Quality Competition, Insurance, and Consumer Choice in Health Care Markets

In this model, insurance offering a choice of hospitals is valued because consumers are uncertain which hospital they will prefer ex post. A competitive insurance market facilitates tacit price collusion between hospitals; high margins induce hospitals to compete for customers through overinvestment in quality. Incentives may exist to lock in market share via managed-care plans with less choice and lower prices. As technology becomes more expensive, the market increasingly offers too little choice. A pure managed care market may emerge, with underinvestment in quality. Relative to a pure insurance regime, however, all consumers are better off under managed care.     

Market Optimism and Merger Waves

We argue that stock and bond market booms and merger waves are both driven by increases in optimism in financial markets and discuss two behavioral hypotheses, the managerial discretion and overvaluation hypotheses that claim that merger waves are driven by market optimism. Empirical support for the managerial theory is provided by evidence that the amounts of assets acquired increase as optimism in financial markets increases and that the returns to acquiring companies are inversely related to market optimism at the time of mergers. Our measures of market optimism also explain managerial choices of finance for mergers. Copyright © 2012 John Wiley & Sons, Ltd.     

Flow Signals: Evidence from Patent and Alliance Portfolios in the US Biopharmaceutical Industry

Integrating signalling theory and the portfolio diversity literature, we theorize that diversity in a firm's patent and alliance portfolios sends contrasting flow signals impacting its market value in a nuanced way. Diversity in an alliance portfolio mediates the patent portfolio diversity – market value relationship by suppressing the negative effect of patent portfolio diversity creating an overall positive effect. We test our mediation model on a longitudinal set of 225 US biopharmaceutical firms that were awarded 17,078 patents and participated in 37,744 alliances between 1990 and 2006. Our theory and findings contribute three novel insights. First, we demonstrate the value of a temporal lens in explaining why diversity in a firm's patent and alliance portfolios send flow signals that establish expectations among market observers and have performance implications. Second, establishing that patent and alliance portfolio diversity are temporally sequenced provides compelling evidence for the value of studying multiple types of portfolios, their temporal relationships and effects on firm outcomes. Third, since diversity in a firm's portfolios can send contrasting flow signals conditioned on the cognitive demands and proximity involved in interpreting the signals, firms that do not maintain a ‘signalling fit’ with market observers increase the probability of unintentional negative signalling effects.     

Competition among Health Maintenance Organizations

We develop a model of competition among health maintenance organizations (HMOs) to analyze the effects of market power, scale economies, and asymmetric knowledge of health risk on market outcomes. We find that competition among HMOs may, but need not, ensure socially preferred outcomes. Market power or scale economies can sometimes admit socially preferred outcomes when they would otherwise not arise. Asymmetric knowledge of health risk may or may not be constraining. When it is constraining, a variety of patterns of incomplete health insurance can arise, along with excessive or insufficient treatment and preventive care for either high-risk or low-risk individuals.     

Utilization control in HMOs.

Health Maintenance Organizations (HMOs) have emerged as a major vehicle to reduce transaction costs associated with defining the limits of health insurance coverage and to provide appropriate provider incentives. This article explains the heterogeneous set of incentives used by HMOs to reimburse providers and performs empirical tests of their effectiveness. The empirical analyses reveal that utilization of health care services is reduced when (1) physician compensation is based on salary or capitation arrangements rather than some measure of output; (2) bonuses and paybacks are based on individual rather than group performance; and (3) when the HMO operates as a proprietary (for-profit) organization. Utilization is not significantly affected by incentives placed on the hospital. Finally, physician ownership of the HMO was found to lead to higher levels of utilization.     

HMO Participation in Medicare+Choice

In recent years, many health maintenance organizations (HMOs) have exited Medicare+Choice (M+C), the program that provides a managed‐care option to Medicare. This paper answers the following questions: How does the equilibrium number of HMOs participating in county M+C markets vary with the capitation payment they are offered? How large a payment is required at the margin to ensure that various percentages of county markets have a M+C HMO, or to ensure that various percentages of Medicare beneficiaries have the choice of a M+C plan in their county of residence? The strategy for identifying the effect of government payment on HMO participation relies on a natural experiment; in 1997, Congress divorced M+C payments to HMOs from changes in underlying costs. The results in this paper suggest that the Centers for Medicare & Medicaid Services (CMS) has consistently underestimated the payment necessary to support HMOs in rural, sparsely populated areas. We also find that it would require a large incremental payment to support HMOs in M+C for the final 10% of counties or final 10% of Medicare beneficiaries.     

