The Samaritan’s Dilemma and public health insurance

When the government cannot commit to withdraw from providing charity health care, as is the case when it faces the Samaritan's Dilemma, a pub- lic health insurance scheme can be Pareto improving. However, the large heterogeneity in the design of such schemes observed around the world begs the question of what characterizes the optimal public health insurance plan. In this paper, we examine the distortions created by three plans, nested in terms of the constraints they place on the individual's decision problem. We ¯nd that linking public health insurance bene¯ts to the use of a certain type of health care, such as treatment in public hospitals, creates incentives against the e±cient use of higher quality health care. When such constraint is lifted, but the public insurance scheme still determines a minimum level of coverage for each illness, ¯rst best e±ciency is achieved. It turns out that placing constraints in the form of minimum levels of coverage for each illness is necessary for e±ciency. Removing such constraint decreases the relative price of high quality care for a subset of illnesses, and leads to too much high quality care used in equilibrium. This analysis suggests that the widespread practice of determining illness by illness coverage in public health insurance systems has an e±ciency rationale, despite the administrative and informational di±culties that it entails.Samaritan's Dilemma, Health insurance.

The Samaritan’s Dilemma and public health insurance

When the government cannot commit to withdraw from providing charity health care, as is the case when it faces the Samaritan's Dilemma, a public health insurance scheme can be Pareto improving. However, the large heterogeneity in the design of such schemes observed around the world begs the question of what characterizes the optimal public health insurance plan. In this paper, we examine the distortions created by three plans, nested in terms of the constraints they place on the individual's decision problem. We find that linking public health insurance benefits to the use of a certain type of health care, such as treatment in public hospitals, creates incentives against the efficient use of higher quality health care. When such constraint is lifted, but the public insurance scheme still determines a minimum level of coverage for each illness, first best efficiency is achieved. It turns out that placing constraints in the form of minimum levels of coverage for each illness is necessary for e±ciency. Removing such constraint decreases the relative price of high quality care for a subset of illnesses, and leads to too much high quality care used in equilibrium. This analysis suggests that the widespread practice of determining illness by illness coverage in public health insurance systems has an efficiency rationale, despite the administrative and informational difficulties that it entails

Does higher owner participation increase conflicts over common land? An analysis of communal forests in Galicia (Spain)

Communal forests or Montes Vecinales en Mano Común (MVMC) are a type of private collective land in Galicia (northwest Spain) representing approximately one-third of its forest land. There has been a series of changes in MVMC ownership and management throughout the 20th century. Uncertainty about ownership, changes in population and the presence of the Forestry Administration has caused deficiencies in management and increased conflict. This paper analysed MVMC management in 1731 parishes in Galicia. The digital records of local and regional newspapers were used to compile a database of 2734 news reports related to MVMC issues. The results of hypothesis testing and spatial analysis showed that population, agricultural activity and land use affected management and conflict rates. This paper discusses how active management and conflict are complementary models, and how the presence or absence of one or the other is a determining factor in the situation of each parish. It concludes that it is necessary to implement management models and strategies to minimize conflict and increase active management for sustainable forest development in the region.We are grateful to the Galician Government, Xunta de Galicia, Dirección Xeral de Investigación, Desenvolvemento e Innovación, Xunta de Galicia, for funding the project “A decision support system for montes veciñais en man común (DSSMVMC)” (07MRU035291PR)S

Inherently Governmental Functions and Other Work Reserved for Performance by Federal Government Employees: The Obama Administration’s Proposed Policy Letter

[Excerpt] On March 31, 2010, the Office of Federal Procurement Policy (OFPP) in the Office of Management and Budget (OMB) issued a proposed policy letter on inherently governmental functions and other “work reserved for performance by federal government employees.” While not final, the policy letter represents the Obama Administration’s proposed guidance for agencies determining (1) whether particular functions are inherently governmental and (2) when functions closely associated with the performance of inherently governmental functions and critical functions should be performed by government personnel. The proposed policy letter was, in part, issued under the authority of the Duncan Hunter National Defense Authorization Act for FY2009 (NDAA\u2709) and President Obama’s memorandum of March 4, 2009, on government contracting. Section 321 of NDAA\u2709 tasked OMB with (1) reviewing existing definitions of “inherently governmental function” to determine whether such definitions are “sufficiently focused” to ensure that only government personnel perform inherently governmental functions or “other critical functions necessary for the mission of a Federal department or agency;” (2) developing a “single consistent definition” of “inherently governmental function” that would address any deficiencies in the existing definitions, reasonably apply to all agencies, and ensure that agency personnel can identify positions that perform inherently governmental functions; (3) developing criteria for identifying critical functions” that should be performed by government personnel; and (4) developing criteria for identifying positions that government personnel should perform in order to ensure that agencies develop and maintain “sufficient organic expertise and technical capacity” to perform their missions and oversee contractors’ work. President Obama’s March 4, 2009, memorandum similarly charged OMB with clarifying when outsourcing is “appropriate.

