Labor and Investment Demand at the Firm Level: A Comparison of French, German and U.S. Manufacturing, 1970-79

We investigate how labor and investment demand at the firm level (gross as well as net and replacement investment separately) differs in French, German and U.S. manufacturing, and has changed since the 1974-75 crisis. We use three consistent panel data samples of large firms for1970-79, and rely on simple models of the accelerator-profits type. We find that the accelerator effects and the profits effects did not vary much between 1970-73 and 1976-79, and were quite comparable in the three countries, the former being of a more permanent nature and the latter more transitory.To a large extent these effects account for the important changes and differences in labor and investment demand between the two subperiods and across the three countries.

Ageing and changes in medical practices : reassessing theinfluence of demography

On the basis of French individual data, this paper compares the effect of demographic change, changes in morbidity and changes in practices on the growth in health expenditures that occurred between 1992 and 2000. Microsimulations show that the rise in expenditures due to aging is relatively small and that the impact of changes in practices is 3.8 times larger. Furthermore, changes in morbidity induce savings which more that offset the increase in spending due to the population aging.Aging - Health Expenditures - Micro-Simulations

Intergenerational inequalities in GPs' earnings : experience, time and cohort effects

This paper analyses the regulation of ambulatory care and its impact on physicians careers, using a representative panel of 6016 French self-employed GPs over the years 1983 to 2004. The beginning of their activity is influenced by the regulated number of places in medical schools, named in France numerus clausus. We show that the policies aimed at manipulating the numerus clausus strongly affect physicians permanent level of earnings. Our empirical approach allows us to identify experience, time and cohort effects in GPs earnings. The estimated cohort effect is very large, revealing that intergenerational inequalities due to fluctuations in the numerus clausus are not negligible. GPs beginning during the eighties have the lowest permanent earnings: they faced the consequences of an unlimited number of places in medical schools in the context of a high density due to the baby-boom numerous cohorts. Conversely, the decrease in the numerus clausus led to an increase in permanent earnings of GPs who began their practice in the mid nineties. Overall, the estimated gap in earnings between "good" and "bad" cohorts may reach 25%. We performed a more thorough analysis of the earnings distribution to examine whether individual unobserved heterogeneity could compensate for average differences between cohorts. Our results about stochastic dominance between earnings distributions by cohort show that it is not the case.GPs, self-employed, longitudinal data, earnings, stochastic dominance

Medical Demography and Intergenerational inequalities in GPs' earnings

This article examines the link between restrictions on the number of physicians and general practitioners' earnings. Using a representative panel of 6,016 French self-employed GPs over the years 1983 to 2004, we show that the policies aimed at manipulating the number of places in medical schools strongly affect physicians' permanent level of earnings.We estimate an earnings function to identify experience, time and cohort effects. The cohort effect is very large: the estimated gap in earnings between "good" and "bad" cohorts may reach 25%. GPs beginning during the eighties have the lowest permanent earnings: they belong to the baby-boom numerous cohorts and faced the consequences of an unlimited number of places in medical schools. Conversely, the decrease in the number of places in medical schools led to an increase in permanent earnings of GPs who began their practice in the mid nineties. A stochastic dominance analysis shows that unobserved heterogeneity does not compensate for average differences in earnings between cohorts. These findings suggest that the first years of practice are decisive for a GP. If competition between physicians is too intense at the beginning of career, she will suffer from permanently lower earnings. To conclude, our results show that the policies aimed at reducing the number of medical students succeeded in buoying up physicians' permanent earnings.General Practitioners; self-employed; longitudinal data; earnings; stochastic dominance

The influence of supplementary health insurance on switching behaviour: evidence on Swiss data

This paper focuses on the switching behaviour of sickness fund enrolees in the Swiss health insurance system. Even though the new Federal Law on Social Health Insurance (LAMal) was implemented in 1996 to promote competition among health insurers in basic insurance, there still remains large premium variations within cantons. This indicates that competition has not been able so far to lead to a single price, and reveals some inertia among consumers who seem reluctant to switch to less expensive funds. We investigate one possible barrier to switching behaviour, namely the influence of the supplementary insurance. Our aim is to analyse two decisions (switching decision in basic insurance, subscription to supplementary insurance contracts). We use survey data on health plan choice and import some market data related to the sickness funds (number of enrollees, premiums). The decision to switch and the decision to subscribe to a supplementary contract are estimated both separately and jointly. The results suggest that holding a supplementary insurance contract substantially decreases the propensity to switch. However the impact of supplementary insurance is not significant when the individual assesses his/her health as "very good" ; to the contrary, holding a supplementary contract significantly reduces the propensity to switch when the indivual's subjective health status deteriorates. Futhermore, the switching decision is positively influenced by the expected gain of switching. In comparison with the range of the premium difference, the limitations to switch due to the supplementary insurance is moderate, though non negligible. As for the decision to subscribe a supplementary contract, the results show that the income level has a direct positive influence on the propensity to buy a supplementary insurance. Our results suggest that a major mechanism is going on in relation to supplementary insurance: holding a supplementary contract might stop individuals from switching when the individual thinks that she/he could be regarded as a bad risk due to the selection practices that are allowed in supplementary insurance markets. This result bears major policy implications concerning the regulation of basic and supplementary insurance markets.competition in health insurance ; switching behaviour ; premium convergence ; influence of supplementary insurance

