Lone Mothers: What is to be done?

This Dialogue presents the views of four authors, from the US, the UK, and Norway, on the best policies to help lone mothers. Lone mothers face an inevitable dilemma in allocating their time between earning income and caring for their children. The low-earning capacity of women in an unequal labor market exacerbates the problem, causing material hardship for many lone mothers and their families. The policy solutions proposed lie along a spectrum, ranging from those that seek to enable all lone mothers to take employment to those that aim to let mothers choose whether to take employment or care for their children themselves. Other policies discussed concern ways to value and support caregiving, improve the low-wage labor market for women, and provide a set of income supports that would both boost income and provide time to care for children.     

The Challenge of Obtaining Quality Care: Limited Consumer Sovereignty in Human Services

Abstract

This paper offers a conceptual analysis of the problem of quality in human services: in elementary school, psychiatric care, and the health and social care of children, the elderly, and the intellectually disabled. Geriatric nursing home patients are used as a case. These care recipients cannot enforce their legal right to quality service; their quality-effective demand is low. Formal economic analyses often characterize the weak position of the care recipient as an information asymmetry problem. An additional obstacle, however, is the recipient's inability to safeguard her personal interest due to physical, mental, or social incapacities; that is, “limited consumer sovereignty.” Incapacitated individuals cannot enforce quality even when quality information is available. This creates a fundamental incentive problem in the monitoring of quality. They also depend on services that are complex and non-verifiable, making external monitoring difficult. This paper presents a typology of measures to increase the quality pressure facing providers.     

CHILD CARE PRICES AND MATERNAL EMPLOYMENT: A META‐ANALYSIS

The literature estimates for labor force participation elasticity with regard to child care prices are extensive and varying. While some estimates imply substantial gains from child care subsidies, others find insignificant effects. To determine the causes of the variance, this paper reviews and analyzes the elasticity sizes using estimates from 36 peer‐reviewed articles and working papers in the literature. We start by reviewing the theoretical and empirical aspects related to participation elasticity with regard to child care costs, paying special attention to sample characteristics, methodological aspects, and macro level factors. We conclude by providing a meta‐regression using control variables based on our review of the literature to explain some of the differences between the estimates. As research builds on and improves the methods and assumptions in prior works, elasticity estimates have become smaller over time. This decline might also be partially explained by changes in labor market characteristics. In countries with high rates of part‐time work and very high or very low rates of female labor force participation, we find elasticity rates to be smaller.     

Merit and Evaluation Models for Managers in the National Health System： An Empirical Study

The national health system （NHS） complexity increase requires a review of the managerial human resources evaluation and recruiting methods, considering that nowadays doctors need to improve not just their clinical capabilities, but also managerial competences. At this end it is important to develop performances control models and to identify appropriate results indicators, with the aim of introducing an effective doctors selection system for managerial roles. The paper considers the Italian situation and tests the current evaluation and selection methods, by analysing the literature and the existing legislation and by interviewing experts. Moreover, in order to reach an innovative model, complex organizations have been taken into account as benchmarks. Three different categories of experts have been interviewed and texted： national health care organizations managers, companies managers, and business consultants. The 137 interviewed experts have been asked about four main questions concerning the evaluation for hiring managers as chief medical director, department director, and head of complex units. The conducted research suggests four different options in order to evaluate and to select heads of complex unit for the most strategic roles. By consequence, the analysis shows that required characteristics must be managerial attitudes as well as clinical capabilities.     

