Incentives and cost containment in primary care physician reimbursement

The goal of capitation is to place gatekeepers at financial risk for the services the deliver. However, third party payers should provide gatekeepers with some type of protection against random and systematic risk transfer. Gatekeeper physicians' other alternative is to reduce this risk on their own by actively marketing services to healthier individuals and creating barriers to care for their sicker patients. Thus, the proper balance of risk transfer will result in the most cost-efficient, quality gatekeeper networks. However, even with the right balance of risk transfer, capitation may provide incentive for some physicians to withhold necessary services to further increase their profit margins-making quality of care a key concern. Thus, practice guidelines should be developed to ensure quality is not affected. These guidelines afford explicit criteria on how gatekeepers should respond in specific clinical situations.     

Supply-side investments: An international analysis of the return and risk relationship in the Travel & Leisure sector

This study investigates supply-side investments in the tourism sector, analysing the return and risk relationship of investments in tourism across several countries. The performance of tourism sector companies listed on the stock exchange, for the top one dozen countries according to the World Economic Forum (WEF) tourism rankings, is investigated by region, across these countries and within each country by comparison to other sectors. Several metrics are used to compare the risk-adjusted returns, over a 15-year period ending March 2007 and sub-periods to check the persistence of performance over time. The results present a strikingly different ranking than those of the WEF. The implications for the flow of investment funds are of importance in a global capital market. Money will flow to those investments with the highest expected returns for a given risk level and this has consequential impacts for economic growth and employment in the tourism sector.     

Hard globalization

Many companies aspire to be players in the global marketplace, but the challenges to succeed are now greater than ever. Steve Tappin and Andrew Cave spoke with the CEOs of strongly globalized companies to learn their secrets.     

The Transformation of International Telecommunications

This article starts by identifying the key elements of the antiquated system which has ensured that prices for international telephony have stayed high even though costs have fallen sharply. It then explains why and how that system, built on bilateral relationships between telecommunications companies (telcos) which were formerly monopolies, is now being undermined. The authors conclude that international customers of telcos can look forward to massive price cuts in the near future and that this will make it possible for world-wide communications across disparate operations to expand even faster than before. The telcos themselves must face up to (i) rapidly falling profits from what has been a cash cow and (ii) the strategic dilemma of whether to hold out against change or to roll out new services to compete with new entrants and the new service options opened up by technological advance.     

Interpreting budget deficits in Latin America: the methods with application to Argentina

Fiscal policy in Latin American countries is too often evaluatedon the basis of raw deficit figures. This study demonstrateshow the effects of inflation on the deficit must be removedin order to derive the discretionary component of fiscal policy.Once this correction is made, fiscal policy can be evaluatedby testing the movement of the deficit with respect to alternativepolicy targets. As an illustration I employ Argentine data inorder to decompose the deficit and determine the degree to whichit is a reflection of budget endogeneity versus populism/socialconflict.     

Learning to agree

An explicit model of communication and informational equilibrium is constructed and some results generalizing Aumann's theorem on the impossibility of agreeing to disagree are obtained, together with an example showing that full rationality may be sub-optimal.     

The unfinished history of usage rights for spectrum

The key task in the next stage of spectrum management is to adapt regulation to the prospect of widespread sharing, on a much more sophisticated basis than sharing is used today. There is a role for the regulator to take steps to expand the area of choice within which public and private sector users can operate. This is best done in general by enhancing the flexibility of usage rights, which itself is best achieved by enhancing the freedom to trade them in the dimensions of time, space, level of interference and priority of access, by subdividing, re-aggregating, etc. However, there are considerable transactions cost impediments to trading where unlicensed users are involved. This creates a role for the regulator pro-actively to investigate different allocations, to make provisions for the most promising to occur and to incorporate both in refarming exercises and in primary assignments based on auctions configurations of usage rights, which might favour promising avenues of shared spectrum use.