Towards a Competitive Health Care System

The antitrust laws constitute the foundation and fundamental strength of the U.S. democratic free enterprise system. Competition enhances both the democratic and economic opportunities, including in the healthcare markets. Although healthcare markets have significant market imperfections, a competitive system is more appropriate for the healthcare markets because it delivers choice among alternatives that regulation does not. Thus, the question to ask in the healthcare system is what can be done to make competition work better

Limnology of Four Bauxite Open-Pit Lakes

The aquatic flora and fauna and 18 physicochemical characteristics of four bauxite open-pit lakes were studied from September 1969 to August 1970. The least acid lake (pH 3.4-4.4) supported 49 different aquatic insects, plankton, and higher aquatic plants. The most acid lake (pH 2.7-3.2) supported only 26 different plants and animals. Bauxite open-pit lakes within the pH range studied appear to be as relatively unproductive as their coal strip-mine lake counterparts, with which they share physicochemical and biological characteristics. Benthic macrofaunal diversity and abundance appear to be related more closely to distribution and abundance of leaf detritus than to hydrogen-ion concentration

Finite Lifetimes, Borrowing Constraints, and Short-Run Fiscal Policy

Recent developments in public finance in the analysis of dynamic government debt policies have emphasized effects on the distribution of real resources across generations. At the same time, macroeconomists have emphasized the importance of the length of the time horizon over which agents optimize their decisions about consumption for judging the effects of fiscal policy on aggregate demand. Much of the discussion of these issues has focused on whether linkages among generations are sufficient to give consumers infinite horizons. To the extent that horizons are finite, debt burdens can be shifted to future generations, and substitutions of debt for taxes have real effects. This paper argues that, as a matter of quantitative significance, theoretical and empirical emphasis on the importance of finite horizons for the analysis of many fiscal policies is misplaced. Studies of the role of finite horizons in determining the effects of short-run fiscal policies on consumption have been conducted largely under the assumption of perfect capital markets. We show that while the marginal propensity to consume (MPC) out of temporary tax changes is nonzero in finite- horizon models, it is not very large. We demonstrate that the MPC is, however, quite sensitive to the importance of restrictions on borrowing in the economy. The clear implication is that shifting emphasis from the length of the planning horizon to the structure of capital markets is an important step for empirical research.

Taxation, Corporate Capital Structure, and Financial Distress

Is corporate leverage excessive? Is the tax code distorting corporate capital structure decisions in a way that increases the possibility of an economic crisis owing to "financial instability"? Answering these kinds of questions first requires some precision in terminology. In this paper, we describe the cases for and against the trend toward high leverage, and evaluate the role played by taxation. While provision of proper incentives to managers may in part underlie the trend to the debt, high leverage may in practice be a blunt way to address the problem, and one which opens up the possibility for undue exposure to the risks of financial distress. Our story takes as given the kinds of managerial incentive problems deemed important by advocates of leverage. We maintain, however, that when a firm is subject to business-cycle risk as well as individual risk, a profit maximizing arrangement is not simple debt, but rather a contract with mixed debt and equity features. That is, the contract should index the principal obligation to aggregate and/or industry-level economic conditions. We argue that the tax system encourages corporations to absorb more business cycle risk than they would otherwise. It does so in two respects: First, it provides a relative subsidy to debt finance; second, it restricts debt for tax purposes from indexing the principal to common disturbances. At a deeper level, the issue hinges on the institutional aspects of debt renegotiation. If renegotiation were costless, then debt implicitly would have the equity features relevant for responding to business-cycle risk. However, because of the diffuse ownership pattern of much of the newly issued debt and also because of certain legal restrictions, renegotiation is likely to be a costly activity.

Social Security and Individual Welfare: Precautionary Saving, LiquidityConstraints, and the Payroll Tax

Recent advances in the examination of efficiency gains from dynamic tax reforms have used simulation models to isolate intragenerational and/or intergenerational effects. Important considerations having to do with uncertainty or capital market imperfections are frequently missing from such a framework. In this paper, we focus on the welfare gains from introducing social security retirement annuities, given lifetime uncertainty and borrowing restrictions.Our principal findings are four. First, given the considerations mentioned above, "precautionary saving" exceeds life-cycle saving (that would have taken place in the absence of lifetime uncertainty), lending further support to the notion that the perfect-certainty version of the life-cycle model provides an inadequate explanation of observed saving behavior. Second, the introduction of an actuarially fair social security system leads to a significant partial equilibrium increase in lifetime consumption and welfare, accompanied by a reduction in the capital stock.The increase in lifetime welfare is reduced, however,and in many cases eliminated, when borrowing restrictions are imposed.Third, extending the model to general equilibrium, we find that the partial equilibrium gains in lifetime welfare from participation in social security are offset by the interaction of higher steady-state interest rates and binding liquidity constraints. Finally, replacing the proportional payroll tax with a progressive tax (essentially a linear tax with an exemption), we show that age-specific tax schemes can restore much of the potential gain from introducing social security.

