a proposal to solve the comparability problem in cost utility analysis in cost utility analysis it is assumed that health state valuations are directly comparable across individuals instead health state valuations may be relative and related to people s expectations and abilities then health state valuations are not fully comparable across people and consequently cost utility analysis cannot be applied in full the present paper analyzes this comparability problem and proposes a method to solve it

forecasting recessions the puzzle of the enduring power of the yield curve for over two decades researchers have provided evidence that the yield curve specifically the spread between long and short term interest rates contains useful information for signaling future recessions despite these findings forecasters appear to have generally placed too little weight on the yield spread when projecting declines in the aggregate economy indeed we show that professional forecasters are worse at predicting recessions a few quarters ahead than a simple real time forecasting model that is based on the yield spread this relative forecast power of the yield curve remains a puzzle the appendix is included online as supplementary material

macroeconomic uncertainty through the lens of professional forecasters abstractwe analyze the evolution of macroeconomic uncertainty in the united states based on the forecast errors of consensus survey forecasts of various economic indicators comprehensive information contained in the survey forecasts enables us to capture a real time measure of uncertainty surrounding subjective forecasts in a simple framework we jointly model and estimate macroeconomic common and indicator specific uncertainties of four indicators using a factor stochastic volatility model our macroeconomic uncertainty estimates have three major spikes has three major spikes aligned with the 1973 1975 1980 and 2007 2009 recessions while other recessions were characterized by increases in indicator specific uncertainties we also show that the selection of data vintages affects the estimates and relative size of jumps in estimated uncertainty series finally our macroeconomic uncertainty has a persistent negative impact on real economic activity rather than producing wait and see dynamics

pressure and the division of a public budget this paper considers the division of a public budget among competing interests the planner determines the optimal allocation by maximizing a weighted social welfare function these weights reflect society s attitudes to different recipient groups and are not constrained to be constant by exerting pressure the recipients can attempt to manipulate the weights and hence influence the division of the budget the amount of resources used on pressure and the effects on the preference weights are calculated an important parameter in the model is the elasticity of pressure for which an appropriate estimate is presented from the case of competition for a share of a health services budget in norway

a note on the estimation of the equity efficiency trade off for qalys abstract in this note the veil of ignorance approach is tested as a basis for empirically determining the shape of the social welfare function for qalys an experiment is carried out where the participants choose between different societies that differ with respect to per capita qalys and the distribution of qalys the answers are analyzed using logistic regression analysis according to the results the respondents are willing to give up 1 qaly in the group with more qalys to gain 0 45 qalys in the group with fewer qalys but this trade off is independent of the size of the difference in qalys between the groups

understanding preference for egalitarian policies in health are age and sex determinants this article presents an empirical assessment of the relevance of different factors when understanding preferences for outcome egalitarian policies in health in particular respondent age and sex a representative sample of the spanish population was interviewed n 1209 after being informed that those from the higher social class have longer life expectancy at birth than those from the lower social class respondents were required to choose between two programmes to increase life expectancy of the two groups by the same amount the distribution neutral programme and to target the lowest social class group thereby reducing current health inequalities the targeting or egalitarian programme two variants one with and the other without visual aid are used majority 69 of respondents support targeting an effect of age was observed where younger and older individuals are less likely to target the egalitarian policy than those in middle age however individual s sex was not associated wit

measuring forecast uncertainty by disagreement the missing link using a standard decomposition of forecast errors into common and idiosyncratic shocks we show that aggregate forecast uncertainty can be expressed as the disagreement among the forecasters plus the perceived variability of future aggregate shocks thus the reliability of disagreement as a proxy for uncertainty will be determined by the stability of the forecasting environment and the length of the forecast horizon using density forecasts from the survey of professional forecasters we find direct evidence in support of our hypothesis our results support the use of garch type models rather than the ex post squared errors in consensus forecasts to estimate the ex ante variability of aggregate shocks as a component of aggregate uncertainty copyright 2010 john wiley sons ltd

