Fundamental economic principles tell us that goods should be sold at their marginal cost of productionthe cost of producing one more unit of the good. If a company needs to pay twenty dollars for the material and labor used to produce one more shirt, then shirts should sell for twenty dollars plus a small profitearning markup. The priceequalsmarginalcost principle maximizes economic efficiency and limits opportunities for fraud and corruption. Building on this principle, economists also strongly advocate globalization: the elimination of trade barriers allows consumers to buy goods and services from where they are cheapest, thus maximizing global efficiency and output.
Unfortunately, when it comes to health care, these principles are routinely violated. Prescription drugs that could be manufactured and sold profitably for a few dollars per prescription may instead sell for thousands. Performing one more hightech scan or other medical test may require just a few cents of electricity and a couple of hundred dollars worth of a technicians or a doctors time. But diagnostic procedures can be billed at several thousand dollars a shot. Prices are often well above marginal costs, yet economists involved in health care reform rarely recognize this as a problem.
This article has become a book!
MIT / Cloth / $14.95 / April 2010
There is nothing wrong with economics, but economists routinely ignore their own principles when it comes to policy. What would it look like if we took mainstream economics seriously and applied its lessons consistently?