Medical Demography and Intergenerational inequalities in GPs' earnings

This article examines the link between restrictions on the number of physicians and general practitioners' earnings. Using a representative panel of 6,016 French self-employed GPs over the years 1983 to 2004, we show that the policies aimed at manipulating the number of places in medical schools strongly affect physicians' permanent level of earnings.We estimate an earnings function to identify experience, time and cohort effects. The cohort effect is very large: the estimated gap in earnings between "good" and "bad" cohorts may reach 25%. GPs beginning during the eighties have the lowest permanent earnings: they belong to the baby-boom numerous cohorts and faced the consequences of an unlimited number of places in medical schools. Conversely, the decrease in the number of places in medical schools led to an increase in permanent earnings of GPs who began their practice in the mid nineties. A stochastic dominance analysis shows that unobserved heterogeneity does not compensate for average differences in earnings between cohorts. These findings suggest that the first years of practice are decisive for a GP. If competition between physicians is too intense at the beginning of career, she will suffer from permanently lower earnings. To conclude, our results show that the policies aimed at reducing the number of medical students succeeded in buoying up physicians' permanent earnings.General Practitioners; self-employed; longitudinal data; earnings; stochastic dominance

Intergenerational inequalities in GPs' earnings : experience, time and cohort effects

This paper analyses the regulation of ambulatory care and its impact on physicians careers, using a representative panel of 6016 French self-employed GPs over the years 1983 to 2004. The beginning of their activity is influenced by the regulated number of places in medical schools, named in France numerus clausus. We show that the policies aimed at manipulating the numerus clausus strongly affect physicians permanent level of earnings. Our empirical approach allows us to identify experience, time and cohort effects in GPs earnings. The estimated cohort effect is very large, revealing that intergenerational inequalities due to fluctuations in the numerus clausus are not negligible. GPs beginning during the eighties have the lowest permanent earnings: they faced the consequences of an unlimited number of places in medical schools in the context of a high density due to the baby-boom numerous cohorts. Conversely, the decrease in the numerus clausus led to an increase in permanent earnings of GPs who began their practice in the mid nineties. Overall, the estimated gap in earnings between "good" and "bad" cohorts may reach 25%. We performed a more thorough analysis of the earnings distribution to examine whether individual unobserved heterogeneity could compensate for average differences between cohorts. Our results about stochastic dominance between earnings distributions by cohort show that it is not the case.GPs, self-employed, longitudinal data, earnings, stochastic dominance

To assemble to resemble? A study of tax disparities among French municipalities

The purpose of this paper is to analyze the effect of inter-municipal cooperation on local taxation. Municipalities that join/create an inter-municipal jurisdiction choose between three tax regimes, which may induce both horizontal and vertical tax externalities. Using the differences in differences method with a quasi-exhaustive panel for French municipalities over the 1994-2010 period, we show a positive causal effect of cooperation on the level of cumulative tax rates (i.e. the sum of municipal and inter-municipal tax rates). In addition, we show that cooperation leads to a convergence of tax rates within an inter-municipal structure, which thus reduces tax disparities among municipalities.Inter-municipal cooperation, tax competition, ?scal disparities.

To assemble to resemble? A study of tax disparities among French municipalities

The purpose of this paper is to analyze the effect of inter-municipal cooperation on local taxation. Municipalities that join/create an inter-municipal jurisdiction choose between three tax regimes, which may induce both horizontal and vertical tax externalities. Using the differences in differences method with a quasi-exhaustive panel for French municipalities over the 1994-2010 period, we show a positive causal effect of cooperation on the level of cumulative tax rates (i.e. the sum of municipal and inter-municipal tax rates). Moreover, we show that cooperation leads to a convergence of tax rates within an inter-municipal structure, which thus reduces tax disparities among municipalities.Inter-municipal cooperation, tax competition, fiscal disparities

Intergenerational inequalities in GPs' earnings : experience, time and cohort effects

