The Physician-Patient Relationship Revisited - the Patient's View

The importance of the physician-patient relationship for the health care market is beyond controversy. Most theoretical work is done in a principal-agent framework, dealing with moral hazard problems. Recent work emphasizes a two-sided asymmetric information relationship between physician and patient (double moral hazard). In contrast to most work looking only at the physician's perspectives, our paper concentrates on the patient's view. Estimation results using panel data support the hypotheses that physician consultation and health-relevant behavior are not stochastically independent. This means that health care demand is determined by the patient and not only by the physician. In the recursive bivariate probit model, the patient’s health-relevant behavior has a significant positive influence on the probability of a physician visit. This should be taken into account in the discussion that primary care physicians should function as gatekeepers.physician-patient relationship, health behavior, bivariate probit

Coping with creeping catastrophes: national political systems and the challenge of slow-moving policy problems

No abstract available

Relationalism in Political Theory and Research: The Challenge of Networked Politics and Policy-Making

Political theory and research approaches are in most cases not explicit in all respects, but are usually shaped by implicit background theories and scientific worldviews, e.g. presuppositions and paradigms. Examples are idealism, materialism or institutionalism. A fairly new perspective in this regard is relationalism. This way of thinking, in its ontological orientation, conceives the world only in terms of relations. Research programmes with a relationalist orientation put this idea into practice with methods of social network analysis which are more and more used also in political science. Several variants of this new -ism and type of network thinking are presented in this paper in a critical perspective. Relationalism is ultimately seen as fruitful perspective, but is seen as limited in its explanatory power, though. It should therefore always be combined with other approaches and perspectives.Teoria polityczna i badania w tej dziedzinie nie są zwykle pod każdym względem jednoznaczne, ale podlegają wpływom ukrytych teorii wyjściowych i światopoglądów naukowych, obejmujących na przykład założenia i paradygmaty. Przykładami są idealizm, materializm czy instytucjonalizm. Stosunkowo nowe podejście stanowi w tym względzie relacjonalizm. W ramach tej orientacji ontologicznej świat pojmowany jest wyłącznie w kategoriach relacji. Programy badawcze utrzymane w duchu relacjonizmu realizują tę ideę w praktyce za pomocą metod analizy sieci społecznych, które w coraz większym stopniu wchodzą w użycie także w naukach politycznych. Niniejszy artykuł prezentuje krytyczny ogląd kilku odmian tego nowego “izmu” i rodzajów myślenia sieciowego. Relacjonalizm jest ostatecznie postrzegany jako perspektywa pożyteczna, ale o ograniczonej mocy eksplanacyjnej. Dlatego powinien być zawsze stosowany w połączeniu z innymi podejściami i perspektywami

Risk Adjustment Systems in Health Insurance Markets in the US, Germany, Netherlands and Switzerland

Gesetzliche Krankenversicherung, Versicherungstechnisches Risiko, Vereinigte Staaten, Deutschland, Niederlande, Schweiz, Public health insurance, Actuarial risk, United States, Germany, Netherlands, Switzerland

The innovation impact of EU emission trading: findings of company case studies in the German power sector

This paper provides a comprehensive analysis of how the European Emission Trading System (EU ETS) as the core climate policy instrument of the European Union has impacted innovation. Towards this end, we investigate the impact of the EU ETS on research, development, and demonstration (RD&D), adoption, and organizational change. In doing so, we pay particular attention to the rela-tive influences of context factors (policy mix, market factors, public acceptance) as well as firm characteristics (value chain position, technology portfolio, size, vision). Empirically, our analysis is based on multiple case studies with 19 power generators, technology providers, and project developers in the German power sector which we conducted from June 2008 until June 2009. We find that the innovation impact of the EU ETS has remained limited so far because of the scheme’s initial lack in stringency and predictability and the relatively greater importance of context factors. Additionally, the impact varies tremendously across technologies, firms, and innovation dimensions, and is most pronounced for RD&D on carbon capture technologies and corporate procedural change. Our analysis suggests that the EU ETS by itself may not provide sufficient incentives for fundamental changes in corporate climate innovation activities at a level adequate for reaching political long-term targets. Based on the study’s findings, we derive a set of policy and research recommendations. --EU ETS,emission trading,innovation,technological change,adoption,diffusion,organizational change,power sector

the climate change issue in Germany 2007-2010

This paper assesses the impact of large events such as the financial crisis in 2008 and the Copenhagen meeting in 2009 on the public attention attributed to the climate change issue and to the related policy discourse in the German press. Based on a quantitative content analysis of the two largest German national quality newspapers, a quasi-experimental approach will be adopted, testing the propositions of “punctuated equilibrium theory” (Baumgartner & Jones 1993) in policy analysis. The paper will also use concepts and approaches in the area of discourse analysis – from qualitative methods to more formal quantitative approaches to the analysis of discourse structures and network relations (Janning et al 2009). Large scale and focusing events such as the economic crisis or the Copenhagen meeting can trigger shifts and changes in the discourse on climate change. Preliminary analysis has shown that the economic crisis produced a kink in the issue-attention cycle, triggering a substantial decrease in public attention as public attention to the economic crisis soared. Moreover, the results indicate that actors have changed their discursive behavior in the light of the economic crisis, entailing changes in the actors’ standing and the frames applied by them to the issue of climate change (Vogt 2009). As natural experiments run short of quantifying causal links between variables, the observed changes in public attention and discursive behavior can at least be explained by qualitative explanatory sketches in which the changes and shifts are traced and interrelated by visual descriptions at various levels