Is Market-Oriented Reform Producing a “Two-Track” Europe? Evidence from Electricity and Telecommunications

The European Commission has formally recognised that adequate provision of basic household services, including energy, communications, water and transport, is key to ensuring equity, social cohesion and solidarity. Yet little research has been done on the impact of the reform of these services in this regard. This article offers an innovative way to explore such questions by analysing and contrasting stated and revealed preferences on citizen satisfaction with and expenditure on two services, electricity and telecommunications, in two large countries, Spain and the United Kingdom. In telecommunications, but to a much lesser extent in electricity, we find evidence that reform has led to a “two-track” Europe, where citizens who are elderly, not working or the less-educated behave differently in the market, with the result that they are less satisfied with these services than their younger, working, better-educated, counterparts

Is Market-Oriented Reform Producing a “Two-Track” Europe? Evidence from Electricity and Telecommunications

The European Commission has formally recognised that adequate provision of basic household services, including energy, communications, water and transport, is key to ensuring equity, social cohesion and solidarity. Yet little research has been done on the impact of the reform of these services in this regard. This article offers an innovative way to explore such questions by analysing and contrasting stated and revealed preferences on citizen satisfaction with and expenditure on two services, electricity and telecommunications, in two large countries, Spain and the United Kingdom. In telecommunications, but to a much lesser extent in electricity, we find evidence that reform has led to a “two-track” Europe, where citizens who are elderly, not working or the less-educated behave differently in the market, with the result that they are less satisfied with these services than their younger, working, better-educated, counterparts.Public Service, Electricity, Telecommunications, Revealed preferences, Consumer Behaviour, Vulnerable Consumers. European Union. Regulation

Bringing Citizens Back In: Renewing Public Service Regulation

This essay concerns the ways in which public services – particularly household services such as communications, energy, water and transportation – have been regulated and deregulated, and analyses what consequences this has for users and citizens. Much of the deregulation of public services from the 1980s – liberalization, privatization and New Public Management – was justified by claims that reform would provide users with more choice, whilst they would receive cheaper and better quality services. Little account was taken of the fact that users are highly heterogeneous, that socio-economic differences might be important in determining their consumption of public services, and that this may not lead to socially optimum outcomes. By examining consumption patterns in two large European countries, Spain and the UK, through an analysis of revealed and declared preferences, this paper sheds light on how socio-economic differences among households help determine public service consumption. The main findings are that the supposed benefits of public service deregulation are not evenly spread across populations, and that specifically targeted “bottom-up” regulation from the demand-side could usefully address these issues, thus improving social welfare.Regulation, Privatization, Public Services, Telecommunications, Electricity, Gas and water

The new regulation of public infrastructure services in the European Union. Challenges for territorial cohesion

Public infrastructure services (or Services of General Economic Interest, SGEI) in the European Union have undergone significant reform in the recent period, including privatization, liberalization and deregulation. These reforms, however, have led to concerns about the potential impact of pursuing economic profitability over service quality, affordability, accessibility and universality. Traditionally, because SGEI have been understood as playing a key economic, social and strategic role, they have been subject to specific rules in the general interest: so-called Public Service Obligations (PSO). A key objective of PSO is to ensure equal access to services, independent of the place of residence, income or other factors. PSO are, therefore, a key instrument as regards ensuring equity and territorial cohesion. As such, it constitutes a fundamental concern in European regional policy. Traditionally, the regulation of SGEI has focused on the supply side, as it has been assumed competition in an integrated European market would benefit citizens. Despite this, little research has actually been done on evaluating regulation from the demand side, not to speak of applying a regional focus. The aim of this paper is to evaluate SGEI provision and regulation in the EU from the perspective of citizens as consumers using a regional perspective. We focus on the region (NUTS1) and the urban/rural character of the place of residence as possible determinants of disparities. To do so, a microeconometric analysis of citizens’ revealed and stated preferences is performed, focusing on three large European countries (Italy, Spain and the United Kingdom) for four services: electricity, gas, water and telecommunications. First, disparities in spending on the services are analyzed, using National Household Budget Surveys. Next, differences in dissatisfaction with service access and price are analyzed, using the Eurobarometer. Finally, we analyze whether lower consumption of a particular service in a particular region or rural area is related to problems of accessibility, affordability or to other factors. Findings show different regional patterns of services use. Moreover, serious and widespread problems are observed regarding equal access to services such as gas and telecommunications in rural areas, of some concern for the question of territorial cohesion.

