Price and Profit Regulation in Developing and Transition Economies: A Survey of the Regulators

Rate of return or cost of service regulation was the traditional means by which governments, especially in the USA, regulated profitability and prices in privately-owned public utility businesses. However, rate of return regulation was associated with efficiency disincentives. Hence, in 1983 a price cap was proposed to regulate British Telecom when it was privatized. Price caps were later introduced for other privatized utilities in the UK. Similarly, other countries that privatized their utility sectors in the 1980s and 1990s often introduced price cap regimes. This article reports the results of a questionnaire survey of the methods used to regulate profits and prices in privatized utility sectors in a sample of developing and transition economies. In addition to providing an insight into the different methods used in these economies, the article explains the difficulties that their regulators have in operating profit and price regulation regimes.     

How hospital ownership affects access to care for the uninsured

This article addresses the effect of hospital ownership on the delivery of service to uninsured patients. It compares the volume of uninsured patients treated in for-profit and nonprofit hospitals by regarding hospital ownership and service as endogenous. Instrumental variable estimates are used to predict the percentage of patients who are uninsured, controlling for hospital ownership and service. The study shows that when for-profit and nonprofit hospitals are located in the same area, they serve an equivalent number of uninsured patients, but for-profit hospitals indirectly avoid the uninsured by locating more often in better-insured areas.     

Assessing competition in hospital care markets: the importance of accounting for quality differentiation

Quality differentiation is especially important in the hospital industry, where the choices of Medicare patients are unaffected by prices. Unlike previous studies that use geographic market concentration to estimate hospital competitiveness, this article emphasizes the importance of quality differentiation in this spatially differentiated market. I estimate a random-coefficients discrete-choice model that predicts patient flow to different hospitals and find that demand responses to both distance and quality are substantial. The estimates suggest that patients do not substitute toward alternative hospitals in proportion to current market shares, implying that geographic market concentration is an inappropriate measure of hospital competitiveness.     

Hospital accounts and accounting systems: a study in the French region of Toulouse from the seventeenth to the nineteenth century

Private charity was the origin of the foundation of hospitals in prerevolutionary France and at the same time their principal source of income; the church played an important role. The Revolution introduced many changes to hospitals. This article has two objectives: to describe hospital organization and accounting practices between the seventeenth and the nineteenth centuries as seen in three hospitals in the Toulouse region, and to show how the accounting model adopted was suited to their structure and aims.     

Adverse Selection, Moral Hazard, and Outlier Payment Policy

In this article, we analyze the rationale for introducing outlier payments into a prospective payment system for hospitals under adverse selection and moral hazard. The payer has only two instruments: a fixed price for patients whose treatment cost is below a threshold     and a cost-sharing rule for outlier patients. We show that a fixed-price policy is optimal when the hospital is sufficiently benevolent. When the hospital is weakly benevolent, a mixed policy solving a trade-off between rent extraction, efficiency, and dumping deterrence must be preferred. We show how the optimal combination of fixed price and partially cost-based payment depends on the degree of benevolence of the hospital, the social cost of public funds, and the distribution of patients severity.     

新会计准则对商业银行贷款损失准备的影响

与国际接轨的新会计准则的实施,给我国商业银行的贷款损失准备及其监管带来了很大影响。新会计准则对银行贷款损失准备监管的主要影响有:(1)新会计准则关于贷款损失准备的规定与监管审慎性要求相矛盾;(2)新会计准则规定的贷款损失准备计提方法与监管要求的贷款损失准备计提方法有分歧。新会计准则对商业银行的贷款损失准备的影响主要有:(1)降低了商业银行利用贷款损失准备操纵利润的可能性;(2)使得贷款损失准备具有更大的波动性;(3)引入时间价值,可能导致准备水平的提高;(4)可能导致利息收入和减值准备同步增加,并将影响各会计期间的利润发生一定程度的变化。本文对以上影响进行了分析,并提出了相应的对策建议。     

The comparative statics of deductible insurance in expected- and non-expected-utility theories

This paper identifies comparative statics results for insurance contracts that distinguish between various models of decision making under risk—specifically, expected utility, rank-dependent expected utility, and weighted utility. Insurance contracts offer full coverage above a deductible. Firms offer premium schedules that give the premium charged as a function of the deductible; households choose both an insurance company and a deductible to maximize utility. A competitive equilibrium requires zero expected profit for firms. We identify changes in the distribution of losses such that the optimal deductible increases for utility representations in a particular class but decreases for some representations outside that class. We give results both for the demand for insurance, as well as for the equilibrium contract.     

Instilling activism in trustees

One of the great challenges in America today is the stewardship of its not-for-profit institutions. While the profit motive may be absent in the running of such organizations, the demand for thoughtful budgeting, cost accounting, and financial skills still exists. Voluntary community hospitals in particular--given the economic realities of the day--need leadership, reciprocal education, and future planning. Speaking from his own experience, the author presents an activist's perspective on hospital boards; but service to other types of not-for-profit institutions involves similar demands for change.     

The impact of health information technology on hospital productivity

Health information technology (IT) has been championed as a tool that can transform health care delivery. We estimate the parameters of a value‐added hospital production function correcting for endogenous input choices to assess the private returns hospitals earn from health IT. Despite high marginal products, the total benefits from expanded IT adoption are modest. Over the span of our data, health IT inputs increased by more than 210% and contributed about 6% to the increase in value‐added. Not‐for‐profits invested more heavily and differently in IT. Finally, we find no compelling evidence of labor complementarities or network externalities from competitors' IT investment.     

