Effectiveness of the development of internal auditing in the Victorian Public Service (1982-1987)

The selection of an inappropriate regime by policy makers can thwart the effective implementation of public policy and lead to implementation failure. Competing values in the implementation process have a significant impact on the results of implementation, and the regime selected for implementation implies the choice of one value over another. Stoker has argued that on the one hand central leadership is valued for consistency, benefits of scale, co-ordination and cost sharing (instrumental model); and on the other, diffuse authority is valued as knowledge is particular and situational, and the task of analysis is to understand the problems, perspectives and interactions of implementation participants at the contact point between public programs and their clients (accommodation model). This study examines the implementation regime chosen by the Victorian Government for the introduction of a modern internal auditing function into the Victorian Public Service, using the Bureau of Internal Audit within its Department of Management and Budget. The selection of the Department of Management and Budget for the introduction of Internal Audit as a managerial accountability mechanism indicates that the instrumental model was held by the Victorian Government to be the most important in implementation. It is argued that use of a top-down central agency leadership approach resulted in implementation failure. Three propositions suggesting the mechanisms by which this result is brought about are examined: that lack of co-ordinated planning at the outset will result in inadequate definition of client needs as part of policy formulation; that intraorganisational conflict during the implementation success, as individual participants are likely to exercise their veto; and the increasing the number of participants contributes to complexity, so that they should only be involved in implementation when their presence is absolutely required. It is argued that the essential task of implementation is to create an environment where participants are likely to co-operate to achieve predetermined public policy goals; and that the introduction of a modern internal auditing approach into the Victorian Public Service required a more participatory implementation regime in order to facilitate policy outcomes and prevent implementation failure. It is also argued that the dominance of economic reform over accountability in Victoria restricted the ability of the Bureau of Internal Audit to implement change to internal audit practices within Victorian Government departments. The selection of an instrumental model of implementation by the Department of Management and Budget is examined in the context of the environment that existed in Victoria between 1982-1987; and while some of the values which Stoker associates with the top-down approach to policy making were observed, an alternative view to the development of internal auditing in the Victorian Public Service can be sustained.

The determinants of physician and pharmacist utilization and equity of access under Korean universal health insurance

This study examines the social and behavioral determinants of two types of primary care, seeing a physician or a pharmacist, for Koreans and evaluates the equity of the Korean national health insurance system. The study applies the Aday and Andersen access framework to cross-sectional data from the 1992 Korean National Health Interview Survey (N = 21,841).^ The study found that in Korea, the elderly were most likely, and children least likely, to have used physician services. Women, household heads, those in small families, and the less educated were more likely than their counterparts to use physician and pharmacist services. Health status and need were important determinants of Koreans seeing a doctor or a pharmacist. Differences in need substantially accounted for the original differences observed between subgroups. Resources associated with having insurance coverage, a regular source of care, and place of residence (rural/urban) ameliorated to some extent the subgroup differences in the use of physicians' and pharmacists' services among Koreans. They were also major independent predictors of access. Having insurance remains a particularly important predictor of who uses physician services. Among the insured, trade-offs in the use of physician and pharmacist services were found in the current system, i.e., uninsured and poor Koreans were more likely to use pharmacist services, while insured and rural Koreans were more likely to use doctor services. Among the insured, cost sharing rates are lower for physician than for pharmacist services. Self-employed persons were less likely than government and industrial workers to use physician services. An underlying expectation under universal health insurance was that the Korean health care system would be equitable. The research results, however, did not fully support this expectation.^ The policy implications of these findings are that measures are required to extend insurance coverage to the uninsured, to equalize differences in benefit packages between health plans, and to expand the availability of physicians in rural areas. Further research is also needed to understand those who do not currently have a regular source of care and why and the access barriers that may exist for selected demographic subgroups (those in large families and unmarried or divorced/widowed persons). ^

