EKONOMI KESEHATAN SUPPLY PELAYANAN KESEHATAN DAN KONSEP BIAYA

Outline �Pengertian Supply �Determinan Supply �Kurva �Konsep Biaya �Pentarifan

Supply �Jumlah barang dan jasa yang bersedia dan dapat ditawarkan oleh Produsen kepada konsumen pada setiap tingkat harga selama periode tertentu �Quantity supplied : the amount of a good that sellers are willing and able to sell

Hukum Supply �Law of supply : “the claim that, other things equal, the quantity supplied of a good rises when the price of the good rises”

Faktor 2 yang mempengaruhi perubahan supply 1. Price �the quantity supplied rises as the price rises and falls as the price falls, �So we say that the quantity supplied is positively related to the price of the good

2. Input Price �To produce its output of ice cream, Student Sweets uses various inputs: cream, sugar, flavoring, ice-cream machines, the buildings in which the ice cream is made, and the labor of workers to mix the ingredients and operate the machines. �When the price of one or more of these inputs rises, producing ice cream is less profitable, and your firm supplies less ice cream. �If input prices rise substantially, you might shut down your firm and supply no ice cream at all.

3. Technology �The technology for turning the inputs into ice cream is yet another determinant of supply. The invention of the mechanized ice-cream machine, for example, reduced the amount of labor necessary to make ice cream. �By reducing firms’ costs, the advance in technology raised the supply of ice cream

4. Expectations �The amount of ice cream you supply today may depend on your expectations of the future. �For example, if you expect the price of ice cream to rise in the future, you will put some of your current production into storage and supply less to the market today.

SUPPLY SCHEDULE �Supply Schedule : a table that shows the relationship between the price of a good and the quantity supplied

SUPPLY SCHEDULE

Market Supply �The market supply is the sum of the two individual or more supplies. �Market supply depends on all those factors that influence the supply of individual sellers, such as the prices of inputs used to produce the good, the available technology, and expectations. �In addition, the supply in a market depends on the number of sellers

SUPPLY PELKES �In our examination of the supply side of medical care sector, the criterion of economic efficency is also important �If the variuos market within medical sector are not economically efficient, the cost of medical care will be higher than it sholud be �We can make policy recommendation to improve the efficiency of the market and reduce the rise in the cost of medical care. �It can also to do redistributive policies.

Determinan Supply Pelkes �Market Structure : Kinds of Market �Competitive Behaviour : Product Strategies �Market Performance : Technical (Max output fro given inputs) and Economic (least-cost combination of inputs used) efficient. Can Use Price/cost ratio �Public Policies: Prevent monopolization, Health Manpower distribution

Gambar 1: Kurva supply untuk… Price ($) S P 2 P 1 0 Q 1 Q 2 Quantity

Jika tingkat biaya faktor produksi berubah (mis: gaji perawat naik atau sewa menjadi lebih murah) maka kurva supply akan bergeser (Gambar 2 dan 3)

Gambar 2: Gaji perawat naik S’ Price ($) S P 2 P 1 0 Q 1 ’ Q 1 Q 2 ’ Q 2 Quantity

Gambar 3: Biaya sewa turun S Price ($) S’ P 2 P 1 0 Q 1 ’ Q 2 ’ Quantity

Kesetimbangan pasar (Market equilibrium) Definisi Situasi dimana harga terbentuk pada: Jml demand thd barang = Jml barang yg disupply

Gambar 4: Pasar barang …. . Price ($) S Market Equilibriu m P 1 D 0 Q 1 Quantity

Gambar 5: Excess demand Price ($) S Market Equilibriu m P 1 P 2 Excess Demand D 0 Q 2 Q 1 Q 2’ Quantity

Gambar 6: Excess supply S Excess Supply Price ($) P 2 Market Equilibriu m P 1 D 0 Q 2 Q 1 Q 2’ Quantity

Respon pasar (market) thd sebuah tekanan atau “shock” �Tekanan atau “shock” adl segala sesuatu yang menggerakkan pasar (market) keluar dari ekuilibrium �Andaikata income penduduk naik: bagaimana pasar osteopathy bereaksi? Gambar 7 mengilustrasikan situasi ini �Proses ini akan terjadi kapanpun jika ada sebuah tekanan yang menyebabkan pergeseran demand atau supply �Pasar akan bergerak keluar dari ekuilibrium dg wujud excess demand atau excess supply �Harga akan menyesuaikan hingga dicapai ekuilibrium kembali

Gambar 7: Dampak kenaikan income pd pasar …. . Price ($) S P 1 P D 1 D 0 Q Q 1 Q 2 Quantity

�Andaikata diinginkan menaikkan jml layanan gigi �Dlm jangka pendek akan memerlukan penambahan jam kerja dokter gigi & stafnya. Krn mereka memberi nilai pd jam istirahat mereka mungkin menuntut upah yg lebih tinggi utk kerja lembur �Dlm jangka panjang, kita hrs mampu menambah jml dokter gigi. Utk itu, kita hrs menaikkan upah dokter gigi agar menarik lulusan SMA masuk FKG dan berkarier sbg dokter gigi

�Jadi implikasi dlm jangka pendek dan jangka panjang adalah bahwa utk meningkatkan output diperlukan penggunaan sumberdaya yg lebih banyak. �Oleh krn itu, jml atau kuantitas yg lebih banyak hanya dapat di-supply pd harga yg lebih tinggi.

