
Evidenzia (giallo) - Posizione 167
Public Choice--The Economics of the Political Market
Nota - Posizione 167
T
Nota - Posizione 301
T
Evidenzia (giallo) - Posizione 301
Evidence
Evidenzia (giallo) - Posizione 329
Part III: The Case Against Economics
Nota - Posizione 329
T
Nota - Posizione 342
T
Evidenzia (giallo) - Posizione 342
Rationality
Evidenzia (giallo) - Posizione 342
The central assumption of economics is rationality--that people have objectives and tend to choose the correct way of achieving them.
Nota - Posizione 343
I OBIEZIONE. ASSUNTO CONTESTATO
Evidenzia (giallo) - Posizione 348
To take a trivial example, most of our objectives require that we eat occasionally, so as not to die of hunger (exception--if my objective is to be fertilizer). Whether or not people have deduced this fact by logical analysis, those who do not choose to eat are not around to have their behavior analyzed by economists. More generally, evolution may produce people (and other animals) who act rationally
Nota - Posizione 351
LA RAZIONALITÀ NN È NECESSARIAMENTE DEDUTTIVA
Evidenzia (giallo) - Posizione 351
The same result may be produced by a process of trial and error. If you walk to work every day you may by experiment find the shortest route, even if you do not know enough geometry to calculate it.
Nota - Posizione 352
RAZIONALITÀ TRIAL AND ERROR
Evidenzia (giallo) - Posizione 360
the idea that economists assume that "all anyone is interested in is money." Put in that way the assertion is wrong; economists usually assume that people desire money only as a means to other objectives. What is true is that although economics can, in principle, take account of the full richness of human objectives, it is necessary for many practical purposes to assume away all save the most obvious--the consumption of goods, leisure, security, and the like.
Nota - Posizione 363
EGOISMO SPIEGATO
Evidenzia (giallo) - Posizione 366
Suppose we know someone's objective, and also know that half the time he correctly figures out how to achieve it and half the time he acts at random. Since there is usually only one right way of doing things (or perhaps a few) but very many wrong ways, the rational behavior can be predicted but the irrational behavior cannot. If we predict his behavior on the assumption that he is always rational we will be right half the time; if we assume he is irrational we will almost never be right,
Nota - Posizione 369
UTILITÀ DELL ASSUNZIONE
Evidenzia (giallo) - Posizione 369
We are better off assuming he is rational
Evidenzia (giallo) - Posizione 374
it takes a theory to beat a theory; until some better alternative is found, rationality is the best we have.
Nota - Posizione 374
TEORIA BATT TEORIA
Evidenzia (giallo) - Posizione 377
when it comes to analyzing a market--a complicated interacting system--" common sense" turns out in practice to mean a poorly thought out, inconsistent, and untested theory.
Nota - Posizione 378
COMMON SENSE
Evidenzia (giallo) - Posizione 380
Economics and the Poor
Nota - Posizione 380
T
Evidenzia (giallo) - Posizione 380
A second set of objections to the market and the economic approach is based on the claim that neither gives proper consideration to the implications of income inequality.
Nota - Posizione 381
OBIEZIONE: IL VALORE DEL DENARO VARIA
Evidenzia (giallo) - Posizione 382
the market--and the criterion of efficiency according to which its outcome is often judged--measures individual values in dollars, not in intensity of feeling;
Nota - Posizione 383
PRIMO ARG CONDIVISIBILE
Evidenzia (giallo) - Posizione 389
This is equivalent to doing an interpersonal utility comparison on the assumption that the marginal utility of a dollar is the same for everyone.
Nota - Posizione 390
CONCESSIONE
Evidenzia (giallo) - Posizione 393
Most of the decisions an economist is interested in affect large and heterogeneous groups of people.
Nota - Posizione 393
GRUPPI AMPI
Evidenzia (giallo) - Posizione 394
differences among individuals can be expected to average out when we consider the effect on the whole group.
Nota - Posizione 395
AVAREGE OUT
Evidenzia (giallo) - Posizione 398
obvious case is the decision of whether or not to provide free medical care (or housing, or food, or money) to the poor at the expense of the rest of us.
Nota - Posizione 399
CASI IN CUI PESA IL DIFETTO
Evidenzia (giallo) - Posizione 404
This is the traditional utilitarian argument for redistribution.