Risk adjustment in aging societies

Background In Switzerland, age is the predominant driver of solidarity transfers in risk adjustment (RA). Concerns have been voiced regarding growing imbalances in cost sharing between young and old insured due to demographic changes (larger fraction of elderly >65 years and rise in average age). Particularly young adults aged 19–25 with limited incomes have to shoulder increasing solidarity burdens. Between 1996 and 2011, monthly intergenerational solidarity payments for young adults have doubled from CHF 87 to CHF 182, which corresponds to the highest absolute transfer increase of all age groups. Results By constructing models for age-specific RA growth and for calculating the lifetime sum of RA transfers we investigated the causes and consequences of demographic changes on RA payments. The models suggest that the main driver for RA increases in the past was below average health care expenditure (HCE) growth in young adults, which was only half as high (average 2% per year) compared with older adults (average 4% per year). Shifts in age group distributions were only accountable for 2% of the CHF 95 rise in RA payments. Despite rising risk adjustment debts for young insured the balance of lifetime transfers remains positive as long as HCE growth rates are greater than the discount rate used in this model (3%). Moreover, the life-cycle model predicts that the lifetime rate of return on RA payments may even be further increased by demographic changes. Nevertheless, continued growth of RA contributions may overwhelm vulnerable age groups such as young adults. We therefore propose methods to limit the burden of social health insurance for specific age groups (e.g. young adults in Switzerland) by capping solidarity payments. Conclusions Taken together, our mathematical modelling framework helps to gain a better understanding of how demographic changes interact with risk adjustment and how redistribution of funds between age groups can be controlled without inducing further selection incentives. Those methods can help to construct more equitable systems of health financing in light of population aging.

Case Study of Applied LIP Approach/Activities in the Philippines The Training Services Enhancement Project for Rural Life Improvement (TSEP-RLI) Experience

TSEP-RLI was a technical cooperation project jointly conducted by GOP thru DA-Agricultural Training Institute (ATI) and GOJ thru JICA aimed at institutionalizing the training program for Rural Life Improvement (RLI) at the (ATI). As expected, farmers, fisherfolk, women, youth and extension agents were provided with efficient and effective training services from ATI leading to the improvement of quality of life in the rural areas through efforts of human resource development. The ATI- Bohol was chosen as the model center where participatory trials and various activities of the project were undertaken for five years. These activities were participatory surveys and data collection of on-farm and off-farm productive activities; planning workshop for RLI; feedbacking of survey results and action plans to the community and the Local Government Units (LGUs), and signing of Memorandum of Agreement between the Project and participating LGUs. The above activities were done to facilitate the planning and development of most effective and necessary rural life improvement activities, to confirm the willingness of the people to support and participate and to formalize the partnership between the Project and the LGUs. Since the concept of rural life covers a vast range of activities, a consensus had been reached that the total aspects of rural life be grasped in three spheres, namely, Production & Livelihood (P/L), Rural Living Condition (RLC) and Community Environment (C/E). The RLI for Ubi (Yam) Growers was one of the pilot activities undertaken in two pilot barangays and the target beneficiaries were members of the Rural Improvement Club (RIC- a group of organized women) with the LGU of the Municipality of Corella as the implementing partner. During the planning workshop, the barangay residents articulated their desire to promote production and processing of ubi (sphere on P/L - as the entry point), lack of nutritious food was one of the identified problem (sphere on RLC- expansion point) and environmental degradation such as deforestation, and soil erosion was another problem articulated by the community people (sphere on C/E- expansion point). Major activities that were undertaken namely, Ubi cooking contest, cooking/processing seminar, training courses on entrepreneurial development, ubi production and storage technology, packaging and product design, human resource development and simplified bookkeeping motivated the beneficiaries as well as developed and enhanced their skills & capabilities while strengthening their associations. Their participation to the 5 ubi festivals and other related activities had brought some impacts on their economic and rural life improvement activities. The seven principles of TSEP-RLI include the participatory process, holistic approach, dialogical approach, bottom -up training needs assessment, demand-driven approach, cost sharing approach and collaborative implementation with other agencies including LGUs and the community.