Improving Regulation of Public Infrastructure Services : from the Consumer Perspective: Insights from Behavioural Economics.

Due to the intense market-oriented reform introduced during the last decades, particularly in the EU context, public infrastructure services have experienced deep recent changes in their modes of organisation and regulation. A key aim of market-oriented reforms was to introduce competition and further opportunities for choice, which was expected to increase citizens’ satisfaction in their role as consumers. Nevertheless, the regulation of these markets after the reforms has proven to be more complex than first thought, whilst significant problems from the perspective of consumers have been detected. In this light, international organizations and regulators and policy makers are paying increasing attention to the new insights on consumer behaviour derived from Behavioural Economics. Regulators and policy makers are considering how a deeper understanding of consumers’ behaviour may be translated into specific regulatory policies from the consumer perspective, as a complement to the more traditional competition policies, aiming to improve consumers’ well-being and satisfaction. In this context, a crucial concern is whether, due to the increasing complexity of the markets, certain groups of consumers (the so-called “vulnerable consumers”) may be at a disadvantaged position for taking satisfactory consumption decisions in the market place. However, further empirical evidence is required on the relation between consumers’ socioeconomic characteristics, behaviour and satisfaction, aiming at establishing which kind of regulatory policies may be applied and, in case, in which markets and socioeconomic dimensions they should focus. The objective of this paper is to analyse the differences in consumers’ decisions and attitudes in the markets of public infrastructure services, focusing on three socio-economic dimensions representative of potential vulnerability: education, age and employment. To this aim, this paper contrasts information on citizens’ revealed preferences (expenditure decisions), obtained from national Household Budget Surveys, and stated preferences (satisfaction with price), obtained from the last Eurobarometer on Services of General Interest. The paper focuses on two essential services (electricity and telecommunications) and on three different large European countries (Italy, Spain and the UK) where comparable information is available. The results obtained show that, for some of the services and socioeconomic dimensions under analysis, potentially vulnerable consumers exhibit particular difficulties for satisfactory decision making, reflected in lower satisfaction associated to different expenditure decisions. However, the characteristics of the service and other contextual factors also demonstrate to play a significant role for explaining the distinctive features observed. Insights from Behavioural economics provide a useful base for interpreting these results. The empirical evidence obtained from this paper, combined with a Behavioural economics approach, permits to obtain some clear recommendations for improving results of regulation from the point of view of consumer satisfaction, by focusing on incorporating citizens’ heterogeneity as consumer

Glaucoma Neovascular:Comportamiento clínico y manejo en pacientes del Centro Nacional de Oftamología (CENAO). Enero-Noviembre 2013

El glaucoma neovascular (GNV), es el glaucoma secundario más común presentándose de forma agresiva, en personas con factores de riesgo tales como enfermedades crónicas (Diabetes, Hipertensión) o antecedentes de Glaucoma, Traumas oculares, Desprendimiento de retina y otras. La detección tardía, o tratamiento inadecuado desembocan inevitablemente en la pérdida total de la visión y posiblemente del globo ocular. Puede considerarse una enfermedad prevenible si se detecta en etapa temprana y se aplica el tratamiento adecuado de la causa subyacente. Con el objetivo de Investigar el comportamiento clínico y manejo de pacientes con Glaucoma Neovascular en el Centro Nacional de oftalmología durante Enero – Noviembre 2013. Se realizó un estudio descriptivo que incluyó 67 pacientes que fueron atendidos con diagnóstico de Glaucoma Neovascular, durante el periodo de estudio. La mayoría están en el rango de edad de 48-75 años, predominio sexo masculino. Los factores de riesgo más frecuente fueron: Hipertensión arterial (34.3%) y Diabetes Mellitus (14.3%), un alto porcentaje de pacientes sin antecedentes (40%). Glaucoma es el antecedente patológico ocular más frecuente (14%), seguido por antecedente de Trauma ocular (7.5%). El 61% de los pacientes no tienen ningún antecedente de patologías oculares. Según los resultados del examen físico reportado en los expedientes de cada paciente, los casos de GNV estaban en los Estadios I, II, y III en un 31.4% respectivamente y del IV (5.97%). Los esquemas de tratamiento empleados fueron principalmente: sólo tópicos (40.3%), seguido por la combinación de tópicos + crioterapia (38.8%). El resto de esquemas combinados como el uso de Avastin, Pancrioterapia, TBT, fueron menos frecuentes. A pesar de las limitantes que suponen los estudios retrospectivos, este estudio resulta de gran importancia por cuanto constituye una alerta y un compromiso para mejorar en el diagnóstico y manejo del GNV. Palabras claves: Glaucoma neovascular, Glaucoma, Retinopatía diabética

