Efficiency outcomes of market concentration and managed care

The paper examines how hospital cost efficiency has reacted to extensive horizontal integrations of hospitals and rapid growth of managed care in the US health care industry. Cost efficiency is estimated by using panel data approaches to relax the assumptions for the hospital effects imposed in earlier studies. The paper shows that higher managed care penetration over time is associated with greater hospital efficiency, and higher market concentration is positively associated with efficiency when markets are highly competitive or highly concentrated.     

存款保险制度的产生发展及其理论基础

本文通过对存款保险制度在国际上产生发展的背景分析 ,发现该制度在实践中有内在的必然性 ,在理论上有坚实的基础 ,银行的存在是金融效率所在 ,尽管挤兑可能会发生甚至迅速演化为银行危机 ,但不能否定银行的客观必要性。相反 ,需要防止挤兑和银行危机发生的制度安排 ,其中没有任何一种安排能够取代存款保险制度。中国现在比以往任何时候都需要采纳这一制度以适应市场化金融改革开放的需要 ,当然相应的技术问题仍需要解决。     

Violations of Service Fairness and Legal Ramifications: The Case of the Managed Care Industry

Adapted from Chan's (2000) model depicting success of litigation, this paper argues that with the application of various legislation, health maintenance organizations' (HMOs') violations of service fairness to each group: enrollees, physicians, and hospitals give rise to each group's lawsuits against the HMOs. Various authors (Bowen et al., 1999; Seiders and Berry, 1998) indicate that justice concepts such as distributive, procedural, and interactional justice can be applied to the area of service fairness. The violation of these underlying justice principles with HMOs' service unfairness to enrollees, physicians, and hospitals is examined. A general synopsis of the ethical issues in the managed care industry is provided. The various lawsuits launched by each group: enrollees, physicians, and hospitals together with the key statutes used are discussed. This paper also highlights the provisions and ramifications of the 11 April 2000 landmark agreement that Aetna made with Texas Attorney General John Cornyn to settle the 1998 lawsuit brought against the company. Lastly, the current ethical issues in the managed care industry are further discussed. The value of this paper can be adapted to the study of organizations' service fairness violations in other industries or in the educational, governmental, and not-for-profit sectors both nationally and internationally.     

Designing Optimal Crop Revenue Insurance

When the indemnity schedule is contingent on the farmer's price and individual yield, an optimal crop revenue insurance contract depends only on the farmer's gross revenue. However, this design is not efficient if, as is the case with available contracts, the coverage function is based on imperfect estimators of individual yield and/or price. The producer's degree of prudence and the extent of basis risks have important influences on the optimal indemnity schedule. In this broader context, optimal protection is not provided by available U.S. crop insurance contracts and may include combinations of revenue insurance, yield insurance, futures, and options contracts.     

加强企业统计基础工作初探

文章提出规范和加强企业统计基础工作是确保源头数据质量的需要,并通过对企业统计工作的现状、存在的问题、统计基础工作薄弱的原因进行分析,提出了加强和改进企业统计工作的几点建议。     

Finding Pareto Optimal Insurance Contracts

This paper deals with on-line computation—or step-wise learning—of Pareto optimal insurance contracts. Our approach tolerates that the loss distribution might be unknown, intractable, or not well specified. Thus we accommodate fairly inexperienced parties. Losses are here simulated or observed, one at a time, and they cause iterated revisions of the premium. The mechanical and global nature of probability calculus thereby yields to more tentative, myopic procedures, possibly closer to how humans operate or reason in face of risk. Sequential revisions may also reduce the expense of insurers' time and money in seeking sufficient statistics. Emphasized below is the remarkable simplicity and stability of the resulting adaptive procedures. Special attention goes to catastrophic risks, and to subsidized or competitive insurance.     

A note on “Bed allocation techniques based on census data”

Capacity planning and resource allocation are crucial to the cost-effective delivery of health care services. In this paper, we present an analytic approach based on a modified version of the Holt-Winters multiplicative seasonality forecasting model to determine the frequency distribution associated with a hospital care unit's census. This paper is a follow-up to the census frequency distribution simulation model described in Lapierre et al. (Socio Econ. Plan. Sci. 33 (1999) 25). We demonstrate that our model can provide census frequency distributions equivalent to the simulation model of Lapierre et al. [1], but without the computational effort common to simulation models.     

浅谈基础英语的测试

在教授基础英语中,无论采用何种教学方法,教学过程中的测试,是考查教学效果的一个手段,也是教学中的重要 环节。本文着重对测试的认识以及运用等进行了论述。     

关于上海地区屋顶绿化的思考

在上海市平面绿化工作已初见成效,大型公共绿地越来越多,城市越来越美之时,构建立体绿化 成为当务之急。本文通过对上海地区屋顶绿化的现状及存在的问题的阐述,结合绿化植物的选择和维护的一 些基本理论,展示了屋顶绿化广阔的发展前景。