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.

The growth of private property vehicles in the UK: causes and conditions

The UK private indirect real estate market has seen a rapid growth in the last seven years. The gross asset value (GAV) of the private property vehicle (PPV) market has about tripled from a GAV of £22.6bn in 1998 to a GAV of £67.1 billion at the end of 2005 (OPC, 2006). Although this trend of growing syndication of real estate is not only a UK phenomenon, the rate of growth has been significantly faster in the UK. For example the German open-ended funds have grown over the same period from €50.4bn to €85.1bn (BVI, 2006). In the US the market capitalization of equity real estate investment trusts (REIT) has grown 155% since 1999 to US$ 301bn (NAREIT, 2006). Each jurisdiction is offering different formats to invest indirectly into real estate but at the core all these vehicles are the same in that they provide a different route for investors to access real estate. In the UK, although the range of ‘products’ is now quite diverse, all structures have in common the ‘wrapping’ of property assets into a multi-investor vehicle. This paper examines the nature, pattern and process of market growth in PPVs and constructs a series of associations between causes and effects to explain this market shift.

Can company-fund manager meetings convey informational benefits? Exploring the rationalisation of equity investment decision making by UK fund managers

Conventional economic theory, applied to information released by listed companies, equates ‘useful’ with ‘price-sensitive’. Stock exchange rules accordingly prohibit the selec- tive, private communication of price-sensitive information. Yet, even in the absence of such communication, UK equity fund managers routinely meet privately with the senior execu- tives of the companies in which they invest. Moreover, they consider these brief, formal and formulaic meetings to be their most important sources of investment information. In this paper we ask how that can be. Drawing on interview and observation data with fund managers and CFOs, we find evidence for three, non-mutually exclusive explanations: that the characterisation of information in conventional economic theory is too restricted, that fund managers fail to act with the rationality that conventional economic theory assumes, and/or that the primary value of the meetings for fund managers is not related to their investment decision making but to the claims of superior knowledge made to clients in marketing their active fund management expertise. Our findings suggest a disconnect between economic theory and economic policy based on that theory, as well as a corre- sponding limitation in research studies that test information-usefulness by assuming it to be synonymous with price-sensitivity. We draw implications for further research into the role of tacit knowledge in equity investment decision-making, and also into the effects of the principal–agent relationship between fund managers and their clients.

Pushing the boundaries of the social: private agri-food standards and the governance of Fair Trade in European public procurement

The article explores how fair trade and associated private agri-food standards are incorporated into public procurement in Europe. Procurement law is underpinned by principles of equity, non-discrimination and transparency; one consequence is that legal obstacles exist to fair trade being privileged within procurement practice. These obstacles have pragmatic dimensions, concerning whether and how procurement can be used to fulfil wider social policy objectives or to incorporate private standards; they also bring to the fore underlying issues of value. Taking an agency-based approach and incorporating the concept of governability, empirical evidence demonstrates the role played by different actors in negotiating fair trade’s passage into procurement through pre-empting and managing legal risk. This process exposes contestations that arise when contrasting values come together within sustainable procurement. This examination of fair trade in public procurement helps reveal how practices and knowledge on ethical consumption enter into a new governance arena within the global agri-food system.

O desempenho de médio e longo prazo do preço das ações de empresas brasileiras após a realização de seasoned equity offerings : um estudo de evento

Este estudo examinou o comportamento do preço das ações de empresas brasileiras após a realização de seasoned equity offerings (SEOs), no médio e no longo prazo, tendo como base as companhias com ações negociadas na Bolsa de Valores de São Paulo (BOVESPA), entre 1993 e 1997. O retorno anormal cumulativo (CAR) apresentou um retorno residual de –15,80% para o período de três anos após a emissão e de –34,04% para o período de cinco anos, estatisticamente significante ao nível de 5% e 1%, respectivamente. Na segmentação das amostras por setor de atividade econômica, ano de emissão e classe de ação emitida, os resultados encontrados sugerem que esses fatores podem influenciar os desempenhos de longo prazo das companhias brasileiras após a realização de SEOs. Verificou-se que os piores desempenhos estão concentrados nas empresas de menor patrimônio líquido. Além do mais, os piores retornos dos preços, em relação ao mercado, ocorreram para empresas que realizaram SEOs em 1993 e 1994, sugerindo que aspectos conjunturais presentes na economia brasileira influenciam o comportamento do preço das ações.