on aggregating qalys a comment on dolan dolan dolan p 1998 the measurement of individual utility and social welfare journal of health economics vol 17 pp 39 52 in a recent paper suggested an empirical method for estimating the shape of the social welfare function using a simple theoretical model it is shown that dolan s proposed empirical method has no theoretical foundation the main problem with the approach is that it measures only the altruistic values that individuals attach to other peoples health status and ignores the utility that individuals attach to their own health status

measuring uncertainty and its impact on the economy we propose a new framework for measuring uncertainty and its effects on the economy based on a large var model with errors whose stochastic volatility is driven by two common unobservable factors representing aggregate macroeconomic and financial uncertainty the uncertainty measures can also influence the levels of the variables so that contrary to most existing measures ours reflect changes in both the conditional mean and volatility of the variables and their impact on the economy can be assessed within the same framework moreover identification of the uncertainty shocks is simplified with respect to standard var based analysis in line with the favar approach and with heteroskedasticity based identification finally the model which is also applicable in other contexts is estimated with a new bayesian algorithm which is computationally efficient and allows for jointly modeling many variables while previous var models with stochastic volatility could only handle a handful of variables empirically we apply the method to estimate uncertainty and its effects using us data finding that there is indeed substantial commonality in uncertainty sizable effects of uncertainty on key macroeconomic and financial variables with responses in line with economic theory

utilities versus rights to publicly provided goods arguments and evidence from health care rationing grounds of the consequentialist and sometimes approximately utilitarian moral framework on which it is based an alternative methodological approach is suggested and in addition to consequences four normative determinants of health care entitlements are identified rights public opinion social contracts and community values survey evidence is presented which shows support for these alternative frameworks and a rejection of consequentialism the paper suggests that a if not the major challenge facing the designers of rationing guidelines is that of pluralism i e the need to integrate considerations from a set of frameworks

axioms for health care resource allocation this paper examines principles of health care resource allocation based on axioms for individual preferences and distributive justice we establish axioms for representing individual preferences by quality adjusted life years qalys as well as axioms for existence of a social welfare function depending only on qalys a symmetric cobb douglas social welfare function is characterized by an axiom stating that social welfare is anonymous with respect to the distribution of individual life years replacing this axiom with an axiom of non age dependence we obtain a characterization of a utilitarian social welfare function with certain weights further we give axioms for a social welfare function being a weighted sum of power transformations of individual qalys

priority setting in health care and higher order degree change in risk this paper examines how priority setting in health care expenditures is influenced by the presence of uncertainty about the severity of the illness and the effectiveness of medical treatment we provide necessary and sufficient conditions on social preferences under which a social planner will allocate more health care resources to populations at higher risk changes in risk are defined by the concept of stochastic dominance up to order n the shape of the social utility function and an equity weighting function are used to model the inequality aversion of the social planner we show that for higher order risk changes the usual conditions on preferences such as prudence or relative risk aversion are not necessarily required to prioritise health care when there are different levels of uncertainty associated with otherwise similar patient groups

common and country specific economic uncertainty abstract we use a factor model with stochastic volatility to decompose the time varying variance of macroeconomic and financial variables into contributions from country specific uncertainty and uncertainty common to all countries we find that the common component plays an important role in driving the time varying volatility of nominal and financial variables the cross country co movement in volatility of real and financial variables has increased over time with the common component becoming more important over the last decade simulations from a two country dsge model featuring epstein zin preferences suggest that increased globalisation and trade openness may be the driving force behind the increased cross country correlation in volatility

common drifting volatility in large bayesian vars the general pattern of estimated volatilities of macroeconomic and financial variables is often broadly similar we propose two models in which conditional volatilities feature comovement and study them using u s macroeconomic data the first model specifies the conditional volatilities as driven by a single common unobserved factor plus an idiosyncratic component we label this model bvar with general factor stochastic volatility bvar gfsv and we show that the loss in terms of marginal likelihood from assuming a common factor for volatility is moderate the second model which we label bvar with common stochastic volatility bvar csv is a special case of the bvar gfsv in which the idiosyncratic component is eliminated and the loadings to the factor are set to 1 for all the conditional volatilities such restrictions permit a convenient kronecker structure for the posterior variance of the var coefficients which in turn permits estimating the model even with large datasets while perhaps misspecifi

