Should I stay or should I go? Exit options within mixed systems of public and private health care finance

Mixed public–private finance is widespread in health care systems internationally. In one variant of mixed finance, some countries (e.g., Germany) allow eligible beneficiaries to fully exit from the public (social insurance) system and purchase private insurance. Using a controlled laboratory experiment, we empirically investigate the predictions of a political economy model of mixed systems of public and private finance with two types of exit: universal-exit, when all individuals can choose to exit the public system, and conditional-exit, when only individuals with an income at or above a threshold income level can choose to exit. We find that high-income individuals are less likely to exit under universal-exit than under conditional-exit, despite having the same incentive to exit in both treatments. Sensitivity treatments suggests that a number of factors may be at play in explaining this result, including learning effects, a priming effect and a framing effect, but that other-regarding preferences do not appear to be an important factor

Support for public provision of a private good with top-up and opt-out: A controlled laboratory experiment

This paper presents the results of a revealed-choice experiment testing the theoretical predictions of political economy models regarding public support for a publicly provided private good financed with proportional income taxes when individuals can purchase the good privately and either continue to consume public provision (‘top-up’) or forego public provision (‘opt-out’), but in each case continue to pay income taxes. Our laboratory results confirm behavior is consistent with the predicted majority-preferred tax rate under mixed financing with top-up, but we identify preferences for significantly higher rates of public provision than predicted under mixed financing with opt-out. Using non parametric regression analysis, we explore the relationship between individuals’ top-up and opt-out decisions and both their income levels and the implemented tax rates

A Behavioral Economic Study of Tax Rate Selection by the Median Voter: Can the Tax Rate Be Influenced by the Name of the Publicly Provided Private Good?

This paper presents the results of a behavioral economics study to test if the tax rates submitted to finance the public provision of a private good are influenced by changing the name of the private good. A revealed-preference laboratory decision-making experiment is used to test if participants choose significantly different tax rates to support provision of a private good named as a health care investment compared to an identical good named as a neutral monetary investment. Although some previous studies focusing on both framing and context effects find differences associated with health versus non-health environments, these studies have not involved voting over public provision of a private good. In our experimental environment, participants with different income endowments provide their preferred proportional tax rates for financing public provision of a private good in either a neutral or a health context. The implemented tax rate is the median preferred tax rate, and once the budget is determined, each participant receives the same quantity of the publicly provided private good. In each context, the payoff functions are the same. The only difference between the contexts is the name attached to the publicly provided private good, regardless of the name attached to the publicly provided private good, consuming it imposes no externalities. This controls for the positive externality characteristics of many health care goods, but not for preferences evoked by the merit good character of health care which factor into decisions about the public provision of health care. We find that the theoretical predictions of the median voter model are generally supported by the data. However, the conjecture that the implemented tax rate would be affected by context is not supported by the results

Use of 16S ribosomal RNA gene analyses to characterize the bacterial signature associated with poor oral health in West Virginia

<p>Abstract</p> <p>Background</p> <p>West Virginia has the worst oral health in the United States, but the reasons for this are unclear. This pilot study explored the etiology of this disparity using culture-independent analyses to identify bacterial species associated with oral disease.</p> <p>Methods</p> <p>Bacteria in subgingival plaque samples from twelve participants in two independent West Virginia dental-related studies were characterized using 16S rRNA gene sequencing and Human Oral Microbe Identification Microarray (HOMIM) analysis. Unifrac analysis was used to characterize phylogenetic differences between bacterial communities obtained from plaque of participants with low or high oral disease, which was further evaluated using clustering and Principal Coordinate Analysis.</p> <p>Results</p> <p>Statistically different bacterial signatures (<it>P </it>< 0.001) were identified in subgingival plaque of individuals with low or high oral disease in West Virginia based on 16S rRNA gene sequencing. Low disease contained a high frequency of <it>Veillonella </it>and <it>Streptococcus</it>, with a moderate number of <it>Capnocytophaga</it>. High disease exhibited substantially increased bacterial diversity and included a large proportion of Clostridiales cluster bacteria (<it>Selenomonas</it>, <it>Eubacterium, Dialister</it>). Phylogenetic trees constructed using 16S rRNA gene sequencing revealed that Clostridiales were repeated colonizers in plaque associated with high oral disease, providing evidence that the oral environment is somehow influencing the bacterial signature linked to disease.</p> <p>Conclusions</p> <p>Culture-independent analyses identified an atypical bacterial signature associated with high oral disease in West Virginians and provided evidence that the oral environment influenced this signature. Both findings provide insight into the etiology of the oral disparity in West Virginia.</p

Glauber Dynamics for the mean-field Potts Model

We study Glauber dynamics for the mean-field (Curie-Weiss) Potts model with $q\geq 3$ states and show that it undergoes a critical slowdown at an inverse-temperature $\beta_s(q)$ strictly lower than the critical $\beta_c(q)$ for uniqueness of the thermodynamic limit. The dynamical critical $\beta_s(q)$ is the spinodal point marking the onset of metastability. We prove that when $\beta<\beta_s(q)$ the mixing time is asymptotically $C(\beta, q) n \log n$ and the dynamics exhibits the cutoff phenomena, a sharp transition in mixing, with a window of order $n$. At $\beta=\beta_s(q)$ the dynamics no longer exhibits cutoff and its mixing obeys a power-law of order $n^{4/3}$. For $\beta>\beta_s(q)$ the mixing time is exponentially large in $n$. Furthermore, as $\beta \uparrow \beta_s$ with $n$, the mixing time interpolates smoothly from subcritical to critical behavior, with the latter reached at a scaling window of $O(n^{-2/3})$ around $\beta_s$. These results form the first complete analysis of mixing around the critical dynamical temperature --- including the critical power law --- for a model with a first order phase transition.Comment: 45 pages, 5 figure