Preventive health care and payment systems to providers

Prevention has been a main issue of recent policy orientations in health care. This renews the interest on how different organizational designs and the definition of payment schemes to providers may affect the incentives to provide preventive health care. We present, both the normative and the positive analyses of the change from independent providers to integrated services. We show the evaluation of that change to depend on the particular way payment to providers is done. We focus on the externality resulting from referral decisions from primary to acute care providers. This makes our analysis complementary to most works in the literature allowing to address in a more direct way the issue of preventive health care.

Monopolistic competition and different wage setting systems

In this paper we match the static disequilibrium unemployment model without frictions in the labor market and monopolistic competition with an infinite horizon model of growth. We compare the wages set at the firm, sector and national (centralized) levels, their unemployment rates and growth of the economic variables, for the Cobb-Douglas production function, in order to see under wich conditions the inverse U hypothesis between unemployment and centralization of wage bargain is confirmed. We also analyze, in the three wage setting systems, the effect of an increase in the monopoly power on employment and growth.

Towards economic and monetary union: changing trends in payment systems for new european members

The objective of this paper is preciselyto study the evolution of payment systems within the accession countries between 1996 and 2003 and compare them with those of the E.U. and the Eurozone countries

Contagion and efficiency in gross and net interbank payment systems

The increased fragility of the banking industry has generatedgrowing concern about the risks associated with the paymentsystems. Although in most industrial countries differentinterbank payment systems coexist, little is really knownabout their propierties in terms of risk and efficiency. Wetackle this question by comparing the two main types ofpayment systems, gross and net, in a framework whereuncertainty arises from several sources: the time ofconsumption, the location of consumption and the return oninvestment. Payments across locations can be made either bydirectly transferrring liquidity or by transferring claimsagainst the bank in the other location. The two mechanism areinterpreted as the gross and net settlement systems ininterbank payments. We characterize the equilibria in the twosystems and identify the trade-off in terms of safety andefficiency.

El mercado de trabajo español en la unión monetaria : flexibilidad de salarios y política laboral

La baja movilidad espacial de la mano d'obra y la incapacidad estabilizadora del presupuesto comunitario como mecanismos de ajuste alternativos a la política monetaria y al tipo de cambio exigen que el mercado de trabajo español muestre una alta flexibilidad salarial para poder reaccionar con rapidez a los eventuales shocks asimétricos nacionales en el marco de la Unión Monetaria. En este trabajo se analizan, en primer lugar, el grado de rigidez de los salarios y se identifican, a continuación, los principales factores explicativos del mismo. El análisis aporta evidencia empírica sobre el grado de rigidez de los salarios en un amplio número de países de l'OCDE a partir de la estimación de ecuaciones de salarios en forma de curva de Phillips aumentada con expectativas. Los resultados obtenidos permiten afirmar que el mercado de trabajo español funciona de forma deficiente, con una elevada rigidez de los salarios, y en consecuencia, una incapacidad de los mismos para ayudar a l'ocupación a recuperarse ante una perturbación recesiva. En segundo lugar, el análisis de los factores explicativos de esta rigidez permito concluir que se podría conseguir una mayor flexibilidad salarial mediante l'actuación coordinada y consensuada de los agentes económicos y sociales en el proceso de negociación salarial, así como mediante políticas activas de mercado de trabajo, incidiendo sobre todo en el componente formación, o pasivas, reduciendo la duración de las prestaciones contributivas. Un tercer factor que permitiría obtener una mayor flexibilidad sería un desplazamiento del nivel de negociación hacia formas mucho mas centralizadas o, por el contrario, altamente descentralizadas

El mercado de trabajo español en la unión monetaria : flexibilidad de salarios y política laboral

La baja movilidad espacial de la mano d'obra y la incapacidad estabilizadora del presupuesto comunitario como mecanismos de ajuste alternativos a la política monetaria y al tipo de cambio exigen que el mercado de trabajo español muestre una alta flexibilidad salarial para poder reaccionar con rapidez a los eventuales shocks asimétricos nacionales en el marco de la Unión Monetaria. En este trabajo se analizan, en primer lugar, el grado de rigidez de los salarios y se identifican, a continuación, los principales factores explicativos del mismo. El análisis aporta evidencia empírica sobre el grado de rigidez de los salarios en un amplio número de países de l'OCDE a partir de la estimación de ecuaciones de salarios en forma de curva de Phillips aumentada con expectativas. Los resultados obtenidos permiten afirmar que el mercado de trabajo español funciona de forma deficiente, con una elevada rigidez de los salarios, y en consecuencia, una incapacidad de los mismos para ayudar a l'ocupación a recuperarse ante una perturbación recesiva. En segundo lugar, el análisis de los factores explicativos de esta rigidez permito concluir que se podría conseguir una mayor flexibilidad salarial mediante l'actuación coordinada y consensuada de los agentes económicos y sociales en el proceso de negociación salarial, así como mediante políticas activas de mercado de trabajo, incidiendo sobre todo en el componente formación, o pasivas, reduciendo la duración de las prestaciones contributivas. Un tercer factor que permitiría obtener una mayor flexibilidad sería un desplazamiento del nivel de negociación hacia formas mucho mas centralizadas o, por el contrario, altamente descentralizadas