Rationalizing Northern Ireland Hospital Services Towards Larger Providers: Best-Practice Efficiency Studies and Current Policy

This article explores the relative efficiency of Northern Ireland hospitals, and in particular the efficiency of small hospitals relative to their large counterparts, employing a technique called data envelopment analysis. The empirical analysis revealed that larger hospitals displayed higher cost efficiency, higher allocative efficiency and higher technical efficiency than their smaller counterparts. These results support Northern Ireland's recent strategy of concentrating hospital services in six large hospitals, supported by medium sized hospitals, and closing or restructuring smaller hospitals.     

The Impact of Health Care Reform on Capital Acquisition for Hospitals

In this paper, the response of the market for hospital stocks to the episode of the Medicare Prospective Payment System (PPS) legislation and its resulting impact on the ability of hospitals to generate capital for expansion and growth are addressed. The response to PPS legislation is evaluated by examining stock returns of publicly traded hospital companies using both traditional event study analysis and intervention analysis. The paper focuses on the effect of PPS over time and uses qualitative data to support the empirical evidence. Before and after its passage, the market reacted negatively to PPS legislation. This result supports qualitative evidence showing that hospitals' capital positions were impaired. When profit margins fell, bond ratings went down, while borrowing costs increased; the rate of hospital bond defaults went up and capital improvements were delayed.     

人民币升值对出口产品的减利压力与“倒逼”效应分析

本文从出口产品周转过程入手,建立了反映出口产品增利与跑量、提价、人民币升值、提高利润率、加快周转速度等因素间内在联系的基础公式,在此基础上,进一步探索人民币升值对出口产品的减利压力及由此压力引发的“倒逼”效应。     

基于"资金池"设想的信用卡监管模式研究

信用卡业务的高利润,引发了激烈同业竞争,风险也接踵而至。本文基于以独立经济实体为单位的客户"资金池"创新结构设想,构建客户群体分类、行为规则预判和事中风险监控为主的三位一体监管模式,提高信用卡风险防范能力。     

The Significance of the Profit and Loss Account in Nineteenth-Century Britain: A Reassessment

This article presents a reassessment of the development of regulated financial disclosure in nineteenth-century British companies legislation. Most accounting historians have emphasized the importance of the balance sheet under the disclosure requirements of various Acts. The relative importance of the profit and loss account has been largely neglected by historians. This paper contends that the profit and loss account was a considerably more important document in the financial regulation of companies than previously contemplated. In fact, the profit and loss account was required in the disclosure regulations of numerous Acts, including the Joint Stock Banks Act (1844), the Regulation of Railways Act (1868), the Life Assurance Companies Act (1870) and the Building and Friendly Societies Act (1874).     

Are for-profit hospital conversions harmful to patients and to Medicare?

We examine how changes in hospital ownership to and from for-profit status affect quality and Medicare payments per hospital stay. We hypothesize that hospitals converting to for-profit ownership boost post acquisition profitability by reducing dimensions of quality not readily observed by patients and by raising prices. We find that 1-2 years after conversion to for-profit status, mortality of patients, which is difficult for outsiders to monitor, increases while hospital profitability rises markedly and staffing decreases. Thereafter, the decline in quality is much lower. A similar decline in quality is not observed after hospitals switch from for-profit to government or private nonprofit status.     

Stock-price manipulation

It is generally agreed that speculators can make profits frominsider trading or from the release of false information. Bothforms of stock-price manipulation have now been made illegalIn this article, we ask whether it impossible to make profitsfrom a different kind of manipulation, in which an uninformedspeculator simply buys and sells shares. We show that in a rationalexpectations framework, where all agents maximize expected utility,it is possible for an uninformed manipulator to make a profit,provided investors attach a positive probability to the manipulatorbeing an informed trader.     

The supply of charity services by nonprofit hospitals: motives and market structure

This article studies provision of charity care by private, nonprofit hospitals. We demonstrate that in the absence of large positive income effects on charity care supply, convex preferences for the nonprofit hospital imply crowding out by other private or government hospitals. Extending our model to include impure altruism (rivalry) provides a possible explanation for the previously reported empirical result that both crowding out and income effects on indigent care supply are often weak or insignificant. Empirical analysis of data for hospitals in Maryland provides evidence of rivalry on the supply of charity care.     

Does Medical Equipment Expansion Lead to More Diagnostic Services? Evidence from China’s Sichuan Province

A major goal of China’s healthcare reform is to control the increasing healthcare spending, much of which can be attributed to the overuse of diagnostic tests and has been relatively less studied in the literature. This article analyzes the correlation between medical equipment expansion and the increase in diagnostic test expenditure in China, using Sichuan Province as an example. County-level data aggregated from hospitals’ annual reports in Sichuan Province from 2008 to 2012 were used. The results show a positive correlation between the expansion of medical equipment and the increase in diagnostic test expenditure. Our study provides implications on reforming China’s healthcare delivery system and medical equipment regulation policies.     

Reputation and adverse selection: theory and evidence from eBay

How can a marketplace introduce mechanisms to overcome inefficiencies caused by adverse selection? In this article, I use a unique data set that follows eBay sellers to show that reputation is a major determinant of price variations. I develop a model of sellers' dynamic behavior where sellers have heterogeneous qualities unobservable by buyers. Using reputation as a signal of quality, I structurally estimate the model to uncover buyers' utility and sellers' costs and underlying qualities. I show that removing the reputation mechanism increases low‐quality sellers' market share, lowers prices, and consequently reduces sellers' profit by 66% and consumer surplus by 35%.