This paper analyses the regulation of ambulatory care and its impact on physicians careers, using a representative panel of 6;016 French self-employed GPs over the years 1983 to 2004. The beginning of their activity is influenced by the regulated number of places in medical schools, named in France numerus clausus. We show that the policies aimed at manipulating the numerus clausus strongly affect physicians permanent level of earnings. Our empirical approach allows us to identify experience, time and cohort effects in GPs earnings. The estimated cohort effect is very large, revealing that intergenerational inequalities due to fluctuations in the numerus clausus are not negligible. GPs beginning during the eighties have the lowest permanent earnings: they faced the consequences of an unlimited number of places in medical schools in the context of a high density due to the baby-boom numerous cohorts. Conversely, the decrease in the numerus clausus led to an increase in permanent earnings of GPs who began their practice in the mid nineties. Overall, the estimated gap in earnings between "good" and "bad" cohorts may reach 25%. We performed a more thorough analysis of the earnings distribution to examine whether individual unobserved heterogeneity could compensate for average differences between cohorts. Our results about stochastic dominance between earnings distributions by cohort show that it is not the case. [Authors]]]> Physicians ; Family Practice ; Income eng https://serval.unil.ch/resource/serval:BIB_82874F474C19.P001/REF.pdf http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_82874F474C190 info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_82874F474C190 info:eu-repo/semantics/submittedVersion info:eu-repo/semantics/openAccess Copying allowed only for non-profit organizations https://serval.unil.ch/disclaimer application/pdf oai:serval.unil.ch:BIB_8288AEF7ACCB 2022-05-07T01:21:39Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_8288AEF7ACCB Significant improvement of quality of life following atrioventricular synchronous pacing in patients with hypertrophic obstructive cardiomyopathy. Data from 1 year of follow-up. PIC study group. Pacing In Cardiomyopathy info:doi:10.1053/euhj.1998.1331 info:eu-repo/semantics/altIdentifier/doi/10.1053/euhj.1998.1331 info:eu-repo/semantics/altIdentifier/pmid/10381856 Gadler, F. Linde, C. Daubert, C. McKenna, W. Meisel, E. Aliot, E. Chojnowska, L. Guize, L. Gras, D. Jeanrenaud, X. Kappenberger, L. info:eu-repo/semantics/article article 1999-07 European Heart Journal, vol. 20, no. 14, pp. 1044-50 info:eu-repo/semantics/altIdentifier/pissn/0195-668X <![CDATA[AIMS: Atrioventricular synchronous pacing exerts beneficial effects, including reduction of left ventricular outflow tract gradients, in patients with hypertrophic obstructive cardiomyopathy. The Pacing in Cardiomyopathy study was initiated to explore the effects of pacing in a double-blind randomized crossover fashion. The aims were to ascertain the beneficial effects of pacing in a controlled study and to rule out a placebo effect by pacing. This paper deals with the outcome of pacing on quality of life during 1 year of follow-up. METHODS: Quality of life was evaluated with the Karolinska questionnaire, validated for patients paced for bradyarrhythmias and ischaemic heart disease. Drug-refractory patients with hypertrophic obstructive cardiomyopathy were recruited for the study and after a temporary pacing procedure implanted with permanent pacemakers. Patients were randomized to two study arms defining the sequence of pacemaker programming. In one arm the pacemaker was inactive, in the other active. After 3 months the pacemaker was reprogrammed to the alternate mode and a further 3 months followed. After this period subsequent pacemaker programming corresponded to the mode preferred by the patient. A last assessment was made 1 year after baseline examinations. RESULTS: Eighty patients completed the first crossover period and 75 completed the full 1 year of follow-up. Active pacing induced significant quality of life improvements, in the order of 9-44%, regardless of programming sequence. Discontinuation of pacing after a first active period resulted in the return of symptoms. Fourteen patients requested early reprogramming after having been programmed to inactive pacing after a first period of active pacing. Seventy-six patients preferred active pacing after the crossover period. A further 6 months of pacing induced progressive improvement in symptoms already favourably influenced. CONCLUSION: Atrioventricular synchronous pacing has a profound beneficial effect on most domains of quality of life in patients with hypertrophic obstructive cardiomyopathy refractory to drug treatment

The Demography of the Medical Profession and the Careers of General Practitioners (GPs: Intergenerational Inequalities)

