Self-interest, public interest, and public health

Summary

Although the activities of physicians, as represented by the AMA, have long been viewed from a self-interest perspective by economists, public-health processes have not been subjected to such an examination. But just as the conduct of ostensibly charitable hospitals cannot be examined independently of the interests of the physicians who staff them, so too, we think, the conduct of public-health bureaus should not be examined in isolation from the interests of the medical community that they represent. An interest-group interpretation of public health would look to the ways in which public-health processes increase the aggregate demand for medical services, thereby generating quasirents for specialized input suppliers. We have explored in preliminary fashion some ways in which public-health agencies may advance the collective interests of physicians, though we would be the first to acknowledge that much work remains to be done on this topic.