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Equity and Need
© Allen C. Goodman, 2013
Remember the Trade-off Between Efficiency and Equity?
• They are not the same.
• We saw this in production.
• We’ll see this in consumption.
What’s the most cost-effective place?
• Thought experiment. Most cost effective place is where we get the highest mean score. Why?
10
10
30
20
Ed
Harry
45o
• We can draw a line with a slope of –1. This line gives us places with equal totals. Start with S = SE + SH = 10.
SE+SH=10
SE+SH=20
SE+SH= max
Mean = (0+10)/2 = 5
Mean = (8+8)/2 = 8
Mean = (20+0)/2 = 10
Highest mean!About 22/2
Let’s review Pareto Efficiency
Context of trade.
One can’t make oneself better off, without making someone else worse off.
We usually do this with an exchange Edgeworth Box.
Abner
Belinda
Abner’s Preferences
Belinda’s Preferences
Spam
L-Surg
Let’s review Pareto Efficiency
Start at Point A.
Is this an Equilibrium?
Abner
Belinda
No, they can trade (A trades spam; B trades surgery
Belinda can be better off.
ASo can Abner.
BL-Surg
Spam
LA
SA
SB
LB
Let’s review Pareto Efficiency
We can plot similar points, which we recognize as a “contract curve”
Abner
Belinda
And so on.
A
BL-Surg
Spam
Let’s review Pareto Efficiency
We must recognize that point X is Pareto Optimal.
Abner
Belinda
So is point Y.
A
B
is a place where you haveequity as defined by eachperson’s having the same amount of each good. Is this PO?
L-Surg
Spam
2
L
2
S
L
SX
Y
Utility Possibility Frontier
We can plot Abner’s utility against Belinda’s Utility.
It is monotonically decreasing. Why do we draw it this way?
Abner’s Utility
Be l
i nd
a’s
Uti
li ty
X´
Y´
What if we want a perfectly egalitarian society?
Does equal utility mean equal allocations?
What about a utility functionfavoring people like Belinda?
A Critique
• Fundamental Issue. How well does the model work?
• Recall that with Edgeworth Box, the 1st Welfare Theorem says that markets will always get us to a Pareto Optimal allocation.
Abner
Belinda
A
BL-Surg
Spam
Tom Rice argues:• Looks at several assumptions, including:
– Consumers have perfect information– Firms don’t have monopoly power– There are no externalities– Prices reflect resource scarcity
• One can argue numerous points– How bad is bad information. What about informed sources, care managers?– What causes monopoly power? Is it the market, or is it government actions?– In what way do externalities come in? Rice argues that lavishing resources
on the rich will create a negative externality of “envy” by the poor.– Insurance (through moral hazard) impacts relative prices.
• Also, you have equity questions
Thoughts
• Rice wants us to think good thoughts about national health insurance proposals, arguing that they can address efficiency and fairness considerations at least as well as markets.
• Ultimate issue: Economic theory tells us that at best the ideal market can tie an ideal government, not that it can do better.
• The reverse is also true.