Food safety and product liability

This paper focuses on the U.S. product liability system for food poisoning cases and makes six key points. First, current legal incentives to produce safer food are weak, though slightly stronger in outbreak situations and in markets where foodborne illness can be more easily traced to individual firms. Far less than 0.01% of cases are litigated and even fewer are paid compensation. Second, even if potential plaintiffs can overcome the high information and transaction costs necessary to file lawsuits, monetary compensation provides only weak incentives to pursue litigation. Firms paid compensation in 56% of the 294 cases examined in this study and the median compensation was only $2,000 before legal fees. Third, indirect incentives for firms may be important and deserve more research. For example, firms may be influenced by costly settlements and decisions against other firms in the same industry. Fourth, confidential settlements, health insurance, and product liability insurance distort legal incentives to produce safer food. Fifth, the ambiguity about whether microbial contamination is “natural” or an “adulterant” hinders the legal system from effectively dealing with food safety issues. Sixth, a brief comparison of the incentives from U.S. and English legal systems suggests that more research is needed to understand the strengths, weaknesses, and relative impact of each country's legal system on the incentives to produce safer food.     

新生儿未参保之谜:基本事实、成因及其影响

中国已基本实现全民医疗保险覆盖,基本医疗保险参保率多年维持在95%以上,剩下的未参保人群成为真正实现全民医疗保险的“最后一公里”。精准识别未参保人群对于完善当前医疗保障制度具有重要意义。本文基于中国家庭追踪调查数据(CFPS),描述了大量新生儿未参加基本医疗保险的事实,并实证分析了参保率较低的原因及其对医疗服务利用的影响。描述性统计结果显示,新生儿参保率不足1/2,大大低于其他年龄阶段人群的参保率。进一步实证分析发现,父母不了解新生儿参保政策信息、基层组织缺乏向新生儿家庭宣传参保政策的激励是新生儿参保率低的主要原因。最后,考察未参保对新生儿医疗服务利用产生的影响,发现未参保状态显著降低了新生儿的医疗服务利用率。为了提高新生儿基本医疗保险参保率,政府一方面应针对性地加强新生儿医疗保险政策宣传,降低新生儿参保的信息障碍;另一方面应积极推动新生儿自动纳入基本医疗保障范围,甚至应考虑制定专门针对新生儿的医疗保健计划。     

加强对养老保险基金有效投资初探

由国家筹集的全国社会保障基金可以投资运营，企业年金实行市场运营，地方管理的基本养老金不能投资运营。从宏观上说，养老保险基金有效投资有利于减轻国家、企业和个人的负担，为国家经济建设提供长期基金，有利于养老金的保值增值，以应对未来养老金的支付能力。为了加强养老保险基金的有效投资，必须健全和完善养老保险基金有效地投资的内部条件和外部环境。     

Vertical Alignment Between Hospitals and Physicians as a Bargaining Response to Commercial Insurance Markets

The relationship between physicians and hospitals has dramatically changed over the last decade, with the employer–employee model supplanting the traditional model of private physicians with hospital admitting privileges. We examine the motivation for this form of vertical integration by considering physician–hospital alignment as a tool to increase bargaining power with private insurers. We find a positive and significant relationship between private insurance concentration on physician–hospital alignment, which is driven predominantly by for-profit hospitals.     

A positive theory of give-away privatization

We make a first step towards a positive theory of privatization, in a framework similar to the one of Shleifer and Vishny's “Politicians and Firms” (QJE, 1994). In our model, a government may want to privatize because privatization can provide managers with stronger incentives to exert effort and more managerial effort may help to maintain jobs that otherwise would be destroyed. However, the government trades off better managerial incentives with the costs of losing control, here, over funds that the government provides for the restructuring of firms. We also show that if managers care for the size of their firm, privatization may weaken, not strengthen incentives.     

Do Owners Take Better Care of Their Housing Than Renters?

According to conventional wisdom, homeowners take better care of their housing than do renters, as a result of the rental externality. We argue that two forms of homeowner externality ootentially create similar incentives for owners to undermaintain their housing. The first is due to the inability of prospective buyers to fully observe past seller maintenance, and the second is a result of the limited liability of borrowers in the event of mortgage default. Empirical analysis verifies the existence of the mortgage externality, but we find no evidence for the resale externality.     

Health Care Competition and Antibiotic Use in Taiwan

Antibiotic resistance, a negative externality of antibiotic use, is a growing threat to public health. Health care competition may encourage antibiotic use because receiving an antibiotic is a form of ‘quality’ for many patients. This paper examines the effect of market concentration on antibiotic use in a large, nationally‐representative data set from Taiwan. Moving from the 75th percentile to the 25th percentile of market concentration is associated with 6.6 per cent greater antibiotic use. We control for leading market‐level confounds, including population density and community health. We also show that the correlation is robust using fixed effects for patients, physicians and diagnoses. We document the correlation between antibiotic use and patient retention, which suggests a mechanism for this result. Finally, we show that strict regulation of antibiotics reduces but does not eliminate the effect of competition on antibiotic use.     

