Marmor T R, Wittman D A, Heagy T C
J Health Polit Policy Law. 1976 Spring;1(1):69-84. doi: 10.1215/03616878-1-1-69.
This paper discusses the politics of anti-inflationary policy in the medical care sector. We first clarify the issue by distinguishing between four different conceptions commonly used when discussing medical inflation. We then present some of the standard solutions to these problems suggested by economists. In the main part of the paper, we analyze the response of the government. We show that the underlying causes for failure in the economic market are likely to exist in the political market as well. In particular, the public good aspect of anti-inflationary policy fails to provide a strong incentive for the consumers of medical care. In contrast, the providers have very powerful incentives in the political market because the benefits of governmental action in this sector greatly affect them. Providers exert great pressure to prevent government policies aimed at reducing medical care expenditures. We present evidence and theory to explicate which sets of circumstances are most conducive to governmental action. We show that the most effective anti-inflationary programs in medical financing are least likely to be implemented and that a dispersed, pluralistic financing structure reduces the government's incentive to curb inflation.
本文探讨了医疗保健部门反通胀政策的政治因素。我们首先通过区分讨论医疗通胀时常用的四种不同概念来阐明问题。然后,我们介绍一些经济学家针对这些问题提出的标准解决方案。在论文的主要部分,我们分析了政府的应对措施。我们表明,经济市场中失败的潜在原因在政治市场中可能同样存在。特别是,反通胀政策的公共利益方面未能为医疗保健消费者提供强大的激励。相比之下,提供者在政治市场中有非常强大的动机,因为政府在该部门的行动所带来的利益对他们有很大影响。提供者施加巨大压力以阻止旨在减少医疗保健支出的政府政策。我们提供证据和理论来阐明哪些情况最有利于政府采取行动。我们表明,医疗融资中最有效的反通胀计划最不可能实施,而且分散、多元化的融资结构会降低政府抑制通胀的动机。