Naked Economics: Undressing the Dismal Science pdfdrive com


party to a transaction knows more than another. Their insights are relevant to



Yüklə 1,42 Mb.
Pdf görüntüsü
səhifə32/122
tarix16.03.2023
ölçüsü1,42 Mb.
#88090
1   ...   28   29   30   31   32   33   34   35   ...   122
Naked Economics Undressing the Dismal Science ( PDFDrive )


party to a transaction knows more than another. Their insights are relevant to
some of our most pressing social issues, from genetic screening to discrimination
in the workplace.
Consider a small law firm interviewing two job candidates, one male and one
female. Both candidates are recent Harvard Law School graduates and are
eminently qualified for the position. If the “best” candidate for the job is the one
who will earn the most money for the firm, which seems a reasonable
assumption, then I will argue that the rational choice is to hire the man. The
interviewer has no specific information on the family plans of the candidates at
hand (and is forbidden by law from asking about them), but can make a
reasonable inference based on what everyone knows about America at the
beginning of the twenty-first century: Women still bear the bulk of child-rearing
responsibilities. Demographics suggest that both candidates are likely to start
families in the near future. Yet only the female candidate will take paid
maternity leave. More important, she may not return to work after having the
child, which leaves the firm with the cost of finding, hiring, and training another
lawyer.
Is any of this certain? No. The male candidate may have dreams of staying
home with his five children; the female candidate may have decided years ago
that she has no interest in having children. But these are not the most likely
scenarios. The female candidate is punished because the firm has no information
on her specific circumstances but good data on broad social trends. Is this fair?
No. (And it’s not legal either.) Yet the firm’s logic makes sense. In other words,
it is rational to discriminate in this case, which turns the whole idea of
discrimination on its head. Discrimination is usually irrational. As Nobel
laureate Gary Becker pointed out in The Economics of Discrimination,
employers with a “taste for discrimination” sacrifice profits because they pass
over minorities in favor of less qualified whites.
1
A patient who refuses to see an
eminent black doctor because of his skin color is a fool. A law firm that


minimizes employee turnover by playing the statistical averages may offend our
sensibilities and violate federal law—but it is not foolish.
When we approach this situation as an information problem, there are several
crucial insights. First, firms are not the only villains. When professional women
choose to have a child, take paid maternity leave, and then quit their companies,
they impose a cost, arguably unfair, on their firms. More important, they impose
a cost on other women. Firms that feel they have been “burned” by employees
who take maternity leave and then quit are more likely to discriminate against
young women in the hiring process (particularly those who are already pregnant)
and less likely to offer generous maternity benefits. The good news is that there
is a quick and easy solution: a generous but refundable maternity package. Keep
it if you come back to work, return it if you don’t. That simple policy change
gives us nearly everything we want. Firms no longer have to be concerned about
paying benefits to women who will not return to work. Indeed, it becomes
possible to offer more generous benefits without providing an incentive for
workers to take the money and run. Women, in turn, do not face the same level
of discrimination in the hiring process.
Statistical discrimination, or so-called “rational discrimination,” takes place
when an individual makes an inference that is defensible based on broad
statistical patterns but (1) is likely to be wrong in the specific case at hand; and
(2) has a discriminatory effect on some group. Suppose an employer has no
racial prejudice but does have an aversion to hiring workers with a criminal
background. That’s certainly a reasonable preference, for all kinds of reasons. If
this employer has to make a hiring decision without access to applicants’
criminal backgrounds (either because he doesn’t have the time or resources to
gather such information, or perhaps because he is forbidden by law from asking),
then it’s entirely plausible that he will discriminate against black male
applicants, who are far more likely to have served time in prison (28 percent)
than white male applicants (4 percent).
Of course, all this employer cares about is whether or not the person standing
in front of him has a criminal record. If he can acquire that information with
certainty, then the broader social patterns don’t matter. In theory, we would
expect access to criminal background checks to reduce discrimination against
black men without criminal records. In fact, that is what the data show us. A
group of economists compared hiring decisions at firms that conduct criminal
background checks with hiring decisions at firms that don’t. They concluded,
“We find that employers who check criminal backgrounds are more likely to hire
African-American workers, especially men. This effect is stronger among those
employers who report an aversion to hiring those with criminal records than


