Health Policy Final Exam
Status quo bias
tendency to do nothing when faced with making a decision - prefer current state of affairs to change
Herd Immunity
the rate of vaccination must be high enough to ensure that most people will be protected against disease this will help protect those who have not been vaccinated as well if they are too young or for medical reasons
Demand for RX Drugs is often.....?
Inelastic because - drugs are essential -the choice for which prescription is made by the physician not the patient - role of insurance
What is a nudge?
Is a deception or device that the chooser would be complicit in putting into effect -should steer people into decisions that are better for them -conducted by a choice architect -policy/ government can play a powerful role in the choices presented to consumers/ constituents in a way that can lead to better more desirable outcomes Ex: Cafeteria The placement of the food influences your choices; perhaps you make healthier choices because of the placement Ex: Opt in Opt out
How has Marijuana use trended over time?
It is hard to know as it can be hard to identify substance use over time as data is mostly self-reported or really bad outcomes are administered
What is the current state of legality on the federal level for weed?
Jan 2018, Attorney general sessions issued Memorandum allowing federal prosecutors to decide how to prioritize enforcement of federal marijuana laws
Orphan Drug Act of 1983
Offers addition patent protection (+7 years) on a patent for an orphan drug + tax incentives
What is the problem definition that addresses the solutions we have seen in the alcohol control policy space?
Alcohol consumption causes externalities - addictive properties -drinking and driving -health outcomes
Monopoly Model
* look at hand written graph guide*
Why the Government SHOULD Intervene in the sugar beverage consumption issue
- We are presented with a market failure of negative externalities due to asymmetric information -inequity concerns - revenue generation
What is the current state policy like for marijuana?
- decriminalization -medical cannabis -recreational/ legalization
What are Prescription Drug Monitoring Programs?
- electronic database that tracks controlled substances prescriptions in each state - all states have this -there are mixed results on whether this works
Concerns against Government Vaccine Policy
- government mistrust -parents freedom to make their own health decisions for their children -right to education without meeting education vaccine requirements -concerns about safety and side effects -asymmetric information; profit motive by pharmaceutical companies
what is classified as prescribing guidelines/ patient education in the governments response to the opioid crisis
- provider education - CDC prescribing guidelines - patient education about the risks of opioid misuse, dependence, role of naloxone, and substance misuse treatment
The Public policy arguments against legalizing weed
- public safety -SR/ LR outcomes with health and brain development -driving while under the influence -youth dependence -potential poisonings -work place rules
Why the Government SHOULD NOT Intervene in the sugar beverage consumption issue
- regressive tax -interfere with individual decisions making
What are Pain Management Laws/ Pill Mill Laws?
-Role for federal, state, and local health policy Pain Management Clinic / Pill Mill Laws•Pain clinics that may be facilitating the drug-seeking endeavors of prescription drug users and/or the drug-seeking behaviors of prescription drug users who use pain clinics as a primary source for drugs -PMC laws arose in the 2000s to respond to prescribing behaviors that deviated from sound clinical practice (e.g., cash-for-pill exchanges with no medical examination) -PMC laws impose state oversight on pain clinics, including routine inspections, requirements for those who practice within them, and civil and criminal penalties when violations occur.• -12 states have PMC laws
Ethics of Organ Donation Compensation?
-commodification of body parts -equity concerns about willingness to pay/ ability to poor; exploitation of poor -undermine voluntary organ donation -coercion -additonal costs of organ transplant transferred to donor
What are policys that promote vaccination?
-educational campaigns -FDA Approval/ review process -NIH/Govt funding to new vaccines -reduced cost or free vaccinations -easy access to vaccines -expanding scope of practice like having pharmacists vaccinating people
Can you think of any behavioral nudges that address tobacco consumption?
-excise Taxes -smoking restrictions by place -restricting access to youth legally and through advertising
Wha policy levers exist to incentizes organ donation?
-government education/public health efforts -presumed consent/ opt out system (rather then opt in) -
what are the effects of different cost sharing on use of health services? (RAND)
-positive cost sharing decreases services/visits - most reductions resulted from not initializing care rather than reducing intensity
Sources of organ donation
1. Altruism 2. Cadaver Donors 3. Living Donors
What are the 4 categories of CDC vaccine guidelines for healthcare workers?