Nota - Posizione 404
REDISTRIBUZIONE UTILITARISTA
Evidenzia (giallo) - Posizione 412
The standard argument for redistribution begins with the claim that, for a given individual, the marginal utility of income declines as income increases. This seems plausible in terms of introspection,
Evidenzia (giallo) - Posizione 414
The next step is to claim that, absent information about differences in individual utility functions, we must treat each individual utility function as a random draw from the same population, so declining marginal utility of income applies not only to the same individual with different incomes but (on average) to different individuals
Nota - Posizione 416
DECLINING: VERO X IL SINGOLO MA X IL GRUPPO? I SOLDI NN PORTANO FELICITÀ
Evidenzia (giallo) - Posizione 419
It is quite implausible if differing income is the result of differing effort. An individual who greatly values the things that money buys will be more willing than others to give up other goods, such as leisure, in order to get income, so he will, on average, end up with a higher income.
Nota - Posizione 421
EFFORT
Evidenzia (giallo) - Posizione 467
the claim that poor people cannot really be said to choose poor medical care, or poor nutrition, or whatever, since they cannot afford anything else.
Nota - Posizione 468
POTERSELO PERMETTERE
Evidenzia (giallo) - Posizione 470
used to justify programs to provide "necessities" to the poor, whether or not such programs are actually redistributive--and often enough they are not.[
Nota - Posizione 471
BENI NECESSARI
Evidenzia (giallo) - Posizione 476
Why not give money, and let the poor family decide for itself what it is most important to spend it on?
Nota - Posizione 477
VOUCHER O CASH?
Evidenzia (giallo) - Posizione 479
The Value of Life
Nota - Posizione 479
T
Evidenzia (giallo) - Posizione 480
error--the failure to realize that life is infinitely more valuable than money.
Nota - Posizione 481
UN ERRORE DEL MERCATO
Evidenzia (giallo) - Posizione 485
The real comparison is not between life and money but between life and other things people value--leisure, consumption goods, education for their children, housing, et multa caetera.
Nota - Posizione 486
IL VERO CFR
Evidenzia (giallo) - Posizione 489
Anyone who both smokes and believes the conclusions of the surgeon general's report is deliberately trading life--an increased probability of dying of heart disease or lung cancer--for the pleasure of smoking.
Nota - Posizione 490
PREF RILEVAT
Evidenzia (giallo) - Posizione 494
the assumption that life is infinitely valuable imply that we should take no avoidable risks--no sky diving, no skiing, no skin diving--it also implies a society wholly devoted to achieving a single goal.
Nota - Posizione 496
ZERO RISK
Evidenzia (giallo) - Posizione 500
Few of us would agree to be hung tomorrow in exchange for a payment of a million dollars, or even ten billion. Does not that imply that our value for life is very high and perhaps infinite? No. It proves that money is of no use to a corpse.
Nota - Posizione 502
SOLDI AL MORTO
Evidenzia (giallo) - Posizione 506
studies of wage differentials in hazardous professions generate value of life estimates well below a million dollars.
Nota - Posizione 507
1MILIONE
Evidenzia (giallo) - Posizione 510
intellectual sympathy
Evidenzia (giallo) - Posizione 511
emotional sympathy
Evidenzia (giallo) - Posizione 513
Suppose there is some individual who requires--and does not get--a ten million dollar operation to save his life. Further suppose that ten million dollars is precisely the sum spent, during a year, by all the people in the U.S. in order to have mint flavor in their toothpaste.
Nota - Posizione 515
VITA E DENTIFRICIO
Evidenzia (giallo) - Posizione 518
meaning--we have no intuition for how much the importance of a trivial pleasure is increased when it is multiplied by two hundred million.
Nota - Posizione 519
SOMMA UTILITÀ
Evidenzia (giallo) - Posizione 519
we end up comparing the value of one life to the value of a trivial pleasure to one person, or perhaps a few.
Nota - Posizione 520
ERRORE
Evidenzia (giallo) - Posizione 522
Suppose I know that by eliminating mint flavor from my toothpaste I can avoid a one in 200 million chance of my own death. That is, in some sense, an equivalent problem--at
Nota - Posizione 523
SAME PROBLEM
Evidenzia (giallo) - Posizione 524
Put this way, the answer is far from obvious;
Evidenzia (giallo) - Posizione 532
Rights to Life and Similar Claims
Nota - Posizione 532
T
Evidenzia (giallo) - Posizione 537
It is sometimes claimed that individuals have a self-evident right to life, hence to that necessary to life, hence to medical care.
Nota - Posizione 538
DIRITTO ALLA VITA
Evidenzia (giallo) - Posizione 538
One difficulty with this argument is that it proves too much. Medical care is not the only thing whose consumption affects life expectancy.
Nota - Posizione 539
COSA ALLUNGA LA VITA?
