Finding a lasting cure for U.S. health care

In "Making Competition in Health Care Work" (July-August 1994), Elizabeth Olmsted Teisberg, Michael E. Porter, and Gregory B. Brown ask a question that has been absent from the national debate on health care reform: How can the United States achieve sustained cost reductions while at the same time maintaining quality of care? The authors argue that innovation driven by rigorous competition is the key to successful reform. A lasting cure for health care in the United States should include four basic elements: corrected incentives to spur productive competition, universal insurance to secure economic efficiency, relevant information to ensure meaningful choice, and innovation to guarantee dynamic improvement. In this issue's Perspectives section, eleven experts examine the current state of the health care system and offer their views on the shape that reform should take. Some excerpts: "On the road to innovation, let us not forget to develop the tools that allow physicians, payers, and patients to make better decisions." I. Steven Udvarhelyi; "Health care is not a product or service that can be standardized, packaged, marketed, or adequately judged by consumers according to quality and price." Arnold S. Relman; "Just as antitrust laws are the wise restraints that make competition free in other sectors of the economy, so the right kind of managed competition can work well in health care." Edward M. Kennedy "Biomedical research should be considered primarily an investment in the national economic well-being with additional humanitarian benefits." Elizabeth Marincola.     

The biological reserve: The future's last stand

This article addresses the societal and cultural aspects of bioreserves and environmental restoration programmes. It begins with a discussion of bioreserves, then uses the example of a Man and Biosphere (MAB) inspired study of the US Everglades to illustrate how land has been shaped historically by culture and technology. It then demonstrates how current conflicts of values and culture, from both inside and outside the region, from interest groups with both pragmatic and emotional stances, are determining the future of an environment—the Everglades. The article thereby shows how human values and perceptions impact on the development of a sustainable Everglades, using the findings of surveys and public meetings to highlight the interests of the competing communities, ethnic and interest groups involved. If bioreserves are to survive they cannot become alienated from the people in the regions in which they are located.     

Market share and market size variances in a multi-product environment: An evaluation of competing formulations

Market share and market size variances are typically included in cost and managerial accounting texts in the discussion on sales variances. Shank and Churchill (1977) introduced a widely-adopted methodology wherein these variances are equal to the sales quantity variance, with the sales mix variance accounting for the entire variation in sales mix. Hirsch (1988) treats multiple products differently than Shank and Churchill (1977) and offers an alternative formulation for analyzing market share and market size variances. This paper compares the two variance formulations and demonstrates that the market share and market size variances under the Hirsch formulation more realistically reflect changes in market share and market size. As a result, the variances under the Hirsch formulation are more useful for managerial decision-making.     

Profits for nonprofits: find a corporate partner

Here's a familiar story. A nonprofit organization joins forces with a corporation in a caused-related marketing campaign. It seems like a win-win deal, but the nonprofit--and the media--find out several weeks into the campaign that the corporation's business practices are antithetical to the nonprofit's mission. The nonprofit's credibility is severely damaged. Is the moral of the story that nonprofits should steer clear of alliances with for-profit organizations? Not at all, Alan Andreasen says. Nonprofit managers can help their organizations avoid many of the risks and reap the rewards of cause-related marketing alliances by thinking of themselves not as charities but as partners in the marketing effort. More than ever, nonprofits need what many companies can offer: crucial new sources of revenue. But nonprofits offer corporate partners a great deal in return: the opportunity to enhance their image--and increase the bottom line--by supporting a worthy cause. Consider the fruitful partnership between American Express and Share Our Strength, a hunger-relief organization. Through the Charge Against Hunger program, now in its fourth year, American Express has helped contribute more than +16 million to SOS. In return, American Express has seen an increase in transactions with the card and in the number of merchants carrying the card. How can nonprofit managers build a successful partnership? They can assess their organization to see how it can add value to a corporate partner. They can identify those companies that stand to gain the most from a cause-related marketing alliance. And they can take an active role in shaping the partnership and monitoring its progress.     

Dividends and Profits: Some Unsubtle Foreign Influences

American corporations earn a significant share of their profits from foreign sources, out of which they appear to pay dividends at rates that are three times higher than their payout rates from domestic profits. Why firms do so is unclear, although this behavior is consistent with the use of dividends to signal profitability. This payout behavior implies that a significant part of the U.S. tax revenue generated by the foreign profits of U.S. corporations arises through the taxation of dividends received by individuals, and that the cost of capital may be higher for foreign than for domestic operations.     

Subordinated Market Index Models: A Comparison

The paper compares various processes subordinated to the Wiener process tomodel the leptokurtic characteristics of index returns. Empirical analysisis performed on the Dow Jones and Nikkei 225 indexes. A good model to capturethe typical tail behaviour of these indexes turns out to be a long Studentt distributed one.     

Managing Price Risk in the Pakistan Wheat Market

The government intervenes in the wheat market in Pakistan toensure food security for consumers and to provide adequate andstable incomes for producers. The cost of this interventionis high, and its impact on the performance of agriculture hasbeen significantly negative. The World Bank is urging policychanges such as removing agricultural trade restrictions, pricesupports, and subsidies. However, policymakers often resistsuch reforms, fearing that they will expose the domestic marketto fluctuating international commodity prices. This article assesses the risk management needs of the sectorand evaluates whether using financial instruments—suchas commodity hedging using futures, options, or swaps—wouldimprove risk management. Simulations based on monthly data for1994 show that market-based methods of risk management couldreduce the impact of international price volatility on the domesticmarket without incurring high government cost or distortingprice signals.     

CEO Contracting and Antitakeover Amendments

This article examines incentives for adopting antitakeover charter amendments (ATAs) that are associated with compensation contracts. The evidence is consistent with the hypothesis that antitakeover measures such as ATAs help managers protect above-market levels of compensation. Chief executive officers (CEOs) of firms that adopt ATAs receive higher salaries and more valuable option grants than CEOs at similar firms that do not adopt them. Furthermore, the magnitude of this difference increases following ATA adoption. The evidence is inconsistent with the hypothesis that ATAs facilitate the writing of efficient compensation contracts.     

Spatial Statistics and Real Estate

Real estate has historically employed statistical tools designed for independent observations while simultaneously noting the violation of these assumptions in the form of clustering of same sign residuals by neighborhood, along roads, and near facilities such as airports. Spatial statistics takes these dependencies into account to provide more realistic inference (OLS has biased standard errors), better prediction, and more efficient parameter estimation. This article provides an overview of the field and directs readers to the relevant literature and software.