Allocation rules on networks

When allocating a resource, geographical and infrastructural constraints have to be taken into account. We study the problem of distributing a resource through a network from sources endowed with the resource to citizens with claims. A link between a source and an agent depicts the possibility of a transfer from the source to the agent. Given the supplies at each source, the claims of citizens, and the network, the question is how to allocate the available resources among the citizens. We consider a simple allocation problem that is free of network constraints, where the total amount can be freely distributed. The simple allocation problem is a claims problem where the total amount of claims is greater than what is available. We focus on consistent and resource monotonic rules in claims problems that satisfy equal treatment of equals. We call these rules fairness principles and we extend fairness principles to allocation rules on networks. We require that for each pair of citizens in the network, the extension is robust with respect to the fairness principle. We call this condition pairwise robustness with respect to the fairness principle. We provide an algorithm and show that each fairness principle has a unique extension which is pairwise robust with respect to the fairness principle. We give applications of the algorithm for three fairness principles: egalitarianism, proportionality and equal sacrifice.

Small-area variation in health care affecting the choice of cesarean delivery: the case of a Colombian health insurer

In the midst of health care reform, Colombia has succeeded in increasing health insurance coverage and the quality of health care. In spite of this, efficiency continues to be a matter of concern, and small-area variations in health care are one of the plausible causes of such inefficiencies. In order to understand this issue, we use individual data of all births from a Contributory-Regimen insurer in Colombia. We perform two different specifications of a multilevel logistic regression model. Our results reveal that hospitals account for 20% of variation on the probability of performing cesarean sections. Geographic area only explains 1/3 of the variance attributable to the hospital. Furthermore, some variables from both demand and supply sides are found to be also relevant on the probability of undergoing cesarean sections. This paper contributes to previous research by using a hierarchical model and by defining hospitals as cluster. Moreover, we also include clinical and supply induced demand variables.

The design of optimal education policies when individuals differ in inherited wealth and ability

In this paper I consider the role of education poli-cies in redistribution of income when individuals differ in two aspects: ability and inherited wealth. I discuss the extent to which the rules that emerge in unidimensional settings apply also in the bidimen-sional setting considered in this paper. The main conclusion is that, subject to some qualifi cations, the same type of rules that determine optimal education policies when only ability heterogeneity is considered apply to the case where both parameters of heterogeneity are considered. The qualifi cations pertain to the implementation of the optimal alloca-tion of resources to education and not the way the optimal allocations fi rst- and second-best differ.

Access, equity and the role of rights in health care

Modern health care rhetoric promotes choice and individual patient rights as dominant values. Yet we also accept that in any regime constrained by finite resources, difficult choices between patients are inevitable. How can we balance rights to liberty, on the one hand, with equity in the allocation of scarce resources on the other? For example, the duty of health authorities to allocate resources is a duty owed to the community as a whole, rather than to specific individuals. Macro-duties of this nature are founded on the notion of equity and fairness amongst individuals rather than personal liberty. They presume that if hard choices have to be made, they will be resolved according to fair and consistent principles which treat equal cases equally, and unequal cases unequally. In this paper, we argue for greater clarity and candour in the health care rights debate. With this in mind, we discuss (1) private and public rights, (2) negative and positive rights, (3) procedural and substantive rights, (4) sustainable health care rights and (5) the New Zealand booking system for prioritising access to elective services. This system aims to consider: individual need and ability to benefit alongside the resources made available to elective health services in an attempt to give the principles of equity practical effect. We describe a continuum on which the merits of those, sometimes competing, values-liberty and equity-can be evaluated and assessed.

Whose land was it anyway? The Crichel Down Rules and the sale of public land

The guiding principle of compulsory purchase of interests in land in England and Wales is that of fairness, best stated in the words of Lord Justice Scott in Horn v Sunderland Corporation when he said that the owner has “the right to be put, so far as money can do it, in the same position as if his land had not been taken from him”. In many instances, land acquired by compulsion subsequently becomes surplus to the requirements of the acquiring authority. This may be because the intended development scheme was scrapped, or substantially modified, or that after the passage of time the use of the land for which the purchase took place is no longer required. More controversially it may be that for ‘operational reasons’ the acquiring authority knowingly purchased more land than was required for the scheme. Under these circumstances, the Crichel Down Rules (‘the Rules’) require government departments and other statutory bodies to offer back to the former owners or their successors, any land previously so acquired by, or under the threat of, compulsory purchase.

