Healthy markets - healthy people/ : reforming health care in Cambodia

Health care reform has been described as a global epidemic. This thesis deals with nature and experience of health care reform in developing countries. Increasing privatisation, economic transition, and structural adjustment have provided the context for health system changes. Different approaches to reform have been developed by international organisations such as the World Bank, WHO and UNICEF. What has driven national health care reforms? Are such policies really appropriate to developing countries? Has a consensus now emerged in relation to international health policy? Has a new health care ‘model’ appeared? The study of health care reform in Cambodia is a timely opportunity to investigate the implementation of health care reform under extreme conditions. These conditions include a legacy of genocide, long-term conflict, political isolation, and economic transition. This case study uses both qualitative and quantitative methods and multiple sources of data to analyse the reform program. The study reinforces the conclusion that, under conditions of extreme poverty, market based reforms are likely to have limited positive impact. Rather, understanding the cultural conditions that determine demand, delivering health care of a satisfactory quality, providing appropriate incentives for health practitioners, and supporting services with adequate public funding are the prerequisites for improved service delivery and utilisation. Cambodia's strategy of integrated district health service development and universal population coverage may provide an instructive example of reform. Emerging policy issues identified by this case study include the fundamental role of equity in service provision, the influence of the social determinants of health and illness and interest in the appropriate use of evidence in international health policy-making.

Corporate social responsibility : corporate reputation, business performance and public liability

Corporate Social Responsibility (CSR) may be viewed as a business strategy rather than a philanthropic concept. The increasing use of CSR as a corporate core strategy, in reaction to consumers‘ growing sentiments, can influence aggregate consumption and consumers‘ quality of life. As such, CSR would be of interest to the policy makers and may become subject to corporate governance and control mechanism. CSR is largely unregulated. Reliance on corporations‘ self-restraint and voluntary initiatives is inadequate to protect the society and avoid the disadvantages that may emerge from the potential deceptive practices in using a CSR strategy. This study investigates the evidence of economic benefits as incentives to corporations for using CSR. CSR is measured in terms of the firm‘s relationships with primary stakeholders. A model is constructed to identify the primary stakeholders and to estimate the association between CSR, corporate reputation and business performance. Policy implications of CSR are discussed.

Green roof retrofit potential in the central business district

Purpose – The purpose of this paper is to illustrate the potential for green roof retrofit to commercial buildings in a city centre to property managers and other property professionals.

Design/methodology/approach – This paper addresses the research question: what is the potential of existing buildings in the CBD to accommodate a retrofitted green roof? Furthermore, it questions how many buildings are suitable for green roofs? The researchers compile a unique building database incorporating information about 536 commercial buidings and evaluate the potential suitability of each building to undergo a green roof retrofit. Assisted by other commercially available databases and software, the researchers are able to assess each roof based on criteria derived from an extensive literature review.

Findings – A relatively small proportion of roofs are found to be suitable, partly a result of local climate conditions and rainfall patterns, and the physical property stock. On a purely physical assessment, only a very small proportion of CBD stock is found to be suited. These buildings are most likely to be in low secondary locations, ungraded or B grade buildings, privately owned, concrete framed and not overshadowed by adjoining properties.

Practical implications – Property managers and other property professionals can now determine the potential of their portfolio stock for green roof retrofit based on the review of building attributes required for success adaptation in this paper. It possible that greater potential for green roof retrofit exists in the suburbs or regional towns where lower rise buildings may reduce the amount of overshadowing found in city centres. Follow-up research could focus on a comparison of regional and suburban developments.

Originality/value – This is the first study of its kind and has assessed such a large number of buildings for their suitability for green roof retrofit; the findings provide a reliable guide for policymakers regarding the potential number of city centre buildings which would be possible to retrofit. Such findings should influence policymaking and incentives to target effective sustainability policies with regards to existing buildings.

An efficient privatization mechanism

We consider the privatization of State-Owned Enterprises (SOEs) of which markets can be opened to competition once privatization takes place and competitors can compete successfully against them in a few years. The currently used "Revenue Maximization (RM)" scheme maximizes the government revenue from privatization but does not provide incentives for the privatized SOE to charge a price lower than the monopoly price until competition arises. We propose the "Welfare Maximization (WMY scheme, which induces the privatized SOE to charge a competitive price without resorting to regulation. Also, WM provides greater incentives for post-privatization cost reduction.