Gambar 8 a: Perubahan dlm supply check-up kes gigi Price ($) S 1 S 2 Price Level P 1 P 3 0 Q 3 Q 1 Q 2 Quantity (# of check-

Gambar 8 b: Perubahan dlm supply check-up kes gigi Price ($) S 3 S 1 Price Level P 1 0 S 2 Q 3 Q 1 Q 2 Quantity (# of check-

Supply pelkes dlm praktik-01 � Dlm praktik, supply pelkes adl lebih komplek dibandingkan dg model dasar dari supply, dlm hal-hal sbb: 1. Dalam model supply yg telah dipelajari diasumsikan bahwa tujuan utama produsen adalah utk maximasi profit. Kenyataannya, produsen pelkes di seluruh dunia juga mencakup badan pemerintah dan organisasi non-profit maupun perusahaan yg mencari profit. 2. Bahkan dimana sebagian besar produsen adl swasta pun masih ada intervensi pemerintah yg signifikan, spt subsidi, regulasi harga/tarip, pendanaan publik, dll.

Supply pelkes dlm praktik-02 3. 4. Bicara ttg supply pelkes mengasumsikan bahwa pelkes mempunyai output yg dpt diukur scr objektif. Kenyataannya, hampir setiap pasien menerima sebundel pelayanan yg unik yg membentuk pengobatan mereka. Artinya, pelkes itu bukan sebuah produk yg homogen. Sangat sulit utk mengukur input dan output dr pelkes (khususnya mutu pelayanan). Tidak spt barang manufaktur, pelkes disediakan oleh sekumpulan tenaga profesional yg menyediakan pelatihan, regulasi dan kode etik yg akan mempengaruhi semua pengaturan pelkes.

Konsep Biaya �Biaya : Pengorbanan sumber daya yang diukur dengan nilai moneter untuk mencapai tujuan, pada kurun waktu tertentu �Explicit vs implicit �Historical vs predetermined �Actual, normative, standar �Direct vs Indirect �Short vs Long Run

�Explicit Costs : input costs that require an outlay of money by the firm �Implicit Costs : input costs that do not require an outlay of money by the firm Opportunity Cost �Capital : biaya yg hilang untuk bunga �Gaji : biaya yg hilang untuk upah �Barang Modal : biaya yg hilang bila disewakan

ECONOMIC PROFIT VERSUS ACCOUNTING PROFIT

Klasifikasi Biaya �Sifat Hubungan dengan Volume produk : 1. Fixed Cost : Tidak terpengaruh dengan volume output 2. Variabel Cost : Terpengaruh dengan volume output 3. Semi variabel Cost : Bersifat fixed cost jika tidak digunakan dan bersifat variabel cost jika digunakan Ex: Gaji dan insentif

Klasifikasi Biaya 1. Kegunaan : Investasi, operasional, pemeliharaan 2. Fungsi dalam proses produksi : Direct dan Indirect 3. Frekuensi Pengeluaran : Biaya Modal dan Biaya Rutin

AVERAGE AND MARGINAL COST �Average Total Cost : total cost divided by the quantity of output �Average Fixed Cost : fixed costs divided by the quantity of output �Average Variable Cost : variable costs divided by the quantity of output �Marginal Cost : the increase in total cost that arises from an extra unit of production

AVERAGE AND MARGINAL COST

Cost Curve �Marginal cost eventually rises with the quantity of output. � The average-total-cost curve is U-shaped. � The marginal-cost curve crosses the average-totalcost curve at the minimum of average total cost.

THE RELATIONSHIP BETWEEN SHORT-RUN AND LONG-RUN AVERAGE TOTAL COST

ECONOMIES AND DISECONOMIES OF SCALE �Economies Of Scale : the property whereby long-run average total cost falls as the quantity of output increases �Diseconomies Of Scale : the property whereby long-run average total cost rises as the quantity of output increases �Constant Returns To Scale : the property whereby long -run average total cost stays the same as the quantity of output changes

ECONOMIES AND DISECONOMIES OF SCALE �Economies of scale often arise because higher production levels allow specialization among workers, which permits each worker to become better at his or her assigned tasks �Diseconomies of scale can arise because of coordination problems that are inherent in any large organization

Analisis Titik Impas �Penentuan Tarif jika biaya dan output diketahui �Penentuan output jika tarif sudah ditetapkan �Total Revenue = Total Cost �TR adalah pendapatan/unit (Tarif) dikali dgn total output (Quantity) = (P x Q) �TC adalah TFC + TVC (VCU x Q)

Q FC 0 VC MC TC PRICE= MARGINAL REVENUE (MR) 100 - - 100 - 1 100 12 12 112 35 35 -77 2 100 24 12 124 35 70 -54 3 100 36 12 136 35 108 -31 4 100 44 8 144 35 140 -4 5 100 58 14 158 35 17 6 100 64 6 164 35 210 46 7 100 82 18 182 35 245 63 8 100 103 21 203 35 280 77 9 100 127 24 227 35 315 88 10 100 154 27 254 35 350 96 11 100 185 31 285 35 385 100 12 100 220 35 320 35 420 100 13 100 259 39 35 455 90 14 100 303 44 403 35 490 87 Max Profit pada Keadaan : * TR-TC = Max * MC=MR TR PROFIT (TR -TC) -100

Cost Curve 900 TR=TC Break even Profit = 0 800 700 600 Keuntungan Kurang/semu Tidak ada investasi FC 500 MC TC 400 PRICE= MARGINAL REVENUE (MR) TR Profit Max (TR-TC) Max business enterprise 300 200 MR=MC 100 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

Sources �Feldstein (1999) �Mankiw (2003) �Wonderling et. all (2005) �Najib (2011)

THANK YOU