The income redistribution effects of Medicaid: Application in New York State

The efficacy of Medicaid as an income redistribution mechanism among New York State counties was examined to determine tthe degree of income shifting from higher to lower income counties. A sample of 21 counties, grouped into four discrete income classes according to 1970 per capita income was taken.Costs and expenditures (attributed to Medicaid) were allocated over all counties, adjusting for federal and state aid transfers. The data were tabulated for each of the 21 counties and six key ratios (including: Medicaid expenditures per authorized recipient, etc.) were developed as measures of income distribution.The impact of Medicaid was tested using two independent statistical techniques, goodness of fit and pooled comparisons between each pair of means for each ratio. Results indicated that no appreciable shift in income from high to low counties existed. Medicaid failed 45 of 72 mean difference tests, and the true distribution of costs and expenditures across income classes did not differ significantly from a uniform distribution in 77.7% of the cases.The results indicate that the mandated funding structure of Medicaid impinges more severely on poorer counties. Lack of an adequate health care infra-structure may seriously limit the ability of lower income counties to provide care even with Medicaid covering a large share of medical costs.     

The impact of marketing systems on soil sustainability of agriculture in developing countries: a method and an application

This article is concerned with soil‐sustainability problems of agriculture in developing countries, in particular with soil erosion. The aim of our study is to develop a comprehensive model that explains the adoption of sustainable agricultural practices with respect to soil conservation. Our approach includes the following special features: (a) the model is comprehensive in that it includes a large number of institutional, personal–social, economic, and physical explanatory variables; (b) particular attention is paid to the influence of marketing systems on the adoption of sustainable agricultural practices, which to our knowledge has been neglected in past research; (c) the concept of adopting sustainable agricultural practices (ASAP) is differentiated into a limited number of basic components of soil conservation; and (d) the model is estimated by Principal Component Regression, which enhances efficient estimation of the impact of many explanatory variables on ASAP. Our model is applied to Cabuyal hillside farming in Colombia. The application demonstrates the usefulness of the proposed model. ASAP is differentiated into three basic components: soil‐disturbance control, soil‐protection practices, and run‐off control. It appears that soil‐disturbance control is particularly influenced by farmers' characteristics, such as education and managerial variables. The second component, soil‐protection practices, appears to be strongly influenced not only by farmers' managerial variables but also by their relationship with their environment, in particular marketing institutions. The third soil‐conservation component, run‐off control, is influenced by the physical characteristics of the plot and by the available farm labor. Our empirical results demonstrate the usefulness of the proposed model in designing agricultural policies, because it can determine which variables are more likely to influence the adoption of a specific type of soil conservation.     

Migration and farm technical efficiency: evidence from Kosovo

This article investigates the effect of migration on farm technical efficiency drawing on a large and representative sample of agricultural households in Kosovo. A two‐stage estimation procedure is applied: a frontier technique to estimate the effect of migration on farm efficiency, followed by a propensity score based matching approach to robustly estimate the sample average effect on efficiency for different levels of migration intensity. Migration is found to have an efficiency decreasing effect, which is amplified for better educated workers. The observed negative effect of migration on efficiency is evident even at low levels of migration intensity.     

A Marketing Approach to Commodity Futures Exchanges: A Case Study of the Dutch Hog Industry

This paper proposes a marketing strategic approach to commodity futures exchanges to optimise the (hedging) services offered. First, the environment of commodity futures exchanges is examined. Second, the threats and opportunities of commodity futures exchanges are analysed. Our analysis demonstrates that market orientation is an important element in the market strategies of commodity futures exchanges. Our market strategic framework is applied to the Dutch hog futures market. It is concluded that market penetration is an appropriate strategy. Consequently, to identify the variables that distinguish between farmers who initiate futures positions and farmers who do not, we conducted a discriminant analysis on data gathered from 418 Dutch hog farmers. The discriminant analysis shows that latent variables, such as farmers' perceived performance, farmers' reference price and farmers' market orientation, are important discriminating variables. Furthermore, farmers' cash market behaviour (in terms of the frequency of selling in the spot market) is an important discriminating variable as well. The usefulness of these results as input for a penetration policy is demonstrated.     

Predicting binary outcomes

We address the issue of using a set of covariates to categorize or predict a binary outcome. This is a common problem in many disciplines including economics. In the context of a prespecified utility (or cost) function we examine the construction of forecasts suggesting an extension of the  and  maximum score approach. We provide analytical properties of the method and compare it to more common approaches such as forecasts or classifications based on conditional probability models. Large gains over existing methods can be attained when models are misspecified.     

A United Kingdom-based economic evaluation of ranibizumab for patients with retinal vein occlusion (RVO)

Objective:

This study compares the cost-effectiveness of intravitreal ranibizumab vs observation and/or laser photocoagulation for treatment of macular edema secondary to retinal vein occlusion in a UK-based model.

Methods:

A Markov model was constructed using transition probabilities and frequency of adverse events derived using data from the BRAVO, CRUISE, and HORIZON trials. Outcomes associated with treatments and health states were combined to predict overall health costs and outcomes for cohorts treated with each option.

Results:

In branch retinal vein occlusion, ranibizumab produced a gain of 0.518 quality-adjusted life years at an incremental cost of £8141, compared with laser photocoagulation. The incremental cost-effectiveness ratio was £15,710 per quality-adjusted life year, and the incremental cost per month free from blindness was £658. In central retinal vein occlusion, ranibizumab produced a gain of 0.539 quality-adjusted life years at an incremental cost of £9216, compared with observation only. The incremental cost-effectiveness ratio was £17,103, and the incremental cost per month free from blindness was £423.

Conclusions:

These incremental cost-effectiveness ratios are below the £20,000–30,000 range typically accepted as a threshold for cost-effectiveness. This suggests that ranibizumab may be regarded as a cost-effective therapy for patients with macular edema secondary to retinal vein occlusion, relative to grid laser photocoagulation (for BRVO) and observation (for CRVO). Limitations include sparse data for utilities associated with the severity of visual impairment in the WSE in patients with RVO. A lack of direct comparative evidence between ranibizumab and the dexamethasone intravitreal implant for the treatment of BRVO and CRVO and the infeasibility of an indirect comparison due to significant heterogeneity in trial designs prevented the inclusion of this treatment as a comparator in the Markov model.     

The Influence of Business Ethics Education on Moral Efficacy,Moral Meaningfulness,and Moral Courage: A Quasi-experimental Study

The research described here contributes to the extant empirical research on business ethics education by examining outcomes drawn from the literature on positive organizational scholarship (POS). The general research question explored is whether a course on ethical decision-making in business could positively influence students’ confidence in their abilities to handle ethical problems at work (i.e., moral efficacy), boost the relative importance of ethics in their work lives (i.e., moral meaningfulness), and encourage them to be more courageous in raising ethical problems at work even if it is unpopular (i.e., moral courage). Specifically, the study used a rigorous quasi-experimental pretest–posttest research design with a treatment (N = 30) and control group (N = 30) to investigate whether a graduate-level course in business ethics could influence students’ levels of moral efficacy, meaningfulness, and courage. Findings revealed that participants in the business ethics treatment course experienced significant positive increases in each of the three outcome variables as compared to the control group. The largest increase was in moral efficacy, followed by moral courage, and finally, moral meaningfulness. These findings are discussed in the context of the current research on business ethics education and POS. Implications for future research are discussed.