Estimating the Impacts of Outlet Rationalization on Retail Prices,Industry Concentration,and Sales: Empirical Evidence from Canadian Gasoline Markets

The retail gasoline industry in both Canada and the United States experienced a significant rationalization of outlets from the late 1970s through the 1990s. We estimate the impacts of reduced outlet density by exploiting the 27% decline in retail gasoline outlets across 10 Canadian cities between 1991 and 1997. Ordinary least squares and instrumental variables estimates suggest that rationalization resulted in a significant increase in retail prices, market concentration, and average outlet sales. The decline in retail outlets led to a 9% increase in retail prices, a rise in market concentration between 16% and 22%, and a 22% increase in average outlet sales.     

企业兼并风险及对策研究

企业兼并是经济发展的必然趋势。在西方国家市场经济发展的过程中,先后爆发了四次大规模的企业兼并浪潮,对这些国家的经济发展产生了深远的影响。随着我国社会主义市场经济体制的建立和发展,这种产权交易活动也为众多的企业所关注和采用。但是目前企业兼并中还存在着财务、经营、审计、文化等风险。需要我们采取相应的对策加以解决。     

Market power among physicians in the U.S., 1983–1991

The growth of health care costs and expenditures recently led to suggestions for innovations that would affect demand for health care. However, supply side issues were largely ignored in the debate despite the fact that the American Medical Association has controlled entry since it was granted that power by legislators early in this century. We consider the supply side of the market for physicians' services over 1983–1991. Our estimated index of market power indicates nontrivial power among physicians. This suggests that conventional policy tools could reduce costs in this market. This, in turn, could effectively lower insurance premiums.     

The international drivers of domestic airline mergers in twenty nations: integrating industrial organization and international business

The domestic airline merger phenomenon of the late 1980s and early 1990s sparked a great deal of Industrial Organization (IO) literature; yet, that literature neglected non‐US domestic mergers and potential for international competitive gains. Using an International Business perspective to complement an IO analysis, I argue that factoring international competitive incentives helps explain domestic airline merger activity. A Cournot model of airline competition illustrates that domestic mergers, via enhanced domestic networks and reduced domestic competition, generate international competitive gains. Further, empirical tests—using a structural equations approach on panel data covering interhyphen‐national city‐pair market segments—support domestic mergers improving international competitiveness. Copyright © 2006 John Wiley & Sons, Ltd.     

Is economic efficiency the driving force behind mergers?

Some economists routinely argue against government regulation that limits the number of mergers and acquisitions. They believe that, as a matter of empirical fact, almost all mergers enhance economic efficiency. The possibility that some mergers do not create wealth but merely redistribute it is ignored. We study all companies delisted from the New York Stock Exchange for reason of merger since 1926. We find that economic efficiency cannot easily explain merger waves. Contrary to the disciplinary hypothesis, acquisition targets are not, in large majority, poor stock market performers. We also report evidence consistent with stock market undervaluation as a merger motive.     

Transformations in- and outside the internal labour market: institutional change and continuity in Japanese employment practices

The weak performance of the Japanese economy since the 1990s has renewed the debate on the efficiency of its employment practices. Although actual changes have long trailed expectations, two major developments have taken place in recent years: a rise in non-regular employment and the introduction of performance-related pay (seikashugi). Both affect the internal labour market that has been crucial to human resource management in Japan. The first development diminishes its relevance and the second directly impacts its functioning. This paper discusses these changes and the factors that determine their character. Moreover, it argues that the changes are not just aligned with but also made possible by an important continuity in the support for the core practice of lifetime employment. What results is a story of institutional change and continuity which argues that the specific character of Japanese employment practices remains in spite of an apparent convergence.     

The effect of mergers on firms’ costs: evidence from the HMO industry

We examine the effect of mergers on firms’ costs, using a national data set that contains information on both pre- and post-merger costs for firms in the Health Maintenance Organization (HMO) industry. By utilizing data on all HMOs that operated in the United States from 1985 to 1997, we observe enough mergers to obtain estimates of both short-run and relatively permanent merger effects. On average, we do not find evidence that mergers allowed HMOs to realize greater economies of scale or that mergers improved efficiency by shifting the cost function. On the other hand, mergers between HMOs that produce Medicare and other products are likely to create dis-economies of scope that increase costs.     

