The curves labeled ATCTI and MCTI represent a technically inefficient production process. This would lead to higher prices (P*TI), lower output (Q*TI), and reduced profit represented by the blue shaded area. Because the firm is a monopolist and is still earning profit, market forces don't guarantee technical efficiency. The profit motive, fear of a takeover, or fear of a new entrant may all play a role in encouraging technical efficiency, but there are no market forces to guarantee it in monopoly.
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