Primary Raw Materials (1986-89) Volume 1 (Summary Reports of the R&D Programme). EUR 13647/I EN, 1992

"This document contains the Summary Reports of cost sharing Research and Development contracts funded under the "Primary Raw Materials" subprogramme of the Commission of the European Communities. This programme was part of the research and development programme on "Raw Materials and Advanced Materials" (1986 - 1989). The main objectives of the "Primary Raw Materials" subprogramme were to enhance the competitiveness of the European Community mining and metallurgical Industries and to reduce European Community vulnerability for minerals, particularly those of critical or strategic interest." Three research areas: Research and development exploration; Mining technology; Mineral processing.

Simulating the value of collaboration in multi-actor conservation planning

The loss of habitat and biodiversity worldwide has led to considerable resources being spent for conservation purposes on actions such as the acquisition and management of land, the rehabilitation of degraded habitats, and the purchase of easements from private landowners. Prioritising these actions is challenging due to the complexity of the problem and because there can be multiple actors undertaking conservation actions, often with divergent or partially overlapping objectives. We use a modelling framework to explore this issue with a study involving two agents sequentially purchasing land for conservation. We apply our model to simulated data using distributions taken from real data to simulate the cost of patches and the rarity and co-occurence of species. In our model each agent attempted to implement a conservation network that met its target for the minimum cost using the conservation planning software Marxan. We examine three scenarios where the conservation targets of the agents differ. The first scenario (called NGO-NGO) models the situation where two NGOs are both are targeting different sets of threatened species. The second and third scenarios (called NGO-Gov and Gov-NGO, respectively) represent a case where a government agency attempts to implement a complementary conservation network representing all species, while an NGO is focused on achieving additional protection for the most endangered species. For each of these scenarios we examined three types of interactions between agents: i) acting in isolation where the agents are attempting to achieve their targets solely though their own actions ii) sharing information where each agent is aware of the species representation achieved within the other agent’s conservation network and, iii) pooling resources where agents combine their resources and undertake conservation actions as a single entity. The latter two interactions represent different types of collaborations and in each scenario we determine the cost savings from sharing information or pooling resources. In each case we examined the utility of these interactions from the viewpoint of the combined conservation network resulting from both agents' actions, as well as from each agent’s individual perspective. The costs for each agent to achieve their objectives varied depending on the order in which the agents acted, the type of interaction between agents, and the specific goals of each agent. There were significant cost savings from increased collaboration via sharing information in the NGO-NGO scenario were the agent’s representation goals were mutually exclusive (in terms of specie targeted). In the NGO-Gov and Gov-NGO scenarios, collaboration generated much smaller savings. If the two agents collaborate by pooling resources there are multiple ways the total cost could be shared between both agents. For each scenario we investigate the costs and benefits for all possible cost sharing proportions. We find that there are a range of cost sharing proportions where both agents can benefit in the NGO-NGO scenarios while the NGO-Gov and Gov-NGO scenarios again showed little benefit. Although the model presented here has a range of simplifying assumptions, it demonstrates that the value of collaboration can vary significantly in different situations. In most cases, collaborating would have associated costs and these costs need to be weighed against the potential benefits from collaboration. The model demonstrates a method for determining the range of collaboration costs that would result in collaboration providing an efficient use of scarce conservation resources.

Reducing dependence on big brother:Higher Education looks for innovative funding opportunities

This paper presents innovative programs that business schools can utilize to reduce dependence on public funds. A review of the literature shows the theoretical and empirical foundation of higher education funding dilemmas. While higher education is moving towards a global ambition, scarcity hinders governments to fully support programs long-term; thus, cost-sharing and cost-shifting measures must occur for higher education to support current programs. In this study, we examine two universities (one U.S. and one U.K.) and provide practical summaries of programs that have provided additional funds. We show that diversity of funding sources is essential for survival of higher education institutions. Market forces require competition to reduce higher education operational costs while providing students and corporate clients an a la carte educational experience.

