Managed competition

People don't like change. That includes materiel managers, administrators, and clinical providers. Managed competition or managed care will work if, and only if, the American professions and the American public recognize the value of highly educated and qualified clinical and nonclinical providers and if the health care industry responds in kind.     

The measurement of left-right and libertarian-authoritarian values: A comparison of balanced and unbalanced scales

In this paper we compare the performance of balanced and unbalanced Likert scales of two core dimensions of political attitudes: left-right and libertarian-authoritarian values. The balanced scales control for the effects of acquiescence response sets, whereas the unbalanced scales do not. Using data from two panel surveys, balanced and unbalanced scales are compared for reliability, stability and validity both with each other, and with other measures of political ideology and values (left-right self-placement and postmaterialism). Both balanced and unbalanced versions of the left-right and libertarian-authoritarian Likert scales are found to be more stable and strongly associated with social characteristics than are the other measures. The unbalanced scales have slightly higher reliability than the balanced scales; they are also orthogonal, whereas balanced left-right and libertarian-authoritarian scales are moderately correlated. Unbalanced scales also display a slightly stronger relationship with social characteristics, but they do not differ in their pattern of association with political preferences. Differences between balanced and unbalanced scales are attributed to the effects of acquiescence bias. This needs to be considered when using the scales for substantive analyses, but its effects are not problematic.     

Multidimensional scaling of consumer preferences for a public transportation system: An application of two approaches

Consumer attitudes toward a proposed new public transportation system were assessed through the application of two multidimensional scaling models to data on preference choices for system attributes. Carroll's vector model and Kruskal and Carmone's nonmetric unfolding model were compared on theoretical and empirical levels to determine their utility for exposing the latent structure of attitudes for a public project. While the unfolding model was attractive because of a theoretical property, the vector model was able to uncover latent dimensions for the attitudes which could be related via discriminant analysis to socio-economic and demographic characteristics of the respondents. The vector model also produced an outcome which was more closely related to a unidimensional analysis of these data. Therefore, even though both the vector and unfolding models produced plausible geometric representations of the attitudes which arc expected to aid urban transportation planners in designing systems, the vector model produced the more acceptable outcome.     

Decomposing hospital productivity changes, 1985–1988: A nonparametric Malmquist approach

Annual data on U.S. hospitals from 1985–1988 are evaluated by ownership type—profit, nonprofit, state and local government, and U.S. Department of Veterans Affairs (VA)—for changes in hospital productivity over time. Distance functions are used to measure Malmquist indices of productivity change, which are then decomposed into indices of efficiency change and technology change. In contrast to previous studies using this approach, we allow for variable returns to scale and use both input and output orientations. We find that changes in technology dominate changes in inefficiency in determining changes in productivity.     

Borrowing constraints,the cost of precautionary saving and unemployment insurance

When it is costly for individuals to save or to borrow, unemployment insurance (UI) provides an alternative source of liquidity that smooths consumption over time and leads individuals to spend longer unemployed searching for a suitable job. We show in a tractable life-cycle model how the optimal unemployment replacement ratio and the fall in consumption on job loss depend on the cost of self-insurance and the cost of borrowing. This implies that the value of UI depends on age at job loss, consumption needs (such as the presence of children), discount rates, the return on saving, access to credit and the presence of other social insurance programmes. Optimal replacement rates vary substantially with plausible variation in these factors (from less than 20 percent to almost 60 percent).     

Selling to the moneyed masses

Over the past decade, the distribution of household incomes has shifted so much that a much larger proportion of consumers now earn significantly higher-than-average incomes--while still falling short of being truly rich. As a result, what used to be a no-man's-land for new product introductions has in many categories become an extremely profitable "new middle ground." How can marketers capitalize on this new territory? The key, say the authors, is to rethink the positioning and design of offerings and the ways they can be brought to market. Take, for instance, how Procter & Gamble redefined the positioning map for tooth-whitening solutions. A decade ago, dental centers were popularizing expensive bleaching techniques that put the price of a professionally brightened smile in the 400 dollars range. At the low end, consumers also had the choice of whitening toothpastes that cost anywhere from 2 dollars to 8 dollars. P&G wisely positioned itself between the two ends, successfully targeting the new mass market with its 35 dollars Whitestrips. In product categories where it's clear the middle ground has already been populated, it's important for companies to design or redesign offerings to compete. An example is the Polo shirt. How do you sell a man yet another one after he's bought every color he wants? Add some features, and call it a golf shirt. Here, marketers have introduced designs based on the concept of "occasional use" in order to stand out. Finally, companies wishing to reach the "almost rich" can change how they go to market. Perhaps no mass retailer has made a stronger bid for the mass affluent than Target Stores, which has pioneered a focus the company itself characterizes as upscale discount. The strategy has made Target an everyday shopping phenomenon among well-heeled urbanites and prosperous professionals.     

The Gilt-Equity Yield Ratio and the Predictability of UK and US Equity Returns

A number of financial variables have been shown to be effective in explaining the time-series of aggregate equity returns in both the UK and the US. These include, inter alia , the equity dividend yield, the spread between the yields on long and short government bonds, and the lagged equity return. Recently, however, the ratio between the long government bond yield and the equity dividend yield – the gilt-equity yield ratio – has emerged as a variable that has considerable explanatory power for UK equity returns. This paper compares the predictive ability of the gilt-equity yield ratio with these other variables for UK and US equity returns, providing evidence on both in-sample and out-of-sample performance. For UK monthly returns, it is shown that while the dividend yield has substantial in-sample explanatory power, this is not matched by out-of sample forecast accuracy. The gilt-equity yield ratio, in contrast, performs well both in-sample and out-of-sample. Although the predictability of US monthly equity returns is much lower than for the UK, a similar result emerges, with the gilt-equity yield ratio dominating the other variables in terms of both in-sample explanatory power and out-of-sample forecast performance. The gilt-equity yield ratio is also shown to have substantial predictive ability for long horizon returns.