Yanti Tugas Dari Puskesmas

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minished when supply is more inelastic; because of greater costs the feasibility ofinstituting such a program, as well as its comprehensiveness, is reduced.

The economic efficiency of the supply side of medical care will influence

decisionmakers as to the type of national health insurance program that is developed,

when it will be implemented, and what it wii cover. there will also be redistributiveeffects among different population groups in society depending upon the

inelasticityin princes,wages and incomes of the providers of medical services. The

rest of the population will finance such increases from their own incomes and fromtaxes they pay to support demand shift program in medical care.

By analyzing the elasticity of the supply of medical services, it is possible to

more accurately forecast the efffect on princes and expenditures of demand increasingprograms and to evaluate the performance of the providers of medical care. if analysis

reveals that the supply of medic services is determined solely by the nature of

theproduction function forproducing those services and further, that the provider areattempting to minimize their costs the very few changes will be possible to improve

the perfomance of the industry. The increase in medical prices and the type of outputbeing produced could not be altered without serious and harmful effects on the

industry and the patients. If however, the production function is artificiallyconstrained by legal restriction, and there are few incentives for the providersto

minimize theirs costs of production,the it would be possible to improve the

performance of the medical sector.In evaluating the performance of each of the medical markets, our first step

will be to axamine the market structure of each of the separate markets, beginning

with the institutional setting in which care is privided, proceeding to the man powermarkets and ending with the education markets. Each medicalmarket wiil be

compared with a hypothetically competitve medical market. The competitive market

is used as the yardstick for comparison, since it is inclusive of the condition necessary

for economuc efficiency. The performance tha migh be expected under a competitivemarket will then be compared with what is observed in the particular medical market.

Any divergence in performance between what is theoretically expected and what is

observed will be analyzed in term of differences in the structure and assumptionsunderlying the hypothetically cpmpetitive and actual markets. Public policy

recommendations to imprive the performance of the particular market studied will be

made with reference to the differences in the structure and consequently theexpeected performance of the two markets.

Markets performance can presumably be impoved throug alternative

approaches: first the actual market can be restructured to more closely approximate acompetitive industy, wherein decisionmaking is decentralized and greater reliance is

placed on competitive pressures to achieve the goal of a competitive market. Under

either of these approaches there needs to each market . Unless there is some

similarity between the desired outcome measure, differences between the advocatesof increased regulation and the proponents of greater use of marker pressures will be

expressed in term of value judgments rather than in more measurable terms reflection


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the most efficient way to achieve a give outcome. In the health field, proposals forrestructuring the delivery of medical services are often based more upon a general set

of values that stop shortof a clear definition of what the performance outcome of the

industry should be. If the health industry is evaluated economic efficiency, the those

measures should be cleary enunciated and the implicit values underlyng them shouldalso be clearly explained. The two approaches suggested for improving market

performance-increased regulation versus greater reliance on market oressures-will to

indicate what might be expected to occur under these different approaches towardimproving market performanc3 in medical care.

For each of the institutional and education markets, we are interested in the

following aspects of economic efficiency 1) is each firm (hospitals, physiciansoffices, medical schools) minimizing its costs of production ? 2) is the number of

firms in the industry the right number;i.e., is each firm taking advantage of

whatever economimies of scale may exist? 3) are the firm, and the industry as awhole, producing both a type and a quantity of output demanded by the consumers?.

Taking each of the above concerns in orderin an industry characterized bypure competition 1) each firn must be efficient, otherwise it will not be able to

survive: 2) the number of firm in the industry is determined by both the evtent ofeconomies of scale in production and in the long run, each firm is operating at that

palnt size that is most efficient, i.e., the minimum point on the long-run average-cost

curve, and patient travel cost; and 3) the suppliers each respond in the short run ( andin the long run through the entry of new firms) to changes in demand. To what extent

does this performance occur in each of the medical markets?For each of the

institutional and education markets an analysis will


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minished manakala persediaan jadilah lebih tidak elastis; oleh karena biaya-biaya lebih besar[adalah] kelayakan dalam mendirikan/memulai program seperti itu, seperti halnyakelengkapan/keluasan nya, dikurangi.