Public and private hospital services reform:an investigation in Iranian hospitals

This research aimed to present a model of efficiency for selected public and private hospitals of East Azerbaijani province of Iran by making use of DEA approach in order to recognize and suggest the best practice standards. In other words, its aim was to suggest a suitable context to develop efficient hospital systems while maintaining the quality of care at minimum expenditures. It is recommended for inefficient hospitals to make use of the followings: transferring, selling, or renting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals or other health centers; pensioning off, early retirement clinic officers, technicians/technologists, and other technical staff. The saving obtained from the above approaches could be used to improve remuneration for remaining staff and quality of health care services of hospitals, rural and urban health centers, support communities to start or sustain systematic risk and resource pooling and cost sharing mechanisms for protecting beneficiaries against unexpected health care costs, compensate the capital depreciation, increasing investments, and improve diseases prevention services and facilities in the provincial and national levels.

The Shapley value for airport and irrigation games

In this paper cost sharing problems are considered. We focus on problems given by rooted trees, we call these problems cost-tree problems, and on the induced transferable utility cooperative games, called irrigation games. A formal notion of irrigation games is introduced, and the characterization of the class of these games is provided. The well-known class of airport games Littlechild and Thompson (1977) is a subclass of irrigation games. The Shapley value Shapley (1953) is probably the most popular solution concept for transferable utility cooperative games. Dubey (1982) and Moulin and Shenker (1992) show respectively, that Shapley's Shapley (1953) and Young (1985)'s axiomatizations of the Shapley value are valid on the class of airport games. In this paper we show that Dubey (1982)'s and Moulin and Shenker (1992)'s results can be proved by applying Shapley (1953)'s and Young (1985)'s proofs, that is those results are direct consequences of Shapley (1953)'s and Young (1985)'s results. Furthermore, we extend Dubey (1982)'s and Moulin and Shenker (1992)'s results to the class of irrigation games, that is we provide two characterizations of the Shapley value for cost sharing problems given by rooted trees. We also note that for irrigation games the Shapley value is always stable, that is it is always in the core Gillies (1959).

The Affordable Care Act and the Transformation of US Health Care

The neoliberal period was accompanied by a momentous transformation within the US health care system.  As the result of a number of political and historical dynamics, the healthcare law signed by President Barack Obama in 2010 ‑the Affordable Care Act (ACA)‑ drew less on universal models from abroad than it did on earlier conservative healthcare reform proposals. This was in part the result of the influence of powerful corporate healthcare interests. While the ACA expands healthcare coverage, it does so incompletely and unevenly, with persistent uninsurance and disparities in access based on insurance status. Additionally, the law accommodates an overall shift towards a consumerist model of care characterized by high cost sharing at time of use. Finally, the law encourages the further consolidation of the healthcare sector, for instance into units named “Accountable Care Organizations” that closely resemble the health maintenance organizations favored by managed care advocates. The overall effect has been to maintain a fragmented system that is neither equitable nor efficient. A single payer universal system would, in contrast, help transform healthcare into a social right.

Agriculture, Environmental Incentive Payments, and Water Quality in the Chesapeake Bay

Nonpoint sources (NPS) pollution from agriculture is the leading source of water quality impairment in U.S. rivers and streams, and a major contributor to lakes, wetlands, estuaries and coastal waters (U.S. EPA 2016). Using data from a survey of farmers in Maryland, this dissertation examines the effects of a cost sharing policy designed to encourage adoption of conservation practices that reduce NPS pollution in the Chesapeake Bay watershed. This watershed is the site of the largest Total Maximum Daily Load (TMDL) implemented to date, making it an important setting in the U.S. for water quality policy. I study two main questions related to the reduction of NPS pollution from agriculture. First, I examine the issue of additionality of cost sharing payments by estimating the direct effect of cover crop cost sharing on the acres of cover crops, and the indirect effect of cover crop cost sharing on the acres of two other practices: conservation tillage and contour/strip cropping. A two-stage simultaneous equation approach is used to correct for voluntary self-selection into cost sharing programs and account for substitution effects among conservation practices. Quasi-random Halton sequences are employed to solve the system of equations for conservation practice acreage and to minimize the computational burden involved. By considering patterns of agronomic complementarity or substitution among conservation practices (Blum et al., 1997; USDA SARE, 2012), this analysis estimates water quality impacts of the crowding-in or crowding-out of private investment in conservation due to public incentive payments. Second, I connect the econometric behavioral results with model parameters from the EPA’s Chesapeake Bay Program to conduct a policy simulation on water quality effects. I expand the econometric model to also consider the potential loss of vegetative cover due to cropland incentive payments, or slippage (Lichtenberg and Smith-Ramirez, 2011). Econometric results are linked with the Chesapeake Bay Program watershed model to estimate the change in abatement levels and costs for nitrogen, phosphorus and sediment under various behavioral scenarios. Finally, I use inverse sampling weights to derive statewide abatement quantities and costs for each of these pollutants, comparing these with TMDL targets for agriculture in Maryland.

