Modeling usage of medical care services: the medical expenditure panel survey data, 1996-2000

We explore the determinants of usage of six different types of health care services, using the Medical Expenditure Panel Survey data, years 1996-2000. We apply a number of models for univariate count data, including semiparametric, semi-nonparametric and finite mixture models. We find that the complexity of the model that is required to fit the data well depends upon the way in which the data is pooled across sexes and over time, and upon the characteristics of the usage measure. Pooling across time and sexes is almost always favored, but when more heterogeneous data is pooled it is often the case that a more complex statistical model is required.

Sequencing lifeline repairs after an earthquake: an economic approach

Recoveries after recent earthquakes in the U.S. and Japan have shown that large welfare gains can be achieved by reshaping current emergency plans as incentive-compatible contracts. We apply tools from the mechanisms design literature to show ways to integrate economic incentives into the management of natural disasters and discuss issues related to the application to seismic event recovery. The focus is on restoring lifeline services such as the water, gas, transportation, and electric power networks. We put forward decisional procedures that an uninformed planner could employ to set repair priorities and help to coordinate lifeline firms in the post-earthquake reconstruction.

The effect of structural fund spending on the spanish regions: an assessment of the 1994-99 objective 1 CSF

This paper analyzes the growth and employment effects of the 1994-99 Community Support Framework (CSF) for the Objective 1 Spanish regions using a simple supply-side model estimated with a panel of regional data. The results suggest that the impact of the Structural Funds in Spain has been quite sizable, adding around a percentage point to annual output growth in the average Objective 1 region and 0.4 points to employment growth. Over the period 1994-2000, the Framework has resulted in the creation of over 300,000 new jobs and has eliminated 20% of the initial gap in income per capita between the assisted regions and the rest of the country.

The possibility for continuous growth with exhaustible resources: unknowingly an agreement has been reached, but it may not be correct

It is the size of the elasticity of substitution that has been the central issue in the long debate over the possibility of continuous growth in the presence of exhaustible resources. This paper reviews the debate and comes to the surprising conclusion that , unnoticed by the pessimists, the optimist position has gradually evolved so that it now approximates that of the pessimists. The paper also summarises some preliminary work by the author that indicates that this common position may not be correct

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.

Reference prices: the spanish way

The aim of this paper is to analyse the effects of recent regulatory reforms that Spanish Health Authorities have implemented in the pharmaceutical market: the introduction of a reference price system together with the promotion of generic drugs. The main objectives of these two reforms are to increase price competition and, ultimately, reduce pharmaceutical costs. Before the introduction of reference prices, consumers had to pay a fixed copayment of the price of whatever drug purchased. With the introduction of such system, the situation differs in the following way: if (s)he buys the more expensive branded drug, then (s)he pays a sum of two elements: the copayment associated to the reference price plus the difference between the price of this good and the reference price. However, if the consumer decides to buy the generic alternative, with price lower than the reference price, then (s)he has to pay the same copayment as before. We show that the introduction of a reference price system together with the promotion of generic drugs increase price competition and lower pharmaceutical costs only if the reference price is set in a certain interval. Also profits for the duopolists might be reduced. These results are due to the opposing effects that reference prices have on branded and generic producers respectively.

Redistribution and subsidies for higher education

The financing of higher education through public spending imposes a transfer of resources from taxpayers to university students and their parents. We provide an explanation for this phenomenon. Those who attend higher education will earn more income in the future and will pay more taxes. People whose children do not attend higher education, however should agree to help pay the cost of such education, providing that the taxes are sufficiently high to ensure that there will be an adequate redistribution in favor of their own children at some time in the future.

Endogeneizing know-how flows through the nature of R&D investments

In this paper we carefully link knowledge flows to and from a firms innovation process with this firms investment decisions. Three types of investments are considered: investments in applied research, investments in basic research, and investments in intellectual property protection. Only when basic research is performed, can the firm effectively access incoming knowledge flows and these incoming spillovers serve to increase the efficiency of own applied research.. The firm can at the same time influence outgoing knowledge flows, improving appropriability of its innovations, by investing in protection. Our results indicate that firms with small budgets for innovation will not invest in basic research. This occurs in the short run, when the budget for know-how creation is restricted, or in the long-run, when market opportunities are low, when legal protection is not very important, or, when the pool of accessible and relevant external know-how is limited. The ratio! of basic to applied research is non-decreasing in the size of the pool of accessible external know-how, the size and opportunity of the market, and, the effectiveness of intellectual property rights protection. This indicates the existence of economies of scale in basic research due to external market related factors. Empirical evidence from a sample of innovative manufacturing firms in Belgium confirms the economies of scale in basic research as a consequence of the firms capacity to access external knowledge flows and to protect intellectual property, as well as the complementarity between legal and strategic investments.

Not all university degrees yield the same return: private and social returns to higher education for males in Spain

In this paper we use micro data from the Spanish Family Expenditure Survey for 1990 to estimate, for the first time, the private and social rates of return of different university degrees in Spain. We compute internal rates of return and include investment on higher education financed by the public purse to estimate social rates of return. Our main finding is that, as presumed, there is large heterogeneity in rates of return amongst different university

The demand elasticity on tolled motorways

This paper analyses the elasticities of demand in tolled motorways in Spain with respect to the main variables influencing it. The demand equation is estimated using a panel data set where the cross-section observations correspond to the different Spanish tolled motorways sections, and the temporal dimension ranges from the beginning of the eighties until the end of the nineties. The results show a high elasticity with respect to the economic activity level. The average elasticity with respect to petrol price falls around -0.3, while toll elasticities clearly vary across motorway sections. These motorway sections are classified into four groups according to the estimated toll elasticity with values that range from -0.21 for the most inelastic to -0.83 for the most elastic. The main factors that explain such differences are the quality of the alternative road and the length of the section. The long-term effect is about 50 per cent higher than the short term one; however, the period of adjustment is relatively short.

Revisión crítica de las limitaciones y sesgos del análisis económico convencional de las políticas de cambio climático. Hacia un análisis coherente con el desarrollo sostenible

En el presente trabajo se ponen de manifiesto los numerosos problemas del análisis económico convencional en la evaluación de las políticas de mitigación del cambio climático causado antropogénicamente. Tras señalar las principales características del fenómeno, se destacan las muchas limitaciones, arbitrariedades y omisiones que han caracterizado a la mayoría de modelos aplicados hasta el momento. Éstas actúan de forma casi abrumadora sesgando el resultado hacia la recomendación de una menor agresividad en las políticas de mitigación. En consecuencia, se cuestiona que los resultados obtenidos por los modelos convencionales de evaluación den una respuesta adecuada al problema. A continuación, se señalan algunos de los puntos que deberían tenerse en cuenta para realizar un análisis de las políticas de mitigación coherente con el desarrollo sostenible. Finalmente, se recogen las principales conclusiones del trabajo.