Why Economists Should Support Populist Antitrust Goals

Antitrust policy can be a powerful tool to tackle important social and economic problems. For decades antitrust enforcement has been shackled by the so-called Consumer Welfare Standard (“CWS”) that has limited the goals considered to be “legitimate.” The CWS limits antitrust goals to those that impact demand in markets, and primarily in output markets. Recently, new voices have come forward to suggest that antitrust policy should address several other important social objectives. Such goals include the traditional antitrust goals that motivated passage of the antitrust statutes, and which were discussed in Pre-Rehnquist Court opinions, including dispersion of economic and political power, and protection of small business. Additionally, it has been suggested that antitrust law should contribute to alleviating inequality, protecting labor when mergers occur or in the presence of monopsony, protect macroeconomic growth and stability when financial entities merge, and possibly contribute to efforts to advance sustainability. While some argue that the CWS is flexible enough to support some or all of these objectives, we disagree. There are at least five reasons why the CWS is severely limited or defective, preventing it from being an appropriate standard for modern antitrust. First (Section III below), it is a “material welfare” approach derived from Alfred Marshall, meaning an approach that cannot incorporate important issues that affect welfare such as political democracy and sustainability. This is made clear in the writings of Marshall and Pigou, the originators of the theory imported into antitrust by Judge Bork. Second (Section IV), the CWS assumes that the marginal utility of money (or the marginal social welfare with respect to a change in anyone’s surplus) is constant and equal among individuals impacted by anticompetitive practices. As a consequence, the CWS treats as inconsequential transfers of income between groups resulting from alleged restraints or mergers. Third (Section V), CWS is biased in favor of the wealthy, despite Section IV’s findings that CWS is neutral with respect to marginal transfers. Fourth (Section VI), CWS uses an indefensible measure of efficiency. Fifth (Section VII), CWS ignores the input market when analyzing restraints in the output market.We suggest that there are three questions that must be addressed when considering an antitrust criterion. First: is there credible social science research showing that the policy goals embodied in the criterion result in material increases in human well-being (the basis of economic welfare)? Second: can competition policy substantially advance the criterion? Finally, does the criterion provide a method for dealing with tradeoffs between the goals it embodies, if such tradeoffs are present? The CWS is so seriously limited that it does not even allow consideration of the first requirement. A more general welfare approach certainly can address the first two questions and may hold promise for satisfying the third

A Very Ambiguous Empire:Russia’s Hybrid Exceptionalism

Legal rules are often designed to provide different incentives to plaintiffs and defendants. With regard to prejudgment interest, however, it is not clear why there should be a bias in either direction. Absent a convincing argument for leaning toward one party or the other, we conclude that as a normative matter, the ideal rule for prejudgment interest should be neutral with regard to delay: plaintiffs are compensated fully for delay and defendants pay the market rate for the benefits they implicitly derive from holding money that belongs to the plaintiff. This simple “neutrality rule” implies, of course, that all claims should be treated equally with regard to applying prejudgment interest; that there should not be a legislatively-set prejudgment rate or legislative mandating of simple, rather than compound, interest; and that prospective damages should be discounted to the date of injury and not the date of trial. We conclude this Article with another admonition from the Eleventh Circuit: “Symmetrical treatment should be given to the estimated lost earnings both before and after trial so that neither party can benefit by delaying the final judgment.”161 Utah could substantially reduce the problems and inconsistencies that derive from the current legal treatment of prejudgment interest if it were to adopt a simple principle: other than adding prejudgment interest, if a change in the trial date increases or decreases estimated damages, the methodology being used embeds an inconsistency concerning the treatment of time

Clinical Effectiveness, Access to, and Satisfaction with Care Using a Telehomecare Substitution Intervention: A Randomized Controlled Trial