Sourcing Policy: Selected Developments and Issues

[Excerpt] Sourcing policy refers, generally, to determining which sector—public (government) or private—will perform an agency’s function(s). Both federal employees and contractor employees have valid roles to play in performing the work of the federal government. This combined workforce is known as a blended workforce. Determining which sector will perform which functions, including determining when federal employee performance is, or should be, required can be challenging, however. Efforts to address this issue, and related questions, have been the subject of the federal government’s sourcing policy since at least the 1950s. This report begins with a history of sourcing policy that focuses on the terms commercial and inherently governmental, and the policy of government reliance on the private sector. The following section examines the two strains of sourcing policy: competitive sourcing and multi-sector workforce management. The juxtaposition of the Bush Administration’s competitive sourcing initiative and the Obama Administration’s multi-sector workforce management effort aids in understanding different, yet potentially complementary, facets of sourcing policy. Policy issues that may be of interest to the 112th Congress are also discussed

Exploring the role of messenger effects and feedback frames in promoting uptake of energy-efficient technologies

The persuasive potential for varying messenger types and feedback frames to increase pro-environmental choice was explored in a 2 (feedback frame: financial vs. environmental) × 5 (messenger type: neighbour, government, industry, utilities vs. control) factorial design experiment. Using the context of home heating choice, 493 non-student participants were given information on either the financial or environmental benefits of selecting an energy-efficient heat pump versus a standard boiler, as described by one of four messenger types (versus a no-messenger control). Likelihood of selecting the ‘green’ technology was assessed, as well as any carry-over effects on real-life behavioural intentions. Additionally, we assessed the messenger attributes that appeared to be most important in this context, in terms of whether sources that were perceived to be trustworthy, knowledgeable, or a combination of both dimensions, would hold greater sway over preference formation. Overall, no evidence was found for any impact of messenger type on either preference formation or behavioural intentions. However, message content (i.e. how information on the benefits of pro-environmental choice was framed), was found to have substantial impact on behaviour; with the financial versus environmental decision frame being significantly more likely to encourage uptake of the energy-efficient versus standard technology. We suggest that the level of processing required for the kinds of large-scale purchase decisions we consider here may explain the lack of any messenger effect on choice behaviour. Implications for the development of behaviour change interventions designed to promote consideration of energy-efficient technologies in this context are discussed

Fiscal decentralization and development: How crucial is local politics?

Does fiscal decentralization in a politically decentralized less developed country help strengthen democratic institutions at the grass root level? And is the impact of such decentralization on local politics important in determining local development? Our study on Indonesia suggests that fiscal decentralization enhanced free and fair local elections, though the incidence of elite capture, and the consequent breakdown of local democracy, was also present in significant proportions. Fiscal decentralization promoted development mostly in communities which transited out from elite capture to embrace free and fair elections. This was followed by communities that experienced the emergence of elite capture. Communities that continued to remain under either elite capture or free and fair elections did the worst. These findings suggest that while the emergence of elite capture exists, it may not necessarily be the most harmful. Instead, and surprisingly so, stability of local polity hurts development the most

An HEI-disaggregated input-output table for Wales

This paper describes how the education sector of the Welsh Input-Output tables is disaggregated to identify a separate sector for each of Wales’s twelve Higher Education Institutions (HEIs). The process draws on accounting and survey data to accurately determine the incomes and expenditures of each institution. In particular we emphasise determining the HEIs incomes source of origin to inform their treatment, as endogenous or exogenous, in subsequent analyses. The HEI-disaggregated Input-Output table provides a useful descriptive snapshot of the Welsh economy and the role of HEIs within it for a particular year, 2006. The table can be used to derive multipliers and conduct various impact studies of each institution or the sector as a whole. The table is furthermore useful to calibrate other multi-sectoral, HEI-disaggregated models of regional economies, including Social Accounting Matrix (SAM) and computable general equilibrium (CGE) models

An HEI-disaggregated input-output table for Scotland

This paper describes how the education sector of the Scottish Input-Output tables is disaggregated to identify a separate sector for each of Scotland’s twenty Higher Education Institutions (HEIs). The process draws on accounting and survey data to accurately determine the incomes and expenditures of each institution. In particular we emphasise determining the HEIs incomes source of origin to inform their treatment, as endogenous or exogenous, in subsequent analyses. The HEI-disaggregated Input-Output table provides a useful descriptive snapshot of the Scottish economy and the role of HEIs within it for a particular year, 2006. The table can be used to derive multipliers and conduct various impact studies of each institution or the sector as a whole. The table is furthermore useful to calibrate other multi-sectoral, HEI disaggregated models of regional economies, including Social Accounting Matrix (SAM) and computable general equilibrium (CGE) models