1. Assessment Requirements (requires healthcare facilities to assess the vaccination status of health care workers) 2. Administrative Offer Requirements (requires facilities to offer vaccinations to healthcare workers) 3. Administrative Ensure Requirements (require healthcare workers to be vaccinated) 4. laws that require healthcare workers to wear make who choose to not get vaccinated
Health Examples of Nudges
1. Automatic enrollment in health insurance (like organ donation- opt out rather than opt in) 2. Making a plan- asking residence when they plan to get their flu vaccine 3. Framing - messaging about stopping a "bad" activity compared to promoting a preventative activity 4. Default for food side dishes are healthy options 5. Tie behavior to monetary costs and benefits
Deviations of the Standard Model (Behavioral Econ)
1. Bounded rationality 2. Bounded Willpower 3. Bounded Self interest
What does state vaccination policy look like for children?
1. CDC has guidelines 2. pediatricians outline vaccine requirements for schools and guidelines for timing 3. public school requirements (some private too)
Behavioral Econ Approach to dealing with Sugar Consumption
1. Changing the default option 2. reframing the conversation to a positive outlook
How to Define a Problem using the Example of Taxes on Sugar Sweetened Beverage
1. How to frame the problem? - Rise in obesity and negative health challenges -sugar is a large driver in obesity -past decade, per capita intake of calories from soda has increased by 30% 2. What is the scope? 3. What is the current policy context? 4. What kinds of evidence are presented? - soda tax would reduce consumption by 7.85% 5. Is this a public problem? - Medicare/Medicaid are covering about 1/2 of obesity costs 6. Who are the most relevant stakeholders?
What are the competitive issues in the Seaman Vs Duke case?
1. It is unlawful to apply wage setting agreements 2. No poaching agreements are like wage setting because they agree to not compete on certain dimensions like employee allocation 3. Restricted information to employees on their value. Think about the impact on employees
What were the two examples that we talked about in class regarding collusion on the buying side?
1. Kamakahu vs. American Society 2. Seaman Vs. Duke
What are the state vaccination exceptions?
1. Medical exceptions 2. Religious Exceptions 3. Philosophical Exceptions
can you think of behavioral nudges that address alcohol consumption?
1. Minimum Drinking Legal Age 2. Graduated Drivers Licenses 3. Blood Alcohol Content (adults, minors) 4. Zero Tolerance policy 5. no sales on Sundays; dry counties 6. location of sales 7. advertising restrictions to minors 8. warning labels 9. funding and support for alcohol treatment use disorder
how to qualify for a patent (4 things)
1. Patentable subject matter 2. Novelty 3. Utility 4. Non-obviousness - denies patentability if the differences between the claimed invention and the relevant prior works are such that the claimed invention would have been obvious at the time the invention was made to a person having ordinary skills in the subject matter
Top US prescription drug spending in billions
1. Private Health Insurance 2. Medicare 3. Out of Pocket 4. Medicaid
Other terms related to cognitive limitations
1. Status quo bias 2. Choice overload 3. Rules of Thumb 4. Loss Aversion 5. Procrastination 6. Present Oriented 7. Framing 8. Saliency
What is the purpose of patent policy?
1. encourage/ stimulate research, development, and innovation 2. provide society with benefits from the invention of new ideas and innovation 3. promote public good 4. R & D can cost millions of dollars with no guarantee of success/ Copying or free-riding can reduce investment even further
What is the role of government in the opioid crisis?
1. prescribing guidelines/ patient education 2. Prescription Drug Monitoring Programs 3. Pain Management Clinics/ Pill mill laws 4. Naxolone Access Policies 5. Good Samaritan Policies 6. Safe/Supervised Injection Sites 7. needle exchange programs 8. Substance Use Treatments (SUD) 9. Access to Substance Use Treatments (SUD)
What federal programs exist in regard to vaccines?
1. vaccines for child program - free vaccines for uninsured children, medicaid-eligible, and uninsured (through FQHC) 2. section 317 of public health services act - administered by the CDC and provides grants to states for vaccine purchase, outreach programs, and disease surveilance 3. ACA - requirement for preventative care 4. Vaccine Adverse Event Reporting System - early warning system to identify problems with vaccines. If there is an a adverse event with permanent side effect, you can file a claim with the National Vaccine Injury Compensation Program. 5. Immunization Information Systems - electronic registry to help health care professionals see immunization history
What does recreational marijuana law/ legalization mean
16 states including DC have legalization policies Colorado and Washington were first
What does decriminalization mean in regards to cannabis?