Do physician incentives affect hospital choice? A progress report

The US health reforms of March 2010 introduced new provisions for physicians providing Medicare and Medicaid services to be given financial incentives to control costs. Physician payment mechanisms generating similar incentives are currently used by some health maintenance organizations in California. We describe an ongoing research project in which we investigate physician responses to these payment schemes. The question is whether patients whose physicians have incentives to control hospital costs are admitted to lower-priced hospitals than other patients, all else equal. We provide an initial analysis of California hospital discharge data from 2003, documenting evidence consistent with this hypothesis.     

Profit-sharing as a cure for unemployment: Some doubts

In this paper, we argue that given that a wage system is preferred to profit-sharing in an insider-outsider model, tax incentives to encourage profit-sharing could be dissipated by the use of cosmetic schemes. The same may also be true in models in which unions care about employment. Hence, we should be cautious about accepting Weitzman's claim that profit-sharing will reduce unemployment.     

The volunteer's dilemma and alternate solutions for ensuring responsibility within accountable care organizations

ABSTRACT

The emphasis on accountable care organizations (ACOs) in recent health care reform increases the potential for social dilemmas such as the volunteer's dilemma within networks of providers who collectively share responsibility for a patient population. Providers in an ACO often receive financial incentives based on how well the group performs in defined quality measures. Care interventions may be indicated for certain patients, such as postdischarge follow-up to prevent readmission. However, the providers conducting the interventions may be unreliable if they vary in their belief in the intervention's effectiveness. We characterize such potential for care coordination failures as instability of an asymmetric equilibrium, illustrated by an example in which ACO patients would benefit from interventions to prevent readmission but individual providers or care teams do not perceive sufficient value in conducting the intervention. We then propose three economic mechanisms that can help ensure that patients receive indicated interventions, illustrate the impact of each with an example, and explore conditions that lead to significant improvements in overall utility.     

Incentive Redesign and Collaboration in Organizations: Evidence from a Natural Experiment

Research summary : Separating the individual from the social effects of incentives has been challenging because of the possibility of synergies in team production. We observe a unique natural experiment in a South Korean e‐commerce company in which a switch from pay‐for‐performance to fixed (but different) salaries took place in a staggered and effectively random manner across employees. In this case, social and individual effects perspectives make opposing predictions, enabling a critical test. We find evidence consistent with social effects of incentives, particularly as predicted by goal framing theory. The results have implications for the design of incentives to foster collaboration, organizational learning, and organizational performance. Managerial summary : Managers often neglect the deeper hypothesis behind pay‐for‐performance schemes—that people primarily care about how much they are individually paid. An opposing school of thought contends that incentives have social effects too—that individuals care about not only what they receive but also what their peers receive. It is difficult to say whether individual or social effects would be more salient in a context, without a proper experiment with randomization. We exploit a rare opportunity provided by a company that changed its incentive system in a random order, thus unintentionally creating a natural experiment. The results strongly validate the existence of social effects of incentives, but also make the general case for the opportunity to learn from experimenting with organization design in a systematic manner. Copyright © 2017 John Wiley & Sons, Ltd.     

The Effect of State Workers’ Compensation Program Changes on the Use of Federal Social Security Disability Insurance

In addition to traditional forms of private and public medical insurance, two other large public programs help pay for costs associated with ill health. In 2008, Workers’ Compensation (WC) insurance provided $57.6 billion in medical care and cash benefits to employees who are injured at work or contract a work‐related illness, and Social Security Disability Insurance (DI) provided $106 billion to individuals who suffer from permanent disabilities and are unable to engage in substantial gainful activity. During the 1990s, real DI outlays increased nearly 70 percent, whereas real WC cash benefit spending fell by 12 percent. There has been concern that part of this relationship between two of the nation’s largest social insurance programs may be due to individuals substituting toward DI as state WC policies tightened. We first show that this negative correlation between the national series does not hold over time within states, the level at which a causal relationship should operate. We then test for a causal effect of changes in WC enrollment on DI applications and new DI cases within states over time, using state policy (the maximum WC benefit) as an instrument for WC enrollment. Despite a strong first stage fit, we find no statistically significant evidence that WC tightening caused DI rolls to increase, although the standard errors are large enough that we cannot reject effects of substantial magnitude. We conclude it is unlikely that state WC changes were a meaningful factor in explaining the rise in DI during our study period of 1986–2001, although further study using individual level data is warranted.     

The Value of Employer-Sponsored Child Care to Employees

This article uses the contingent valuation method for calculating the value of employer-sponsored child care to employees. Like many environmental amenities, there may be a nonuse or existence value of working for a company that offers employer-sponsored child care (ESCC), as well as a use value to parents who have children in the center. We test this hypothesis using data from three firms, two of which have on-site child care. Our findings indicate that price is a determinant of willingness to pay for the continued existence or establishment of an on-site center. We find evidence of the existence value, even for employees without young children, and a greater valuation among recent hires than among longer-term employees.     