La prise en compte de l’adaptation au changement climatique dans les politiques publiques de verdissement (2005-2015) : le cas de Montréal

Les connaissances scientifiques sur le changement climatique (CC) évoluent rapidement. Toutefois, des incertitudes persistent sur l’étendue de ses conséquences, particulièrement dans les milieux urbains, qui subiront des impacts différents de ceux vécus par les milieux ruraux. Les autorités publiques ont récemment commencé à élaborer des politiques publiques d’adaptation au changement climatique (ACC) qui visent à en limiter les conséquences indésirables. En milieu urbain, la littérature suggère qu’un des outils que devraient privilégier ces politiques est le verdissement. Des auteurs signalent que les actions visant l’ACC peuvent se greffer dans des politiques existantes. L’ACC, comme enjeu public, peut donc être réalisée par l’entremise de sa prise en compte dans les politiques publiques de verdissement. Cette prise en compte devrait affecter le contenu (quoi?) et le pilotage (comment?) des différentes étapes des politiques. Le cas de la politique publique de verdissement de la Ville de Montréal, au Québec, nous a permis d’étudier cette prise en compte. En utilisant un cadre d’analyse des politiques publiques développé par Knoepfel et al. (2015), qui porte entre autres sur la mobilisation des ressources par différents acteurs concernés par ces politiques, nous montrons que cette dernière s’est opérée de quelques façons. Premièrement, il y a eu un changement dans l’argumentaire pour le verdissement, outil qui vise à lutter contre les îlots de chaleur urbains et assurer une meilleure gestion des eaux pluviales. Ensuite, le choix de l’échelle d’agglomération pour la prise en compte de l’ACC a entraîné un changement d’échelle dans la gestion du verdissement. La publication d’un plan d’action majeur de verdissement urbain pour l’agglomération, et dont le leitmotiv est l’ACC, le démontre. Quelques modifications réglementaires et l’inclusion de nouveaux acteurs dans la politique témoignent aussi que la prise en compte a eu lieu. Finalement, le plan d’action fournit un cadre pour la mise en œuvre du verdissement dans les zones les plus vulnérables au CC en plus d’une structure de partage des coûts. Cependant, la mise en oeuvre du verdissement dans une visée d’ACC n'a pas été évaluée dans la présente étude. Nous avons aussi noté que la biodiversité est un enjeu d’importance qui va de pair avec l’ACC dans la politique de verdissement. Il y a donc une prise en compte, partielle, de l’ACC dans la politique publique de verdissement à Montréal (avec certains écueils). Nous arguons que l’enjeu de l’ACC sert peut-être d’argument supplémentaire pour verdir la ville plutôt que d’être un véritable moteur de transformation de la politique de verdissement.

