Reference Pricing of Pharmaceuticals for Medicare: Evidence from Germany, the Netherlands and New Zealand

This paper describes three prototypical systems of therapeutic reference pricing (RP) for pharmaceuticals -- Germany, the Netherlands, and New Zealand -- and examines their effects on the availability of new drugs, reimbursement levels, manufacturer prices and out-of-pocket surcharges to patients. RP for pharmaceuticals is not simply analogous to a defined contribution approach to subsidizing insurance coverage. Although a major purpose of RP is to stimulate competition, theory suggests that this is unlikely and this is confirmed by the empirical evidence. Other effects of RP differ across countries in predictable ways, reflecting each country's system design and other cost control policies. New Zealand's RP system has reduced reimbursement and limited the availability of new drugs, particularly more expensive drugs. Compared to these three countries, if RP were applied in the US, it would likely have a more negative effect on prices of on-patent products, due to the more competitive US generic market, and a more negative effect on R&D and on the future supply of new drugs, due to the much larger US share of global pharmaceutical sales.

Student Perceptions and Learning Outcomes: Evidence from the Education Testing Service (ETS) Major Field Test in Business

We examine course evaluation data from the core finance course and analyze how these data relate to performance on the finance portion of the Educational Testing Service Major Field Test in Business (ETS). We find that gender, SAT scores, GPA and concentration all have significant impacts on student performance. We also find that student perceptions of teaching and of how much knowledge they gained do not relate to the finance ETS score. Finally, we find that students who feel challenged in their finance core course do significantly better on the finance portion of the exam. This result is robust to different data partitions

The Idea of Democracy in the Modern Era

Although the last half of the twentieth century has been called the Age of Democracy, the twentyfirst has already demonstrated the fragility of its apparent triumph as the dominant form of government throughout the world.Reassessing the fate of democracy for our time, distinguished political theorist Ralph Ketcham traces the evolution of this idea over the course of four hundred years. He traces democracy's bumpy ride in a book that is both an exercise in the history of ideas and an explication of democratic theory. Ketcham examines the rationales for democratic government, identifies the fault lines that separate democracy from good government, and suggests ways to strengthen it in order to meet future challenges. Drawing on an encyclopedic command of history and politics, he examines the rationales that have been offered for democratic government over the course of four manifestations of modernity that he identifies in the Western and East Asian world since 1600.Ketcham first considers the fundamental axioms established by theorists of the Enlightenment—Bacon, Locke, Jefferson—and reflected in America's founding, then moves on to the mostly postDarwinian critiques by Bentham, Veblen, Dewey, and others that produced theories of the liberal corporate state. He explains latenineteenthcentury Asian responses to democracy as the third manifestation, grounded in Confucian respect for communal and hierarchical norms, followed by latetwentiethcentury postmodernist thought that views democratic states as oppressive and seeks to empower marginalized groups.Ketcham critiques the first, second, and fourth modernity rationales for democracy and suggests that the Asian approach may represent a reconciliation of ancient wisdom and modern science better suited to today's world. He advocates a reorientation of democracy that deemphasizes group or identity politics and restores the wholeness of the civic community, proposing a return to the Jeffersonian universalism—that which informed the founding of the United Statesif democracy is to flourish in a fifth manifestation.The Idea of Democracy in the Modern Era is an erudite, interdisciplinary work of great breadth and complexity that looks to the past in order to reframe the future. With its global overview and comparative insights, it will stimulate discussion of how democracy can survive—and thrive—in the coming era

Sabotage

Artwor

Do Physical Self-Efficacy and Physical Self-Concept Mediate the Relationship Between Past Sports Participation, Past Gym Grades and Physical Activity Across the Life-Span?

Retrospective studies have shown that the formation of habits, both health and activity related, during childhood is vital to carrying those habits into adulthood (Azevedo, Araujo & Hallal, 2007; Barnekow-Bergkvist et al. 1996; Nelson, Gordon-Larsen, Adair, & Popkin, 2005; Telama et al. 1997; Telama, Yang, Viikari, Valimaki, Wanne & Raitakari, 2005). These studies demonstrate that passive participation in an activity is not sufficient; rather organized participation, such as being part of a team, is necessary for continuation of a physical activity later in life. In addition, researchers have found that sound physical and strong academic educations are also important in promoting and sustaining a physically active lifestyle. In general, the education process trains ndividuals to stick to routines (physical education) and follow through with commitments (academic education) (Barnekow-Bergkvist et al. 1996

Towards a Biological Explanation of Sin in Walter M. Miller, Jr.’s “A Canticle for Leibowitz”

Walter M. Miller, Jr.’s 1959 novel A Canticle for Leibowitz is on one level a theological reflection on the human propensity to sin. Not coincidentally, the story is located in an Albertinian abbey in the former American southwest six hundred years after a nuclear holocaust, recounting three separate historical periods over the following twelve hundred years: a dark age, a scientific renaissance, and finally a time of technological achievement where a second nuclear holocaust is imminent. Miller asks the question of whether humans as a species cannot avoid committing acts of sin that cumulatively and continually lead to acts of societal and technological self-destruction; his response oscillates between a fatalistic pessimism (the final extinction of the human species) and a vague optimism (the “new creature,” the mutant Rachel, or perhaps a last group of humans leaving the Earth as the curtain falls). It is my thesis in this article that theological questions about sin (as explored by Augustine and later scholars) can be fruitfully approached by analogous genetic processes; more precisely by reference to the rising science of Epigenetics, which explores how genes can express themselves differently without mutating in response to life stressors. In light of the idea of a genetic and epigenetic expression of moral rules of existence, Augustine’s thesis of original sin as something that is inherited makes new sense. In this light, it may also be possible to approach the question that the Canticle proposes: are we destined to self-destruction, or is there a way out of this destructive cycle

The Inflation-Hedging Properties of Risk Assets: The Case of REITs

This study examines the inflation-hedging abilities of REITs over the period 1972:2-1992:12 to determine whether REITs act as a hedge against expected and/or unexpected inflation. The time period used in this study is substantially longer than in earlier studies. A model of real estate returns is derived that has components for expected and unexpected returns and allows for variation in the real return on risky assets. The results indicate that REITs provide some hedging capability against expected inflation, but act as perverse hedges against unexpected inflation. These results are robust with respect to time period studied, measure of expected inflation and proxy for the market portfolio, indicating that the apparent perverse hedging property of real estate investments is not due to methodological problems.

DEVELOPMENT OF NOVEL ELECTROPHILIC RUTHENIUM(II) AND IRIDIUM(III) COMPLEXES AND THEIR APPLICATIONS AS HOMOGENEOUS CATALYSTS

Our aim was to develop the synthetic potential and reaction chemistry of Ir3+ and Ru2+ electrophiles by preparing well-characterized complexes whose properties are controllable by modification of the ancillary ligand environment Specifically, we prepared a series of ruthenium complexes to serve as selective hydrogenation and hydrogenolysis catalysts of furan derivatives. We also expanded the synthesis of electrophilic Ir3+ di-thiolate complexes. These types of compounds could eventually serve as catalysts precursors for the addition of weak nucleophiles to alkynes and nitriles