26 states current have laws which decriminalize marijuana for personal use
What does medical cannabis mean?
36 states currently have policies which permit cannabis for medical use
what is a shove?
A deception or device that the chooser would not be complicit in putting into effect can be connected to a frame change based on a partial truth or an outright lie
What is a patent
A device intended to explicitly give an inventor a property right over its discovery; the owner has the right to exclude all others from making, using, or selling the invention in the USA for 20 years starting on the date the application was filed
What are safe/ supervised injection sites?
A medically supervised facility designed to provide a safe environment in which drug addicts are able to consume illicit recreational drugs intravenously. Being proposed in US - Some in Canada
How do we expand access to SUD treatment/ opioids treatment?
ACA expansion Medicaid coverage of different types of MAT; take home naxolone; limits on treatment duration/settings; and prior authorization
Product Hopping Context
An initial patent on a prescription drug coves an active ingredient that is delivered in a specific form and dose with a specific absorption rate During the life of the patent, the patentee may develop and new and modified version of the patent by (1) altering the dose to improve efficiency (2) changing absorption rate (3) switching from tablets to capsules The drug manufacturer may incentivize physicians to prescribe the newer version instead If the new product improves health and is more impactful then this gesture could be considered be competitive; however, sometimes this action can be anticompetitive via exclusionary product hopping
What is anticompetitive behavior governed by?
Antitrust laws: Sherman act and Clayton act Antitrust enforcement: Antitrust division of department of justice and FTC
What have the opioid lawsuits against manufactures looked like?
Approx 2000 lawsuits -Plaintiffs are alleged to have improperly marketed and distributed opioids to states and cities in the United States. • -Over-distributed to areas of the country ("should have known"), likely diversion -This led to the deaths of hundreds of thousands of Americans. -Plaintiffs are alleged to have underplayed the risks of opioid prescribing and overstate benefits - First settlements - Purdue Pharm agreed to pay $24m to Kentucky. MANY MORE since. -A large deal proposed $26 Bil settlement with state and local governments
What are Good Samaritan Laws?
Are state laws which offer immunity to bystanders of overdoses; legal protections for those who call for help Like university response to alcohol, overdose bystanders may not be likely to call in fear of getting in trouble 46 states have GS policies
Repugnant Markets
Area of commerce that is considered by society to be outside the range of market transactions and bring it in would be morally wrong (ex. prostitution, gambling, organs)
Why have Emi-pen prices hiked up to over 400%?
Because the company can. $100 in 2009 to $608 in 2019
what were the second round of OR findings
Better self-reported health Better mental health (lower incidence of depression)• No effect on blood pressure, cholesterol (diagnosis or use of medication); increased probability of diabetes diagnosis Increased use of preventative services; reduction in financial burden of medical debt
Biden vs Trump on Medicaid
Biden: - Wants to provide federal support for state Medicaid programs during COVID/economic crisis -Public option available to individuals in states that chose to not expand Medicaid Trump: -Believes states should decide if they should expand Medicaid -Challenging the ACA which includes the expansion of Medicaid -Supported Medicaid work requirements -Preserve benefits for US citizens and legal residents only
Biden vs Trump Rx Drug Policy
Biden: -Supports prohibition on "surprise medical bills" and disclosure of standard hospital charges - wants federal government to be able to negotiate prescription drug prices in Medicare Trump: - Supports prohibition on surprise medical bills and disclosure of standard hospital charges -Executive Orders( importing drugs from other countries, Most Favored Nations Clause, reduce insulin costs for some Medicare beneficiaries)
Biden vs Trump Medicare
Biden: -wants to lower Medicare eligibility age from 65 to 60 years old -Against Medicare for all, but proposed a public option available to some citizens in the US Trump: -Focus on private sector Medicare Advantage -Against Medicare for all or any version of it
Biden vs Trump COVID 19 Policy
Biden: - Federal focus and response -Use of defense protection act to increase supply of PPE -No cost COVID testing -Invest ~25$ Billion in vaccine development and distribution -federal mask mandate -support expanded Telehealth efforts Trump: -State response and focus -Operation Warp speed ($12 billion to accelerate development and production of vaccine) -No cost COVID testing -No mask mandate -expanded Telehealth efforts
Biden vs Trump on the Affordable Cares Act
Biden: - Supports the ACA -Would preserve and expand the ACA -Would add more subsidies to those at higher income levels (above 400$ FPL) -Would also preserve prohibition of pre-existing conditions -public option (available to who?) -Expand ACA coverage to DACA recipients Trump: - replace and repeal the ACA -Worked with congress to undo the "individual mandate" that signified no financial penalty anymore for not having insurance(Tax cuts and jobs act) -Preserve the prohibition on pre-existing conditions -Supports the California va TX suit that is challenging the individual mandate as unconstitutional and could affect other pieces of the ACA -has not offered a plan to replace the ACA
Biden vs Trump Abortion Policy
Biden: -pro-choice -Federal support/funding for abortion Trump: -Pro-life - appointed Amy Coney Barret to the Supreme Court; and has stated he wants Roe V. Wade to be reconsidered -ACA being challenged could affect no cost sharing reproductive/ contraceptive coverage
Why do people purchase inapproprite amounts of coverage?