Employees' Innovative Behavior in Social Context: A Closer Examination of the Role of Organizational Care

A substantial body of research has examined the antecedents of innovation in organizational settings, but our current understanding of how social aspects of the work environment influence the innovative behavior of employees remains underdeveloped. One of these social aspects connected to the theme of “doing well by doing good” concerns organizational care, with scholars examining how actions centered on promoting employee well‐being may result in pro‐organizational outcomes. The purpose of this study is to present a conceptual analysis of the intricate relationship between organizational care and employees' innovative behavior by detailing key mediating mechanisms and conditional factors. This research will combine insights from multiple theories and literatures, most notably self‐determination theory, social exchange theory, and the literatures on organizational care, work motivation, and innovation. The proposed multilevel model clarifies how organizational care affects the creative, complex, and mundane elements of employees' innovative behavior through its effect on the motivational constructs of intrinsic motivation, identified motivation, and introjected obligation feelings, respectively. Moreover, the model highlights the potential dark sides of organizational care that managers must consider when designing and implementing caring policies and practices. Specifically, it clarifies how the effect of organizational care on employees' innovative behavior may depend on their subjective perceptions of care intrusiveness and care insincerity. As such, this study responds to calls for rich and nuanced conceptual research in the innovation field, especially concerning the role of employees' social work environment in motivating their innovative behavior. Important theoretical and practical implications of this conceptual analysis will be discussed, and valuable directions for future research will be outlined.     

The effects of a relative value reimbursement scheme on the medical market: Lessons from medicaid

One question which has been the subject of debate, without resolution, in the health economics literature is whether physicians face distorted incentives. This paper examines the possible effects of an attempt to correct the incentives facing physician firms: namely the use of a relative valued fee schedule. Though a type of relative value scale is currently under implementation for the Medicare system, little is known about the effects of such mechanisms. This paper attempts to glean information from natural experiments by several state Medicaid programs that have used relative value scales in the past.The author would like to express his appreciation to Karen Smith Conway, Thomas Hoerger, and Torsten Schmidt for their helpful comments and suggestions. Valuable research assistance was provided by Sharon Kunz. All remaining errors are, of course, the sole responsibility of the author.     

California's Health Insurance Act of 2003: View of the Market

This “play or pay” mandate would have required California employers to either provide medical insurance for their employees or pay into a state insurance fund. Although the law ultimately did not go into effect, movements in shareholder wealth provide evidence about the differential effects of such health‐care mandates on various types of employers. Large or unionized firms had no negative effects; expected profits declined most for firms with 50–199 employees.     

Sensitivity of new industrial product risk to R&D incentives

Incentives for research and development have frequently been a feature of government policy to increase the level or alter the direction of new product development activity in industrial product companies. Conceptually, these incentives may be viewed as "risk-modifiers they may encourage managers to undertake innovation projects where the potential payoffs may be attractive, but where some dimensions of risk are perceived as too high to proceed. This research explores the sensitivity of different dimensions of risk faced by managers to incentives of different kinds, at different levels. Implications are cited for different types of R&D incentives aimed at these different dimensionsof risk.     

The Inevitability of Marketwide Underpricing of Mortgage Default Risk

Lenders are frequently accused of mispricing the put option embedded in nonrecourse lending. Prior research shows one lender's incentives to underprice. Here, we identify the conditions for a marketwide underpricing equilibrium. We demonstrate that, in a market with many players, given sufficient time, a race to the bottom and marketwide mispricing are inevitable. Underpricing occurs because bank managers and shareholders exploit mispriced deposit insurance. We show that the probability of the underpricing equilibrium increases with time since the previous market crash and that the more volatile the underlying asset market, the more likely it is subject to underpricing.     

浅谈电力项目建设期的保险安排

简单介绍了电厂项目建设期常见的保险种类和保单的安排过程,指出电厂项目的保险安排要结合电厂建设模式和建设合同一起考虑,由负责照看财产安全的一方来购买保险.具体的保险安排可以请专业的保险经纪人来负责,在索赔时注意保存物证,还要与公估行配合,并通过案例分析说明了如何根据保单去进行索赔.     

Monoline Restrictions, with Applications to Mortgage Insurance and Title Insurance

Insurance firms in the United States generally operate on a multiline basis, meaning that they provide coverage for two or more insurance lines, such as auto and homeowner insurance. Most states, however, require that firms offering mortgage or title insurance operate on a monoline basis, meaning that an insurance firm may provide coverage against only one type of risk. This paper investigates the conditions under which monoline restrictions represent efficient regulatory policy. Monoline requirements are an intriguing issue because multiline insurance firms receive the diversification benefit that the firm’s capital is available to pay insurance claims on any of its lines. The paper shows, however, that the specific features of the mortgage and title insurance lines create a special case in which monoline restrictions may represent efficient regulatory policy.