PHYSICIANS' COST SHIFTING BEHAVIOR: MEDICAID VERSUS OTHER PATIENTS

Much of the debate about rising health care costs in the United States centers on the notion of "cost shifting." Cost shifting is loosely defined as charging one set of patients a higher price to offset losses on another set of patients. One aspect of the cost shifting debate that the empirical work has ignored is whether or not doctors—as opposed to hospitals—practice cost shifting. The analysis here investigates this question using the Physicians' Practice Costs and Income Survey, 1983–1985 (PPCIS, expanded version)
Using variation across states in Medicaid reimbursements, the analysis finds that lower Medicaid reimbursements tend to lower the fees physicians charge, contradicting the standard cost shifting story. Evidence also suggests that lower Medicaid reimbursements tend to cause physicians to treat fewer Medicaid patients. These results are consistent with profit maximizing behavior for physicians and also with the hypothesis that physicians exert some monopoly power.     

Allocations and Common Costs in Long-Run Investing and Pricing Decisions: An Historical Analysis

The extent to which allocated common costs should influence business decisions remains controversial in management accounting. In the finance and investment literature this issue is generally ignored or dismissed by appeals to the'incremental' principle. This article presents an historical analysis of allocations in long-run investing and pricing decisions. It is demonstrated that seminal figures in the development of both investment and price theory were conscious of the need for firms to cover common costs and generally favoured some form of allocation. The anti-allocationist position is shown to be of relatively recent origin and to have caused an inconsistency in the management accounting literature in the treatment of common costs. European costing theory is shown to have been consistently allocationist. Evidence of a return in the recent U.S. literature to the older Anglo-American, and continuing European, allocations tradition is presented.     

Extensification of agriculture and deforestation: empirical evidence from Sudan

Extensification of agriculture is one of the major factors contributing to the destruction of forests in Africa. In Sudan, such horizontal expansion comes at the expense of land devoted to trees and other vegetation, thereby inducing conditions that are inimical to sustainable agricultural production. Different factors have contributed to extensification. Although high economic returns from crop (mainly sorghum) production was an important factor encouraging extensification of rainfed mechanized farming, other factors outside agriculture have also contributed to that expansion. This paper uses data from eastern Sudan and an acreage response model, to identify the most important factors influencing acreage expansion. Different measures and forms of risk were used in the acreage response model. The paper shows how policies in the energy sector can indirectly influence acreage expansion in the agricultural sector.     

Educating business schools about safety & health is no accident

This paper summarizes the consequences of safety and health inattentiveness, and reviews four primary dangers in the workplace. In addition, perspectives of employee health and safety are presented from industry and academia which provide the basis for a strong recommendation to include safety and health issues in business school curricula. Wayne H. Stewart's areas of research and teaching interest include Social Responsibility in Management, Entrepreneurship, and International Business. Wayne is currently on the editorial board of the International Journal of Case Studies, and has published in the Journal of Management Learning, as well as participating in several academic conferences. Donna E. Ledgerwood is currently the Secretary for the Southern Management Association. Donna was President of the Southwest Academy of Management in 1993 and served as the Academy of Management's Director of Exhibits/Publisher Relations and Director of Advertising from 1983–1991. Having written one of the first articles on sexual harassment in 1980, Donna serves on the Editorial Review Board for the Journal of Business Strategies and has published in the Labor Law Journal, the Monthly Labor Review, and the Personnel Administrator. Ruth C. May's areas of expertise are International Business, Business Policy and Strategy and International Human Resource Management. Specializing in the transfer of Western management practices to the former Soviet Union, Ruth is currently involved in the development of training programs and privatization processes in central Russia. She has published in the Academy of Management Executive, Multinational Business Review, and Socialist Labor (Russia).     

DISCOUNT RATES AND ENERGY EFFICIENCY

Empirical studies provide compelling evidence that economic agents do not adopt the complete range of energy-efficient technologies that are cost-effective under prevailing prices and market conditions. Analysts commonly attribute this anomaly to the use of high discount rates in energy-related decisions-an interpretation that is difficult to reconcile with standard models of rational choice. This paper recasts the controversy from the perspective of economic theory and finds that market failures related to asymmetric information, bounded rationality, and transaction costs are major contributors to the so-called "efficiency gap."     

On optimality in intergenerational risk sharing

Summary. This paper defines and studies optimality in a dynamic stochastic economy with finitely lived agents, and investigates the optimality properties of an equilibrium with or without sequentially complete markets. Various Pareto optimality concepts are considered, including interim and ex ante optimality. We show that, at an equilibrium with a productive asset (land) and sequentially complete markets, the intervention of a government may be justified, but only to improve risk sharing between generations. If markets are incomplete, constrained interim optimality is investigated in two-period lived OLG economies. We extend the optimality properties of an equilibrium with land and give conditions under which introducing a pay-as-you-go system at an equilibrium would not lead to any Pareto improvement. Received: October 5, 1998; revised version: April 3, 2001