Choice overload/ decision fatigue Uncertainty over future costs and benefits
Behavioral Economics Definition
Combination of psychology and economics that investigates what happens in markets when some agents do not act rationally Leads with the assumption that people are not necessarily rational
Insulin situation in the united states
Diabetes is expensive and with 34 million Americans having the disease, care is up to approximately $300 billion a year There are allegations that the 3 largest insulin companies have conspired to fix prices of insulin
what is the relevance of the lottery to this study
Disentangle the "selection" effects Randomized design: those who were eligible and got insurance are similar tothose who were eligible and did not get insurance.
Al Roth Donation Program Proposal
Kidney Exchange Matching you would exchange and if you had some who was willing to donate for their loved one but weren't a match and then the same with another pair- they could switch and the 4 could work to together to get their loved ones the kidneys Relevant terms: -paired donors -non-directed donors -market exchange; matching process
What is a substance use treatment (SUD) for opioids ?
Gold standard for opioid treatment = Medication Assisted Treatment (MAT) -Methadone -Buprenorphine -Naltrexone Methodone Clinics SUD-facility Buprenorphine Waivered Physicians, office based
The COVID Vaccine as a fire house? How so?
How effective will the vaccine be if introduced into a population where the virus is surging? If the vaccine is like a fire hose, a powerful fire hose, the ability for that fire hose to do its job is a function of the size of the fire. Their model estimates that while the vaccine is being distributed that 10mil more people would contract the virus and an additional 160,000 would die. "We'll get out of this pandemic faster if we give the vaccine less work to do" Public health efforts can mitigate the results from this model including mask wearing, social distancing, and rapid testing.
why would a small payment work better than a tax on cigarettes?
How is this different than the standard externality correction? What are the possible intended and unintended consequences?
Can we correct externalities?
If we force the responsible party to internalize the cost (or benefit) of the externality
Prescription Drug Affordability and Access Act
Independent federal agency that determines appropriate drug prices and enforces those prices Weigh costs of R&D against costs of comparable therapies and consider federal money that may have contributed to its development
Trump Recent Drug Executive Orders
Importation of drugs from other countries; no additional risk to public health or safety to decrease insulin costs medicare should pay no more than the most favor nation's pricing
MMR does not lead to Autism
In 1998, a study was published linking autism and the Measles vaccine In 2010, this study was late debunked many times but this had a lasting impact on parent vaccination decisions
What are we assuming with a tax levy?
Law of demand holds, but demand will decrease hopefully with a better substitute This action is less about revenue and more about decreasing demand which will depend on how large the tax is (if P increases, Q decreases)
Procrastination
Limited self-control
What is Product Hopping?
Manufacturer forces the switch from the original drug to the newer version. May withdraw older drug from the market which will effectively forestalls generic market entry or substituion
Traditional Economics Definition
Markets are efficient when there are no market failures AND people choose rationally according to their preferences.... if people cant choose rationally , the choices made will not allow the market to reach efficiency
Loss Aversion
May be more sensitive to losses than gains
Ranking of market power between perfect competition, oligopoly, and monopoly
Monopoly is when firms have complete control over market power. Next is oligopoly then perfect competition is when firms have the least market power.
What is naxolone?
