The Welfare Consequences of Hospital Mergers

In the 1990s the US hospital industry consolidated. This paper estimates the impact of the wave of hospital mergers on welfare focusing on the impact on consumer surplus for the under-65 population. For the purposes of quantifying the price impact of consolidations, hospitals are modeled as an input to the production of health insurance for the under-65 population. The estimates indicate that the aggregate magnitude of the impact of hospital mergers is modest but not trivial. In 2001, average HMO premiums are estimated to be 3.2% higher than they would have been absent any hospital merger activity during the 1990s. In 2003, we estimate that because of hospital mergers private insurance rolls declined by approximately .3 percentage points or approximately 695,000 lives with the vast majority of those who lost private insurance joining the ranks of the uninsured. Our estimates imply that hospital mergers resulted in a cumulative consumer surplus loss of over $42.2 billion between 1990 and 2001. It is estimated that all but a modest$95.4 million of the loss in consumer surplus is transferred from consumers to providers.

Did the HMO Revolution Cause Hospital Consolidation?

During the 1990s US healthcare markets underwent a significant transformation. Managed care rose to become the dominant form of insurance in the private sector. Also, a wave of hospital consolidation occurred. In 1990, the mean population-weighted hospital Herfindahl-Hirschman Index (HHI) in a Health Services Area (HSA) was .19. By 2000, the HHI had risen to .26. This paper explores whether the rise in managed care caused the increase in hospital concentration. We use an instrumental variables approach with 10-year differences to identify the relationship between managed care penetration and hospital consolidation. Our results strongly imply that the rise of managed care did not cause the hospital consolidation wave. This finding is robust to a number of different specifications.

Insulin-like Growth Factor Binding Protein Expression in Human Retinal Pigment Epithelial Cells

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73426/1/j.1749-6632.1993.tb26229.x.pd

Technological agglomeration and the emergence of clusters and networks in nanotechnology

Research and development at the nanoscale requires a large degree of integration, from convergence of research disciplines in new fields of enquiry to new linkages between start-ups, regional actors and research facilities. Based on the analysis of two clusters in nanotechnologies (MESA+ (Twente) and other centres in The Netherlands and Minatec in Grenoble in France), the paper discusses the phenomenon of technological agglomeration: co-located scientific and technological fields associated to coordinated technology platforms to some extent actively shaped by institutional entrepreneurs. Such co-location and coordination are probably a prerequisite for the emergence of strong nanocluster

Ground-water Quality in the Bethpage-Hicksville-Levittown Area, Long Island, New York, with Emphasis on Volatile Organic Compounds

A plume of contaminated ground water has been delineated within an 11.4-square-mile area in east-central Nassau County, where residential neighborhoods surround an area zoned for industrial use. The industrial zone contains several firms that, in the past, have discharged effluent containing volatile organic compounds into the upper glacial aquifer through onsite recharge basins. The upper glacial aquifer is in direct hydraulic connection with the underlying Magothy aquifer; the first continuous formation that impedes downward movement of ground water is the Raritan confining unit, which is more than 500 feet below sea level. The chemicals in ground water·and their distribution were identified through analysis of water samples collected from 56 monitoring wells and 11 industrial wells in the spring and fall of 1986 and 1987. Trichloroethylene and tetrachloroethylene were found near the water table at concentrations greater than 1,000 micrograms per liter and were detected more than 5,000 feet downgradient of the industrial zone. The distribution of several other volatile organic compounds indicates more than one contaminant source in the industrial area. The plume of contaminated ground water in 1987 was 12,000 feet long, 5,700 feet wide, and more than 500 feet thick. In 1987, water was pumped from 14 industrial wells, completed in the Magothy aquifer, at an average rate of 8.05 million gallons per day, mainly for cooling purposes. The water was returned chemically unaltered to recharge basins from which it could percolate to the water table. Water-table mounding beneath basins and drawdowns near the pumped wells greatly increase the vertical component of ground-water flow beneath the industrial zone, which has increased the rate of advective movement of contaminated ground water downward toward the screened zones of pumped wells, which are 370 to 560 feet deep in the Magothy aquifer. The concentration of tetrachloroethylene decreases much more rapidly than that of trichloroethylene downgradient of the industrial zone, which indicates that sorption and (or) biodegradation may be occurring. The major effect of industrial activity on inorganic constituents is to decrease the concentration of constituents near the water table in the vicinity of the recharge basins by the addition of water from the Magothy aquifer, where the concentration of inorganic constituents is lower

The Welfare Consequences of Hospital Mergers

In the 1990s the US hospital industry consolidated. This paper estimates the impact of the wave of hospital mergers on welfare focusing on the impact on consumer surplus for the under-65 population. For the purposes of quantifying the price impact of consolidations, hospitals are modeled as an input to the production of health insurance for the under-65 population. The estimates indicate that the aggregate magnitude of the impact of hospital mergers is modest but not trivial. In 2001, average HMO premiums are estimated to be 3.2% higher than they would have been absent any hospital merger activity during the 1990s. In 2003, we estimate that because of hospital mergers private insurance rolls declined by approximately .3 percentage points or approximately 695,000 lives with the vast majority of those who lost private insurance joining the ranks of the uninsured. Our estimates imply that hospital mergers resulted in a cumulative consumer surplus loss of over $42.2 billion between 1990 and 2001. It is estimated that all but a modest$95.4 million of the loss in consumer surplus is transferred from consumers to providers

Late Pleistocene human genome suggests a local origin for the first farmers of central Anatolia

Anatolia was home to some of the earliest farming communities. It has been long debated whether a migration of farming groups introduced agriculture to central Anatolia. Here, we report the first genome-wide data from a 15,000-year-old Anatolian hunter-gatherer and from seven Anatolian and Levantine early farmers. We find high genetic continuity (~80–90%) between the hunter-gatherers and early farmers of Anatolia and detect two distinct incoming ancestries: an early Iranian/Caucasus related one and a later one linked to the ancient Levant. Finally, we observe a genetic link between southern Europe and the Near East predating 15,000 years ago. Our results suggest a limited role of human migration in the emergence of agriculture in central Anatolia