Retrofitting for ventilation, infiltration and comfort

Legislation is demanding that our existing building stock be improved to a minimum of 4.0 Star AGBRS (Aust. Green Building Rating Scheme) energy standards. In the 'Green Building Fund' scheme for office buildings and other government incentives, retrofitting our existing building stock makes plain good sense. However, many of the stakeholders (owners, facilities managers, occupants) do not know where to begin to invest, for making these savings. This paperdemonstrates through two case studies, in government related  office buildihgs,how real energy savings were approached and obtained. It illustrates a process whereby preliminary and pretesting results lead to solutions of building ventilation, infiltration and comfort improvement. Furthermore, it discusses how post building performance testing results verified improvement as well as provided inputs to energy simulation, indicating where further invested improvements could be made.
One case study illustrates how the weatherisation of a building prevented a 1.5 million dollar retrofitting spending, costing the client less than one-tenth of the initial retrofitting cost. Another example demonstrates how over-engineering and incorrect ventilation concepts can cost the client up to 70% of their energy bill. Both papers involve real evidence-based pre and post measurement results in existing occupied buildings.

Grouper aquaculture in three Asian countries : farming and economic aspects

The study focussed on three key suppliers of fingerlings and live fish in Asia. Grouper hatchery businesses are lucrative even at low survival rates. The findings indicate that farming practices across these countries are similar. Most farmers adopt traditional practices and lack incentives to reduce cost, but remain proce focussed.

The quality and outcomes framework reduces disparities in health outcomes for cardiovascular disease

Jamie Robinson, the Berkeley health economist, famously remarked in 2001 that ‘the three worst ways to pay doctors are salary, capitation and fee-for-service.’ Different financial incentives produce different clinical and service outcomes, sometimes perversely.1 In 2004, the UK government introduced pay for performance (P4P) for general practitioners, the Quality and Outcomes Framework (QOF). Its introduction was associated with the general trend in the National Health Service away from placing implicit trust in doctors and more active monitoring of their performance. One-quarter of GP pay can be earned from achieving scores on 147 indicators.2 These indicators were acceptable to doctors because the majority are evidence-based clinical outcome measures for 10 chronic diseases. Others relate to patient access and satisfaction, and practice organisation.

Clean technology, willingness to pay and market size

This paper extends Salop’s model of localized competition by introducing the consumers’ willingness to pay (WTP) for clean products and allows an individual firm to choose between a clean or a dirty technology. We assume that a clean technology is relatively costly to adopt. The consumer is willing to pay more for a product produced with clean technology and the model can also be interpreted as a world economy model where each firm represents a country. There exists a critical value of m (proportion of firms adopting the clean technology), m*, such that if m < m* then no country adopts the clean technology, all countries adopt the clean technology only if m > m* while some countries will adopt the clean technology and some will not adopt the clean technology if m = m*. Our results also identify an example of coordination failure. Since symmetric technology adoption delivers the same level of profits as non-adoption, global coordination will be necessary to achieve the clean technology adoption outcome. Finally, we demonstrate that the
private and public (social planner) incentives to adopt clean technology differ.

Perceptions of representatives of public, private, and community sector institutions of the barriers and enablers for physically active transport

Active transport bridges many shared concerns in the public health and transport sectors. To positively affect opportunities for active transport, public health and transport professionals are engaging with other sectors, including urban planning, housing, recreation, retail, education, and employer groups. A first step in such inter-sectoral collaboration is to understand the perceptions of key players in all of these sectors. This paper describes the results of structured interviews with senior and middle-level administrators from public, private, and community groups in a rapidly developing region in Queensland, Australia, to assess the perceived barriers and enablers to active transport. Key themes emerged relating to infrastructure delivery, public transport services, walk- and cycle-friendly community attributes, political leadership and government coordination, and societal travel norms and culture. There were also themes relating to limits due to resources and limited relevant technical expertise, institutional and practitioner cultures, and agencies not identifying with their roles in active transport. Policies and cross-government initiatives were seen to hold promise, including economic incentives and built environment guidelines, campaigns targeting public attitudes and opinions, and community participation in policy-making. These elements are potential keys to positively promoting comprehensive active transport initiatives among gatekeepers and leaders across different sectors.

The transnational corporation and new corporate citizenship theory : a critical analysis

A recent conceptualisation of corporate citizenship by Matten and Crane (2005) shifts focus onto the corporation's role in providing individuals with the rights they are entitled to as citizens. This expanded corporate role is depicted as filling an institutional vacuum resulting from the withdrawal of the state. Marking an innovation to the corporate citizenship literature, we devise a three-part analytical framework from political institutionalism to question the concept's ideological and empirical groundings. Incorporating a constrained game theory perspective, we use an example of the provision of Western corporate services by low-labour-cost nation-states to argue that the concept as strategy would in some circumstances exacerbate the implications of globalisation on individual citizenship rights. The analytical framework has application for research directed toward proposals to extend the reach of corporations in traditional public services and, more generally, for studies of corporate responsibilities. Future research on corporate citizenship would be strengthened in recognising, as we do, institutional incentives, constraints, decision-making modes and resources as used by the transnational corporation.