Land administration in a micro-state: the role of land use planning

Land policy in micro-states and the land administration that underpins it is often devised within a legacy framework inherited from a colonial past. Independence has allowed self-determination of the future political direction yet the range, legal framework, institutional structure and administration systems tend to mirror those of ex-colonial powers. Do land policies, administration systems and processes developed to serve large heavily populated countries scale down to serve the requirements of micro-states? The evidence suggests not: many land administration systems in the Caribbean face difficulties due to poor records, unclear title, exploitation of state lands, incomplete or ongoing land reform programmes, irregular or illegal settlement and non-enforced planning regulations. Land matters are typically the responsibility of several government departments and agencies responsible for land titling and registration, cadastral surveying of property interests, physical planning, taxation and financial regulation. Although planning is regarded as a land administration function, organisational responsibility usually rests with local rather than central government in large countries, but in microstates local government may be politically weak, under-resourced or even non-existent. Using a case study approach this paper explores how planning functions are organised in the Caribbean state of St Vincent & the Grenadines in relation to land administration as a whole and compares the arrangement with other independent micro-states in the region.

On fairness and claims

Perhaps the best known theory of fairness is John Broome’s: that fairness is the proportional satisfaction of claims. In this paper, I question whether claims are the appropriate focus for a theory of fairness, at least as Broome understands them in his current theory. If fairness is the proportionate satisfaction of claims, I argue, then the following would be true: fairness could not help determine the correct distribution of claims; fairness could not be used to evaluate the distribution of claims; fairness could not guide us in distributing claims (or unowed goods); we could not have a claim to be treated fairly; and we would not be wronged when treated unfairly. These entailments mean that it is questionable that fairness is concerned with claims in the way Broome suggests. At the very least, the relationship between fairness and claims appears to be more complex than the picture painted by Broome.

Exploring unanticipated consequences of strategy amongst stakeholder segments: the case of a European Revenue Service

This article applies FIMIX-PLS segmentation methodology to detect and explore unanticipated reactions to organisational strategy among stakeholder segments. For many large organisations today, the tendency to apply a “one-size-fits-all” strategy to members of a stakeholder population, commonly driven by a desire for simplicity, efficiency and fairness, may actually result in unanticipated consequences amongst specific subgroups within the target population. This study argues that it is critical for organisations to understand the varying and potentially harmful effects of strategic actions across differing, and previously unidentified, segments within a stakeholder population. The case of a European revenue service that currently focuses its strategic actions on building trust and compliant behaviour amongst taxpayers is used as the context for this study. FIMIX-PLS analysis is applied to a sample of 501 individual taxpayers, while a novel PLS-based approach for assessing measurement model invariance that can be applied to both reflective and formative measures is also introduced for the purpose of multi-group comparisons. The findings suggest that individual taxpayers can be split into two equal-sized segments with highly differentiated characteristics and reactions to organisational strategy and communications. Compliant behaviour in the first segment (n = 223), labelled “relationships centred on trust,” is mainly driven through positive service experiences and judgements of competence, while judgements of benevolence lead to the unanticipated reaction of increasing distrust among this group. Conversely, compliant behaviour in the second segment (n = 278), labelled “relationships centred on distrust,” is driven by the reduction of fear and scepticism towards the revenue service, which is achieved through signalling benevolence, reduced enforcement and the lower incidence of negative stories. In this segment, the use of enforcement has the unanticipated and counterproductive effect of ultimately reducing compliant behaviour.

Overall and income specific effect on prevalence of overweight and obesity of 20% sugar sweetened drink tax in UK: econometric and comparative risk assessment modelling study

Objective To model the overall and income specific effect of a 20% tax on sugar sweetened drinks on the prevalence of overweight and obesity in the UK. Design Econometric and comparative risk assessment modelling study. Setting United Kingdom. Population Adults aged 16 and over. Intervention A 20% tax on sugar sweetened drinks. Main outcome measures The primary outcomes were the overall and income specific changes in the number and percentage of overweight (body mass index ≥25) and obese (≥30) adults in the UK following the implementation of the tax. Secondary outcomes were the effect by age group (16-29, 30-49, and ≥50 years) and by UK constituent country. The revenue generated from the tax and the income specific changes in weekly expenditure on drinks were also estimated. Results A 20% tax on sugar sweetened drinks was estimated to reduce the number of obese adults in the UK by 1.3% (95% credible interval 0.8% to 1.7%) or 180 000 (110 000 to 247 000) people and the number who are overweight by 0.9% (0.6% to 1.1%) or 285 000 (201 000 to 364 000) people. The predicted reductions in prevalence of obesity for income thirds 1 (lowest income), 2, and 3 (highest income) were 1.3% (0.3% to 2.0%), 0.9% (0.1% to 1.6%), and 2.1% (1.3% to 2.9%). The effect on obesity declined with age. Predicted annual revenue was £276m (£272m to £279m), with estimated increases in total expenditure on drinks for income thirds 1, 2, and 3 of 2.1% (1.4% to 3.0%), 1.7% (1.2% to 2.2%), and 0.8% (0.4% to 1.2%). Conclusions A 20% tax on sugar sweetened drinks would lead to a reduction in the prevalence of obesity in the UK of 1.3% (around 180 000 people). The greatest effects may occur in young people, with no significant differences between income groups. Both effects warrant further exploration. Taxation of sugar sweetened drinks is a promising population measure to target population obesity, particularly among younger adults.