Changing social norms and CEO pay: the role of norms entrepreneurs

This is the third in a series of papers examining different aspects of the CEO compensation debate. This Article will explore attempts by norms entrepreneurs to create or modify social norms. It argues that the relevant social norms are in a state of flux because of the work of norms entrepreneurs, whose efforts might reduce the need for legislative intervention. Several new norms like majority voting for board election, say on pay, smaller multiples for severance packages, and respect for shareholder activists may be emerging due to the work of norms entrepreneurs. Part II analyzes the rich literature on social norms to determine if there are models capable of application to better correlate executive compensation with performance. Despite several problems at the definitional level, it argues that the actions of constituencies relevant to the CEO pay debate might be explained by signaling, esteem, and expressive theories. Further, social norms theories neglecting internalization are deficient; corporate actors undertake self-improvement only when they internalize norms. Part III identifies the work of norms entrepreneurs in creating or changing norms pertaining to CEO compensation, and analyzes the reasons for their success. The examples considered demonstrate the effects of dynamic normative transformations on corporate actors and illustrate the contrast in behavioral changes accompanying resistance and acceptance of new norms. Part IV concludes that norm creation in corporate law is facilitated by the role of groups where membership benefits are dependent on reputation; that directors cannot tradeoff reputation like CEOs, making the deployment of reputational sanctions against them powerful; that behavioral change is more effective when there is norm internalization; and that norms entrepreneurs ought to focus on socializing relevant actors if they aspire to be successful in achieving normative change.

A discrete choice experiment to examine the preferences of patients with cancer and their willingness to pay for different types of health care appointments

BACKGROUND: This study sought to understand the preferences of patients with cancer and the trade-offs between appointment attributes using discrete choice experiment (DCE). METHODS AND STUDY DESIGN: Patients with cancer at 3 hospitals completed a self-administered DCE. Each scenario described 6 attributes: expertise of health care professionals (HCPs), familiarity of doctors with patients' medical history, waiting time, accompaniment by family/friends, travel time, and out-of-pocket costs. Patient preferences were estimated using logistic regression. Willingness to pay (WTP) estimates were derived from regression coefficients. RESULTS: Of 512 patients contacted, 185 returned the questionnaire. The mean age was 61 years, and 60% of respondents were female. The mean time since cancer diagnosis was 34 months, 90% had received treatment; and 61% had early-stage disease. The most important attributes were expertise and familiarity of doctors with patients' medical history; distance traveled was least likely to influence patient preferences. The WTP analysis estimated that patients were willing to pay $680 (95% CI, 470-891) for an appointment with a specialist, $571 (95% CI, 388-754) for doctors familiar with their history, $422 (95% CI, 262-582) for shorter waiting times, $399 (95% CI, 249-549) to be accompanied by family/friends, and $301 (95% CI, 162-441) for shorter traveling times. Male patients had a stronger preference for accompaniment by family/friends. The expertise of HCP was the most important attribute for patients regardless of geographic remoteness. CONCLUSIONS: Our study can assist the development of patient-centered health care models that improve patient access to experienced HCPs, support the role of primary care providers during the cancer journey, and educate patients about the roles of non-oncology HCPs to cope with increasing demand for cancer care.

Health-related quality of life and willingness to pay per quality-adjusted life-Year threshold—A study in patients with epilepsy in China

Objectives
To assess the health-related quality of life (HRQOL) and willingness to pay (WTP) per quality-adjusted life-year (QALY) amount of patients with epilepsy in China.
Methods
Adults with epilepsy and a healthy control were recruited in two tertiary hospitals in China. Participants completed two indirect utility elicitation instruments (Quality of Well-being Scale-self administered version and EuroQol five-dimensional questionnaire) and a WTP questionnaire. Correlations between sociodemographic or epilepsy-specific variables (age of epilepsy onset, duration of epilepsy, seizure types, types of antiepileptic drug treatment, etc.) and HRQOL or WTP/QALY were assessed to identify the candidate predictor. Multiple linear regression models were adopted to investigate the predictive performances of identified candidate predictors. Data analyses were performed on SPSS 20.0 (SPSS, Inc., Chicago, IL).
Results
For utilities of both the Quality of Well-being Scale-self administered version and the EuroQol five-dimensional questionnaire, patients with epilepsy had statistically lower values than did the control group (P < 0.0001). In terms of the WTP/month, the percentage of WTP accounting for the monthly income and the WTP/QALY values from the epilepsy group were substantially higher than those from the control group (P < 0.0001).
View the MathML sourceWTP/QALY=12×WTPMonth1−Utility(CurrentHealth)
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The multiple linear regression model identified working status (P = 0.05), seizure types (P = 0.022), income (P = 0.006), and self-rating health state (P < 0.05) as predictors of HRQOL while income (P = 0.000) and self-rating health state (P < 0.05) statistically contributed to the variations in WTP/QALY value for the epilepsy group.
Conclusions
Patients with epilepsy had substantially lower HRQOL than did the healthy population.

A risk worth taking: perceived risk as moderator of satisfaction, loyalty, and willingness-to-pay premium price

This research investigates the moderating role of perceived risk in the relationship between satisfaction, loyalty, and willingness to pay premium price (WTP). A total of 364 respondents were recruited from Amazon's Mechanical Turk panel. Financial, social, performance, and psychological risks have significant negative effects on the relationship between satisfaction and WTP, whereas only financial risks have significant negative effects on the relationship between loyalty and WTP. Using moderated mediation analysis, we found that the mediating effects of loyalty diminish significantly in high social risk conditions and diminish completely in high financial risk conditions.