Economist
gravenewworld said:No. One of the reasons monopolies/oligopolies exist is because of high costs to entry into the market for a firm. There are natural barriers to entry in some markets (like astronomically high costs of getting started) that limit the amount of firms that can enter the market. Economists define an oligopolist market by the 4 firm ratio--the amount of the market that the largest 4 firms in the industry have a share of. If it is above 40% of the market then the market is considered oligopolist. Examine the market for health care. According to the GAO (govt accountability office)
-Blue Cross and Blue shield had over 50% of the market in 9 states (THAT IS JUST 1 FIRM!)
-In almost every state, the largest insurer in that state had an average of 43% of the market (again only 1 firm!)
It is true that some markets have high costs to entry, which produces less than perfect competition. However, there is a lot of debate in the economic community about whether government intervention can help in such markets. I bet if I researched some other industries which have high costs to entry, you may not be crying for government intervention in that particular industry. Competing with Boeing is also an industry which has high costs to entry. Maybe you think the US gov't should start making airplanes?
Economists might define an oligopoly by the 4 firm ratio, however, this tells you nothing about the welfare effects of such a firm. For example, you could have what economists call a natural monopoly, which means that you are a monopoly, but only because other firms can't compete with you. Such as, a firm who's prices are so low (because of low costs of production) that when additional firms enter the market, consumers choose to buy from the monopoly, which is actually beneficial to consumers. This is why economists use the Lerner Index (instead of the 4 firm ratio). The Lerner Index tells you how much a frim marks-up it's prices. You need to realize that being the only firm in a market does not mean you are bad for consumers. Monopolies and oligopolies can and do arise because they are really good at what they do.
You should also ask yourself how monopolies and oligopolies happen in the first place? Often times, market power is a result of government intervention. Part of the reason doctors have market power in the first place, is because the AMA severly limits the number of doctors. You might think that the AMA does this to keep you "safe" from "bad" doctors, but the truth is that the AMA does this precisely to gain market power so that current doctors will have higher salaries. There is also a large amount of market power in the pharmaceutical industry. Again, this happens because of regulation. The FDA makes it so that the average drug requires $1 billion just to get it approved. The result is that, small firms cannot compete because they can't afford this $1 billion, and now you've created oligopolies. You pointed out that high costs to entry result in monopolies/oligopolies. Often times, government regulation is the exact thing which increases costs of entry, which decreases market competition.
gravenewworld said:You preach freedom of choice and free markets for health care, but in reality WE ALREADY DON'T HAVE A FREE MARKET FOR HEALTH CARE! The insurance industry sure as hell is an oligopolist market! In almost every state 1 firm owns 40+% of the health insurance market! That completely blows out the 4-firm ratio litmus test that economists use to determine whether or not a market is run by an oligopoly.
Again, the 4 firm ration is not a litmus test when it comes to the effects oligopolies have on consumers. I agree that we already don't have a free market for health care. I think many of the current problems are probably a result of this government intervention, which is why I don't want us to make it even worse by getting government more involved.
If you really want to know why health care insurance is not a free market, then I suggest you listen to the podcast below:
http://www.econtalk.org/archives/2006/05/the_economics_o_3.html
gravenewworld said:You've answered your own question. Of course a perfectly inelastic demand doesn't exist. Even health care demand is not perfectly inelastic, however it is pretty damn inelastic. Once you go beyond a certain point for charging for a MRI, no one will demand it.
Listen, elasticity of demand is not the only thing you must consider. Yes, it is true that MRIs might be fairly inelastic. However, so are many other things that do not have extremely high prices. Food and cigarettes are not that high priced even though they are fairly inelastic. On the other hand, many things have high prices even though they are fairly elastic, such as cars. One thing I think you're forgetting to bring into your analysis, is the supply side of things. The point is, firms compete for costumers by lowering their prices. Therefore, MRI prices may not have much to do with the elasticity of demand.
gravenewworld said:So you claim the law of diminishing utility is not all to be considered here, but then go on to talk about consumer demand behaviors? That doesn't make sense, seeing as demand is defined by marginal utility! This website actually explains how demand is derived through marginal utility pretty well:
I was trying to point out that just because people have diminishing marginal utility, does not mean that they won't consume more than is available. Economists assume that people have diminishing marginal utility for all goods. However, economists also know that people will often overconsume when prices are artificially low, just as many economists have pointed out even in health care and gasoline consumption.
