Lecture Notes: May 5
Econ. 103,
Spring 2003, Prof. Nancy Folbre
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Final exam for this course is scheduled
for 4PM on Saturday, May 17 at Totman Gym.
The make-up exam is scheduled for 1PM on Friday May 23 (don't know room yet). This make-up exam will also provide accommodation for LDSS students. YOU MUST EMAIL ME BEFORE THE REGULAR EXAM REQUESTING PERMISSION TO TAKE THE MAKE-UP EXAM. IF YOUR NAME IS NOT ON THE PERMISSION LIST YOU WILL NOT BE ALLOWED TO TAKE IT. Competition should eliminate discrimination because
In "winner-take-all" markets,
Chief executive officers are paid on average about 1000 times what ordinary workers are paid because
Chapter 14 provides an overview of the following public policy issues:
What unifies the answers to all these questions? An emphasis on incentives. How do we provide incentives to people to behave in ways that are efficient, and honest, and likely to lead to good social outcomes? I am going to focus on health and pollution, which I think are particularly important from a policy perspective.
Should health care be a commodity? Or should everyone have access to it? Think back to the first weeks of the course, when your homework assignment asked you to consider such questions? Virtually all advanced industrial countries have given mixed answers--the U.S. is the only major country that does not have a unified national system. I say "unified" because we do have a system--but it is an incredible patchwork. We have Medicaid for very poor individuals. We have Medicare for individuals over age 65 who have paid into Social Security, and we have emergency room treatments for those in between. Almost everyone agrees it's a mess; but they can't reach agreement on how to fix it. In principle, some kind of cost/benefit analysis is a good idea, given scarce resources.. The "third-party payment" system creates significant distortions. People will always tend to "over-consume" a free good. A partial solution--high deductibles. But important also to give health care providers an incentive to reduce costs. This is why HMOs or Health Maintenance Organizations came into prominence. Problem: HMOs go to the OPPOSITE extreme, giving physicians an incentive to deny care--and to speed up provision of services. Their contracts often offer bonuses for helping keep costs down and they are paid "per person" so the more patients they see, the more money they make. On the other hand, both professional standards and norms (and the threat of malpractice suits) keeps them from going too far (in most instances). But health care costs keep going up--putting pressure on employers to cut back on provision of benefits, and also making it difficult for individuals to pay. Medicaid and Medicare costs in particular, are rising very quickly, but states don't have the money to pay (especially given the current fiscal crisis). So they keep trying to cut reimbursements rates for hospitals and doctors, which in turn have to rise prices for other customers in order to make up the difference. Problems of "adverse selection" have intensified. PLUS, there has been a great deal of consolidation and "monopolization" in the health care sector, and huge bureaucratic firms that are more oriented toward making profits than providinq quality care. TENET corporation is a good example--one of the largest health care providers in the country--it's stock price has recently toppled with the revelation that they have been bilking the Medicare system, manipulating prices to overcharge the government. The corporation has a history of serious malfeasance--defrauding private insurance companies and it was forced to pay a huge settlement in the early 1990s when it admitted keeping mental patients incarcerated and under medication in order to prevent their release. The textbook lays out a system for simplification, centralization and government reimbursement for health insurance costs, sometimes called a "single-payer" system. Canada has a version of this. Many of the details need more elaboration, but it's a very promising idea. Environmental Regulation Let's take it as a given that we need stronger environmental regulation to protect our climate, our air and water quality, our wilderness areas, etc. because these are "common property resources" that offer enormous "externalities" or benefits to us all. What's the best way to do this? Sometimes we need to set standards, e.g. "just say no" to things like lead in gasoline, or asbestos in building materials. Also, we need to pay attention to the political process by which standards are set, which often seems politically corrupt, to say the least. E.g. SUVs were exempted from mandatory standards of fuel economy--the resulting additional consumption of gas about equivalent to supplies in Arctic wilderness preserves, But let's also think about prices and efficient incentives. The price of gas is TOO low. It doesn't reflect the negative externalities that use of automobiles create. It creates incentives for over-utilization of cars. By some estimates, it would be more appropriate to put the price of gas at about $5.00 a gallon. Or, in general, to impose a "carbon tax" on consumption of all forms of polluting greenhouse gases, including the coal and oil and natural gas used to generate electricity and warm houses. Ohmigod, you might say. That would be so expensive. But the money raised could be used to reduce other taxes, leaving overall after-tax income unchanged. So why is there so much resistance to this idea? Auto and oil companies hate it. But also consumers hate big changes--they have already invested in a capital stock of existing cars and houses that is "oil-intensive"--older consumers in particular. A related idea--trading pollution "permits." Idea here is similar--instead of a "one size fits all" rule, such as "everyone needs to cut their emissions by 50%" the government could auction off pollution permits at a price designed to achieve the same result: See example 14.7, on p. 14.7 Cost of Reducing Pollution for Two Firms with Five Technologies
Which technology would each firm use in the absence of regulation? What would resulting level of pollution be?
What would be the effect of a regulation requiring each company to reduce by one-half?
Now, what would the effect be if the government auctioned the price of a pollution permit for one ton at $101?
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