Since 1971 the number of doctors providing ambulatory care in France has been restricted by a limited number of places for students. We use a representative sample of 6016 GPs observed over the period 1983-2004 and belonging to 'sector 1', where fees are fixed by bargaining. We estimate an earnings function to identify experience, time and cohort effects. Doctors' earnings depend heavily on the demography of the medical profession that prevails at the beginning of their careers. The cohorts who started practicing in the 1980s suffered the combined impact of the baby boom and a high number of medical school places. The fall in the number of medical school places improved the situation for subsequent cohorts.GPs, Self-employed, Longitudinal Data, Earnings, Stochastic Dominance

To assemble to resemble? A study of tax disparities among French municipalities

The purpose of this paper is to analyze the effect of inter-municipal cooperation on local taxation. Municipalities that join/create an inter-municipal jurisdiction choose between three tax regimes, which may induce both horizontal and vertical tax externalities. Using the differences in differences method with a quasi-exhaustive panel for French municipalities over the 1994-2010 period, we show a positive causal effect of cooperation on the level of cumulative tax rates (i.e. the sum of municipal and inter-municipal tax rates). Moreover, we show that cooperation leads to a convergence of tax rates within an inter-municipal structure, which thus reduces tax disparities among municipalities

Médecins généralistes à faibles revenus : une préférence pour le loisir ?

This article looks at a remarkable point in the GPs'population : the existence of a large minority of low income physicians. 5 to 7 % of GPs earn less that 1.5 net SMIC (French minimum wage). These GPs are more frequently women or physicians practicing in areas where the medical density is very high but also where the quality of life is better. Using an econometric analysis, we measure their reaction to a demand shock. We find that these GPs never react to a positive demand shock and only react to a negative one : their activity decreases when they are constrained to. We show that their low income results from a greater preference for leisure. Their very low level of activity reflects an advantage of the profession of self-employed physician : GPs may choose to work less.GPs, self-employed, low-income physicians, target income, work-leisure trade-off, longitudinal data

Newtoning financial development with heterogeneous firms

Abstract: This article theoretically and empirically tests the link between financial constraints and the extensive (proportion of exporters) and intensive (volume of exports) margins of international trade. The article&apos;s main contribution is its macroeconomic analysis of this relationship, which is further reaching than the sector-based focus found in the current literature. It also presents new information on firm behavior under financial constraints. The paper develops a trade model with heterogeneous firms and shows that countries with a high level of financial development have a lower productivity cut-off above which firms export and a higher proportion of exporting firms. Nevertheless, financial development is not correlated with firms&apos; export volumes once they become exporters. An empirical analysis is developed on the basis of an international trade database on 135 countries between 1994 and 2007. The empirical analysis estimates a two-step gravity equation using panel data and confirms the first theoretical proposition that finance has a positive impact on the extensive margin. However, the intensive margin results are striking. They find a negative relationship between financial development and trade flows, confirmed by all the sensitivity tests. Despite the positive effect of financial development found by the literature in some economic sectors, the macroeconomic impact on overall exports was negative during the analyzed period

A RasGAP SH3 Peptide Aptamer Inhibits RasGAP-Aurora Interaction and Induces Caspase-Independent Tumor Cell Death

The Ras GTPase-activating protein RasGAP catalyzes the conversion of active GTP-bound Ras into inactive GDP-bound Ras. However, RasGAP also acts as a positive effector of Ras and exerts an anti-apoptotic activity that is independent of its GAP function and that involves its SH3 (Src homology) domain. We used a combinatorial peptide aptamer approach to select a collection of RasGAP SH3 specific ligands. We mapped the peptide aptamer binding sites by performing yeast two-hybrid mating assays against a panel of RasGAP SH3 mutants. We examined the biological activity of a peptide aptamer targeting a pocket delineated by residues D295/7, L313 and W317. This aptamer shows a caspase-independent cytotoxic activity on tumor cell lines. It disrupts the interaction between RasGAP and Aurora B kinase. This work identifies the above-mentioned pocket as an interesting therapeutic target to pursue and points its cognate peptide aptamer as a promising guide to discover RasGAP small-molecule drug candidates