Background. Hospitalization accounts for 70% of heart failure (HF) costs; readmission rates at 30 days are 24% and rise to 50% by 90 days. Agencies anticipate that telehomecare will provide the close monitoring necessary to prevent HF readmissions. Methods and Results. Randomized controlled trial to compare a telehomecare intervention for patients 55 and older following hospital discharge for HF to usual skilled home care. Primary endpoints were 30- and 60-day all-cause and HF readmission, hospital days, and time to readmission or death. Secondary outcomes were access to care, emergency department (ED) use, and satisfaction with care. All-cause readmissions at 30 days (16% versus 19%) and over six months (46% versus 52%) were lower in the telehomecare group but were not statistically significant. Access to care and satisfaction were significantly higher for the telehomecare patients, including the number of in-person visits and days in home care. Conclusions. Patient acceptance of the technology and current home care policies and processes of care were barriers to gaining clinical effectiveness and efficiency

Synthesis and preliminary biological evaluation of a novel P2X7R radioligand [18F]IUR-1601

The reference standard IUR-1601 ((S)-N-(2-chloro-3-(trifluoromethyl)benzyl)-1-(2-fluoroethyl)-5-oxopyrrolidine-2-carboxamide) was synthesized from tert-butyl (S)-5-oxopyrrolidine-2-carboxylate, fluoroethylbromide, and 2-chloro-3-(trifluoromethyl)benzylamine with overall chemical yield 12% in three steps. The target tracer [18F]IUR-1601 ((S)-N-(2-chloro-3-(trifluoromethyl)benzyl)-1-(2-[18F]fluoroethyl)-5-oxopyrrolidine-2-carboxamide) was synthesized from desmethyl-GSK1482160 with 2-[18F]fluoroethyl tosylate, prepared from 1,2-ethylene glycol-bis-tosylate and K[18F]F/Kryptofix2.2.2, in two steps and isolated by HPLC combined with SPE in 1–3% decay corrected radiochemical yield. The radiochemical purity was >99%, and the molar activity at end of bombardment (EOB) was 74–370 GBq/μmol. The potency of IUR-1601 in comparison with GSK1482160 was determined by a radioligand competitive binding assay using [11C]GSK1482160, and the binding affinity Ki values for IUR-1601 and GSK1482160 are 4.31 and 5.14 nM, respectively

Synthesis and initial in vitro characterization of a new P2X7R radioligand [18F]IUR-1602

The overexpression of P2X7R is associated with neuroinflammation and plays an important role in various neurodegenerative diseases. The [18F]fluoropropyl derivative of GSK1482160, [18F]IUR-1602, has been first prepared and examined as a new potential P2X7R radioligand. The reference standard IUR-1602 was synthesized from tert-butyl (S)-5-oxopyrrolidine-2-carboxylate, fluoropropylbromide, and 2-chloro-3-(trifluoromethyl)benzylamine with overall chemical yield 13% in three steps. The target tracer [18F]IUR-1602 was synthesized from desmethyl-GSK1482160 with 3-[18F]fluoropropyl tosylate, prepared from propane-1,3-diyl bis(4-methylbenzenesulfonate) and K[18F]F/Kryptofix2.2.2, in two steps and isolated by HPLC combined with SPE in 2–7% decay corrected radiochemical yield. The radiochemical purity was >99%, and the molar activity at end of bombardment (EOB) was 74–370 GBq/μmol. The potency of IUR-1602 in comparison with GSK1482160 was determined by a radioligand competitive binding assay using [11C]GSK1482160, and the binding affinity Ki values for IUR-1602 and GSK1482160 are 23.6 and 3.07 nM, respectively. The initial in vitro evaluation results, 8-fold less potency of [18F]IUR-1602 compared to [11C]GSK1482160, prevent further in vivo evaluation of [18F]IUR-1602 in animals and human

Simple Frameshifts in MIS Postoperative Pain Management Significantly Reduce Opiate Prescriptions

Aims for Improvement The intervention aimed to reduce narcotics provided to patients after MIS by reducing number of narcotic prescriptions and amount prescribed by 25% without affecting patientreported pain scores Usage measured in Morphine Equivalent Doses (MED) MED and pain score assessed at 3 time points: post-op day 1 (POD1), discharge (D/C) and follow-up (FU) apt Pre- and Post-intervention cohorts - Month 1 (Pre-intervention): 21 patients and Month 2 (Post-intervention): 30 patient

A Randomized, Controlled Trial of Financial Incentives for Smoking Cessation.

