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.     

Earning the “Write to Speak”: Sell‐Side Analysts and Their Struggle to Be Heard

This paper explores the ways in which sell‐side (SS) financial analysts seek to position themselves advantageously within the wider field of investment advice in spite of widespread skepticism over the value that their forecasts and recommendations add to investment decisions. The field of investment advice has been characterized in recent years by a number of regulatory and technological changes that have forced SS analysts to reconstitute the ways in which they influence the investment decisions of buy‐side (BS) actors. Faced with existential threats, SS analysts have responded to the disruptive impact of technology and regulation by struggling hard to ensure that their services are still valued by fund managers. Key to this ongoing process is the recalibration of professional expertise, which previous research has alluded to but not explored in detail. Central to the persistence of SS analysts in processes of investment decision making are activities revolving around the production and use of analyst reports which, our findings indicate, are less valuable for their informational content than their role as “relational devices,” ascribing legitimacy to SS analysts and earning them an entry ticket to more substantive, value‐adding interactions with companies and BS actors. We also show that economic considerations in the area of investment advice are influenced by social ties, the motivations of various actors in the field, and their relative position vis‐à‐vis other actors. More generally, we contribute to the literature on professional projects by showing how professional groups are constantly engaged in attempts to reposition themselves in the social space, but that field‐level changes can restrict the outcomes of these strategies to mitigation rather than advancement for the professionals concerned.     

Management accounting,performance measurement and strategy in English local authorities

This paper analyses the results of an extensive survey of UK local government which explored the relationship between strategy, management accounting practices (MAPs), and performance measurement techniques (PMTs). The research investigated a resource-based view of strategic capabilities and Porter’s strategic typologies. PMTs and MAPs were shown to be associated with strategic capabilities. Strategic typologies, however, were found to be only weakly associated with the use of PMTs and MAPs.     

The role of travel agents’ ethical concerns when brokering information in the marketing and sale of sustainable tourism

ABSTRACT

Using conservation tourism as a test case, this study explores the role high-end travel agents play in selling sustainable tourism. It examines a niche marketing activity in that process. The study focuses on agents’ consideration of ethics as they act as information brokers between tourists and operators. Data were collected from interviews with agents and analysed using a deductive content analysis based on six overarching concepts and theories on ethical decision-making. The findings emphasize the implicit influence within conservation tourism of tourism's ethical dimensions, whilst identifying many constraints that prevent a full consideration and/or disclosure of ethical concerns in the sales process. Most importantly, agents made assumptions using a false consensus bias about clients' preferences for service over concerns for the environment, and were not prepared to discuss the more sensitive issues surrounding conservation with their clients. A number of recommendations are proposed regarding the need to unpack conservation information, overcome the false consensus bias, and agents’ reluctance to discuss ethics in the sales process. Finally, the findings have broader implications for the development of sustainable tourism, which ultimately will depend on a dialogue of ethical concerns and values within the tourism supply chain between suppliers, brokers and tourists.     

Effects of Lightness‐Location Congruency on Consumers’ Purchase Decision‐Making

A considerable body of psychological and neuroscientific research has demonstrated the existence of robust sensory correspondences between various features, attributes, or dimensions of experience in different sensory modalities. Despite findings indicating the importance of sensory correspondences to human information processing, research on purchase decision‐making has not to date focused sufficiently on this phenomenon. The present study examines how the lightness of packaging colors, and the location of products on a display shelf interact to affect consumers’ purchase decision‐making via perceived visual heaviness. As predicted, a display with light (dark) colored products positioned in the upper (lower) shelf positions increases shoppers’ perceptual fluency and facilitates their visual search, thus leading to the suggestion that “light” (heavy) locations are most appropriate for light (dark) colored products. Moreover, the lightness‐location congruent display is shown to influence people's choice behavior positively as well. This research also demonstrates that when consumers consider the lightness (in terms of their weight) of the products, they are more likely to choose light (vs. dark) colored products located in the upper shelf positions. These results therefore demonstrate that consumers’ purchase decision‐making may be promoted by in‐store environments designed to be congruent with their sensory correspondences.     

Who should own it? An agency‐based explanation for multi‐outlet ownership and co‐location in plural form franchising

Plural forms exist when managers use two owners to perform one activity. Franchising is a plural form explained by agency theory, however, the theory is unable to explain two franchisor actions: 1) allowing franchisees to own multiple outlets and 2) co‐locating company‐owned and franchised outlets. We use research that describes a symbiosis between company‐owned and franchised outlets to extend agency theory and explain these actions. Our investigation of ownership patterns among 4,339 outlets of 16 plural form franchisors is consistent with our theory that multi‐outlet franchising is cost efficient and that co‐location occurs when franchisors fill market gaps left by franchisees. Copyright © 2011 John Wiley & Sons, Ltd.     

Exploring the relative influences of transport disadvantage and social exclusion on well-being

This paper explores the separate and combined effects of transport disadvantage and social exclusion on well-being using an empirical analysis of data from a travel and disadvantage survey in Victoria, Australia. Previous research explores the impact of transport on social exclusion but does not study the downstream impacts on well-being. To explore this relationship measures of subjective well-being are compared across four groups: (i) people who are neither transport disadvantaged nor socially excluded, (ii) transport disadvantaged only, (iii) socially excluded only and (iv) both transport disadvantaged and socially excluded. The paper explores which component aspects of social exclusion and transport disadvantage have the greatest impact on well-being and which social groups are most likely to face transport disadvantage and social exclusion together. The paper concludes with a commentary on how the findings might be used to better target policy interventions meant to improve well-being.     

Modelling the Risks Associated with the Increased Importation of Fresh Produce from Emerging Supply Sources Outside the EU to the UK

The risk of non‐indigenous plant pests entering the UK via international trade in fresh produce is increasing. The objective of this article is to identify existing and emerging supply sources for UK fresh produce importers and examine the extent to which they could provide invasion pathways. We tested the hypothesis that increased imports of fresh produce from new sources outside the European Union could increase the risks of non‐indigenous insect pests. We use a bio‐economic model approach in which the number of species arrivals is a function of the volume of imports, whereas the volume of imports itself is a function of gross domestic product, relative import prices and seasonality. The study has identified clear trends, which show import volumes of fresh produce and species detections increasing from new supply sources. If this trend continues in the future, then the UK inspection agency should expect to confront species from new suppliers in much greater numbers, given that import volumes of fresh produce are income elastic.