How consumers’ socio-economic background influences satisfaction: Insights for better utility regulation

Augmenting consumer welfare was a key justification behind the reform of utilities from the 1980s. But, three decades later, evidence is mounting that consumer satisfaction with household utilities is quite uneven. Moreover, governments, regulators and international organizations are increasingly recognizing that consumers from specific socio-economic backgrounds may be less satisfied than those from other backgrounds. To attend to this, instances of demand-side regulation have been implemented, but there remains a lack of empirical research on the precise links between consumers’ socioeconomic background and their satisfaction. This article contrasts consumers’ stated and revealed preferences for three major household utility services (electricity, gas and telecommunications, including internet) across twelve European countries. Contrasting stated and revealed preferences has been applied to policy on transportation, marketing and the environment: this article pioneers the application of this technique to the analysis of satisfaction with household utilities across multiple countries. We find strong evidence that consumers’ socio-economic category matters: consumers with lower levels of education, the elderly and those who are not employed exhibit particular expenditure patterns and lower satisfaction levels vis-à-vis some of or all the services under analysis. We conclude by highlighting how our findings may be of use to regulators in the ongoing quest to improve the quality of utility regulation

The impact of socio-economic background on satisfaction: evidence for policy-makers

Consumer satisfaction with utility services has received increased attention from firms, consumer associations, regulators and governments since the 1990s. Evidence is mounting that consumers in specific socio-economic groups express lower satisfaction levels than their peers, at least, in some utility markets. Seeing this as part of their remit to protect consumer welfare, governments and international organizations are exploring possible demand-side policy responses with the intention of ameliorating lower satisfaction levels of these groups of consumers. However, more information on the precise relationships between satisfaction and consumers' socio-economic background is required if policy is to be proportional and effective. This paper provides new empirical knowledge on this topic by contrasting consumers' stated and revealed preferences for five utility services (electricity, gas, fixed and cellular telephony and Internet) across twelve European countries. We find strong evidence that consumers' socio-economic characteristics matter: consumers with lower levels of education, the elderly and those not employed exhibit particular expenditure patterns on, and lower satisfaction levels with, some utility services. However, this relationship is uneven and depends on the socio-economic category and service in question. We conclude by highlighting five findings which may be of use to policy-makers when considering whether demand-side regulatory policies are require

Public infrastructure services in the European Union: challenges for territorial cohesion.

ABSTRACT. Public infrastructure services in the European Union: challenges for territorial cohesion, Regional Studies. Territorial cohesion has emerged as an important objective for EuropeanUnion authorities, particularly since the Treaty of Lisbon. One important strand of territorial cohesion is citizen access to affordablepublic infrastructure services. While place of residence may influence use of services, insufficient evidence exists as to whetherresidence may constitute a disadvantage to citizens as regards service use. This paper assesses this by contrasting citizens’ statedand revealed preferences for services in three large countries. Residence frequently conditions expenditure on public infrastructureservices and satisfaction with service accessibility and affordability, disadvantaging residents in some territories, posing challenges forterritorial cohesion.RESUMEN. Servicios públicos de infraestructura en la Unión Europea: retos para la cohesión territorial, Regional Studies. La cohesión territorial ha pasado a ser un objetivo esencial para las autoridades de la Unión Europea, especialmente tras el Tratado de Lisboa. Un aspecto clave para la cohesión territorial es el acceso de los ciudadanos a servicios públicos de infraestructura asequibles. Aunque el lugar de residencia puede influir en el uso de los servicios, hay evidencia insuficiente acerca de si la residencia podría suponer una desventaja para los ciudadanos en lo que respecta al uso de los servicios. En este artículo evaluamos esta cuestión contrastando las preferencias declaradas y reveladas de los ciudadanos respecto a estos servicios en tres países grandes. La residencia condiciona en muchos casos el gasto en servicios públicos de infraestructura y la satisfacción con respecto a la accesibilidad y la asequibilidad de los servicios, perjudicando a los residentes en algunos territorios, lo que plantea retos para la cohesión territorial