Endogenous political competition and political accountability

We contribute to the debate over the effectiveness of elections in motivating incumbents to perform well. We show that with endogenous political competition the effectiveness of democracy in disciplining officials can be largely diminished.     

Budget balances in OECD countries: what makes them change?

Fiscal balances have deteriorated quickly in recent years, bringing back to the foreground the question what factors explain such sharp changes. This paper takes a broad perspective at the issue regarding countries included, the range of potential explanatory variables, and the time-span covered. The empirical analysis shows that changes in budget balances are affected by debt growth, macroeconomic developments and political factors. In particular, we find that the run-up to EMU induced additional consolidation in Europe and that budget balances deteriorate markedly in election years. Asset prices also affect budgets, but the impact remains limited in normal times.      

Association between glycemic control and short-term healthcare costs among commercially insured diabetes patients in the United States

Abstract

Objectives:

Glycemic control, measured by HbA_1c, is well known to be a risk marker for long-term costly diabetes-related complications. The relationship between HbA_1c and short-term costs is unclear. This study investigates how HbA_1c is correlated to short-term diabetes-related medical expenses.

Methods:

Patients with diabetes with an HbA_1c reading ≥6% between April and September 2007 were identified from a large US managed-care organization. Healthcare utilization data was obtained during the subsequent 12-month period. Multivariate analyses were performed to estimate the correlation between HbA_1c and diabetes-related healthcare costs.

Results:

In all, 34,469 and 1,837 patients with type 2 and type 1 diabetes, respectively, were identified with an HbA_1c reading ≥6% (mean HbA_1c: 7.4% and 7.9%). The majority of patients with type 1 diabetes were treated with insulin, while most patients with type 2 diabetes were treated with metformin. The multivariate analysis showed that several characteristics, including HbA_1c, significantly correlate with diabetes-related medical costs for both patients with type 1 and type 2 diabetes. A 1-percentage-point increase in HbA_1c will, on average, lead to a 6.0% and 4.4% increase in diabetes-related medical costs for type 1 and type 2 diabetes, respectively. This corresponds to an annual cost increase of $445 and $250 for patients with type 1 and type 2 diabetes, respectively.

Limitations:

Retrospective data analyses inherently associated with selection bias which can only partly be adjusted by statistical techniques. Furthermore, the study population is not necessarily representative of the general population and there can be isolated coding or data errors in the dataset.

Conclusions:

These results suggest that tighter glycemic control is associated with short-term cost benefits for patients with diabetes. This supplements conventional wisdom that HbA_1c affects risk of long-term complications and long-term costs.     

The Basic Needs Strategy,the Congressional Mandate,and U.S. Foreign Aid Policy

In line with Veblen's contributions on the "dark side" of commercial and political relationships, we show how promises can be used to manipulate the "common man." By imposing excessive access costs on potential promisees (e.g., citizens or consumers), a promiser (e.g., a politician or a firm) can benefit from making a promise without having to wholly fulfill it. These strategically manipulated access costs can be legitimized by the need to prevent abuse and fraud that exempts the promiser from being accused of cheating. Here, two case studies on promises offered to eligible households - the Food Stamp/Supplemental Nutrition Assistance Program and rebates - are developed. Some policy implications are drawn and extensions are suggested.     

Promising politicians,rational voters,and election outcomes

Overwhelming anecdotal evidence suggests that politicians often promise more during an election campaign than they are willing or able to deliver once elected. In this paper, we present two signaling models to explain this phenomenon. In the first model, two candidates maximize their share of the vote. In the second model both try to convince the median voter. In each model, candidates rationally distort their true policy position. Voters, however, are not fooled. Upon observing election promises, they can rationally infer the true position of each candidate. Hence, the election outcome is not affected.JEL Classification: D72, D82The author thanks Peter Kooreman, Wilko Letterie, Bert Schoonbeek, and two anonymous referees for useful comments. Financial support from The Netherlands Organization for Scientific Research (NWO) is gratefully acknowledged.     

公司治理投票机制优化设计初探

借鉴一般性政治投票机制,并结合公司治理目的及其利益主体特性,提出两种改进公司治理投票机制的方案——可转移的累积投票和贮存式投票,并对这两种改进方案的积极意义进行评估和分析。最后,对公司治理投票机制优化设计的后续研究问题进行了展望。     

An institutional analysis of voter turnout: the role of primary type and the expressive and instrumental voting hypotheses

Recent events highlight primary type as an institutional variable that merits further examination in the economics literature on voter turnout. Using panel data for U.S. gubernatorial elections and treating primary type as a proxy for candidate deviation from the median voter, we test whether primary type changes voter turnout and whether that change is dominated by instrumental or expressive voting. The results show that states with more open primaries tend to have greater voter turnout in general elections, and that this increase reflects the effect of open primaries on expressive voting.

Healthcare resource utilization among patients diagnosed with idiopathic pulmonary fibrosis in the United States

Abstract

Objectives:

Few studies have characterized healthcare resource utilization among patients with idiopathic pulmonary fibrosis. The objective of this study is to assess healthcare resource utilization among patients with idiopathic pulmonary fibrosis as compared to members without this condition.

Methods:

Patients newly diagnosed with idiopathic pulmonary fibrosis were identified from a national administrative claims database (2006–2011) as having ≥2 claims with idiopathic fibrosing alveolitis, or ≥1 claim with idiopathic fibrosing alveolitis and ≥1 claim with post-inflammatory pulmonary fibrosis (earliest claim with idiopathic fibrosing alveolitis denoted the index date), a procedure of lung biopsy or high-resolution computed tomography within ±90 days of the index date, 12-month pre-index continuous enrollment, plus ≥2 confirmatory idiopathic fibrosing alveolitis diagnoses after the procedure. For each idiopathic pulmonary fibrosis patient, three members without the condition were matched by age/gender/region/payer type. Demographic/clinical characteristics were measured during the 1-year pre-index period. Healthcare resource utilization was assessed by quarter during 1-year pre- and post-index periods. Generalized estimating equation models controlling for patient characteristics were constructed to estimate adjusted post-index healthcare resource utilization.

Results:

In total, 1735 patients with idiopathic pulmonary fibrosis and 5205 without (mean age?=?71.5 years; 46.1% female) were included. Adjusted results revealed idiopathic pulmonary fibrosis patients were more likely to use healthcare resources than members without the condition 1-year post-index (number of hospitalizations, emergency room visits, and outpatients visits: 0.63 vs 0.31, 0.62 vs 0.48, and 5.7 vs 3.1 per person-year, respectively).

Conclusions:

Healthcare resource utilization is considerably higher among patients with idiopathic pulmonary fibrosis than members without the condition. Effective treatments for patients with idiopathic pulmonary fibrosis are needed to help reduce burden of healthcare resource use.     

Accountability in government and regulatory policies: Theory and evidence

A key market institution is the degree of accountability to which the officials involved in regulation are exposed. While elected officials strive for re-election, appointed ones are career-concerned. Provided that the effort exerted to uncover the firm’s unknown cost is sufficiently effective in swaying votes, elected officials produce more information than appointed ones do. As a result, when the demand is inelastic, appointment induces wider allocative distortions and higher profits which, in turn, yield stronger incentives to invest. Hence, appointment will prevail on election when investment inducement is sufficiently relevant and shareholders are sufficiently more powerful than consumers. Data on electricity rates and costs, and the methods of selecting regulators and appellate judges for a panel of forty-seven US states confirm these predictions.     

Can money buy EU love?

We explore the role played by Cohesion Policy in the Brexit referendum and the subsequent 2017 general election. Although the UK has been a net contributor to the EU, some regions receive significant amounts of regional aid funds. We find that while Cohesion Policy is positively correlated with the remain vote, this relationship is weak. Most of the variation in the remain vote is explained by economic factors. In contrast, there is a robust negative correlation between Cohesion Policy and voter turnout. We estimate that had there not been this negative relationship, some 2 million more voters would have participated in the referendum, which is more than the winning margin between the remain and leave votes. Our analysis of the 2017 election suggests that Conservatives lost and Labour gained votes in the regions that benefited from Cohesion Policy, while remain-supporting regions showed gains for the Liberal Democrats.     

Rhetoric on the economy: have European parties changed their economic messages?

This study analyses the determinants of dispersion of economic issue mentions in European party manifestos. We examined three main economic domains (governmental control of the economy, free market capitalism and support for the welfare state) as consequences of globalization forces, economic conditions, partisanship and electoral turnout. Employing aggregate-level Comparative Manifesto Project (CMP) data from legislative elections in 15 European countries from 1970 to 2010, we confirm that parties hold a common view of the salience of economic control of the state as a consequence of globalization pressure and economic growth levels. Partisanship of the cabinets (regardless of the political orientation) counteracted issue salience concentration in the welfare domain. Government size favoured dispersion in the free market realm. Our results do not indicate clear homogenization of parties’ economic messages in elections over the last 40 years.     

The Contribution of Privatization to Welfare

The primary focus of this work is on the nature of the privatization debate rather than on an attempt to explore the truth or validity of each of the many claims and counterclaims that have been made for the practice of privatization. The main objective is to discover why the issues remain controversial and whether there are prospects for reconciliation. The results obtained from the evidence examined suggest there is no well-formed theory of privatization, and no well-formed opposing theory. In the absence of a convincing theory, the authors conclude they expect the debate to continue on the lines of competition, free markets and choice versus complaints about unfulfilled promises and unexpected costs, corruption scandals and disadvantages to the poor, and suggest possible ways forward.

Electoral competition with policy-motivated candidates

In the multi-dimensional spatial model of elections with two policy-motivated candidates, we prove that the candidates must adopt the same policy platform in equilibrium. Moreover, when the number of voters is odd, if the gradients of the candidates' utility functions point in different directions, then they must locate at some voter's ideal point and a strong symmetry condition must be satisfied: in particular, it must be possible to pair some voters so that their gradients point in exactly opposite directions. If the number of dimensions is more than two, then our condition is knife-edge. When the number of voters is even, the situation is worse: such equilibria never exist, regardless of the dimensionality of the policy space.