Buying Time: Real and Hypothetical Offers

This paper provides the results of a field test of contingent valuation estimates within a willingness to accept framework. Using dichotomous choice questions in telephone-mail-telephone interviews, we compare responses to real and hypothetical offers to survey respondents for the opportunity to spend time in a second set of interviews on an undisclosed topic. Five hundred and forty people were randomly split between the real and hypothetical treatments. Our findings indicate no significant differences between people's choices with real and hypothetical offers. Choice models indicate the size of the offer and income were significant determinants of respondents' decisions, and these models were not significantly different between real and hypothetical offers.

Does Nature Limit Environmental Federalism?

This research considers whether the principles developed to analyze the optimal jurisdiction for producing public goods can be applied in cases where regulations of private activities provide the primary means to deliver different amounts of public and quasi-public goods. The analysis evaluates how devolution affects the development of benefit cost analyses for regulations and the role of economic versus environmental factors in defining the extent of the regulatory market. Using a study of nutrient control for the Neuse River in North Carolina, the analysis develops area specific measures of the benefits and costs of regulations and illustrates how changes in the composition of the areas allowed to "count" for policy design can affect decisions about the levels of control judged to meet the net benefit test.

Valuing a Homeland Security Policy: Countermeasures for the Threats from Shoulder Mounted Missiles

This paper reports estimates for the ex ante tradeoffs for three specific homeland security policies that all address a terrorist attack on commercial aircraft with shoulder mounted missiles. Our analysis focuses on the willingness to pay for anti-missile laser jamming countermeasures mounted on commercial aircraft compared with two other policies as well as the prospect of remaining with the status quo. Our findings are based a stated preference conjoint survey conducted in 2006 and administered to a sample from Knowledge Networks' national internet panel. The estimates range from $100 to$220 annually per household. Von Winterfeldt and O'Sullivan's [2006] analysis of the same laser jamming plan suggests that the countermeasures would be preferred if economic losses are above $74 billion, the probability of attack is larger than 0.37 in ten years, and if the cost of the measures is less than about$14 billion. Our results imply that, using the most conservative of our estimates, a program with a cost consistent with their thresholds would yield significant aggregate net benefits. More generally, this research grows out of a need to measure the benefits of an iconic public good -- national defense -- to assess the economic efficiency of Department of Homeland Security policies.

Do Citizens Want the Truth about Terrorist Threats Regardless of the Consequences?

This paper proposes the use of consumers’ preferences in formulating policies for keeping secret information about terrorist activities and threats that might compromise future security. We report the results from two surveys indicating that people have clear preferences for full disclosure of some terrorist related information regardless of its consequences for specific industries or future threats. This result is especially clear for threats involving commercial airlines. For those threats associated with more general surveillance or threats to the financial system respondents were more willing to allow government authorities to withhold information.

Unpackaging demand for water service quality : evidence from conjoint surveys in Sri Lanka

In the early 2000s, the Government of Sri Lanka considered engaging private sector operators to manage water and sewerage services in two separate service areas: one in the town of Negombo (north of Colombo), and one stretching along the coastal strip (south from Colombo) from the towns of Kalutara to Galle. Since then, the government has abandoned the idea of setting up a public-private partnership in these two areas. This paper is part of a series of investigations to determine how these pilot private sector transactions (forming part of the overall water sector reform strategy) could be designed in such a manner that they would benefit the poor. The authors describe the results of a conjoint survey evaluating the factors that drive customer demand for alternative water supply and sanitation services in Sri Lanka. They show how conjoint surveys can be used to unpackage household demand for attributes of urban services and improve the design of infrastructure policies. They present conjoint surveys as a tool for field experiments and a source of valuable empirical data. In the study of three coastal towns in southwestern Sri Lanka the conjoint survey allows the authors to compare household preferences for four water supply attributes-price, quantity, safety, and reliability. They examine subpopulations of different income levels to determine if demand is heterogeneous. The case study suggests that households care about service quality (not just price). In general, the authors find that households have diverse preferences in terms of quantity, safety, and service options, but not with regard to hours of supply. In particular, they find that the poor have lower ability to trade off income for services, a finding that has significant equity implications in terms of allocating scarce public services and achieving universal water access.Town Water Supply and Sanitation,Water and Industry,Economic Theory&Research,Water Use,Water Supply and Sanitation Governance and Institutions

Preferences and priorities for relapsed multiple myeloma treatments among patients and caregivers in the United States

Introduction/Background: This study aimed to describe patient and caregiver preferences for treatments of relapsed or refractory multiple myeloma (MM). Materials and Methods: A survey including discrete-choice experiment (DCE) and best-worst scaling (BWS) exercises was conducted among US patients with relapsed or refractory MM and their caregivers. The DCE included six attributes with varying levels including progression-free survival (PFS), toxicity, and mode and frequency of administration. In addition, the impact of treatment cost was assessed using a fixed-choice question. The BWS exercise included 18 items (modes and frequency of administration, additional treatment convenience, and toxicity items). The survey was administered online to patients recruited from the Multiple Myeloma Research Foundation CoMMpass study (NCT01454297). Results: The final samples consisted of 94 patients and 32 caregivers. Avoiding severe nerve damage was most important to patients, followed by longer PFS. Caregivers considered PFS to be the most important attribute. We estimate that a third or more of patients were cost-sensitive, meaning their treatment preference was altered based on cost implications. Caregivers were not cost-sensitive. The three most bothersome treatment features in the BWS exercise were risk of kidney failure, lowering white blood cell counts, and weakening the immune system. Conclusion: Patients with relapsed or refractory MM and their caregivers consider many factors including efficacy, toxicity, mode/frequency of administration, and cost in their decisions regarding treatment options. The study provides a basis for future Research on patient and caregiver treatment preferences, which could be incorporated into shared decision-making with physicians

A Randomised, Blinded, Placebo-Controlled Trial in Dementia Patients Continuing or Stopping Neuroleptics (The DART-AD Trial)

In a randomized trial of patients with dementia, Clive Ballard and colleagues show that withdrawal of neuroleptics had no overall detrimental effect, and by some measures improved, functional and cognitive status