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Healthcare

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Roman Sheremeta, Ph.D.

Professor, Weatherhead School of Management

Case Western Reserve University

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Part 1: Healthcare Collective Action Problems

Part 2: COVID-19 Pandemic

Part 3: Vaccination

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Part 1: �Healthcare Collective Action Problems

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Collective action problems�

  • Collective action problems are widespread throughout healthcare issues.
    • Individuals want to act selfishly in order to maximize their wellbeing, but groups would benefit from cooperation.

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  • Some examples:
    • Individuals want to eat animal foods, resulting in substantial environmental impact from greenhouse gas emissions and other negative externalities, but society is better off with less animal foods consumption.
    • Healthy individuals do not want to pay for healthcare insurance, and the people who want to buy insurance are those who will be using it a lot. As a result, the insurance companies will charge higher prices to compensate for this misbalance causing many people not to buy insurance. But society would be better off if all had insurance.

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Other examples�

  • Examples of healthcare problems:
    • COVID-19 pandemic
    • Vaccination
    • Overreliance on antibiotics
    • Organ donation
    • Universal healthcare insurance
    • Eating animal foods
    • Etc.

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  • All these healthcare problems are collective action problems: there is a conflict between the individual interest and the group interest.

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Part 2: �Covid-19 Pandemic

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Collective action problem�

  • Collective action problem:
    • Individual interests: People do not want to make personal sacrifices, such as wearing masks, maintaining social distance, or quarantine.
    • Group interests: As the group, people want to stop the pandemic and the spread of the coronavirus.

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Some facts�

  • Deaths per million people

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Some facts�

  • Excess mortality

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Some facts�

  • Infection fatality rate (IFR) by age

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Potential solutions�

  • 1) Government regulation
    • Restrictions (lockdown, travel ban)
    • CDC guidelines (masks, social distancing, quarantine)
    • Incentives (fines, free vaccination, free testing, stimulus checks)

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  • 2) Private ownership
    • Assign liabilities to different parties to make them responsible for the spread of COVID-19 (making airlines liable for an outbreak that occurs as a result of the transportation of sick passengers)

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  • 3) Self-organization
    • Building trust
    • Monitoring
    • Social norms (encouraging others to wear masks)
    • Making hand sanitizer commonly and easily available

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Potential solutions�

  • Global COVID-19 Prevention

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Part 3: �Vaccination

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Collective action problem�

  • Collective action problem:
    • Individual interests: People do not want to experience potential side effects of vaccines. However, if a large enough number of people avoid vaccination, there will be insufficient herd immunity.
    • Group interests: The society wants to achieve herd immunity which will decrease mortality and morbidity for all. However, those who refrain from vaccination are nevertheless protected by the actions of their vaccinated peers. Nonvaccinated people hence enjoy a free ride – they are provided protection (herd immunity) at no cost (the injection and possible side effects).

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How vaccination works�

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Potential solutions�

  • 1) Government regulation
    • Mandate vaccination
    • Impose sanctions for non-vaccination
    • Subsidies (pay for vaccination)

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  • 2) Private ownership
    • Criminal liability for spreading disease

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  • 3) Self-organization
    • Education and awareness
    • Employing reminders and follow-ups
    • Social norms (encouraging others to vaccinate)
    • Leading by example (engaging religious or other influential leaders to promote vaccination in the community)

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References�

  • Siegal, G., Siegal, N., & Bonnie, R. J. (2009). An account of collective actions in public health. American Journal of Public Health, 99(9), 1583-1587.
  • Harring, N., Jagers, S. C., & Löfgren, Å. (2021). COVID-19: large-scale collective action, government intervention, and the importance of trust. World Development, 138, 105236.
  • Sandler, T. (2020). COVID-19 and collective action. Peace Economics, Peace Science and Public Policy. 26(3). 1-8.

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