measuring future grandparents preferences for equality and relative standing individuals aversion to risk and inequality and their concern for relative standing are measured through experimental choices between hypothetical societies it is found that on average individuals are both fairly inequality averse and have a strong concern for relative income the results are used to illustrate welfare consequences based on a utilitarian swf and a modified crra utility function it is shown that the social marginal utility of income may then become negative even at income levels that are far from extreme

modeling time varying uncertainty of multiple horizon forecast errors we estimate uncertainty measures for point forecasts obtained from survey data pooling information embedded in observed forecast errors for different forecast horizons to track time varying uncer

changes in the effects of monetary policy on disaggregate price dynamics abstract based on a time varying factor augmented vector autoregression we demonstrate that the propagation mechanism of monetary policy disturbances differs across disaggregate components of personal consumption expenditures while many disaggregate prices rise temporarily in response to a monetary tightening in the early part of the sample there is no evidence of a price puzzle at the aggregate level the share of disaggregate prices that exhibit the price puzzle diminishes from the early 1980s onwards there also is evidence of a substantial decline in the dispersion of disaggregate price responses over time this gradual decrease in cross sectional heterogeneity of disaggregate price responses is associated with a dampening effect on aggregate real economic activity and a stronger effect on the aggregate price level we illustrate by means of a multi sector sticky price model augmented by a cost channel how key structural parameters would have had to change to match this evolution of sectoral price dynamics

economic evaluation of services for a national health scheme the case for a fairness based framework in this paper we argue that the usual framework for evaluating health services may need modification in the context of a national health scheme nhs some costs and benefits may need to be ignored or discounted others included at face value and some transfer payments included in the decision algorithm in contrast with the standard framework we argue that economic evaluation in the context of an nhs should focus on social transfers between taxpayers and beneficiaries and that the nature and scope of these transfers is determined by the level of social generosity some of the implications of a modified framework are illustrated with a re examination of i costs and transfer payments ii unrelated future costs iii moral hazard and iv the rule that marginal costs should equal marginal benefits we argue that an explicitly fairness based framework is needed for the evaluation of services in an nhs in contrast the usual welfare economic theoretic framework facilitates the sidelining of issues of fairness

news and noise in g 7 gdp announcements revisions to gdp announcements are known to be quite large in all g 7 countries quarterly growth rate revisions are regularly more than a full percentage point at an annualized rate we examine the predictability of these revisions using standard statistical tests of whether the preliminary announcement is a rational forecast of the subsequently revised data previous work suggests that u s gdp revisions are largely unpredictable as would be the case if the revisions reflect news not available at the time that the preliminary number is produced we find that the degree of predictability varies throughout the g 7 although we find little predictability in u s revisions the data revisions for several foreign countries are highly predictable we also perform a simple real time forecasting exercise showing that for several countries the predictability of data revision could be used to generate improved preliminary data

the effects of oil price uncertainty on global real economic activity this paper investigates the effect of oil price uncertainty on global real economic activity using a quarterly vector autoregressive model with stochastic volatility in mean stochastic volatility allows oil price uncertainty to vary separately from changes in the level of oil prices and allows one to incorporate an extraneous indicator of oil price uncertainty such as realized volatility that greatly improves the precision of the estimated uncertainty series the estimation results show that an oil price uncertainty shock has negative effects on world industrial production all else equal for example it is shown that a doubling of oil price volatility is associated with a cumulative decline as high as 0 3 percentage points in world industrial production