Do you really think that just because people have diminishing marginal utility, means they won't consume a lot of something? For example, if steak dinners and BMWs were free, I wouldn't consume infinity of them, but I would consume a lot more than I currently am. I'd probably have like 5 BMWs and eat steak 2 - 3 times a week. People rarely stop consuming something because of diminishing marginal utility, rather, their budget constraint usually kicks in way before that which is why they tend to limit their consumption.
gravenewworld said:You are comparing apples to oranges. The food market is not an oligopolist market! In fact, many times in basic econ the food market is used as an example of a type of market that is almost perfect competition! So according to you " the most important things" should be handled by the free market? Okay so how about national defense? Would you want private companies in charge of all of our nuclear weapons, tanks, and stealth bombers? The problem with health care in America is the fact that it is run by an oligopoly. Oligopolies and monopolies ALWAYS lead to inefficiencies, i.e. market faliures.
You're right that the food market is fairly free market, however in economics classes it is also used as a great example of an industry that has many-free trade barriers because of subsidies. Imagine how good it could be if we made it even more free market by eliminating government intervention?
In my opinion, national defense is a trickier issue than health care when it comes to government intervention. Maybe this is something that cannot be handled by markets, and therefore maybe we need government running it. However, maybe we don't need government as much as previously thought. Even the current US military relies heavily on private industries. Many private industries are hired by the government to build tanks, weapons, and stealth bombers. There are even a large number of private military companies that provide military services (as I'm sure most people are aware given the recent media attention given to Blackwater). Furthermore, the elimination of the draft was hugely studied by economists (in fact, the elimination of the draft happened largely because of these economists). Their solution was that the US government should have to increase pay if they want more soldiers, which essentially made this industry function like a private labor market.
Again, monopolies and ologopolies do not always lead to market failures (see my first couple paragraphs). But you're right that they probably usually do lead to inefficiencies (i.e. market failures). However, once again we need to understand how monopolies and oligopolies often form, which is precisely because of regulation and government intervention. And even more importantly, what can government do about these market failures? You're forgetting that often times, government does not improve the problem, and usually just exaggerates it or has other harmful unintended consequences. You want to talk about market failures, well, what about government failures? You're also forgetting that these market failures can often be solved by markets. These inefficiencies are often tackled by other companies in their quest to make a profit.
gravenewworld said:What is there to be confused about? You are the competitive market guy for health care. A competitive market tends toward equilibrium, this is one of the fundamental laws of economics. But a competitive equilibrium leads to Pareto Optimal efficiency. This however, does not imply at all that the most efficient allocations of resources are the most equitable. You still haven't answered my question. With a free market system for health care is it socially acceptable that thousands and even millions of people may be left without proper access to health care or insurance? A free market type of system for health care inherently leads to some people who will be shut out from health care even when resources are allocated most efficiently (i.e. equilibrium). So once again is this acceptable to you? If you still find this acceptable then tell me this, would you want someone who falls between the cracks in a competitive health care market and is uninsured running around with one of these diseases (see below) and avoiding hospitals and doctors because they had no insurance or couldn't afford it?
I think you're the one who is actually forgetting the fundamental laws of economics. All societies have to allocate scarce resources. In fact, this is exactly what socialism and capitalism are, different ways for society to solve the economic problem (meaning that people have unlimited wants and needs, but limited resources). Let me throw some of the same questions back at you. Is it fair that some people need to wait for 1 year to get a very important medical procedure? Is it fair that some people die waiting for these procedures? Is it fair that some people cannot pay a doctor for his/her services because it is illegal? Is it fair that some people live in countries in which they cannot get private health insurance because it is illegal?
You mentioned that " a free market type of system for health care inherently leads to some people who will be shut out from health care even when resources are allocated most efficiently (i.e. equilibrium)." Socialism does not solve this problem. The problem which I pointed out above is that there are a limited amount of resources to go around, which is why we try to allocate them most efficiently (this is what the study of economics is all about). So which way allocates these resources best? In my opinion, that's capitalism.
Besides, many people are not dying because they can't afford health care in the US. People still go to the hospital and get treated, even in this "greedy, evil system." Hospitals have to treat them, even if they can't pay the bills. And yeah, some people do go bankrupt because of health care reasons. However, I still think it's better than a socialist approach.
gravenewworld said:The uninsured put the general public (insured and uninsured) at huge risk. All its takes is one uninsured person going around with a multi resistant strain of TB to spread it to 100's of people because they didn't have access to a doctor or couldn't afford to seek medical care. But this is the risk you run with a free market system of health care.
Again, see my comments above.
Here's another interesting article written in New York times by a prominent Harvard economist: http://www.nytimes.com/2007/11/04/business/04view.html?ref=business
If you're interested in why capitalism works pretty well, be sure to check out these educational links below:
http://www.econlib.org/library/Essays/hykKnw1.html
http://www.econlib.org/