Liquidity Constraints, Fiscal Policy, and Consumption

macroeconomics, liquidity constraints, fiscal policy, and consumption

Characterizations of four specimens processed as a part of the M553 sphere forming experiment performed during the Skylab 1 and 2 flight

Four specimens identified as SL-1.3, SL-1.8, SL-1.9 and SL-2.5 were submitted for metallurgical characterization. These specimens had been processed in the M512 Facility as a part of the M553 Sphere Forming Experiment performed during the Skylab 1/2 flight. Three of these specimens, SL-1.3, SL-1.8, and SL-2.5 were designed to be melted completely by the electron beam and detach themselves from their support posts and resolidify while floating free in the near zero gravity and vacuum environment of space. Specimens SL-1.3 and SL-1.8 were completely melted, but it is believed they did not leave their posts before solidifying. Specimen SL-2.5 was only partially melted. Specimen SL-1.9 was to be completely melted and retained on a large sting which was accomplished as planned. The nominal composition of the four specimens was: (1) SL-1.3 - Ni 12% Sn; (2) SL-1.8 - Ni 30% Cu; (3) SL-1.9 - Pure Ni; and (4) SL-2.5 - Pure Ni. These four specimens have been examined according to the Phase B Characterization Plan. The results are discussed and compared with similar characterization analyses run on ground base specimens

Risk of cardiovascular events from current, recent, and cumulative exposure to abacavir among persons living with HIV who were receiving antiretroviral therapy in the United States: a cohort study.

BackgroundThere is ongoing controversy regarding abacavir use in the treatment of HIV infection and the risk of subsequent development of cardiovascular disease. It is unclear how the risk varies as exposure accumulates.MethodsUsing an administrative health-plan dataset, risk of cardiovascular disease events (CVDe), defined as the first episode of an acute myocardial infarction or a coronary intervention procedure, associated with abacavir exposure was assessed among HIV-infected individuals receiving antiretroviral therapy across the U.S. from October 2009 through December 2014. The data were longitudinal, and analyzed using marginal structural models.ResultsOver 114,470 person-years (n = 72,733) of ART exposure, 714 CVDe occurred at an incidence rate (IR) (95% CI) of 6·23 (5·80, 6·71)/1000 person-years. Individuals exposed to abacavir had a higher IR of CVDe of 9·74 (8·24, 11·52)/1000 person-years as compared to 5·75 (5·30, 6·24)/1000 person-years for those exposed to other antiretroviral agents. The hazard (HR; 95% CI) of CVDe was increased for current (1·43; 1·18, 1·73), recent (1·41; 1·16, 1·70), and cumulative [(1·18; 1·06, 1·31) per year] exposure to abacavir. The risk for cumulative exposure followed a bell-shaped dose-response curve peaking at 24-months of exposure. Risk was similarly elevated among participants free of pre-existing heart disease or history of illicit substance use at baseline.ConclusionCurrent, recent, and cumulative use of abacavir was associated with an increased risk of CVDe. The findings were consistent irrespective of underlying cardiovascular risk factors

Do the flash-lag effect and representational momentum involve similar extrapolations?

In the flash-lag effect (FLE) and in representational momentum (RM), the represented position of a moving target is displaced in the direction of motion. Effects of numerous variables on the FLE and on RM are briefly considered. In many cases, variables appear to have the same effect on the FLE and on RM, and this is consistent with a hypothesis that displacements in the FLE and in RM result from overlapping or similar mechanisms. In other cases, variables initially appear to have different effects on the FLE and on RM, but accounts reconciling those apparent differences with a hypothesis of overlapping or similar mechanisms are suggested. Given that RM is simpler and accounts for a wider range of findings (i.e., RM involves a single stimulus rather than the relationship between two stimuli, RM accounts for displacement in absolute position of a single stimulus and for differences in relative position of two stimuli), it is suggested that (at least some cases of) the FLE might be a special case of RM in which the position of the target is assessed relative to the position of another stimulus (i.e., the flashed object) rather than relative to the actual position of the target