HETEROGENEOUS EFFECTS OF THE ACA MEDICAID EXPANSION ON HOSPITAL FINANCIAL OUTCOMES

This study examines the effect of the Affordable Care Act's Medicaid expansion on hospital financial outcomes. A key innovation relative to prior studies is that we explicitly account for heterogeneity across states in the timing and extent of the expansion as well as across hospital types. We find that Medicaid expansion led to a decrease in uncompensated care expenditures and an increase in average operating margins. The effects were larger in states where the Medicaid expansion led to a greater increase in program eligibility. Operating margins improved most for public hospitals and facilities located in rural areas. (JEL I11, I13, I18)     

Competition and Public Policy in the Nursing Home Industry

A theory of property needs to give an account of the whole lifecycle of a property right: How it is initiated, transferred, and terminated. Economics has focused on the transfers in the market and almost completely neglected the question of initiation and termination of property in normal production and consumption (not in some original state or in the transition from common to private property). The institutional mechanism for the normal initiation and termination of property is an invisible hand function of the market — the market mechanism of appropriation. Does this mechanism satisfy an appropriate normative principle? The standard normative juridical principle is to assign or impute legal responsibility according to de facto responsibility. It is given a historical tag of being "Lockean," but the basis is contemporary jurisprudence, not historical exegesis. Then, the fundamental theorem of the property mechanism is proven, which shows that if "Hume's conditions" (no transfers without consent and all contracts fulfilled) are satisfied, then the market automatically satisfies the Lockean responsibility principle — i.e., "Hume implies Locke." As a major application, the results in their contrapositive form, "Not Locke implies Not Hume," are applied to a market economy based on the employment contract. I show that the production based on the employment contract violates the Lockean principle (all who work in an employment enterprise are de facto responsible for the positive and negative results), and thus Hume's conditions must also be violated in the marketplace (de facto responsible human action cannot be transferred from one person to another — as is readily recognized when an employer and employee together commit a crime).¹     

Einzelbesprechungen

Ohne ZusammenfassungÜbersetzt von Gerhard Tintner, WienÜbersetzt von Ragnar Nurkse, z. Zt. Wienaus dem Italienischen übersetzt von Dr. Hans Fried, WienÜbersetzt von Paul Brüll, Wien.Aus dem Italienischen übersetzt von Dr. Hans Fried.     

Rock Paper Scissors

Rock Paper Scissors is used to resolve conflict when a compromise is not possible. Individuals playing ``games' tend to have biases they prefer to play. I show that Rock Paper Scissors with biased players results in a player with a high valuation for winning being victorious with a probability greater than a player with a low valuation. Thus, it frequently achieves the efficient outcome. Furthermore, as the benefit to victory increases for all players, victory for each player becomes equally likely. Therefore, it is often efficient for minor conflicts while it performs no better than a coin-flip for major conflicts.      

The Effect of Subsidized Housing on Values of Adjacent Housing

This is a case study of the effect of subsidized housing on the value of adjacent non-subsidized housing. Four townhouse clusters in Fairfax County, Virginia, were selected for study because of the high degree of homogeneity between clusters. The clusters are all in the same community but vary in distance from subsidized housing. Sale prices were analyzed using a regression model which included distance from subsidized housing as an independent variable. Based on the results of the regression analysis, the authors conclude that the subsidized housing had a negative impact on the values of adjacent properties.     

Governance structures in R&D networks: An analysis in the European context

This paper analyses governance structures used to organize partnerships in R&D networks using two approaches: transaction costs theory and social capital theory. We argue that these theories are complementary; this explains forms of governance through the degrees of administrative (structural and safeguard mechanism) and social factors (cohesion and openness) they embody. Data was obtained from European R&D networks created through Framework Programmes which include a great number of universities, non profit institutions and firms. Findings show the variables that characterize and explain the governance forms based on the applicability of R&D networks. This study not only provides a theoretical model for analysing governance structures of these networks, but is also useful for both improving the management of networks and for fostering collaboration at an international level.     

Shifting Taxes from Labor to Consumption: More Employment and more Inequality?

This paper investigates the effect of shifting taxes from labor income to consumption on labor supply and the distribution of income in Germany. We simulate stepwise increases in the value‐added tax (VAT) rate, which are compensated by revenue‐neutral reductions in income‐related taxes. We differentiate between the personal income tax (PIT) and social security contributions (SSC). Based on a dual data base and a microsimulation model of household labor supply behavior, we find a regressive impact of such a tax shift in the short run. When accounting for labor supply adjustments, the adverse distributional impact persists for PIT reductions, while the overall effects on inequality and progressivity become lower when payroll taxes are reduced. This is partly due to increases in aggregate labor supply, resulting from higher work incentives.     

Exclusions of infertility treatment in the aftermath of Bragdon v. Abbott

This article analyzes the Supreme Court's decision in Bragdon v. Abbott to determine whether the Court's reading of ADA necessarily leads to the conclusion that a group health plan's or insurer's exclusion or limitation of coverage with respect to infertility is prohibited by ADA. The authors conclude that it may be advisable for plans to perform at least minimal actuarial calculations with respect to the current or anticipated costs of covering infertility treatments prior to adopting any exclusions or limitations of coverage.