Dissertation abstract: “Essays in applied economics on the intervention of a third player in agency relationships”

Agency theory has established that appropriate incentives can reconcile the diverging interests of the principal and the agent. Focusing on three applications, this dissertation evaluates the empirical relevance of these results when a third party interacts with the primary contract. The analyses provided rely on either laboratory or natural experiments. First, corruption is analyzed as a two-contract situation: a delegation contract between a Principal and an Agent and a corruption pact concluded between this Agent and a third player, called Briber. A survey of the recent microeconomic literature on corruption first highlights how corruption behavior results from the properties of those two agreements. We thereafter show that the Agent faces a conflict in reciprocities due to those two conflicting agreements. The resulting delegation effect, supported by observed behavior in our three-player experimental game, could account for the deterrence effect of wages on corruption. Second, health care is governed by contradictory objectives: patients are mainly concerned with the health provided, whereas containing health care costs is the primary goal of health care administrators. We provide further insights into the ability of incentives to balance these two competing objectives. In this matter, our theoretical and econometric analysis evaluates how a new mixed compensation scheme, introduced in Quebec in 1999 as an alternative to fee-for-services, has affected physicians’ practice patterns. Free switching is shown to be an essential feature of the reform, since it implements screening between physicians. Finally, the demand for underground work departs from the traditional Beckerian approach to illegal behavior, due to the dependence of benefits from illegality on competitors’ behavior. We set up a theoretical model in which the demand for underground work from all producers competing on the same output market is analyzed simultaneously. We first show that competition drastically undermines the individual benefits of tax evasion. At equilibrium, each firm nonetheless chooses evasion with a positive probability, strictly lower than one. This Bertrand curse could then account for the “tax evasion puzzle” i.e. the overprediction of evasion in models that ignore market interactions. We thereafter show that allowing firms to denounce competitors’ evasion is not likely to solve this curse—by providing a credible threat against price cuts, it fosters illegal work. Empirical evidence from a laboratory experiment confirms these predictions. Without denunciation, experimental firms often choose evasion whereas evasion benefits are canceled out by competition. When introduced, denunciation is rarely used by firms, but the threat makes evasion profitable. JEL Classification K42, I18, D21, C25, C91     

加速城市建设应注意的几个问题

目前,我国城市化进程不断加快,城市数量增加,规模扩大,成效显著.但是,也必须清醒地看到,城市建设工作中的短期行为和浮躁之风相当严重,应当引起人们的高度重视.本文认为,城市规模扩张必须以产业支撑为前提,不能搞空壳城市;城市公共设施建设慎向民资伸手,不能滥用市场化手段;居民区搬迁改造应多些人文关怀,不能一拆了之;应遵循城市发展的客观规律,正确处理城市建设中的几个关系问题.     

中国城乡老年健康及照料状况研究

人口老龄化背景下我国城乡的老年健康及老年照料问题日益严重。利用中国城乡老年人状况调查数据、全国残疾人抽样调查数据以及国家卫生服务利用调查数据,从两周患病率、慢性病患病率、残疾水平、自评健康以及健康预期寿命等方面分析了我国城乡老年人的健康状况,探讨了目前我国城乡老年人的照料提供来源。提出了人口老龄化趋势下提高老年健康水平,应对老年人口照料危机的政策建议。     

Globalization with a human face

This paper has six parts. The first part defines globalization. The second discusses globalization eras. The third discusses the irreversibility and inevitability of globalization. The fourth section discusses the benefits and costs of globalization. The fifth section asks what is to be done. The sixth section contains my conclusions.     

长期护理保险在中国的选择-基于制度经济学的分析

为了解决人口老龄化背景下的老年护理问题,德国、日本先后于1995年1月1日、2000年4月1日启动长期护理保险制度。我国在1999年也已经进入老龄化国家行列,老龄化并呈加速趋势。我国农村家庭养老看护功能日益削弱、城镇养老机构数量不足、新型居家养老模式的资金来源不足。有必要借鉴德国、日本长期护理保险制度,采取城市的居家养老护理保险与农村的老年护理救助模式。基于制度经济学的角度,从价值支持、意识形态支持、成本支持与路径支持上论证了该制度的可行性。     

THE AGEING POPULATION: CRUNCH TIME FOR GOVERNMENT REFORMS

Current discussions about reforms to health and long‐term care miss the most important trends that should be influencing debate. With an ageing population that includes a higher proportion of people with manageable illnesses, health and care costs will rise. Reforms must ensure that existing government spending is used more efficiently and that it harnesses – rather than works against – private financing.