Understanding the economic dynamics behind growth-inequality relationships

In this paper, a dynamic general equilibrium (DGE) model of growth–inequality relationships, with missing credit markets, knowledge spillover and self-employed agents, is calibrated to New Zealand data. The model explains how two distinct policy shocks involving redistribution and immigration imply, subsequently, two completely opposite outcomes. Agents’ inability to borrow aggravates a negative macroeconomic effect of heterogeneity on growth. Redistribution mitigates that effect but creates microeconomic disincentives on saving and work-effort. Consequently, immigration shocks that perturb variance of efficiency induce a negative growth–inequality relationship, while redistribution shocks, in New Zealand’s case, produce larger fluctuations in incentives than in macro benefits, implying a positive growth–inequality relationship.

Sui Generis protection for plant varieties and traditional knowledge in biodiversity and agriculture : the international framework and national approaches in the Philippines and India

The so-called ‘biotechnology clause’ of Article 27.3(b) of the WTO-TRIPS Agreement requires from member states protection for plant varieties either via the patent system or via an ‘effective sui generis system’ or by a combination of the two. Many developing countries prefer forms of sui generis protection, which allow them to include exceptions and protection measures for traditional agricultural practices and the traditional knowledge of farmers and local communities. However, ‘traditional knowledge’ remains a vaguely defined term. Its extension to biodiversity has brought a diffusion of the previously clearer link between protected subject matter, intellectual property and potential beneficiaries. The Philippine legislation attempts a ‘bottom-up’ approach focusing on the holistic perceptions of indigenous communities, whereas national economic interests thus far receive priority in India’s more centralist approach. Administrative decentralisation, recognition of customary rights, disclosure requirements, registers of landraces and geographical indications are discussed as additional measures, but their implementation is equally challenging. The article concludes that many of the concepts remain contested and that governments have to balance the new commercial incentives with the biodiversity considerations that led to their introduction, so that the system can be made sufficiently attractive for both knowledge holders and potential users of the knowledge.

The role of traditional knowledge and access to genetic resources in biodiversity conservation in Southeast Asia

The article examines international treaties linking trade and environment, their governance models and implementation in the context of Southeast Asia. Particular attention is being paid to the role of intellectual property concepts, customary law and traditional knowledge as incentives for biodiversity conservation and to difficulties in defining the subject matter and communities of knowledge holders. Indonesia’s regulation of traditional knowledge and access to biodiversity is discussed as example. The article concludes that national development goals and interests in royalty collection frequently dominate the discussion and that key concepts are still insufficiently defined to avoid overlaps and conflicts. Genuine local support for the conservationist aims of the models will depend on whether a benefit flow to communities can be ensured and their original role to act as incentives can be realised. International collaboration is important to avoid disputes concerning biodiversity related knowledge held across borders.

Intellectual property, creativity and innovation : IP models and the political economy of developing Asia

In advanced capitalist societies, intellectual property laws protecting such subject matter as copyright and patents are justified by a combination of theories, which include the provision of economic incentives to foster creativity and innovation and the prevention of unfair competition. IP academics and policy makers have differing views about the appropriate balance between these objectives and public interest considerations such as health, education and the protection of the environment. These different views entered the policy debate in Asian developing countries in connection with an unprecedented introduction and expansion of IP laws over the last 25 years. This paper will use case studies of law reform from Asia, in particular Southeast Asia, to show that the policy considerations of governments in reforming their laws were often quite different from the standard rationale mentioned above. As much of the IP was, at least initially, held by foreigners and introduced to attract foreign investment, national development considerations were joined with the more commonly quoted objectives to promote the rights, creativity and innovation of individuals. Such national development objectives at times coincided and at other times collided with official explanations and received wisdom about the effects of stronger IP rights.

Especially in the early postcolonial period, copyright laws and other IP laws were frequently restricted or simply not implemented, if they conflicted with development policies in areas such as education or public health. Such policies were slowly changing in the wake of WTO-TRIPS and other international agreements. Nevertheless, the implementation and enforcement of the IP laws has been uneven. Specialised institutions such as courts and IP administering agencies compete with other branches of government and administration for limited funding and a rich repertoire of informal dispute settlement procedures has kept the number of court cases relatively low. In some countries, censorship laws have influenced freedom of expression and led to quite idiosyncratic interpretations of intellectual property laws. Governments often also retain a role in the assessment of licensing and technology transfer contracts. And while there are many programs to foster individual creativity, in most cases R & D activities are still largely taking place in government institutions and this has influenced the thinking about intellectual property rights and creativity in the context of employment.

The paper uses a few case studies to examine the implementation of IP laws in selected Asian developing countries to point to the quite different institutional setting for IP law reform in comparison to European or American models. It reaches some tentative conclusions as to the likely effects on creativity and innovation under these different circumstances.