ISSN:1074-3529    

DOI:10.1111/j.1465-7287.1984.tb00790.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

This paper examines the methodology and policy recommendations of Judge Robert Bork's writing on antitrust. It accepts as valid his premise that conventional price theory is the only appropriate organon for evaluating the welfare impact of an antitrust rule. However, it holds that in the analysis of cartels and mergers, Bork does not realize the full implications of his approach.Of the many prohibitions which antitrust law now contains, Bork wants to retain only two‐the prohibition of cartels and of large horizontal mergers. Even these two, however, cannot be maintained on pure price theory grounds. According to price theory, if price or merger agreements are inefficient, and i f entry and exit are free, then these agreements‐like other inefficient practices‐will be eroded by entry. Consistently applied, then, price the0 y provides no support for antitrust laws.A lack of support on price theory grounds does not imply that antitrust laws are unjustified. Most practices prohibited by anti‐trust law have closesubstitutes. Consequently, the law probably inflicts no great harm on economic efjiciency. Moreover, repeal of these laws could result in state‐owned monopolies or economic planning, both of which would be far worse for economic e

ISSN:1074-3529    

DOI:10.1111/j.1465-7287.1984.tb00791.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

In applying economic theory to evaluate antitrust laws, Judge Robert Bork explicitly favors a partial equilibrium over a general equilibrium approach. He believes the general model assumes away too many real‐world aspects to be usefully employed as a criterion by which to judge real‐world laws.However, Bork's partial equilibrium replacement, the Oliver Williamson trade‐off model, implicitly contains many of the same assumptions as general equilibrium theory. Equilibrium prices in all industries, an absence of external effects, and well‐defined demand curves are assumptions of both general equilibrium theory and the Williamson trade‐off model. If one theory is judged inadequate because of these assumptions, so should the other.Bork's analysis is more consistent with market process theory than with his own partial equilibrium approach. Market process theory assumes neither the absence of externalities, nor the presence of well‐defined demand and equilibrium prices in all

ISSN:1074-3529    

DOI:10.1111/j.1465-7287.1984.tb00792.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Judge Robert Bork holds two opposing attitudes towards perfect competition. It is a highly useful economic model for illustrating allocative efficiency, but it is a defective policy model because it deliberately omits productive efficiency. He reconciles these attitudes by combining perfectly competitive allocative efficiency with dynamically competitive productive efficiency in his analysis.However, these two kinds of competition do not readily mix. One is a static equilibrium concept, the other a dynamic disequilibrium concept. One assumes perfect knowledge and the absence of change; the other assumes imperfect knowledge, learning, and continual flux. Each kind of competition is built on assumptions which, if true, would preclude the existence of the other.Bork's policy conclusions require the simultaneous existence of both kinds of competition. If he drops dynamic competition from the analysis, a much more stringent antitrust policy is called for. If he drops static competition, economic theory does not justify even his strictures against mergers and cartels.

ISSN:1074-3529    

DOI:10.1111/j.1465-7287.1984.tb00793.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

In responding to the preceding papers by Professors Dewey, Fink, and High, I will deal primarily with Professor Dewey because his remarks constitute the most wide‐ranging critique. His remarks run the spectrum from political philosophy to price theor

ISSN:1074-3529    

DOI:10.1111/j.1465-7287.1984.tb00794.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Medicare expenditures increased 497 percent, federal medicaid expenditures 484 percent, and state and local medicaid expenditures 458 percent between 1970 and 1981. Private health‐insurance premiums increased 329 percent, while patient direct payments rose 214 percent.1Although these results include quantity and price changes, Waldo and Gibson (1982) show that “price inflation has been a major factor in the increase in health‐care spending.” Moreover, health‐care expenditures exceeded 10 percent of GNP (10.5 percent) for the first time in 1982 (Office of the Secretary 1983); the comparable figure in 1960 was 5.3 percent of GNP.This rapid growth in price and quantity (“expenditures” or “costs”in the nontechnical literature) has raised a cry across the land for cost containment or increased competition in the health‐care sector. Curiously, when one searches for a definition of “competition” in the same nontechnical literature, it is not immediately obvi

ISSN:1074-3529    

DOI:10.1111/j.1465-7287.1984.tb00795.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

The Reagan administration has again proposed in 1984 to limit the tax exemption on health‐insurance premiums. Objectives of the proposal are to curtail rising health costs by reducing insurance coverage—and hence medical‐care use—and to raise revenues to offset the large federal deficit. The change would have little effect on either dimension. Most likely, consumer response would reduce dental, drug, and eyeglass insurance, but would leave coverage for hospital and doctor care—the most bothersome health‐cost sectors—essentially unaffected. Larger tax changes which are structured differently possibly could reduce health costs dramatically and raise up to $27 billion a year in new

ISSN:1074-3529    

DOI:10.1111/j.1465-7287.1984.tb00796.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

This paper discusses competitive‐bidding systems for indigent medical care. Theoretical and empirical research which applies to the specific characteristics of these systems is limited. In particular, it is not clear which set of bidding rules would result in the lowest program costs for the state. Effectively implementing competitive bidding is difficult, given the ambiguity of available research results, since such bidding creates the appearance that policymakers have relinquished budgetary contro

ISSN:1074-3529    

DOI:10.1111/j.1465-7287.1984.tb00797.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Employers' willingness to control costs is a critical aspect of pro‐competition strategies for the health‐care market. Here, we present some of the first quantitative evidence of what employers do to control health‐care costs. Our sample is 44 large private and public employers in Minnesota.We develop a theoretical model in which the employer chooses cost‐control “innovations”—along with wages, fringe benefits, and labor‐force size—to maximize profits. The role of innovations is to reduce unit costs of offering fringe benefits.Our data are from a 1982 survey. Eighty percent of the surveyed employers, representing nearly 200,000 employees, responded. Most respondents offer both indemnity insurance plans and health‐maintenance organizations (HMOs). Many firms and individual health‐insurance plans conduct cost‐control activities, but less than half of the firms which offer HMOs have adopted level‐dollar premium contributions for their family health‐insurance policies. Few plans have increased their coinsurance and deductible requirements in the past five years.We use probit equations to estimate the probability that a firm or a health plan will adopt cost‐control activities. Our analysis suggests that many firms may soon make major plan‐design changes to control health‐care costs, a

ISSN:1074-3529    

DOI:10.1111/j.1465-7287.1984.tb00798.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Despite many proposals to encourage health‐care competition, some underlying assumptions about providers—both physicians and hospitals—have not been examined. This paper attempts to measure the potential for hospital competition by asking a very simple question: What proportion of United States hospitals have neighboring hospitals within reasonable commuting distance?Distances between short‐term general hospitals can be calculated by using geographic coordinates for their addresses. According to data from 48 states and 6,520 hospitals, 47 percent of hospitals have no neighbors within 5 miles, and 77 percent have fewer than five neighbors within 5 miles. At a 15‐mile radius, the numbers drop to 23 percent and 62 percent, respectively.These results imply that the potential for competitive hospital markets might not exist in large portions of the country. National strategies are likely to be most effective in the few dense hospital markets located primarily in the Northeast and Pacif

ISSN:1074-3529    

DOI:10.1111/j.1465-7287.1984.tb00799.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY