CONFLICTS OF INTEREST ON THE BOARD OF DIRECTORS OF NON-PROFIT HOSPITALS: THEORY AND EVIDENCE

ABSTRACT ** :  Non-profit hospitals are overseen by a board of directors that is charged with representing the interests of the communities they serve. Theoretically, society is interested in maximizing both the quality and quantity of medical services available to it through the hospital. But other groups may also want to use the hospital to maximize their own wealth. This paper examines the effect of increasing the proportion of physicians on the board of directors. We show theoretically and empirically that with even one physician on the board, society's optimal quality/quantity vector is compromised.     

Deregulation,competition, and the network size in the market for telecommunication services

This paper analyzes the networking aspect in telecommunication services and the recent divestiture and increased competitiveness of the industry. The product considered is the right to access the network. The utility of a consumer from having access to a network depends on the network's quality, defined by the number of other local and long-distance consumers which can be reached. Network services are provided in two layers; On the lower layer consumers within a local access and transport area (LATA) are connected to a central office which provides the basic switching facility for local telecommunication. On the upper layer, LATAs are connected together by an interLATA carrier, to enable long distance communication from different localities.It is shown that relative to the choices of an unconstrained monopolist, larger networks at both layers may be obtained by imposing quality controls, while price controls may have the opposite effect. A divestiture policy in which all local carriers are connected to a single long distance carrier is likely to reduce the quality of services at both layers. Introducing competition among long-distance carriers further reduces the quality of long distances services but may improve the local service.     

Efficient local taxation and local public goods

This paper considers local public goods which crowd both with respect to the number of people served and the amount of property served. It is shown that it may be possible to have efficient decentralized provision of such goods using marginal cost taxes; however, the pricing system in this case is likely to require very large numbers of competing communities. Thus, it appears to be preferable to have separate jurisdictions provide goods which crowd with respect to people — such as education. The implications for stratification are also considered.     

城市公园绿地供给的公平性定量评价 ——以重庆市中心城区为例

土地和房地产市场化背景下的公园绿地供给的公平 性研究具有重要意义。以重庆市中心城区为例,居住小区为研 究单元,从可达性、数量、面积和质量４个维度衡量不同价格 级别居住小区的公园供给的公平性。采用高德互联网地图分析 步行、公共交通２种方式下研究范围内4 663个居住小区的 公园供给的可达性、数量、面积和质量状况;非参数秩和检验 判别不同级别居住小区的公园供给差异。结果表明：不同级别 居住小区的公园供给未发现明显的不公平现象,低级别居住小 区在可达性、数量、总面积上占优势,人均公园面积低于高级 别居住小区,各级别居住小区在高质量公园的使用机会上没有 差异。本文所采用的公园绿地公平性定量评价方法,可为城市 绿色空间、公共服务设施绩效评价提供方法借鉴     

Quality and quantity in primary care mixed‐payment models: evidence from family health organizations in Ontario

Abstract We study the impact of a mixed capitation model (the Family Health Organization, FHO) on quality and quantity outcomes among primary care physicians in Ontario. Using a panel of administrative data covering one year before and two years after the FHO model was introduced, we find that physicians in the FHO model provide about 6% to 7% fewer services and visits per day, but are between 7% and 11% more likely to achieve preventive care quality targets. These results suggest that the mixed capitation model with contractible quality indicators may be welfare improving relative to the FFS model.     

Distribution of tastes and skills and the provision of local public goods

This paper introduces into the Tiebout model individuals with different skills. It is shown that the production techniques, the distribution of tastes and skills and intercommunity trade will affect the pattern of communities. In the suggested model competition with local public goods is Pareto optimal: communities will not be composed of identical people. The optimal solution requires that every community will tax everybody according to his marginal social cost. A Pareto efficient redistribution policy can be carried out only by a central government using lump-sum taxes. A federal income tax will affect community patterns and therefore is inefficient.     

西部开发中的地方公共品有效供给分析

本文从地方公共品的性质和供给特点出发 ,分析了地方公共品有效供给的帕累托条件。在此基础上指出 ,西部开发中地方公共品有效供给不足主要表现为地方公共品供给总量不足、供给结构不合理及中央政府和地方政府对地方公共品的供求管理错位 ,主要的改进措施是扩大西部地方公共品投资力度、优化供给结构 ,并建立规范的中央财政转移支付制度、健全西部地方公共品管理体制。     

Delegation of Decision-Rights for Wetlands

Different nutrient abatement activities jointly determine water quality. Policies are determined by governments at central and local level, implying that decisions can be affected by strategic considerations. In this article, decentralization of wetland policies is analyzed with regard to the environmental and economic consequences. A two-stage game is used to investigate strategic abatement decisions regarding nitrogen fertilizer reductions, waste water treatment plant phosphorus reductions and wetlands, assuming that wetland decision can be decentralized. It is shown that under particular circumstances, strategic consideration may imply that a central government undertakes more abatement than socially optimal, but in most cases the opposite is likely to occur. Decentralization of wetland decisions is advantageous to the central government but only benefits the local government if its wetland technology is considerably more efficient that the central government’s. This paper explains why local governments often hesitate to take on additional responsibilities for environmental management, and identifies conditions under which local governments make smaller losses or even gain from delegation. The results also contribute to understanding how strategically optimal matching grants are chosen when governments only take into account their own direct costs of abatement and the central government needs to satisfy the local government’s participation constraint.     

THE EFFECT OF FDI ON LOCAL EDUCATION EXPENDITURES: EVIDENCE FROM THE UNITED STATES

The intense competition for foreign direct investment (FDI) by state and local governments within the United States has raised concerns among some that this leads to the underprovision of public services and possibly welfare losses for local communities. Economic analysis of this hypothesis yields mixed results. This paper investigates the impact of FDI on local education expenditures both theoretically and empirically. The theoretical model shows an ambiguous impact of FDI on local expenditures for education. Empirically using US state‐level data from 1991 to 2000 and the system‐GMM estimator that controls for fixed effects, times series issues and endogeneity, I find evidence that FDI is positively correlated with increased expenditures on education.     

Direct democracy and local government efficiency

This paper studies the role of direct democracy in ensuring efficient and cost-effective provision of goods and services in the public sector. The sample consists of the population of municipalities in the German State of Bavaria, where in the mid-1990s considerable direct democratic reforms granted citizens wide opportunities to directly participate in local affairs through binding initiatives. Using information on the municipal resources and the municipal provision of public goods, and applying a fully non-parametric approach to estimate local government overall efficiency, the analysis shows that more direct democratic activity is associated with higher government efficiency. This result suggests that more inclusive governance through direct decision-making mechanisms may induce more accountable and less inefficient governments.     

Boundaries innovation through knowledge convergence-developing triad strategic communities

This paper discusses the process of implementing a micro innovation strategy for the development of the company’s mainstay business at present (incremental innovation) and a future growth strategy (radical innovation) in an age when there are dramatic changes in the environment and the future is hard to predict from the perspective of boundaries innovation that the company should implement based on the creation of boundaries knowledge and convergence knowledge. To implement knowledge convergence processes, outstanding companies dynamically establish various project teams and diverse mixed teams, which are strategic communities, as well as network organisations that integrate these teams and continually generate new boundaries innovation. The paper presents a theoretical framework, a detailed case study, and new insights regarding combination of exploration and exploitation through triadic strategic community formations for boundaries innovation strategies where dynamic strategic communities that overcome and transcend various boundaries create boundaries knowledge from various different types of knowledge and dynamically converge these different types of knowledge to create new convergence knowledge (such as the development of new products and services and the development of new business models, etc.).     

Welfare effects of quality change and new products in the Japanese mobile telecommunications market: 1995–2001

This paper presents a simple framework based on a discrete choice model to assess the welfare effects of quality change and new products. Such a framework is shown to be useful where the hedonic approach is impracticable. This framework is applied to the Japanese mobile telecommunications market during the period 1995–2001. The estimated qualities for mobile telecommunications services in Japan are shown to have improved rapidly during this period, indicating the importance of quality change in the welfare gains of consumers relative to price change, and the need to adjust quality change in the construction of price indexes. However, it is also proven, at least in the earliest stages, that the effect of new services on consumer welfare was limited.     

Quality and Welfare in a Mixed Duopoly with Regulated Prices: The Case of a Public and a Private Hospital

Abstract. Hospital markets are often characterized by price regulation and the existence of different ownership types. Using a Hotelling framework, this paper analyses the effect of heterogeneous objectives of hospitals on quality differentiation, profits and overall welfare in a price‐regulated duopoly with exogenous symmetric locations. In contrast to other studies on mixed duopolies, this paper shows that, in this framework, privatization of the public hospital may increase overall welfare. This holds if the public hospital is similar to the private hospital or less efficient and competition is low. The main driving force is the single‐regulated price which induces under‐provision (over‐provision) of quality of the more (less) efficient hospital compared with the first best. However, if the public hospital is sufficiently more efficient and competition is fierce, a mixed duopoly outperforms both a private and a public duopoly due to an equilibrium price below (above) the price of the private (public) duopoly. This medium price discourages over‐provision of quality of the less efficient hospital and – together with the non‐profit objective – encourages an increase in quality of the more efficient public hospital.     

THE PROVISION OF LOCAL PUBLIC SERVICES THROUGH MIXED ENTERPRISES: THE ITALIAN CASE

ABSTRACT ** :  The rules regulating the creation of mixed enterprises companies (public-private companies) for the provision of local public services have been subjected, in Italy, to a rather complex evolution over time. The new rules introduced allow the creation of a mixed private public enterprise, with either public or private majority; in any case the private shareholder must be selected through a public tender procedure. The data seems to show that mixed enterprises have been used by municipalities as a tool that allows the exploitation of economies of scale and of scope, without necessarily losing control of the leadership and direction of the local utility. Better flexibility of mixed enterprises is also shown by the proportion of mixed enterprises acting outside the territory which is higher than the proportion of public enterprises similarly engaged. Moreover the presence of multi-service units is proportionally higher in mixed enterprises.     

Optimal Taxation with a Trade-off Between Income and Children

This paper explores the implications of endogenous fertility for optimal redistributive taxation in the presence of a trade-off between labour income and children. The labour supply is a decreasing function of the desired quantity and quality of children. Since children enter into the parent's budget constraint in a nonlinear form, their shadow prices are directly distorted by the income tax rate. It is shown that the substitution effects of the income tax rate on the quantity and quality of children cannot be signed uniquely although the effect on labour supply is negative. The aggregate substitution effect of the income tax rate on the quantity of children plays an important role in the determination of the signs of the income tax and child subsidy rates at a Rawlsian or Benthamite social welfare optimum.
JEL Classification Numbers: H21, J13, J22     

Organization, Management and Delegation in the French Water Industry

The water industry is largely a natural monopoly. Water distribution and sewerage services are characterized by networks and its natural monopoly derives from the established local networks of drinking water and sewers: they are capital intensive with sunk costs and increasing returns to scale. In France, local communities have a local requirement of providing public services under optimum conditions in terms of techniques and cost-effectiveness, and subject to respect different kind of standards in terms of water quality and level of services. They are responsible for producing and distributing drinking water, and collecting and treating wastewater. Furthermore, the French water utilities are required to be financially self-sufficient. Rate-setting varies across regions and local territories due to a variety of organizational features of services and availability of water resources. The management of these local public services can be public or private: local governments have the right, by the constitution, to delegate water service management to private companies which operate under the oversight of local municipal authorities. Today, nearly 80 per cent of the French population receive private distributed water. Different reasons are responsible for the poor performance and low productivity of most French public water utilities: technical and operational, commercial and financial, human and institutional, and environmental. Thus, many water public utilities have looked for alternative ways to provide water and sanitation services more efficiently, to improve both operational and investment efficiency, and to attract private finance. The purpose of this paper is to present the French organizational system of providing drinking water services, and collecting and treating wastewater services: legal aspects, contracts of delegation, and competition.     

Socioeconomic dimensions of mercury pollution abatement: Engaging artisanal mining communities in Sub-Saharan Africa

In recent years, strategies to tackle mercury pollution from artisanal gold mining have mainly included restrictions — banning mercury trade internationally, prescribing alternate technologies and tightening regulations on mining (e.g. banning mercury use). However, artisanal mining communities in Africa are often trapped in cycles of poverty that make it difficult for workers to improve technologies and reduce mercury pollution. This article assesses problems with narrow pollution abatement discourses and top-down regulations, examining the need for integrated approaches to address pollution and socioeconomic challenges in low income mining communities. It advances the hypothesis that pollution abatement strategies fail if they do not explicitly address local socioeconomic capacities for improving environmental management, informed by an adaptive understanding of labor dynamics. Case studies in Mozambique and Tanzania are examined where United Nations pilot projects sought to address local challenges. These combined training on improved technologies and environmental risk mitigation with efforts to empower miners by enhancing access to microfinance services and fairer gold marketing arrangements. These case studies demonstrate adaptive ways of engaging local concerns in mining areas, highlighting lessons that are especially urgent now that recent policy commitments from Europe and the United States to ban mercury exports have specifically sought to make mercury more expensive for African mining communities. Ultimately, the analysis suggests how regionally focused ecological economics research has a vital role to play in (a) revealing how narrowly conceived responses to pollution can yield counterproductive results as well as exacerbate exploitative labor conditions in low income contexts; and (b) stimulating analytic focus on innovative ways of integrating pollution reduction strategy with grassroots socioeconomic empowerment strategies.     

THE EFFECTS OF ORGANIZATIONAL FORM IN THE MIXED MARKET FOR FOSTER CARE

ABSTRACT ** : This paper uses proprietary quality of care data to examine the consequences of organizational form in privatized US foster care services. The contract failure hypothesis generically proposes that nonprofits should provide higher quality services, relative to for‐profits, when output is costly to observe. Advocates argue that the nonprofits offer important consumer protections when public services are contracted to private agencies. Contrary to expectations, we find that nonprofit firms do not offer higher quality services. We explore the possibility that monitoring efforts by state regulators or competition among foster care agencies effectively mitigate the influence of organizational form in this particular mixed market.     

Socioeconomic dimensions of mercury pollution abatement: Engaging artisanal mining communities in Sub-Saharan Africa

In recent years, strategies to tackle mercury pollution from artisanal gold mining have mainly included restrictions — banning mercury trade internationally, prescribing alternate technologies and tightening regulations on mining (e.g. banning mercury use). However, artisanal mining communities in Africa are often trapped in cycles of poverty that make it difficult for workers to improve technologies and reduce mercury pollution. This article assesses problems with narrow pollution abatement discourses and top-down regulations, examining the need for integrated approaches to address pollution and socioeconomic challenges in low income mining communities. It advances the hypothesis that pollution abatement strategies fail if they do not explicitly address local socioeconomic capacities for improving environmental management, informed by an adaptive understanding of labor dynamics. Case studies in Mozambique and Tanzania are examined where United Nations pilot projects sought to address local challenges. These combined training on improved technologies and environmental risk mitigation with efforts to empower miners by enhancing access to microfinance services and fairer gold marketing arrangements. These case studies demonstrate adaptive ways of engaging local concerns in mining areas, highlighting lessons that are especially urgent now that recent policy commitments from Europe and the United States to ban mercury exports have specifically sought to make mercury more expensive for African mining communities. Ultimately, the analysis suggests how regionally focused ecological economics research has a vital role to play in (a) revealing how narrowly conceived responses to pollution can yield counterproductive results as well as exacerbate exploitative labor conditions in low income contexts; and (b) stimulating analytic focus on innovative ways of integrating pollution reduction strategy with grassroots socioeconomic empowerment strategies.     

Nonconvex n-person bargaining: efficient maxmin solutions

Summary. This paper provides an axiomatic characterization of a family of so-called efficient maxmin solutions which can be seen as generalizations of the Kalai-Smorodinsky solution to nonconvex n-person bargaining problems. Moreover, it is shown that even though there are several efficient maxmin solutions for some bargaining problems, there is typically a unique efficient maxmin solution. Received: February 15, 2001; revised version: November 14, 2001