Impactos dos processos de mudanças na cultura organizacional: um estudo na secretaria municipal de economia e finanças da prefeitura de Manaus

A mudança organizacional caracteriza-se por transformações cada vez mais rápidas, profundas e amplas que exercem um impacto direto nos trabalhadores seja do setor público ou do setor privado. Seus efeitos, positivos ou negativos, geram instabilidade e estresse, ou seja, implicam em renúncias, perdas e adaptações. Ao se observar a mudança organizacional como ciclo de existência em que se pode examinar determinados momentos organizacionais, considerados estratégicos, como forma de pensamento e forma de decisão dos dirigentes. As mudanças tecnológicas, mais facilmente visualizadas e implementadas na Secretaria Municipal de Economia e Finanças da Prefeitura Municipal de Manaus, exigem, muitas vezes, uma mudança cultural. O estudo propõe uma vertente teórica que destaca parte dos esforços interpretativos das situações decisórias. A pesquisa empírica tem como objetivo principal verificar a cultura organizacional e a dependência de poder, através da análise de valor e dos interesses compartilhados pelos grupos de servidores da Prefeitura de Manaus. A cultura organizacional será analisada por meio dos seus elementos, ou seja, por meio dos valores compartilhados entre os dirigentes e os demais funcionários dos diversos setores da Secretaria Municipal de Economia e Finanças. Para este estudo, se utilizará uma amostra composta dos representantes dos diversos setores da Secretaria, tais como: Cadastro, Contabilidade, Fiscalização, Finanças, Tributação e Apoio administrativo. Nesse contexto, enfatizar-se-á a importância de se respeitar o ritmo de aprendizado e mudanças individuais estimulando a participação e reduzindo os riscos de ansiedade diante das mudanças organizacionais.

Saving-capm: uma proposta de solução para o equity premium puzzle do consumption-capm

Em 1985, Mehra e Prescott levantaram uma questão que até hoje não foi respondida de forma satisfatória: o prêmio de risco das ações americanas é muito maior do que poderia ser explicado pelo “paradigma neoclássico de finanças econômicas” (financial economics) representado pelo modelo C-CAPM. E, a partir de então, este problema não resolvido ficou conhecido como o “Equity Premium Puzzle” (EPP) ou o “Enigma do Prêmio (de risco) das Ações”. Este enigma estimulou a produção de uma série de artigos, dissertações e teses que tentaram ajustar os modelos intertemporais de utilidade esperada aos dados dos mercados financeiros. Dentro deste contexto, esta tese busca (i) revisar a evolução histórica da teoria dos modelos de maximização da utilidade intertemporal dos agentes, (ii) analisar os pressupostos e conceitos chaves desses modelos, (iii) propor um novo modelo que seja capaz de solucionar o EPP, (iv) aplicar este modelo proposto aos dados históricos anuais entre 1929 e 2004 e (v) validar a lógica deste modelo através das metodologias Mehra-Prescott e Hansen-Jagannathan. Esta tese faz uma crítica de que os estudos até aqui desenvolvidos tentaram explicar a dinâmica de um mercado financeiro altamente sofisticado, através de um modelo de economia não-monetária e de subsistência. Assim, a sua contribuição consiste na alteração desse pressuposto de uma economia de subsistência, considerando que a renda disponível do setor privado não seja integralmente consumida, mas que também possa ser poupada. Assumindo que as pessoas obtêm satisfação (utilidade) tanto pelo consumo atual como pela poupança atual (que será o consumo futuro), será deduzido que a utilidade marginal de consumir é igual à de poupar, em todo e qualquer período. Com base nisso, a utilidade marginal a consumir é substituída pela utilidade marginal de poupar dentro do modelo básico do C-CAPM. Para reforçar a idéia de que o modelo desta tese usa dados de poupança em vez de consumo, ao longo do trabalho ele será chamado de Sanving-CAPM, ou S-CAPM. Este novo modelo mostrou-se capaz de solucionar o EPP quando submetidas às abordagens Mehra-Prescott e Hansen-Jagannathan.

Underpricing of equity offerings in Brazil

We examine the underpricing of twenty-seven IPOs and twenty-nine SEOs issued in Brazil from January 1999 to March 2006. Determinants on pre-market demand, underwriting activities and information asymmetry were discussed. Common characteristics seem to exist between all issues. 94% have been on premium market corporate level and 93% were realized via bookbuilding. Underpricing for IPOs and SEOs has been recorded at 9.6% and 3.6%, respectively. IPOs are more underpriced when (i) more informed investors receive shares, (ii)better ranked underwriters lead the offer, and (iii) there is positive revision in the final price compared to the initial price range defined before information disclosure. SEOs are more underpriced when (i) shares presents higher appreciation in pre-offer period, and (ii) the proportion of primary offers are larger, supporting adverse selection costs theory.

What if firms adjust their debt-equity ratios toward a target range?

We estimate optimal target-ranges of capital structure controlling for a series of firmspecific characteristics and accounting for the serial correlation that arises from the dynamic component of the leverage choice. Then, we empirically examine if firms adjust their leverages toward the estimated optimal ranges. Our analysis suggests that the observed behavior of firms is consistent with the notion of range-adjustment.

Using irregularly spaced returns to estimate multi-factor models: application to Brazilian equity data

Multi-factor models constitute a useful tool to explain cross-sectional covariance in equities returns. We propose in this paper the use of irregularly spaced returns in the multi-factor model estimation and provide an empirical example with the 389 most liquid equities in the Brazilian Market. The market index shows itself significant to explain equity returns while the US$/Brazilian Real exchange rate and the Brazilian standard interest rate does not. This example shows the usefulness of the estimation method in further using the model to fill in missing values and to provide interval forecasts.