Efisiensi ekonomi dari sisi persediaan perawatan medik akan mempengaruhidecisionmakers menyangkut jenis asuransi kesehatan program nasional yang

dikembangkan, manakala akan jadi diterapkan, dan apa [yang] [itu] wii [meliput/tutup]. akanada juga efek distributif kembali antar populasi berbeda menggolongkan di (dalam)masyarakat yang tergantung atas inelasticityin princes,wages dan pendapatan dari penyedia[dari;ttg] jasa medis. Sisa dari populasi akan membiayai peningkatan dari pendapatanmereka sendiri dan dari pajak [yang] mereka membayar untuk mendukung permintaanbergeser program di (dalam) perawatan medik.

[Oleh/Dengan] penelitian kekenyalan dari persediaan [dari;ttg] jasa medis, adalah mungkinke dengan teliti meramalkan efffect pada [atas] para pangeran dan pembelanjaan permintaanyang meningkat(kan) program dan untuk mengevaluasi capaian dari penyedia perawatanmedik. jika analisa mengungkapkan [bahwa/yang] persediaan jasa dokter ditentukan semata-mata oleh sifat alami theproduction fungsi yang forproducing jasa itu dan lebih lanjut,[bahwa/yang] penyedia sedang mencoba untuk memperkecil biaya-biaya mereka [adalah]sangat sedikit perubahan akan [jadi] mungkin untuk meningkatkan perfomance dari industri.Peningkatan di (dalam) harga medis dan jenis keluaran yang sedang diproduksi tidak bisadiubah tanpa efek [yang] berbahaya dan serius pada [atas] industri dan pasien itu. Jikabagaimanapun, fungsi produksi secara palsu dibatasi oleh pembatasan sah/tentang undang-undang, dan di sana adalah sedikit perangsang untuk providersto memperkecil biaya-biayaproduction,the [yang] punya mereka adalah mungkin meningkatkan capaian dari [yang]sector.analyzed medis dalam hal perbedaan di (dalam) asumsi dan struktur mendasarisecara hipotetis cpmpetitive dan pasar nyata. Pujian/Rekomendasi kebijakan publik keimprive capaian dari pasar tertentu yang yang dipelajari akan [jadi] dibuat berkenaan denganperbedaan di (dalam) struktur dan sebagai konsekwensi capaian expeected dari dua pasar.

Di (dalam) mengevaluasi capaian dari tiap dari pasar medis, langkah [yang] pertama[kita/kami] adalah untuk axamine struktur pasar dari tiap dari pasar terpisah, mulai denganperaturan baku di mana kepedulian privided, meneruskan tenaga kerja pasar dan akhiran

dengan pendidikan menjual. Masing-Masing medicalmarket wiil dibandingkan dengan suatusecara hipotetis competitve pasar medis. pasar Yang kompetitif digunakan sebagai ukuranuntuk perbandingan, karena inclusif kondisi yang diperlukan untuk economuc efisiensi.capaian itu Tha migh diharapkan di bawah suatu pasar kompetitif akan (menjadi)dibandingkan dengan apa [yang] diamati di (dalam) pasar medis yang tertentu. Manapunpenyimpangan di (dalam) capaian antar[a] apa [yang] secara teoritis diharapkan dan apa[yang] diamati akan [jadi] dianalisa dalam hal perbedaan di (dalam) asumsi dan strukturmendasari secara hipotetis cpmpetitive dan pasar nyata. Pujian/Rekomendasi kebijakanpublik ke imprive capaian dari pasar tertentu yang yang dipelajari akan [jadi] dibuatberkenaan dengan perbedaan di (dalam) struktur dan sebagai konsekwensi capaianexpeected dari dua pasar.

pasar capaian Kaleng [yang] kiranya (adalah) throug pendekatan alternatif impoved: pertama

pasar yang nyata dapat diatur kembali ke lebih lekat mendekati suatu industy kompetitif,dalam mana pengambilan keputusan didesentralisasi dan kepercayaan lebih besarditempatkan pada [atas] tekanan kompetitif untuk mencapai gol dari suatu pasar kompetitif.Di bawah yang manapun pendekatan ini [di/ke] sana harus masing-masing pasar. Kecuali

jika ada beberapa persamaan antar[a] ukuran hasil yang diinginkan, perbedaan antar[a]advokat [dari;ttg] peraturan ditingkatkan dan penganjur [dari;ttg] penggunaan juru


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