Exploring the link between flexible working and organizational performance

The expansion of flexible work experienced since the 1980s in developed economies is consistent with a more generic trend towards organizational flexibility, which many authors see as essential in order to compete in the dynamic global environment (Volberda, 1998). From this point of view, the changing demands of the environment have forced organizations to seek the ability to adapt rapidly and effectively as a means to be successful or even to survive. In the quest for flexibility, every area of the organization has been scrutinized in order to render it as ¿agile¿ as possible. In the human resources arena, this analysis has led to the definition of diverse ¿flexible working practices¿ (FWP) that describe a wide range of employment practices, which differ from the traditional full-time job with a fixed salary and a permanent contract. These practices have been described using other terms, such as ¿alternative¿ (Polivka, 1996; Powell & Mainiero, 1999), ¿non-standard¿ (Kalleberg, 2000), or ¿atypical¿ (De Grip, Hoevenberg, &m Willems, 1997), which coincide in denoting their divergence from the most traditional forms of employment. This article will show that quite different practices have been embraced by the common term ¿flexible working practices.¿ Subsequently, the results of empirical research regarding the implications for organizational performance of a number of flexible practices will be commented on.

European payment system and monetary union

We make a comparative study of payment systems for E.U. -fifteen countries for the 1996-2002 period. Special attention is paid to the introduction of the new European single currency. The overall trend in payments is for a move from cash to noncash payment instruments, although electronic instruments are not widely used yet. We find a significant impact from the introduction of the new banknotes and coins on card use

Effects of institutional environment and technology development on payment choice

The purpose of this paper is to analyze the combination of institutional factors and technology advances as determinants of payment systems choice. The theoretical set up suggests that countries entering into a new institutional environment approach accepting group attitudes towards payment choices as a consequence of institutional pressure and technology development. We apply the results of the model to 2004 European Union enlargement process. Results confirm the relevance of both institutional environment and technology development in retail payment system decisions of newly acceded countries.

Technological adoption in health care

This paper addresses the impact of payment systems on the rate of technology adoption. We present a model where technological shift is driven by demand uncertainty, increased patients' benefit, financial variables, and the reimbursement system to providers. Two payment systems are studied: cost reimbursement and (two variants of) DRG. According to the system considered, adoption occurs either when patients' benefits are large enough or when the differential reimbursement across technologies offsets the cost of adoption. Cost reimbursement leads to higher adoption of the new technology if the rate of reimbursement is high relative to the margin of new vs. old technology reimbursement under DRG. Having larger patient benefits favors more adoption under the cost reimbursement payment system, provided that adoption occurs initially under both payment systems.

Human Capital, the Structure of Production, and Growth

Recent decisions by the Spanish national competition authority (TDC) mandate payment systems to include only two costs when setting their domestic multilateral interchange fees (MIF): a fixed processing cost and a variable cost for the risk of fraud. This artificial lowering of MIFs will not lower consumer prices, because of uncompetitive retailing; but it will however lead to higher cardholders fees and, likely, new prices for point of sale terminals, delaying the development of the immature Spanish card market. Also, to the extent that increased cardholders fees do not offset the fall in MIFs revenue, the task of issuing new cards will be underpaid relatively to the task of acquiring new merchants, causing an imbalance between the two sides of the networks. Moreover, the pricing scheme arising from the decisions will cause unbundling and underprovision of those services whose costs are excluded. Indeed, the payment guarantee and the free funding period will tend to be removed from the package of services currently provided, to be either provided by third parties, by issuers for a separate fee, or not provided at all, especially to smaller and medium-sized merchants. Transaction services will also suffer the consequences that the TDC precludes pricing them in variable terms.

Systemic risk, interbank relations and liquidity provision by the Central Bank

We model systemic risk in an interbank market. Banks face liquidityneeds as consumers are uncertain about where they need to consume. Interbank credit lines allow to cope with these liquidity shocks while reducing the cost of maintaining reserves. However, the interbank market exposes the system to a coordination failure(gridlock equilibrium) even if all banks are solvent. When one bankis insolvent, the stability of the banking system is affected in various ways depending on the patterns of payments across locations. We investigate the ability of the banking industry to withstand the insolvency of one bank and whether the closure ofone bank generates a chain reaction on the rest of the system. Weanalyze the coordinating role of the Central Bank in preventing payments systemic repercussions and we examine the justification ofthe Too-big-to-fail-policy.

Price regulation of plastic money: A critical assessment of Spanish rules

Recent decisions by the Spanish national competition authority (TDC) mandate paymentsystems to include only two costs when setting their domestic multilateral interchange fees(MIF): a fixed processing cost and a variable cost for the risk of fraud. This artificiallowering of MIFs will not lower consumer prices, because of uncompetitive retailing; but itwill however lead to higher cardholders fees and, likely, new prices for point of saleterminals, delaying the development of the immature Spanish card market. Also, to the extent that increased cardholders fees do not offset the fall in MIFs revenue, the task of issuing new cards will be underpaid relatively to the task of acquiring new merchants, causing an imbalance between the two sides of the networks. Moreover, the pricing scheme arising from the decisions will cause unbundling and underprovision of those services whose costs are excluded. Indeed, the payment guarantee and the free funding period will tend to be removed from the package of services currently provided, to be either provided by third parties, by issuers for a separate fee, or not provided at all, especially to smaller and medium-sized merchants. Transaction services will also suffer the consequences that the TDC precludes pricing them in variable terms.