Effects of perceived cost,service quality,and customer satisfaction on health insurance service continuance

This paper aims to contribute to the universal discourse on financial services continuance behavior by examining the impact of service cost on customers’ service-quality perception and service continuance intention. It presents the results of an empirical study that has explored the impacts of service cost, service quality, and customer satisfaction on health insurance customers’ behavioral intention toward continuing or discontinuing with their service providers. Very few studies had examined the impact of service cost on service-quality perception. Our study attempts to fill that gap. A sample of 820 customers was surveyed, and 624 usable responses were analyzed with ANOVA, standard multiple regression, and logistic regression. Our findings indicate that, although highly satisfied health insurance customers will most likely retain their current service providers, customer dissatisfaction does not necessarily lead to discontinuance. Our results also provide some operational implications for health insurance managers, with strategies for reducing attrition and improving customer retention.     

International Cartel Enforcement: Lessons from the 1990s

The enforcement record of the 1990s has demonstrated that international private cartels are neither relics of the past nor do they always fall quickly under the weight of their own incentive problems. Of a sample of forty cartels prosecuted by the United States and European Inion in the 1990s, twenty‐four cartels lasted at least four years. And for the twenty of the cartels in this sample where sales data are available, the annual worldwide sales in the affected products exceeded US$30 billion. Prevailing national competition policies are oriented towards addressing harm done in domestic markets, and in some cases merely prohibit cartels without taking strong enforcement measures. In this paper we propose a sequence of reforms to national policies and to international cooperation that will strengthen the deterrents against international cartels. Furthermore, aggressive prosecution of cartels must be complemented by vigilance in other areas of competition policy. If not, firms will respond to the enhanced deterrents to cartelisation by merging or by taking other measures that lessen competitive pressures.     

Travel for treatment: students' perspective on medical tourism

Medical tourism is the act of travelling abroad for health care. The theory of planned behaviour was used to investigate the medical tourism beliefs of 336 undergraduate students in a basic psychology course at a large midwestern American university. Students did not have positive intentions for mere willingness to seek more information about travelling to a developing country to receive medical treatment. An educational intervention is necessary to help promote travel for medical treatment. The intervention may include educating people on the availability of quality health care, highly trained competent doctors and the ability to vacation and see another country. Copyright © 2010 John Wiley & Sons, Ltd.     

Food assistance programs and food insecurity: implications for Canada in light of the mixing problem

In light of concerns about high rates of food insecurity, some have suggested that it might be time for Canada to implement national food assistance programs like those provided in the US, namely the Supplemental Nutrition Assistance Program (SNAP) and the National School Lunch Program (NSLP). In this paper, we assess how adopting these types of assistance programs would change the food insecurity rate in Canada among households with children. Using data from the Current Population Survey (CPS), we first evaluate the causal impact of these programs on food insecurity rates in the US using the Canadian definition of food security. Following other recent evaluations of food assistance programs, we use partial identification methods to address the selection problem that arises because the decision to take up the program is not random. We then combine these estimated impacts for the US with data from the Canadian Community Health Survey (CCHS) to predict how SNAP and NSLP would impact food insecurity rates in Canada. Partial identification methods are used to address the “mixing problem” that arises if some eligible Canadian households would participate in SNAP and others would not. The strength of the conclusions depends on the strength of the identifying assumptions. Under the weakest assumptions, we cannot determine whether food insecurity rates would rise or fall. Under our strongest nonparametric assumptions, we find that food insecurity would fall by at least 16% if SNAP were implemented and 11% if NSLP were implemented.     

Reciprocity in Caring Labor: Nurses’ Work in Residential Aged Care in Australia

Feminist economists identify reciprocity as a motivation for both paid and unpaid caring work. In general, reciprocity describes people responding to each other in similar ways, either benevolently or harmfully. The quality of care is potentially increased when care relationships are motivated by positive and generalized forms of reciprocity and decreased with negative forms of reciprocity. This study draws on nursing literature and two qualitative studies in Australian residential aged care facilities, conducted in 2002–3 and 2009, to identify a new form called “professional reciprocity.” This form of reciprocity involves deliberate and skilled relational work by nurses to facilitate mutual and interdependent exchanges with care recipients that are beneficial to both care recipients and nurses. This study argues that professional reciprocity, as a skill that can be taught, is important for achieving quality care and workers’ job satisfaction.     

The Tourism Market's Response to the 2009 Black Saturday Bushfires: The Case of Gippsland

One of the key roles of a destination marketing organization (DMO) is to portray their destination in such a way that it is both appealing and inviting to their existing and potential tourism market. A challenge faced by a DMO in the regional Victorian destination of Gippsland in Australia, is the fact that they also have to manage unanticipated sudden changes in market perceptions that may occur in response to a disastrous event. The reoccurring natural disasters of this region (fires, floods and drought)—the most recent being the 2009 Black Saturday bushfires, deemed Australia's worst natural disaster in history—make it imperative that DMOs can respond effectively. This article presents the findings of an exploratory research project designed to investigate the tourism market's response to this particular disastrous event. The primary aim of the research was to better understand how a large-scale disaster impacts upon the tourist's destination image and visitation intentions, and the role of the media in these deliberations. Focus group research reveals the post-disaster media interpretations, images, and visitation intentions of intrastate and interstate, regional and metropolitan tourists. Differences are observed in relation to the participants' geographic location and distance from the fires and their understandings of the event, including their reflections on media coverage. Varying perceptions among the participants of the impact of the fires, the travel risk, and subsequent travel intentions are discussed. Managerial implications relating to media management and the refinement of future disaster management strategies are also presented.     

Captives zur Absicherung von Extremrisiken? Eine Untersuchung am Beispiel der OIL Insurance Limited

The use of captive insurance companies (captives) is quite common among big and international companies. Generally, captives are used to insure against high frequency/low severity risks. However, we can find captives which have been founded to deal with extreme risks as well. An example is the OIL Insurance Limited (OIL Insurance). In this context, we examine from a theoretical perspective whether captives are suitable for insurance against catastrophe risks. We show that regarding actuarial aspects captives have advantages in comparison to internal self-insurance and disadvantages in comparison to external insurance. The foundation of industry captives through the association of several companies can solve some of the problems, but further criteria especially costs have to be considered. Based on the developed arguments, we analyse whether our case example OIL Insurance is an appropriate instrument to transfer extreme risks.     

The Influences of Customer Relationship Metrics on Shareholder Value: What Should Be Done and What Has Been Done?

The contribution of customer relationship (CR) metrics to shareholder value is practically unknown in research and practice. Existing studies report rather ambiguous results. We develop a proposal to identify and measure the multidimensional influences in a valid and reliable way. By comparing existing studies to each other and to our framework, we can find possible reasons for their ambiguity: First, the studies are actually not compatible while using various CR metrics and performance measures. Second, several conceptual and methodological differences also place the comparability of their results in question. The application of our framework should explain the inconsistent outcomes of existing studies and indicate a consistent and general influence of CR metrics on shareholder value.     

Farmland for tomorrow in densely populated areas

The paper describes the results of a research that aimed to come up with a well structured method to estimate future farmland requirements in densely populated areas. By using in depth interviews, scenario analysis and strategic orientation rounds, a method is developed to support policy optimization and to explore alternative future developments. The method is applied to the case of agriculture in the Flemish part of Belgium to show the feasibility of the model and to provide input for the discussion among policy makers in Flanders. The research results can be used by policy makers to build a new Spatial Plan Flanders for the period 2007–2013.