Naxolone is an opioid antagonist, meaning when used quickly and properly, it is possible to reverse the affects of an opioid overdose
what were the preliminary findings for the OR experiment
Not interesting: health insurance is positively associated with hospital visits and more procedures when in the hospital health insurance positive associated with use of RX drugs, out patient visits, and health spending Health insurance positive associated with use of preventative care (e.g., diabetes, cholesterol, breast and cervical cancer screenings) Less medical debt No effect on mortality [why?] Subjective physical and mental health improvements• Better access to care
who was eligible in the OR experiment
OR residents, aged 19-64, uninsured for 6+ months, income below FPL
Product Hopping Example with the drug Namenda which is used to treat Alzheimers
Original Formulation: 2/day (Namenda IR) New Formulation: 1/day (Namenda XR) Court findings for the case State of New York VS. Activis: Court found that discontinuing IR has no explanation except to maintain monopoly profits. Forced switch, without legitimate business justification
What was the Master Settlement Agreement?
Outcome: Big Tobacco company would pay over $200 billion over the first 25+ years and additional funds into state tobacco prevention; they voluntarily restricted advertising; and are prohibited to advertise directly or indirectly to youth Context: Alleged Big Tobacco companies had failed to warn consumers about the addictive properties of cigarettes; causes smoking related injuries to individuals and to insurance companies including Medicaid
What happened in Seaman vs Duke?
Outcomes: -Another example of collusion among buyers -violation fo Section 1 of the Sherman Act Story/Context: Dr. Seaman was a Duke radiologist and applied for a comparable position at UNC. Despite being a great fit, she could not be considered because "lateral moves between Duke and UNC are not permitted" Agreements between rivals to not recruit or hire another firm's employees
What happened in Kamakahu vs American Society Reproductive Society
Outcomes: -Collusion among buyers (fertility clinics) = collusive monopsony -Violation of Section 1 of the Sherman Act Context/ Story: Egg donation is used as a assisted reproductive therapy , specifically in-vitro fertilization In 2000 and re-affirmed in 2007, associations worked together to specify appropriate compensation as part of their guidelines. "no more than $5000, payments over $5000 require justification, payments $10000 and up are prohibited" In response, two women egg donors filed suit against the two associations alleging horizontal collusion as to the compensation of the egg donors
Why do some people fail to enroll in health insurance even when it is free or heavily subsidized
Overconfident regarding risks Status quo bias procrastination framing of the issue
Product Hopping Example with OxyContin
OxyContin was designed as abuse deterrent to limit abuse and diversion *enter opioid crisis* Purdue asked the FDA to withdraw patent for original OxyContin citing abuse concerns so no generics could enter
The three phases of patents/ clinical trials
Phase 1 - small human trial to establish drug safety Phase 2- larger human trial (treatment/control); evaluate safety and effectiveness over long periods of time Phase 3- even larger human trial (heterogenous group); effectiveness and tested with presence of other drugs
Example of Positive Externality
Piguvian subsides
Example of negative externality
Piguvian tax
What are needle exchange programs?
Programs that provide new and sterile syringes to drug users. May also provide other limited services like naloxone
Should we pay people to quit smoking?
Proposal: pay individuals on Medicaid to stop smoking proposal would argue to offer smokers small payments to quit
Maybe the answer to organ markets is a compromise between free markets and altruism?
Provide some compensation to be an organ donor but not direct compensation -tax credit -contribution to retirement plan -early access to medicare -contribution to charity -waiting periods (6 months)
how are antitrust monitored?
Public and private mediation Private is able to bolster public enforcement - if you have to have been harmed to have standing and if you are successful in court you can get back charges X3 according to the Clayton Act
What type of drug is Weed? on the federal level
Schedule 1 Drug
What is the Sherman Act?
Section 1: deals with conspiracies Section 2: deals with monopolization or intent to monopolize
what has the outcome of the orphan drug act been?
Since 1983, over 900 orphan drugs have been approved and developed
Why do people stay in these plans when circumstances change?
Status quo bias Procrastination
The policy arguments in favor for legalizing weed
Tax and regulate - mass incarceration and drug crime -illicit black market; high prices/ quantity unknown; violence -some evidence that weed can address pain, anxiety, and other conditions -
What is the traditional way to address negative externalities in consumption?
Taxes are the traditional policy lever used to address negative externalities
Piguvian Tax
This tax impacts the demand side of things - the goal is to make behavior more expensive so your decisions raise the costs for others tax is used to make up for the externality on others
What do we know about the research concerning medical marijuana, medicaid and Opioids?
The first graph in the Marijuana slide set, suggests that potential cost savings for medicaid because of marijuana shift the second graph suggest a shift from prescriptions to MMLs( medical Marijuana) -Prescriptions for opioids can reduce by 3000 if MML is introduced
How would you describe the Epi-Pen situation in the US
The medicine in an Emi-Pe is not new or currently patented, but the delivery device is
How did we get to the Opioid Crisis?
