Efficiency Effects of Cross-Border Medical Demand

There is a growing interest in cross-border medical care and its comparative advantages. In addition, medical care can be defined as a local assurance good. Little research is being carried out in this field. This paper discusses the individual considerations for medical treatment offered at home and abroad within a micro-economical framework. Specific assumptions as mistrust, monetary and non-monetary transaction-costs, a price and cost gradient, illness severity as well as a lump-sum insurance are discussed. We show that a demand abroad can be utility maximizing, however, only second best. There are inefficiencies in the dimensions of ex-post demand and income risk either on the side of gross-income or of costs. Furthermore, the foreign demand is restricted for low health stages driven by mistrust and restrictions in quality. Higher stages are more capable if fixed costs are low. To demand abroad the marginal treatment costs abroad must fall short of a threshold level. Finally, an out-of-pocket payment can reduce the moral hazard when treatment takes place abroad

Framework for Assessing Indicators of Environmental Impacts in the Transport Sector

International audienceWe addressed the following questions: How can environmental impacts of transport be identified? How can the impacts be represented by operational indicators? How can several indicators be jointly considered? And how can indicators be used in planning and decision making? We firstly derived a definition of "indicator of environmental impact in the transport sector". The concept of "chain of causalities" between a source and a final target is developed, as a common reference for indicators and their assessment. We derived criteria and methods for the assessment and selection of indicators, in terms of measurement, monitoring and management. Finally, the application of the criteria is exemplified for individual indicators of seven chains of causalities and for selected aggregated indicators