Evidenzia (giallo) - Posizione 539
Nutrition, clothing, housing, education--a
Evidenzia (giallo) - Posizione 548
The concept of a right to life makes sense as my right to have other people not kill me. It does not make sense as a blank check against the rest of the human race for anything that extends my life.
Nota - Posizione 549
FARE OD OMETTERE
Evidenzia (giallo) - Posizione 549
A second argument for the special status of medical care holds that economic considerations are appropriate for choices that involve differing tastes, but inappropriate for choices where the right answer is a matter of objective fact.
Nota - Posizione 550
GUSTO
Evidenzia (giallo) - Posizione 553
The problem with this argument is that decisions about medical care, like most decisions human beings make, involve issues of both fact and value.
Nota - Posizione 554
REPLICA: TUTTO È MISCHIATO
Evidenzia (giallo) - Posizione 560
One consequence of lack of medical care may be a drastic reduction in the number of available alternatives--a cripple cannot become an athlete, to take a particularly sharp example. Hence, it is said, while poor people may not have any general right to be given money, they do have a right to be provided with medical care. It is claimed that this argument justifies medical vouchers--payments
Nota - Posizione 562
ALTRO ARGOMENTO: LA SALUTE APRE AD ALTRE SCELTE
Evidenzia (giallo) - Posizione 563
argument proves too much--many inputs other than medical care affect our future choices.
Nota - Posizione 564
PROVA TROPPO
Evidenzia (giallo) - Posizione 564
argument for vouchers appears to contain a simple error of logic--the proposal to increase choice in fact reduces it.
Nota - Posizione 565
I VOUCHER DIMINUISCONO LE SCELTE NN LE AUMENTANO
Evidenzia (giallo) - Posizione 570
removing the requirement that the money be spent on medical care obviously increases choice.
Evidenzia (giallo) - Posizione 577
IV. TECHNICAL ARGUMENTS
Nota - Posizione 578
T
Evidenzia (giallo) - Posizione 593
Imperfect Information
Nota - Posizione 593
T
Evidenzia (giallo) - Posizione 593
The assumption of perfect information seems most appropriate for goods that are purchased repeatedly
Nota - Posizione 594
ITERATIVOTÀ
Evidenzia (giallo) - Posizione 598
Some medical purchases seem to fit this pattern--cold medicines, for example, are used repeatedly, providing the customer an opportunity to determine which ones do noticeably better than others at relieving his symptoms.
Nota - Posizione 600
ANCHE SERVIZI MEDICI
Evidenzia (giallo) - Posizione 604
For many medical services the situation is far worse. Few of us break our bones often enough to form a competent opinion of the skills of those who set them;
Nota - Posizione 605
FRATURE
Evidenzia (giallo) - Posizione 607
our willingness to pay for drugs or services reflects only very approximately their real value to us,
Nota - Posizione 608
PREZZO
Evidenzia (giallo) - Posizione 610
market solutions
Evidenzia (giallo) - Posizione 610
One is to voluntarily shift the decision, and the associated costs and benefits, to some organization better informed than the individual consumer.
Nota - Posizione 611
ASSOCIAZIONE
Evidenzia (giallo) - Posizione 611
health insurance, for example,
Evidenzia (giallo) - Posizione 614
It also raises the problem of how to decide which insurance company to trust. One solution is to purchase life and health insurance in the same package--since
Nota - Posizione 615
A CHI ASSOCIARSI?
Evidenzia (giallo) - Posizione 615
Another is to rely on published reports of the performance of insurance companies.
Nota - Posizione 616
REPORTS
Evidenzia (giallo) - Posizione 618
Another solution is for some expert body to certify the quality of drugs or physicians; a familiar example in another field is the Underwriter's Laboratory.
Nota - Posizione 619
CERTIFICATORI
Evidenzia (giallo) - Posizione 623
Another solution is a guarantee. If customers believe that they are ignorant about the effects of drugs and that the drug companies are not, they should strongly prefer drugs produced by companies that assume liability for unexpected side effects--and be willing to pay more for the drugs sold by such companies.
Nota - Posizione 625
GARANZIE
Evidenzia (giallo) - Posizione 636
Under our present system liability rules are determined by the courts and waivers are unenforceable. The customer ends up paying for the malpractice insurance whether or not he thinks it is worth the price.