Equity and Efficiency in Education: motivations and targets

The recently released "Educational PAC" attempts to place basic education at the center of the social debate. We have subsidized this debate, offering a diagnosis of how different education levels can impact individuals' lives through broad and easily interpreted indicators. Initially, we analyze how much each educational level reaches the poorest population. For example, how are those in the bottom strata of income distribution benefited by childcare centers, private secondary education, public university or adult education. The next step is to quantify the return of educational actions, such as their effects on employability and an individual's wages, and even health as perceived by the individual, be that individual poor, middle class or elite. The next part of the research presents evidence of how the main characters in education, aka mothers, fathers and children, regard education. The site available with the research presents a broad, user-friendly database, which will allow interested parties to answer their own questions relative to why people do not attend school, the time spent in the educational system and returns to education, which can all be cross-sectioned with a wide array of socio-demographic attributes (gender, income, etc.) and school characteristics (is it public, are school meals offered, etc.) to find answers to: why do young adults of a certain age not attend school? Why do they miss classes? How long is the school day? Aside from the whys and hows of teaching, the research calculates the amount of time spent in school, resulting from a combination between absence rates, evasion raters and length of the school day. The study presents ranks of indicators referring to objective and subjective aspects of education, such as the discussion of the advantages and care in establishing performance based incentives that aim at guiding the states in the race for better educational indicators.

Hedge de crédito através de equity: uma análise empírica com uso de ativos corporativos brasileiros

Este trabalho tem como objetivo analisar os resultados de uma operação de hedge de um diversificado portfólio de crédito de empresas brasileiras através do uso de ativos de equity. Inicialmente, faz-se uma alusão aos principais aspectos teóricos da presente dissertação com suas definições e revisão bibliográfica. Posteriormente, são apresentados os parâmetros básicos da seleção da amostra utilizada e do período durante o qual tal estratégia de proteção será implementada.

Motivos determinantes para a internacionalização na indústria brasileira de Private Banking: estudo de caso do Banco Itaú Unibanco S.A.

Este trabalho situa-se no campo de Estratégia Empresarial e trata do tema de internacionalização de empresas, mais especificamente da internacionalização no ramo de Private Bank no Brasil. O objetivo desta pesquisa foi realizar um levantamento dos fatores que influenciam a internacionalização de empresas atuantes no ramo de Private Bank no Brasil. Utilizou-se uma metodologia com abordagem qualitativa de natureza exploratória. Foi realizado um estudo de caso do Private Bank Internacional do Banco Itaú Unibanco S.A.. Foram realizadas 7 entrevistas semiestruturadas com profissionais que atuaram ou atuam no Private Bank do banco selecionado. Os principais resultados encontrados na pesquisa foram: (i) o ramo de Private Bank ainda não foi alvo de análise específica pelos interessados na internacionalização de bancos; (ii) também foi identificado que os autores que estudaram a internacionalização de bancos não recorreram à análise dos Offshore Financial Centers (OFC) para explicar a internacionalização das instituições financeiras, a presente pesquisa propõe que é de fundamental importância a análise dos OFC para o entendimento da internacionalização no ramo de Private Bank; (iii) os principais fatores que influenciaram a internacionalização no caso selecionado são: a busca de fornecimento de serviços financeiros internacionais para os clientes domésticos ou internacionais e a busca de novos mercados para a ampliação da base de clientes; (iv) sugere-se que ao invés do que proposto em outras pesquisas, a internacionalização em bancos não se dá por conta dos bancos seguirem seus clientes fisicamente, mas sim seguirem os investimentos e fluxos financeiros dos clientes; (v) finalmente, sugere-se também que a competição das empresas de Private Bank atuantes no Brasil não se dá somente pela presença internacional, mas sim pela capacidade de interligar recursos diferenciados presentes em diversos países e conseguir gerar valor através dessa rede.

Mobility, targeting and private school vouchers

This paper uses general equilibrium simulations to explore the role ofresidential mobility in shaping the impact of different types of private school voucher policies. In particular, general vouchers available to all residents in the state are compared to vouchers specifically targeted to either underprivileged school districts or underprivileged households. The simulations are derived from a three-community mo deI of low, middle and high income school districts (calibrated to New York data), where each school district is composed of multiple types of neighborhoods that may vary in house quality as well as the leveI of neighborhood extemalities. Households that differ in both their income and in the ability leveI of their children choose between school districts, between neighborhoods within their school district, and between the local public school or a menu of private school altematives.Local public school quality within a district is endogenously determined bya combination of the average peer quality of public school attending children as well as local property and state income tax supported spending. Financial support (above a required state minimum) is set by local majority rule. Finally, there exists the potential for a private school market composed of competitive schools that face production technologies similar to those ofpublic schools but who set tuition and admissions policies to maximize profits. In tbis model, it is demonstrated that school district targeted vouchers are similar in their impact to non-targeted vouchers but vastIy different from vouchers targeted to low income households. Furthermore, strong migration effects are shown to significantly improve the likely equity consequences of voucher programs.