Courts as healthcare policy-makers: the problem, the responses to the problem and problems in the responses

This article starts by analysing healthcare litigation in Brazil by means of a literature review of articles that contribute with empirical findings on this phenomenon. Based on this review, I argue that health care litigation in Brazil makes the public health system less fair and rational. In the second part of this article, I discuss the three most overarching responses to control the level of litigation and its impact on the public health system: (i) the public hearing held by the Supreme Federal Court and the criteria the court established thereafter; (ii) the recommendations by the National Council of Justice aimed at building courts’ institutional capacity; and (iii) the enactment of the Federal Law 12.401/11, which created a new health technology assessment system. I argue that latter is the best response because it keeps the substantive decisions on the allocation of healthcare resources in the institution that is in the best position to make them. Moreover, this legislation will make the decisions about provision of health treatments more explicit, making easier for courts to control the procedure and the reasons for these decisions.

Why designate market makers? affirmative obligations and market quality

We study why most financiaI markets designate one or more agents who precommit to provide more liquidity than they would endogenously choose, and identify two reasons that such affirmative obligations can improve welfare. The first relies on the insight that the informational component of the competi tive bid-ask spread represents a transfer across traders, not a social cost to completing trades. As such, this trading cost dissuades efficient trading, while a restriction on spread widths encourages efficient trading. Secondly, a restriction on spread widths encourages traders to become informed, which speeds the rate at which market prices move toward true asset values in the wake of information events. We consider the setting where competition ensures that affirmative obligations impose net trading losses on designated market makers that must be compensated by side payments, as observed on the Euronext limit order market, and also the setting where the designated market maker is allowed some advantages relative to limit order traders so that profits can be eamed during tranquil periods to offset losses incurred when affirmative obligations are binding, as observed on the NYSE.