Nota - Posizione 636
INEFFICIENZA
Evidenzia (giallo) - Posizione 638
What about governmental solutions? The obvious one is for the government to generate information, leaving the customer free to decide for himself how to make use of it. A familiar example is the labeling of cigarettes;
Nota - Posizione 639
SOLUZIONI GOVERNATIVE. LABELLING
Evidenzia (giallo) - Posizione 642
Although the government may have superior information about the side effects of a drug or the consequences of smoking, the consumer has superior information about his own values--how
Nota - Posizione 644
MEGLIO INFORMARE LASVIANDO LIBRRI
Evidenzia (giallo) - Posizione 645
In the case of physicians, this is an argument for certification and against licensing.
Nota - Posizione 645
CERTIFICAZIONE VS LICENZA
Evidenzia (giallo) - Posizione 651
Physicians are licensed, and unlicensed physicians are forbidden to practice. Similarly, although there is some control over the labelling of drugs,
Nota - Posizione 651
SOLUZIONE EFFETTIVA
Evidenzia (giallo) - Posizione 652
keep drugs off the market until the FDA has approved them.
Evidenzia (giallo) - Posizione 653
present policies assume customers who are not only poorly informed but irrational
Nota - Posizione 654
ASSUNTP IRRAZIONALIYÀ
Evidenzia (giallo) - Posizione 654
An alternative explanation is that the chief objective of at least some regulation is the welfare not of the patient but of the doctor.
Nota - Posizione 655
ALTERNATIVA: LE REGOLE SONO X I DOTTORI
Evidenzia (giallo) - Posizione 660
This raises a general issue frequently ignored by those who wish to substitute governmental for private decisions. Even if the government is better informed than the individual, the individual has one great advantage in making decisions about his own welfare--he can be trusted to have his welfare as one of his principal objectives.
Nota - Posizione 662
ARGOMENTO GENERALE X IL MERCATO. USO DELL ONFO
Evidenzia (giallo) - Posizione 669
If the FDA licenses a drug that turns out to have disastrous side effects, the result is a front page story and the end of the career of whoever made the decision. If it refuses to license a useful drug, the result is to keep a cure rate from rising--say from 92% to 93%. The total cost may be very large, but it is not very visible,
Nota - Posizione 671
BIAS DEL CONTROLLORE
Evidenzia (giallo) - Posizione 679
So far as I know nobody has yet done a comparable study attempting to estimate the net effect, in either dollars or lives, of FDA regulations restricting the introduction of potentially dangerous drugs.
Nota - Posizione 680
COSTI FDA
Evidenzia (giallo) - Posizione 682
Asymmetric Information
Nota - Posizione 682
T
Evidenzia (giallo) - Posizione 683
It involves situations in which one party to a transaction has information that the other lacks, and there is no (convincing) way to share the information with the other party.
Nota - Posizione 684
IL CASO
Evidenzia (giallo) - Posizione 684
used car market.[
Evidenzia (giallo) - Posizione 689
The problem is that a car may fail to be sold even though it is worth more to a potential buyer than it is to its present owner.
Nota - Posizione 690
AFFARI NN CONCLUSI X LA PAURA
Evidenzia (giallo) - Posizione 700
In the context of health insurance, the same problem is called adverse selection. Individuals know more about their own health, past and future, than insurance companies can learn.
Nota - Posizione 700
ADVERSE
Evidenzia (giallo) - Posizione 705
This makes insurance more attractive for the customer who knows he is a bad risk--more
Evidenzia (giallo) - Posizione 709
One market solution is a group policy. If an insurance company insures all the employees of a firm together, the sample of insured individuals is only slightly biased towards bad risks, since the existence of the insurance is only a minor factor in determining who chooses to work for that company.
Nota - Posizione 711
SOLUZIONE GROUP POLICY
Evidenzia (giallo) - Posizione 714
The obvious governmental solution is a group policy for the entire population--national health insurance.
Nota - Posizione 714
ASS OBBLIGATORIA
Evidenzia (giallo) - Posizione 715
If provided by a bureaucrat god perfectly informed about the appropriate level of coverage and all the associated administrative details, and suitably tailored to the requirements of different customers, it would be more efficient than the private alternative.
Nota - Posizione 717
BUROCRATE ONNISCIEMTE
Evidenzia (giallo) - Posizione 723
The problem is called moral hazard.
Nota - Posizione 723
ALTRO PROBLEMA
Evidenzia (giallo) - Posizione 724
Consider an individual deciding whether to stay an extra day in the hospital. The cost of doing so is $ 200. The value to him, in terms of a slight reduction in the chance of a relapse, is $ 50. If he is paying his own bills, he goes home. If the insurance company is paying more than 3/ 4 of the cost, he stays.