BACKGROUND: Smoking is the leading preventable cause of premature death in the United States. Previous studies of financial incentives for smoking cessation in work settings have not shown that such incentives have significant effects on cessation rates, but these studies have had limited power, and the incentives used may have been insufficient. METHODS: We randomly assigned 878 employees of a multinational company based in the United States to receive information about smoking-cessation programs (442 employees) or to receive information about programs plus financial incentives (436 employees). The financial incentives were $100 for completion of a smoking-cessation program,$250 for cessation of smoking within 6 months after study enrollment, as confirmed by a biochemical test, and $400 for abstinence for an additional 6 months after the initial cessation, as confirmed by a biochemical test. Individual participants were stratified according to work site, heavy or nonheavy smoking, and income. The primary end point was smoking cessation 9 or 12 months after enrollment, depending on whether initial cessation was reported at 3 or 6 months. Secondary end points were smoking cessation within the first 6 months after enrollment and rates of participation in and completion of smoking-cessation programs. RESULTS: The incentive group had significantly higher rates of smoking cessation than did the information-only group 9 or 12 months after enrollment (14.7% vs. 5.0%, P CONCLUSIONS: In this study of employees of one large company, financial incentives for smoking cessation significantly increased the rates of smoking cessation. (ClinicalTrials.gov number, NCT00128375.

Endemic Human Coronaviruses in Hospitalized Adults with Community-Acquired Pneumonia: Results from the Louisville Pneumonia Study

Introduction: There are four endemic serotypes of human coronavirus (HCoV) that may cause community-acquired pneumonia (CAP) in humans. The clinical syndrome of CAP due to HCoVs is not well characterized. The objectives of this study were to evaluate incidence, epidemiology, and outcomes of CAP in adults due to HCoV and to compare them with CAP due to influenza. Methods: The Louisville Pneumonia Study (LPS) is a prospective observational study of hospitalized adult patients with CAP in the city of Louisville. Patients enrolled in the LPS in whom a respiratory viral panel polymerase chain reaction (PCR) was obtained were evaluated. Incidence, epidemiology, and outcomes were compared for patients with a positive PCR for HCoV versus patients with a positive PCR for influenza. Results: From 1,974 CAP patients with a PCR performed, HCoV was identified in 65 patients (3.3%), corresponding to the following serotypes: HCoV-229E in 12 patients, HCoV-OC43 in 38 patients, HCoV-NL63 in 6 patients and HCoV-HKU1 in 9 patients. No differences were observed in clinical presentation and early outcomes for patients with CAP due to HCoV compared to 244 patients with CAP due to influenza. One-year mortality after hospitalization was 32% for patients with CAP due to HCoV versus 13% for patients with CAP due to influenza. Conclusions: When compared to patients with CAP due to influenza, the clinical presentation of patients with CAP due to HCoV is similar, but these patients have significantly worse outcomes one year after hospitalization

Community-Acquired Pneumonia due to Endemic Human Coronaviruses compared to 2019 Novel Coronavirus: A Review

The human coronaviruses (HCoVs) are an important etiology of community-acquired respiratory tract infections. Community-acquired pneumonia (CAP) may be caused by serotypes of endemic HCoVs or highly pathogenic HCoVs. In this review we compared the clinical characteristic, management, outcomes, and infection control practices for patients with CAP due to endemic HCoVs versus patients with CAP due to 2019 novel coronavirus