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Chapter 8

chapter 8

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University of Toronto Scarborough
Health Studies

Chapter 8 Markets and Health policy Introduction 1 Since the 1970s social and economic changes have dramatically restructured the global economy specifically the process of production and investment2 In addition concerns about rising deficits that began in the early 1980s drove both federal and provincial gvnts to reduce social and health spendingWhat is a market 1 A market is a complex set of social institutions that enables the exchange of a commodity such as a goodhousing or service health care btwn a seller and a buyer2 The market is thus a mod of exchange that meets the nees of society by buying and selling goods and services as private property or commodities3 In the market the process of distribution is based on competitive supply and demand in the exchange process4 The market also comes to represent a means by which labour power and capital income and wealth are distributed through process of production and consumptionInequalities in such distributions may also give way to differences in political power and influence5 Leys asserts that markets are highly political because politics shape market activities as much as do the processes of cost revenue and profit marginsCharacteristics of Markets 1 Leysidentifies the characteristics and this is particularly helpful for understanding the current orientation of gvnts and others toward market mechanisms to control health care costs2 Markets are systems consisting of rules and regulations set and enforced by both state and nonstate agencies including market actors through trade associations informal agreements and market power such as price maintenance Regulations govern what can be traded as well as when and where trading can occur it also influences costs profit margins and other aspects of the trading processLeys suggests that it is at this juncture of shaping regulations that market politics come into play3 Second markets are complex Any one market is embedded directly or indirectly in a broad series of other social relations Activities of those work in markets also participate in other social realtions and are shaped by them Social realtions refers to the pattern of relationships btwn people in a group or organization in which they function4 Third markets are inherently unstable Their instablility reflects the nature of competition Instability is a function of industry and other market sectors always tryignt o increase their market share which is the proportion of industry sales of a good or service that is controlled by an individual company or firm
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