基于SCP范式对我国财产保险业的发展现状分析

中国自1980年恢复财产保险业务以来,财产保险业得到了快速发展。通过利用"市场结构——市场行为——市场绩效"理论分析财产保险业的发展状况,了解财产保险业发展过程中的内在矛盾,对今后财产保险业的快速发展有着重要的意义.     

Whatever Happened to Goldilocks? The Role of Expectations in Estimates of the NAIRU in the US and the UK*

During the second half of the 1990s the US economy was characterized as the Goldilocks economy: not too hot, nor too cold, but just right. It was argued that this represented a new paradigm, enabling unemployment to remain low without igniting inflationary pressure. We examine the evidence for a change in the relationship between inflation and unemployment for the US and UK using Phillips curve models. The impact of including explicit inflation expectations is also considered. Inflation expectations are found to play an important role, particularly in the US. When expectations are included there is still evidence that the non‐accelerating inflation rate of unemployment (NAIRU) steadily declined during the late 1990s, although this decline in the US NAIRU is not found solely in the 1990s.     

Labor Regulations and European Venture Capital

European nations substitute between employment protection regulations and labor market expenditures (e.g., unemployment insurance benefits) for providing worker insurance. Employment regulations more directly tax firms making frequent labor adjustments than other labor market insurance mechanisms. Venture capital (VC) investors are especially sensitive to these labor adjustment costs. Nations favoring labor market expenditures as the mechanism for providing worker insurance developed stronger VC markets over 1990–2008, especially in high‐volatility sectors. In this context, policy mechanisms are more important than the overall level of worker insurance.     

Merging National Insurance Contributions and Income Tax: Lessons of History

This paper is a response to the British Chancellor of the Exchequer's consultation on closer integration of the operation of National Insurance contributions and income tax. Our historical research on proposals for a complete merger of the two systems enables people interested in tax reform to draw on experience and ideas of officials who grappled with issues similar to those facing us today. We show that officials identified the problem of maintaining increasing numbers of elderly people as long ago as 1950, and identify when and why the British government adopted a pay‐as‐you‐go basis for the National Insurance Fund. We conclude that the advantages of National Insurance contributions separate from income tax are not negligible, but that a merger would be fairer than the present system. Our principal concern is that the contributory principle may raise unrealistic expectations regarding state pensions as it encourages a mistaken belief that these are paid from contributions made by pensioners in the past. We therefore recommend that the government should produce an annual statement showing how state pension liabilities are to be met.     

Inflation targeting and expectation anchoring: Evidence from developed and emerging market economies

Inflation expectations can be inferred from treasury yields data. Previous studies utilizing such data have found evidence for the role of inflation targeting in anchoring inflation expectations in a number of developed market economies. The goal of this paper is to extend the evidence for emerging market economies. We estimate inflation expectations from nominal treasury yields data and infer the anchoring of inflation expectations from the sensitivity of inflation expectations to current inflation rates. Our analysis shows that the effect of inflation targeting is statistically significant in emerging market economies as well as in developed market economies and that the magnitude is marginally greater in the former. Our results are robust to alternative specifications.     

Social exclusion and labour market transitions: a multi-state multi-spell analysis using the BHPS

In this empirical paper, we assess how social exclusion arises in the context of labour market transition behaviour. We estimate a multi-state multi-spell competing risks model and identify five states: high skilled employment, intermediate skilled employment, low skilled employment, unemployment and out-of-the-labour market. Using data from the first seven waves of the British Household Panel Survey, we show that a substantial number of workers were trapped in a vicious circle of low-skilled employment, unemployment and inactivity in the 1990s. Workers who are part of the so-called flexible workforce are more likely to suffer social exclusion.     

我国医疗保险制度存在的问题及对策研究

我国新医改方案推行3年来,用最短的时间编织了世界最大全民医保网,但还存在着社会医疗保障供给与老百姓的医疗保障需求之间差距较大;社会医疗保险的责任范围较小;老百姓的医疗费用负担较重;医疗机构改革滞后等问题。为切实满足人民群众的健康需求,应在建立所有公民都享受全国平均水平的医疗保障体系,有效的实现社会公平和每个公民的健康保障权;本着"最基本的筹资水平、最基本的医疗服务"的理念,建立符合社会主义初级阶段的医疗保险费用筹措制度;在基本医疗的界定和选择上,采用国际上成本效果的评价方法和思想理念;建立行业管理、统筹规划的医疗保险管理体制,促进现代医疗市场的发育和完善;发挥政府、市场两个主体的作用,把商业保险作为对医疗保险的有效补充等方面扎实推进工作。