There was not full understanding of the addictive properties of the drug doctors over prescribed it and pharmaceutical opioid suppliers over supplied caused widespread access to illicit opioids ( heroin and fentanyl)
What is the Lower Cost Drugs Now Act?
This act would give Medicare the ability to negotiate drug prices with drug companies to make those prices available to private insurance consumers OOP limit on RX drugs in Medicare (-$2000)
What is the problem definition that addresses the solutions we have seen in the tobacco control policy space?
Tobacco consumption causes externalities - addictive properties -young people -health consequences - second hand smoke
Patent Infringement
Unauthorized use of another's patent. A patent holder may recover damages and other remedies against a patent infringer. violation of patent rights
Positive externality
Underproduction of the externality
Rules of Thumb
Use mental shortcuts rather than consider the full information available
can cost sharing reduce health care spending?
a blunt tool, it reduces necessary and unnecessary care (problematic) doesn't address other causes of cost increases cost sharing matters most for low income patients and can result in worse outcomes
Orphan Drugs
a drug that treats a relatively rare disease (that affects less than 200,000 ppl) 6000-8000 diseases are considered rare and often are genetic in origin
What is monopsony?
a market situation in which there is only one buyer.
Lerner Index
a measure of a firm's markup, or its level of market power
What is demand for organs driven by
by health and disease outcomes
What is altruism?
acting to help someone at the cost of one's self this is the basis of organ donation
What are the information failures inherent in this problem?
adverse selection and moral harzard
What are Naxolone Access Laws?
all states have these policies; however, they vary. Some include requiring police to be trained and always have this on them.
why is the OR experiment important
answers the question of what are the effects of insurance this is hard to study in a causal way and very expensive
what is a choice architect?
anyone who influences the choices you make
what were the effects of different cost sharing on use of health outcomes? (rand
cost sharing (and the resulting reduction in health care services) did not negatively affect health outcomes. but these findings were not statistically significant a few exceptions: benefits seen among the poorest of patients - hypertension, vision care, dental care, and serious symptoms
what were the effects of different cost sharing on use of appropriateness of care and quality (rand)
cost sharing reduced the use of both effective and ineffective care cost sharing did not effect quality of care
What is supply for organs driven by
driven by individual preferences; family preferences; altruism; incentives; life expectancy and traffic accidents
What are schedule 1 drugs?
drugs with no currently accepted medical use and a high potential for abuse and potential to create several psychological and/ or physical dependence
Bounded rationality definition
individual rationality is limited by the available information, cognitive limitations, and time to make a decisions
what is market power
firms with market power have the ability to affect prices which results in prices above the competitive price and output below the competitive output
Saliency
focus on the most important attribute of choice, while ignoring other important attributes
Why do orphan drugs matter in the discussion of patents
incentives matter - the market for these drugs is smaller than typical drugs so there needs to be more incentives at play to spark innovation and development
bounded self interest definition
individuals are often willing to sacrifice their own interests to help others
Can we think of recreational policies as harm reductionction?
legalization with strict regulate could minimize social, individual, and economic costs and could be proactive in regulating and protecting individuals from cannabis ever being legal without restrictions
what was the RAND experiment
long term, experimental study of cost sharing on service use, quality of care, and health outcomes
Framing
makes choices based on how the decision is presented
Are vaccines cost effective?
money spent now to prevent more money spent later vaccines have saved 400b in medical costs between 1994 and 2018
what is the main takeaway from the RAND experiment
moral hazard exists and depends on the degree of cost sharing
Why do monopolys have complete control over market power?
more inelastic demand, the monopoly has more control because demand is less responsive to price changes Monopolists set MR= MC where MR is not equal to Price, unlike perfect competition
negative externality
overproduction of the externality
Bounded willpower definition
people can make decisions that are not in their long term interests
What is the Clayton Act?
prohibits certain business practices (ex. anticompetitive mergers)
What did OR do with their medicaid program?
selected a fraction of low income uninsured individuals through a lottery of coverage
What is the current supply and demand situation for organ donation
shortage- demand for donated organs exceeds the supply of donated organs
Choice overload
too many choices lead to no choice "decision fatigue"
Present oriented
value present over future
what is an externality?
when an individual takes his or her own internal costs or own internal benefits into account but fails to account for external cost or benefits