La prise en compte de l’adaptation au changement climatique dans les politiques publiques de verdissement (2005-2015) : le cas de Montréal

Les connaissances scientifiques sur le changement climatique (CC) évoluent rapidement. Toutefois, des incertitudes persistent sur l’étendue de ses conséquences, particulièrement dans les milieux urbains, qui subiront des impacts différents de ceux vécus par les milieux ruraux. Les autorités publiques ont récemment commencé à élaborer des politiques publiques d’adaptation au changement climatique (ACC) qui visent à en limiter les conséquences indésirables. En milieu urbain, la littérature suggère qu’un des outils que devraient privilégier ces politiques est le verdissement. Des auteurs signalent que les actions visant l’ACC peuvent se greffer dans des politiques existantes. L’ACC, comme enjeu public, peut donc être réalisée par l’entremise de sa prise en compte dans les politiques publiques de verdissement. Cette prise en compte devrait affecter le contenu (quoi?) et le pilotage (comment?) des différentes étapes des politiques. Le cas de la politique publique de verdissement de la Ville de Montréal, au Québec, nous a permis d’étudier cette prise en compte. En utilisant un cadre d’analyse des politiques publiques développé par Knoepfel et al. (2015), qui porte entre autres sur la mobilisation des ressources par différents acteurs concernés par ces politiques, nous montrons que cette dernière s’est opérée de quelques façons. Premièrement, il y a eu un changement dans l’argumentaire pour le verdissement, outil qui vise à lutter contre les îlots de chaleur urbains et assurer une meilleure gestion des eaux pluviales. Ensuite, le choix de l’échelle d’agglomération pour la prise en compte de l’ACC a entraîné un changement d’échelle dans la gestion du verdissement. La publication d’un plan d’action majeur de verdissement urbain pour l’agglomération, et dont le leitmotiv est l’ACC, le démontre. Quelques modifications réglementaires et l’inclusion de nouveaux acteurs dans la politique témoignent aussi que la prise en compte a eu lieu. Finalement, le plan d’action fournit un cadre pour la mise en œuvre du verdissement dans les zones les plus vulnérables au CC en plus d’une structure de partage des coûts. Cependant, la mise en oeuvre du verdissement dans une visée d’ACC n'a pas été évaluée dans la présente étude. Nous avons aussi noté que la biodiversité est un enjeu d’importance qui va de pair avec l’ACC dans la politique de verdissement. Il y a donc une prise en compte, partielle, de l’ACC dans la politique publique de verdissement à Montréal (avec certains écueils). Nous arguons que l’enjeu de l’ACC sert peut-être d’argument supplémentaire pour verdir la ville plutôt que d’être un véritable moteur de transformation de la politique de verdissement.

Information sharing with key suppliers : a transaction cost theory perspective

Purpose: The purpose of this paper is to explain variations in discretionary information shared between buyers and key suppliers. The paper also aims to examine how the extent of information shared affects buyers’ performance in terms of resource usage, output, and flexibility. ----- ----- Design/methodology/approach: The data for the paper comprise 221 Finnish and Swedish non-service companies obtained through a mail survey. The hypothesized relationships were tested using partial least squares modelling with reflective and formative constructs.----- ----- Findings: The results of the study suggest that (environmental and demand) uncertainty and interdependency can to some degree explain the extent of information shared between a buyer and key supplier. Furthermore, information sharing improves buyers’ performance with respect to resource usage, output, and flexibility.----- ----- Research limitations/implications: A limitation to the paper relates to the data, which only included buyers.Abetter approach would have been to collect data from both, buyers and key suppliers. Practical implications – Companies face a wide range of supply chain solutions that enable and encourage collaboration across organizations. This paper suggests a more selective and balanced approach toward adopting the solutions offered as the benefits are contingent on a number of factors such as uncertainty. Also, the risks of information sharing are far too high for a one size fits all approach.----- ----- Originality/value: The paper illustrates the applicability of transaction cost theory to the contemporary era of e-commerce. With this finding, transaction cost economics can provide a valuable lens with which to view and interpret interorganizational information sharing, a topic that has received much attention in the recent years.

Sharing services, saving money? Five risks to cost saving when organizations share administrative services

Shared services are a popular reform for governments under financial pressure. The hope is to reduce overheads and increase efficiency by providing support services like HR, finance and procurement once to multiple agencies. Drawing on insights from organization theory and political science, we identify five risks that shared services won’t live up to current expectations. We illustrate each with empirical evidence from the UK, Ireland and further afield, and conclude with suggestions on how to manage these risks.