Pasar Pelayanan Kesehatan Ekonomi Kesehatan Pasar Pelayanan Kesehatan

Outline Definisi Pasar Ciri Khusus Pasar Yankes Hubungan S Dan D Dalam Pasar Yankes Pengertian Eksternalitas, Public Goods,private Goods Peranan Pemerintah Dalam Pasar Yankes

Introduction An old song lyric maintains that “the best things in life are free.” A moment’s thought reveals a long list of goods that the songwriter could have had in mind

Introduction Free goods provide a special challenge for economic analysis. Most goods in our economy are allocated in markets, where buyers pay for what they receive and sellers are paid for what they provide. For these goods, prices are the signals that guide the decisions of buyers and sellers. When goods are available free of charge, however, the market forces that normally allocate resources in our economy are absent.

APAKAH PASAR ITU? Apa itu pasar & bagaimana bekerjanya pasar dapat dianalisis dg konsep ekonomi demand & supply Pasar dari sisi demand & sisi supply Pada sisi demand ada konsumen & pada sisi supply ada produsen

APAKAH PASAR ITU? A market is a group of buyers and sellers of a particular good or service. The buyers as a group determine the demand for the product, and the sellers as a group determine the supply of the product. Place/ tempat  bukan secara fisik Penjual dan pembeli masing2 membawa kepentingannya ke pasar

APAKAH PASAR ITU? Markets take many forms. Sometimes markets are highly organized, such as the markets for many agricultural commodities. In these markets, buyers and sellers meet at a specific time and place, where an auctioneer helps set prices and arrange sales

APAKAH PASAR ITU? More often, markets are less organized. For example, consider the market for ice cream in a particular town. Buyers of ice cream do not meet together at any one time. The sellers of ice cream are in different locations and offer somewhat different products. There is no auctioneer calling out the price of ice cream. Each seller posts a price for an ice-cream cone, and each buyer decides how much ice cream to buy at each store.

Coba ingat prinsip ekonomi No.6 !!!! MANFAAT PASAR Coba ingat prinsip ekonomi No.6 !!!!

MANFAAT PASAR PRINCIPLE #6: MARKETS ARE USUALLY A GOOD WAY TO ORGANIZE ECONOMIC ACTIVITY

MANFAAT PASAR Perekonomian pasar  keputusan2 para perencana pusat diambil alih oleh jutaan perusahaan rumah tangga (keputusan masing2 apa yang harus dibeli atau dijual) sehingga memperhitungkan biaya dan manfaat  harga dapat membimbing para pengambil keputusan di tingkat individual mengambil pilihan yang, dalam banyak kasus, memaksimalkan kesejahteraan masyarakat secara keseluruhan

MANFAAT PASAR Markets are useful resource allocation mechanisms because they are automatic, responsive to changes in consumer preferences and, under the right conditions, allocatively efficient (Wonderling, 2005).

A free market is one in which there is perfect competition A free market is one in which there is perfect competition. It is characterized by four features: • many producers selling the same product to many purchasers; • no restrictions on potential producers entering the market; • existing producers have no advantage over the new producers; • producers and purchasers are well informed about prices.

Dlm situasi pasar persaingan sempurna (perfect market) produsen dpt menjual semua yg diinginkan (jd memaksimalkan profit) dan konsumen dpt membeli semua yg diinginkan (jd memaksimalkan utility)  maximum utility at least cost Prasyarat: memenuhi asumsi krusial

ASUMSI KRUSIAL - Certainty /predictable Konsumen tahu apa yg diinginkan, kapan menginginkan, & dimana bisa mendapatkan - No externalities - Perfect knowledge - Consumers act free 1. Konsumen bertindak bebas atas interest-nya sendiri dalam membuat keputusan konsumsi 2.Konsumen bertindak bebas atas interest-nya sendiri dalam menyediakan barang yg dihargai tinggi oleh konsumen relatif thd harganya - Numerous, small producers with no market power 1.Skala tiap-2 produsen adl kecil & berjumlah banyak shg tidak memiliki kekuatan mendikte pasar 2.Mereka saling bersaing hanya berdasarkan harga 3.Utk mempertahankan konsumen, produsen menahan harga serendah mungkin  biaya menjadi minimal

Karakteristik Yankes

Karakteristik Yankes

Karakteristik Yankes Intangible Asimetri informasi Consumer ignorancy Unpredictable need Mixed konsumsi dan investasi Externalitas Fragmented Commodity

Market Failure A situation in which a market left on its own fails to allocate resources efficiently for social welfare (maximizing health benefits) and price optimalization. Example: imperfect information, imperfect competition, public goods, externalities

Externalitas The uncompensated impact of one person’s actions on the well-being of a bystander (Mankiw, 2003) Cost or benefit arising from an individual’s production or consumption decision which indirecly affects the well-being of others (wonderling, 2005). An action undertaken by an individual (or firm) has secondary effect on others, which maybe favorable or unfavor able Externalities result in a non-optimal amount of output being produced because an individual or firm considers only their own benefits and costs when making a production or consumption decisions (Feldstein, 1994)