Nota - Posizione 726
ES
Evidenzia (giallo) - Posizione 731
There are several ways in which the costs of moral hazard can be reduced. One is coinsurance--if the insured is responsible for part of the bill, he has at least some incentive to keep it down.
Nota - Posizione 732
FRANCHIGIA VOASS
Evidenzia (giallo) - Posizione 734
Moral hazard applies to government health insurance just as it does to private health insurance--indeed,
Nota - Posizione 734
MORAL GOV
Evidenzia (giallo) - Posizione 735
The advantage of the private system is that insurance will occur only if the gain due to risk sharing (or other advantages) at least balances the cost imposed by moral hazard--otherwise
Nota - Posizione 736
VANTAGGIO DEL PRIVATO
Evidenzia (giallo) - Posizione 739
Imperfect Competition
Nota - Posizione 739
T
Evidenzia (giallo) - Posizione 750
The main hindrances to competition on that part of the market are the result of government interference--the prohibition on advertising the price of medical services and the restriction on entry to the profession, both enforced by state regulation of who can practice medicine. The same applies to the retailing of medicine; advertising of the prices of prescription drugs has frequently been illegal.
Nota - Posizione 752
OSTACOLI ALLA COMPETIZIONE
Evidenzia (giallo) - Posizione 759
What about imperfect competition resulting from economies of scale in the medical industry? Examples are drug research, hospitals, and physicians in sparsely populated areas.
Nota - Posizione 760
MONOPOLI
Evidenzia (giallo) - Posizione 768
My own conclusion, considering both the theoretical arguments and historical experience, is that regulation of monopolies may never be desirable, and certainly is not in cases that fall substantially short of complete and very long-lived monopoly.
Nota - Posizione 770
PROBLEMI ANTI TRUST
Evidenzia (giallo) - Posizione 771
Externalities/ Public Goods
Nota - Posizione 771
T
Evidenzia (giallo) - Posizione 782
One solution to this problem is to have the good produced by government. This solution, as I pointed out in Part II, raises a second public good problem. Production of good law--or bad law for that matter--is a public good from the standpoint of the group benefitted by the law, so getting the government to do things requires that someone solve a public good problem.
Nota - Posizione 785
L INCASTRO DEL DOPPIO BENE PUBBLICO
Evidenzia (giallo) - Posizione 785
There are also a number of private solutions to the public good problem. One is charity.
Nota - Posizione 786
CARITÀ
Evidenzia (giallo) - Posizione 786
Another is for the producer to organize a contract among those who will benefit from the public good by which each agrees to contribute only if the others do.
Nota - Posizione 787
CONTRATTI BENE PUBBL
Evidenzia (giallo) - Posizione 798
An externality is a cost (or benefit) that one individual's actions impose on another. A public good can be described as a positive externality,
Nota - Posizione 799
ESTERNALITÀ
Evidenzia (giallo) - Posizione 814
If I get inoculated against a contagious disease, that reduces the chance that I will infect you--a positive externality. If my drug company discovers a new family of drugs, that provides information useful to other companies. If I spend money on keeping myself healthy, that benefits all those who care for me and would be made unhappy by my illness;
Nota - Posizione 815
CONTAGIO
Evidenzia (giallo) - Posizione 818
Economic theory suggests that the market will underproduce inoculations, drug research, and health because in each case the individual paying the cost receives only part of the benefit.
Evidenzia (giallo) - Posizione 819
Similarly, if the use of some antibiotics imposes external costs by encouraging the development of resistant strains of bacteria, such antibiotics will be overused,
Nota - Posizione 820
AMTOBIOTOCI
Evidenzia (giallo) - Posizione 821
All of these, however, are what I earlier described as mostly private (or at least, largely private) goods. In each case a large part of the benefit goes to the person who pays for it--I stay healthy because of my inoculation, the drug company makes money off its new drugs, and my own health probably gives more pleasure to me than to even the most altruistic of my friends.
Nota - Posizione 824
BENI PRIVATI AMVHE SE VON ESTERNALITÀ
Evidenzia (giallo) - Posizione 828
My conclusion was that the substitution of the political for the private market was justified, if at all, only in cases of extreme market failure on the private market.
Nota - Posizione 829
CONCLUSIONE
Evidenzia (giallo) - Posizione 831
In most cases the failure implies that a sufficiently wise, powerful, and benevolent authority could improve--in terms of economic efficiency--the outcome of the market. In no case is there any clear reason to believe that assigning additional power to government--as government actually exists--would improve the situation; in many there is reason to believe that doing so would make it worse. In several cases existing problems are the direct result of government interference with the market.
Nota - Posizione 835
CONCLUSIONE
