Losers and Losers: Some Demographics of Medical Malpractice Tort Reforms

Our research examines individual differences in the effects of medical malpractice tort reforms on pre-trial settlement speed and settlement amounts by age and most likely settlement size. Findings of note include that, unlike previously assumed, both absolute and percentage losses from tort reform are small for infants in an asset value sense and that the prime-aged working population is the group most negatively affected by tort reform. Maximum entropy quantile regressions highlight the robustness of our conclusions and reveal that the settlement losses most informative for policy evaluation differ greatly from mean regression estimates.medical malpractice, tort reform, Texas closed claims, damage caps, quantile regression, maximum entropy

Ranking Up by Moving Out: The Effect of the Texas Top 10% Plan on Property Values

Texas engaged in a large-scale policy experiment when it instituted the Top 10% Plan. This policy guarantees automatic admission to their state university of choice for all high school seniors who graduate in the top decile of their high school class. We find evidence that households reacted strategically to this policy by moving to neighborhoods with lower-performing schools, increasing both property values and the number of housing units in those areas. These effects are concentrated among schools that were very low-performing before the change in policy; property values and the number of housing units did not change discontinuously for previously high-performing school districts. We also find evidence that these strategic reactions were influenced by the number of local schooling options available: areas that had fewer school choices showed no reaction to the Top 10% Plan.property values, college choice, affirmative action, Top 10% Plan

Riders to the Sea Design

Course: THAR 130 Faculty: Eric Baratta I created a scenic design concept for the 1903 one act play Riders to the Sea by J.M. Millington. This was a projected for Eric Baratta\u27s THAR 130 class on theatre design. The model was created in Google SketchUp. A number of research images were essential to creating the design, including the backdrop image which is a painting by Ivan Aivazovsky. The play, which takes place on a small island in Ireland, features a woman whose six sons have all drowned on the sea.https://repository.upenn.edu/showcase_webprojects/1009/thumbnail.jp

The Essays on Unintended Consequences of Public Policy

This dissertation studies three examples of public policies having consequences other than those intended when the policy was passed. They demonstrate that due to the interconnectedness of the economy, the intended effect of a policy is rarely the sole effect. The first essay examines the Texas Top 10% Plan. This policy guarantees automatic admission to their state university of choice for all high school seniors who graduate in the top 10% of their high school class. The essay shows evidence that households reacted strategically to this policy by moving to neighborhoods with lower-performing schools, increasing property values by 4.9 percent in those areas relative to areas with slightly better performing schools. The effect is strongest among schools that were the lowest performing before the change in policy; and weakens as the previous performance of the school district increases. These strategic reactions were influenced by the number of local schooling options available: areas that had fewer school choices showed no reaction to the Top 10% Plan. The second essay examines individual differences in the effects of medical malpractice tort reforms on pre-trial settlement speed and settlement amounts by age and likely settlement size. I focus on changes in the value of settlements for those trying to receive quick compensation - an understudied but very important population. Findings of note include that, unlike previously assumed, losses from tort reform among infants are small in an asset value sense and that the prime-aged working population that are the most negatively affected by tort reform, losing over 50 percent of the value of their mean settlements post reform. Maximum entropy quantile results show that the median expected settlement losses are often the most informative for policy evaluation and differ greatly from mean policy effects. The third essay uses the implementation of medical malpractice damage caps in several states, and a panel of private insurance claims to identify the effect of damage caps on the amount physicians charge to insurance companies and the amount that insurance companies reimburse physicians for medical services. In most cases the amount that physicians charge insurers does not change, but the amount that insurers reimburse physicians (which is the price seen in the market) decreases. I estimate price reductions as large as 14.5 percent for specific procedures

Subjective Darkness: Depression as a Disintegration of Meaning in the Core Narrative

In this paper, depression is described as a disintegration of meaning within the context of attempting to narrate one’s life. The difficulties of autobiographical narrative are explored, as are the shortcomings of language in conveying existential pain. A common societal response to attempts at narrative is to turn away, to silence the individual, and this leads to further difficulties in mourning and recovery. Clinical cases are used to elucidate the characteristics of depressive experience and the importance of narrative in the healing process. In addition, ethical issues regarding qualitative narrative research are discussed

Cdk8 Kinase Module Modifies Expression of Specific Translation-Related Proteins Before and After Stress

Translation is tightly coupled to growth status. Efficient protein synthesis is necessary for cell growth in nutrient rich environments, while global translation inhibition combined with selective translation of stress-responsive mRNAs helps limit growth in times of stress. Environmental stress cues which inhibit the nutrient-sensing complex TORC1 are known to reduce general translation, but how does the cell alter protein synthesis machinery to adapt to these conditions? A few mechanisms to promote cell survival in nitrogen starvation include post-translational modification and selective degradation of specific mRNA-binding translation factors, as well as inhibition of activators of genes whose products are required for general translation. How and when these occur, however, have remained elusive. Here, we demonstrate in Saccharomyces cerevisiae that the highly conserved Cdk8 kinase module (CKM) of the mediator complex (cyclin C, Cdk8, Med13, and Med12) transcriptionally upregulates specific 60S ribosome proteins and translation initiation factors such as eIF4G1 to maintain steady state levels of translation-related proteins in physiological conditions. Yeast CKM is known to predominantly repress stress response genes (SRG), and our previous findings revealed that SRG suppression is relieved through the degradation of Med13 and cyclin C following both cell survival and death cues. Our recent data further suggest that degradation of the CKM following nitrogen starvation also plays a transcriptional role in fine-tuning the expression of translation-related proteins. The CKM is thus a multi-faceted hub that can provide insight to how the cell adapts to stress at the levels of transcription, translation, and degradation

An Apple a Day? Adult Food Stamp Eligibility and Health Care Utilization among Immigrants

In this study, we document the effect of food stamp access on adult health care utilization. While the Food Stamp Program provides one of the largest safety nets in the United States today, the universal nature of the program across geographic areas and over time limits the potential for quasi-experimental analysis. To circumvent this, we use variation in documented immigrants’ eligibility for food stamps across states and over time due to welfare reform in 1996. Our estimates indicate that access to food stamps reduced physician visits. Additionally, we find that for single women, food stamps increased the affordability of specialty health care. These findings have important implications for cost-benefit analyses of the Food Stamp Program, as reductions in health care utilization because of food stamps may offset some of the program’s impact on the overall government budget owing to the existence of government-provided health insurance programs such as Medicaid