The Political Economy of Improving Health Care for the Poor in Rural Africa: Institutional Solutions to the Principal–Agent Problem

2004 ◽  
Vol 40 (4) ◽  
pp. 50-77 ◽  
Author(s):  
Kenneth L Leonard ◽  
David K Leonard
2020 ◽  
Vol 37 (1) ◽  
pp. 138-158
Author(s):  
James A. Harris

AbstractMy point of departure in this essay is Smith’s definition of government. “Civil government,” he writes, “so far as it is instituted for the security of property, is in reality instituted for the defence of the rich against the poor, or of those who have some property against those who have none at all.” First I unpack Smith’s definition of government as the protection of the rich against the poor. I argue that, on Smith’s view, this is always part of what government is for. I then turn to the question of what, according to Smith, our governors can do to protect the wealth of the rich from the resentment of the poor. I consider, and reject, the idea that Smith might conceive of education as a means of alleviating the resentment of the poor at their poverty. I then describe how, in his lectures on jurisprudence, Smith refines and develops Hume’s taxonomy of the opinions upon which all government rests. The sense of allegiance to government, according to Smith, is shaped by instinctive deference to natural forms of authority as well as by rational, Whiggish considerations of utility. I argue that it is the principle of authority that provides the feelings of loyalty upon which government chiefly rests. It follows, I suggest, that to the extent that Smith looked to government to protect the property of the rich against the poor, and thereby to maintain the peace and stability of society at large, he cannot have sought to lessen the hold on ordinary people of natural sentiments of deference. In addition, I consider the implications of Smith’s theory of government for the question of his general attitude toward poverty. I argue against the view that Smith has recognizably “liberal,” progressive views of how the poor should be treated. Instead, I locate Smith in the political culture of the Whiggism of his day.


JAMA ◽  
1994 ◽  
Vol 272 (5) ◽  
pp. 352
Author(s):  
Carlos Vallbona

2010 ◽  
Vol 2 (3) ◽  
pp. 44-84 ◽  
Author(s):  
Ulf von Lilienfeld-Toal ◽  
Dilip Mookherjee

What are the effects of restricting bonded labor clauses in tenancy or debt contracts? While such restrictions reduce agents' ability to credibly commit ex ante to repay principals in states where they default on their financial obligations, they also generate a pecuniary externality on other principal-agent pairs by reducing the equilibrium profit earned by principals. This turns out to imply that on both political and normative grounds, restrictions on bonded labor become more attractive when borrowers become wealthier or the range of collateral instruments widens. (JEL D82, D86, J82, K12)


2018 ◽  
pp. 101-114
Author(s):  
Max Abrahms

Militant leaders must not only understand the folly of terrorism, but prevent members from carrying it out. Members are known to harm civilians even when their leaders oppose this targeting practice. This disconnect between the preferences of leaders and behavior of subordinates is due to what economists call a principal–agent problem. This chapter explains the principal–agent problem facing militant leaders and how they can overcome it. The second rule for rebels is grasping this organizational predicament to minimize it. Smart leaders know not only the political costs of civilian attacks, but how to restrain their members from committing them.


2018 ◽  
Vol 48 (2) ◽  
pp. 328-348 ◽  
Author(s):  
Megan M. Reynolds

Growing research on the political economy of health has begun to emphasize sociopolitical influences on cross-national differences in population health above and beyond economic growth. While this research investigates the impact of overall public health spending as a share of GDP (“health care effort”), it has for the most part overlooked the distribution of health care spending across the public and private spheres (“public sector share”). I evaluate the relative contributions of health care effort, public sector share, and GDP to the large and growing disadvantage in U.S. life expectancy at birth relative to peer nations. I do so using fixed effects models with data from 16 wealthy democratic nations between 1960 and 2010. Results indicate that public sector share has a beneficial effect on longevity net of the effect of health care effort and that this effect is nonlinear, decreasing in magnitude as levels rise. Moreover, public sector share is a more powerful predictor of life expectancy at birth than GDP per capita. This study contributes to discussions around the political economy of health, the growth consensus, and the American lag in life expectancy. Policy implications vis-à-vis the U.S. Affordable Care Act are discussed.


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