Health expenditure growth : reassessing the threat of ageing

In this paper we evaluate the respective effects of demographic change, changes in morbidity and changes in practices on growth in health care expenditures. We use microdata, i.e. representative samples of 3441 and 5003 French individuals observed in 1992 and 2000. Our data provide detailed information about morbidity and allow us to observe three components of expenditures: ambulatory care, pharmaceutical and hospital expenditures.We propose an original microsimulation method to identify the components of the drift observed between 1992 and 2000 in the health expenditure age profile. On the one hand, we find empirical evidence of health improvement at a given age: changes in morbidity induce a downward drift of the profile. On the other hand, the drift due to changes in practices is upward and sizeable. Detailed analysis attributes most of this drift to technological innovation.After applying our results at the macroeconomic level, we find that the rise in health care expenditures due to ageing is relatively small. The impact of changes in practices is 3.8 times larger. Furthermore, changes in morbidity induce savings which more than offset the increase in spending due to population ageing.ageing ; health expenditure ; microsimulations ; econometrics

Microéconométrie de la santé : remarques sur l'expérience française

Cet article analyse l'expérience française en microéconométrie de la santé à partir de quatre thèmes: le rôle de l'aléa moral dans la consommation de soins, la demande induite, la taille optimale des hôpitaux et l'effet potentiel d'une tarification par pathologie dans le secteur public hospitalier. [Auteurs] The purpose of this article is to provide a view of French experience using micro data in the field of health econometrics. Four issues are addressed: moral hazard in demand for medical care, supply-induced demand, hospital optimal size, potential outcomes of prospective payment systems in public hospitals. [Authors]]]> Models, Econometric oai:serval.unil.ch:BIB_F3E8522BBC0F 2022-05-07T01:30:05Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_F3E8522BBC0F A. Cornelius Celsus, « De medicina », Die medizinische Wissenschaft, eingeleitet, übersetzt und kommentiert von Thomas Lederer, 3 Bände, WBG (Edition Antike) 2016 Maire, Brigitte info:eu-repo/semantics/article article 2016-12 Museum Helveticum, no. 73:2, pp. 236–237 info:eu-repo/semantics/altIdentifier/pissn/0027-4054 Celse fre oai:serval.unil.ch:BIB_F3E8E639815D 2022-05-07T01:30:05Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_F3E8E639815D Applications of MALDI-TOF Mass Spectrometry in Clinical Diagnostic Microbiology info:doi:10.1002/9781118960226.ch3 info:eu-repo/semantics/altIdentifier/doi/10.1002/9781118960226.ch3 http://dx.doi.org/10.1002/9781118960226.ch3 Opota, Onya Prod'hom, Guy Greub, Gilbert info:eu-repo/semantics/bookPart incollection 2017-04-07 MALDI-TOF and Tandem MS for Clinical Microbiology, pp. 55-92 info:eu-repo/semantics/altIdentifier/isbn/9781118960226 info:eu-repo/semantics/altIdentifier/isbn/9781118960257 <![CDATA[Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) represents one of the most accurate, reliable, and fast methods for the identification of bacterial strains from positive cultures, and therefore it has largely replaced all other previously used approaches for microbial identification. The main application of MALDI-TOF MS in clinical microbiology laboratories is the identification of bacteria from colonies recovered from solid culture media. This chapter discusses specific identification procedures that are needed for some bacteria, such as Actinomycetes and Mycobacteria. The performance of MALDI-TOF MS identification relies on the number of mass spectra that reach the quality allowing identification and the number of correct identifications. MALDI-TOF MS has also been proposed for Staphylococcus aureus strain typing or for the detection of biomarkers of the most virulent toxigenic isolates. MALDI-TOF MS could also be used for Mycobacterium

The influence of supplementary health insurance on switching behaviour : evidence on Swiss data

This paper focuses on the switching behaviour of sickness fund enrollees in the Swiss health insurance system. Even though the new Federal Law on Social Health Insurance (LAMal) was implemented in 1996 to promote competition among health insurers, there still remains large premium variations within cantons. This indicates that competition has not been able so far to lead to a single price, and reveals some inertia among consumers who seem reluctant to switch to less expensive funds. We investigate one possible barrier to switching behaviour, namely the influence of the supplementary insurance on the choice for basic insurance plan in Switzerland, which has not been studied so far. Our aim is to analyse the two decisions (choice of health plan, subscription to supplementary insurance contracts). We use the data of the OFAS survey conducted in 2000 on health plan choice and import some additional data on the sickness funds (number of enrollees, premiums). The decision to switch is estimated by both logit and a fixed-effects logit models; two main explanatory variables are studied: premiums (for basic insurance contracts) and supplementary insurance. The results suggest that holding a supplementary insurance contract substantially decreases the propensity to switch. The switching decision is positively influenced by the expected gain of switching, measured by the premium differential. The expected gain of switching is higher for switchers with no supplementary insurance (CHF 19.44) than for switchers with supplementary insurance (CHF 13.06). The income level has a direct positive influence on the propensity to buy a supplementary insurance. This finding suggests that the purchase of supplementary insurance is influenced, not only by risk aversion, but also by the willingness to pay for the goods covered by the supplementary insurance, which would be higher for rich people. Bad health has a negative influence on the subscription to a supplementary contract, but is no longer significant when the income is introduced into the specification. All the information about health is captured by the income level, a low income being strongly correlated with a bad health status. Income and a supplementary insurance contract are observable by the insurance company, and can be used as tools for selection.Health Insurance, Private Sector