Jenis Eksternalitas Positif -Positive externalities in production or consumption lead markets to produce a smaller quantity than is socially desirable. Co: Vaksinasi, Imunisasi Negatif -Negative externalities in production or consumption lead markets to produce a larger quantity than is socially desirable. Co: Pencemaran Lingkungan

Efficient Market Equilibrium

Eksternalitas Negatif

Eksternalitas Negatif Pemerintah dapat mengintervensi dalam pasar untuk mengurangi dampak negatif eksternalitas -Pemberlakuan pajak dari kerugian biaya sosial dari kegiatan yang merugikan itu. (internalizing an externality :altering incentives so that people take account of the external effects of their actions) Pigovian tax : a tax enacted to correct the effects of a negative externality -Subsidi -Pembuatan regulasi -Transfer Program: Medicaid and Medicare in US (Folland et.all, 1997)

Eksternalitas Positif

Peran Masyarakat dalam Eksternalitas Masyarakat bisa meminimalkan eksternalitas negatif atau meningkatkan produksi untuk eksternalitas positif Contoh: Mobil menggunakan standar emisi yang ditetapkan, hibah ke institusi pelayanan kesehatan

THE DIFFERENT KINDS OF GOODS How well do markets work in providing the goods that people want? The answer to this question depends on the good being considered. In thinking about the various goods in the economy, it is useful to group them according to two characteristics: -Is the good excludable? Can people be prevented from using the good? -Is the good rival? Does one person’s use of the good diminish another person’s enjoyment of it?

Definition : Kind of Goods RIVALRY -the property of a good whereby one person’s use diminishes other people’s use -Ex: buy clothes, eat banana, take drug It’s imposible to eat/use it together EXCLUDABILITY the property of a good whereby a person can be prevented from using it or can be gotten by paying a certain number Ex: toll road

Jenis Barang Private goods - both excludable and rival - Barang tidak dapat dikonsumsi secara bersama (rival), tetapi untuk menikmatinya harus membayar (eksklusif) Public Goods - neither excludable nor rival - Barang dapat dikonsumsi secara bersama (non-rival), tetapi untuk menikmatinya tidak harus membayar (non-eksklusif) Common Resources - are rival but not excludable - Barang tidak dapat dikonsumsi secara bersama (rival), tetapi untuk menikmatinya tidak harus membayar (non-eksklusif) Natural Monopolies - are excludable but not rival - Barang dapat dikonsumsi secara bersama (non-rival), tetapi untuk menikmatinya tidak harus membayar (non-eksklusif)

Barang Publik A public good is ‘a good or service that can be consumed simultaneously by everyone and from which no individuals can be excluded (Wonderling, 2005) Ciri-ciri: Non Excludability Non Rival No Marginal cost (tidak menambah biaya). Biaya yang dirasakan oleh 1 orang dengan 20 orang sama Externality Manfaat intervensi 1 orang bisa dirasakan oleh lebih 1 orang

THE FREE-RIDER PROBLEM If the provider of a public good tries to ask people how much they are willing to pay to receive it, consumers say they don’t want it. Why? Because the consumers know that once the good is provided they can consume it even if they don’t pay for it. This is called the free-rider problem’ (Parkin et al. 2003). F r ee rider is a person who receives the benefit of a good but avoids paying for it (Mankiw, 2003).

THE FREE-RIDER PROBLEM Masyarakat tidak bisa dicegah untuk menikmati layanan penyediaan barang publik. Ada individu yang tidak mau membayar untuk pelayanan publik ini. Masalah ini membuat private market tidak menyediakan layanan barang publik (Najib, 2011)

THE FREE-RIDER PROBLEM Solusi untuk masalah free rider -pemerintah dapat memutuskan memberikan pelayanan publik, jika total keuntungan yang dinikmati lebih besar dari biaya yang dibutuhkan Memerlukan tools CBA -pemerintah memberikan layanan barang publik melalui pembayaran pajak dari warganya Untuk Welfare Economics

Government Roles (Wonderling, 2005 and Folland et all,1997) According to economic theory, there are three main areas of government activity: • redistribution of wealth and income; • stabilization of the macroeconomy (to keep unemployment, inflation and economic growth at reasonable levels); • correction of microeconomic market failure. As regards the last of these, there are four circumstances in which governments can and should get involved: • ensuring and protecting public goods; • controlling monopoly power; • reducing externalities; • reducing asymmetry of information. redistribusion

Government Involvement in Health Care Market (Folland et all, 1997) Direct Provision of care Financing health insurance Subsidy medical education Establishing health facilities Subsidy health insurance through tax structure Regulation in health care industry

Financing Mechanisms Tax-based Social insurance Private health insurance Community based health insurance

Diskusi Apa pendapat anda terhadap eksternalitas ini? Polusi udara Merokok Pengemudi bus yang mabuk Pengendara motor yang memakai helm’ Pendirian rumah sakit/klinik

Diskusi (2) Penanganan kasus HIV/AIDS sebaiknya dimasukkan sbg public atau private goods? Dikaji dari Dampak Eksternalitasnya ? Siapa yang harus menanggung kerugian/biaya eksternal dari merokok??? Perokok atau perusahaan rokok??? Cari tahu tentang inflasi biaya kesehatan????

Thank You