The Regulatory Component of Health Care Reform

Explains the rationales and goals of regulatory intervention. Assesses the likelihood that proposed changes to regulations will be implemented as a component of healthcare reform or that they will help control costs and improve efficiency

Rail Privatisation: The Economic Theory

The purpose of this paper is to examine the relevance of economic theory to the rail privatisation proposals contained in the Railways Act 1993. After a review of the latest rail privatisation literature four major themes emerged: (1) Contestability and Barriers to Entry. (2) Franchising. (3) Vertical Integration. (4) Horizontal Integration. Following a short review of the rail privatisation proposals the paper presents each theme in the context of the proposals. In conclusion, we highlight a number of future issues which will require monitoring and research in the future. In particular, we identify a number of hypotheses, put forward by both those in favour and against the Government's proposals, that should be tested

The Promise of Priority Review Vouchers as a Legislative Tool to Encourage Drugs for Neglected Diseases

Despite the intellectual property system’s success in promoting the economic well-being of the United States, this system has not achieved all socially valuable ends. Insufficient treatments are applied both to diseases endemic in developing countries, such as malaria, and rare diseases, such as rare childhood cancers. Several legislative tools aim to promote socially valuable drugs and biologics through market incentives. The priority review voucher (PRV) program is the latest and most unique of these legislative tools aimed at encouraging the development of drugs for neglected diseases without burdening taxpayers. The Creating Hope Act—recently signed into law as part of the Food & Drug Administration Safety & Innovation Act—extends the PRV program to rare pediatric diseases. This Issue Brief argues that some provisions in this new legislation may result in undesirable collateral effects that could prevent the legislation from fulfilling its objective of encouraging investment in treatments for rare pediatric diseases

Does competition between hospitals improve clinical quality?: a review of evidence from two eras of competition in the English NHS

Gwyn Bevan and Matthew Skellern review evidence on the effects of hospital competition on quality of care within the English NHS and question whether they support government proposals to extend competition

End It, Don't Mend It: What to Do with No Child Left Behind

The looming expiration of the federal No Child Left Behind Act has prompted a flood of commission reports, studies, and punditry. Virtually all of those analyses have assumed that the law should and will be reauthorized, disagreeing only over how it should be revised. They have accepted the law's premises without argument: that government-imposed standards and bureaucratic "accountability" are effective mechanisms for improving American education and that Congress should be involved in their implementation. In this paper, we put those preconceptions under a microscope and subject NCLB to a thorough review. We explore its effectiveness to date and ask whether its core principles are sound. We find that No Child Left Behind has been ineffective in achieving its intended goals, has had negative unintended consequences, is incompatible with policies that do work, is at the mercy of a political process that can only worsen its prospects, and is based on premises that are fundamentally flawed. We further conclude that NCLB oversteps the federal government's constitutional limits -- treading on a responsibility that, by law and tradition, is reserved to the states and the people. We therefore recommend that NCLB not be reauthorized and that the federal government return to its constitutional bounds by ending its involvement in elementary and secondary education

Emerging pluralist politics in Mozambique: the Frelimo-Renamo party system

In 1992, the Mozambican civil war was brought to a close, marking the beginning of a 'pacted' and fundamentally successful process of democratic change. Despite the extreme poverty of the country, Mozambique has managed to introduce a formally competitive electoral regime, in which movements that were formerly in violent opposition to one another have moved towards fragile pluralist practices, in marked contrast to, for example, Angola, whose peace process quickly unravelled. This paper examines the emergence of a two party system in Mozambique, in which the former Renamo guerrilla fighters appear to have embraced the possibilities of peace. Ultimately, however, Carbone warns against undue optimism, and highlights the weaknesses of the system that are still to be resolved. For all that the country has adopted a formally competitive political system, it continues to fall short of fully democratic and liberal practices