among those who do not.”
2
With race, more information is usually better. The corresponding implication
is that less information can be worse. The United States has a huge exoffender
population. (America has a high incarceration rate, and most people who go to
prison eventually get out; the median sentence is less than two years.) Policies
that seek to help exoffenders by suppressing information on their criminal
backgrounds may be bad for a much wider population. The authors of the study
cited above warned that their results “suggest that curtailing access to criminal
history records may actually harm more people than it helps and aggravate racial
differences in labor market outcomes.”
This chapter is not about discrimination. It is about information, which lies at the
heart of many discrimination-related problems. Information matters, particularly
when we don’t have all that we need. Markets tend to favor the party that knows
more. (Have you ever bought a used car?) But if the imbalance, or asymmetry of
information, becomes too large, then markets can break down entirely. This was
the fundamental insight of 2001 Nobel laureate George Akerlof, an economist at
the University of California, Berkeley. His paper entitled “The Market for
Lemons” used the used-car market to make its central point. Any individual
selling a used car knows more about its quality than someone looking to buy it.
This creates an adverse selection problem, just as it did with the Hope
Scholarships. Car owners who are happy with their vehicles are less likely to sell
them. Thus, used-car buyers anticipate hidden problems and demand a discount.
But once there is a discount built into the market, owners of high-quality cars
become even less likely to sell them—which guarantees the market will be full
of lemons. In theory, the market for high-quality used cars will not work, much
to the detriment of anyone who may want to buy or sell such a car. (In practice,
such markets often do work for reasons explained by the gentlemen with whom
Mr. Akerlof shared his Nobel prize; more on that in a moment.)
“The Market for Lemons” is characteristic of the kinds of ideas recognized by
the Nobel committee. It is, in the words of the Royal Swedish Academy of
Sciences, “a simple but profound and universal idea, with numerous implications
and widespread applications.” Health care, for example, is plagued with
information problems. Consumers of health care—the patients—almost always
have less information about their care than their doctors do. Indeed, even after
we see a doctor, we may not know whether we were treated properly. This
asymmetry of information is at the heart of our health care woes.
Under any “fee for service” system, doctors charge a fee for each procedure


they perform. Patients do not pay for these extra tests and procedures; their
insurance companies (or the federal government, in the case of older Americans
who are eligible for Medicare) do. At the same time, medical technology
continues to present all kinds of new medical options, many of which are
fabulously expensive. This combination is at the heart of rapidly rising medical
costs: Doctors have an incentive to perform expensive medical procedures and
patients have no reason to disagree. If you walk into your doctor’s office with a
headache and the doctor suggests a CAT scan, you would almost certainly agree
“just to be sure.” Neither you nor your doctor is acting unethically. When cost is
not a factor, it makes perfect sense to rule out brain cancer even when the only
symptom is a headache the morning after the holiday office party. Your doctor
might also reasonably fear that if she doesn’t order a CAT scan, you might sue
for big bucks later if something turns out to be wrong with your head.
Medical innovation is terrific in some cases and wasteful in others. Consider
the current range of treatments for prostate cancer, a cancer that afflicts many
older men. One treatment option is “watchful waiting,” which involves doing
nothing unless and until tests show that the cancer is getting worse. This is a
reasonable course of action because prostate cancer is so slow-growing that most
men die of something else before the prostate cancer becomes a serious problem.
Another treatment option is proton radiation therapy, which involves shooting
atomic particles at the cancer using a proton accelerator that is roughly the size
of a football field. Doing nothing essentially costs nothing (more or less);
shooting protons from an accelerator costs somewhere in the range of $100,000.
The cost difference is not surprising; the shocking thing is that proton therapy
has not been proven any more effective than watchful waiting. An analysis by
the RAND Corporation concluded, “No therapy has been shown superior to
another.”
3
Health maintenance organizations were designed to control costs by changing
the incentives. Under many HMO plans, general practitioners are paid a fixed
fee per patient per year, regardless of what services they provide. Doctors may
be restricted in the kinds of tests and services they can prescribe and may even
be paid a bonus if they refrain from sending their patients to see specialists. That
changes things. Now when you walk into the doctor’s office (still at a
disadvantage in terms of information about your own health) and say, “I’m
dizzy, my head hurts, and I’m bleeding out my ear,” the doctor consults the
HMO treatment guidelines and tells you to take two aspirin. As exaggerated as
that example may be, the basic point is valid: The person who knows most about
your medical condition may have an economic incentive to deny you care.
Complaints about too much spending are replaced by complaints about too little


spending. Every HMO customer has a horror story about wrangling with
bureaucrats over acceptable expenses. In the most extreme (and anecdotal)
stories, patients are denied lifesaving treatments by HMO bean counters.
Some doctors are willing to do battle with the insurance companies on behalf
of their patients. Others simply break the rules by disguising treatments that are
not covered by insurance as treatments that are. (Patients aren’t the only ones
suffering from an asymmetry of information.) Politicians have jumped into the
fray, too, demanding things like disclosure of the incentives paid to doctors by
insurance companies and even a patient’s bill of rights.
The information problem at the heart of health care has not gone away: (1)
The patient, who does not pay the bill, demands as much care as possible; (2) the
doctor maximizes income and minimizes lawsuits by delivering as much care as
possible; (3) the insurance company maximizes profits by paying for as little
care as possible; (4) technology has introduced an array of massively expensive
options, some of which are miracles and others of which are a waste of money;
and (5) it is very costly for either the patient or the insurance company to prove
the “right” course of treatment. In short, information makes health care different
from the rest of the economy. When you walk into an electronics store to buy a
big-screen TV, you can observe which picture looks clearest. You then compare
price tags, knowing that the bill will arrive at your house eventually. In the end,
you weigh the benefits of assorted televisions (whose quality you can observe)
against the costs (that you will have to pay) and you pick one. Brain surgery

Yüklə 1,42 Mb.

Dostları ilə paylaş:
1   ...   28   29   30   31   32   33   34   35   ...   122




Verilənlər bazası müəlliflik hüququ ilə müdafiə olunur ©azkurs.org 2024
rəhbərliyinə müraciət

gir | qeydiyyatdan keç
    Ana səhifə


yükləyin