measuring global and country specific uncertainty abstract motivated by the literature on the capital asset pricing model we decompose the uncertainty of a typical forecaster into common and idiosyncratic uncertainty using individual survey data from the consensus forecasts over the period of 1989 2014 we develop monthly measures of macroeconomic uncertainty covering 45 countries and construct a measure of global uncertainty as the weighted average of country specific uncertainties our measure captures perceived uncertainty of market participants and derives from two components that are shown to exhibit strikingly different behavior common uncertainty shocks produce the large and persistent negative response in real economic activity whereas the contributions of idiosyncratic uncertainty shocks are negligible

data revisions are not well behaved we document the empirical properties of revisions to major macroeconomic variables in the united states our findings suggest that they do not satisfy simple desirable statistical properties in particular we find that these revisions do not have a zero mean which indicates that the initial announcements by statistical agencies are biased we also find that the revisions are quite large compared to the original variables and they are predictable using the information set at the time of the initial announcement which means that the initial announcements of statistical agencies are not rational forecasts

inequality aversion health inequalities and health achievement this paper addresses two issues the first is how health inequalities can be measured in such a way as to take into account policymakers attitudes towards inequality the gini coefficient and the related concentration index embody one particular set of value judgements by generalising these indices alternative sets of value judgements can be reflected the other issue addressed is how information on health inequality can be used together with information on the mean of the relevant distribution to obtain an overall measure of health achievement

bayesian dynamic factor models and portfolio allocation we discuss the development of dynamic factor models for multivariate financial time series and the incorporation of stochastic volatility components for latent factor processes bayesian inference and computation is developed and explored in a study of the dynamic factor structure of daily spot exchange rates for a selection of international currencies the models are direct generalizations of univariate stochastic volatility models and represent specific varieties of models recently discussed in the growing multivariate stochastic volatility literature we discuss model fitting based on retrospective data and sequential analysis for forward filtering and short term forecasting analyses are compared with results from the much simpler method of dynamic variance matrix discounting that for over a decade has been a standard approach in applied financial econometrics we study these models in analysis forecasting and sequential portfolio allocation for a selected set of international exchange rate retur

monetary policy rules based on real time data this paper examines the magnitude of informational problems associated with the implementation and interpretation of simple monetary policy rules using taylor s rule as an example i demonstrate that real time policy recommendations differ considerably from those obtained with ex post revised data further estimated policy reaction functions based on ex post revised data provide misleading descriptions of historical policy and obscure the behavior suggested by information available to the federal reserve in real time these results indicate that reliance on the information actually available to policy makers in real time is essential for the analysis of monetary policy rules

the impact of the volatility of monetary policy shocks this paper studies the impact of the volatility of monetary policy using a structural vector auroregression svar model enriched along two dimensions first it allows for time varying variance of monetary policy shocks via a stochastic volatility specification second it allows a dynamic interaction between the level of the endogenous variables in the var and the time varying volatility the analysis establishes that the nominal interest rate output growth and inflation fall in reaction to an increase in the volatility of monetary policy the analysis also develops a dynamic stochastic general equilibrium model enriched with stochastic volatility to monetary policy that generates similar responses and provides a theoretical underpinning of these findings

why do forecasters disagree lessons from the term structure of cross sectional dispersion abstract key sources of disagreement among economic forecasters are identified by using data on cross sectional dispersion in forecasters long and short run predictions of macroeconomic variables dispersion among forecasters is highest at long horizons where private information is of limited value and lower at short forecast horizons moreover differences in views persist through time such differences in opinion cannot be explained by differences in information sets our results indicate they stem from heterogeneity in priors or models differences in opinion move countercyclically with heterogeneity being strongest during recessions where forecasters appear to place greater weight on their prior beliefs

the measurement and characteristics of professional forecasters uncertainty there is increased interest in extracting indicators of macroeconomic risk and uncertainty from forecast surveys that include questions about density forecasts in this paper we consider several statistical issues that arise in the construction and interpretation of measures of uncertainty from such data with application to the bank of england survey of external forecasters we find substantial heterogeneity of individual forecast uncertainty and significant persistence in individual relative uncertainty this is an individual characteristic akin to the individual optimism and pessimism already established among point forecasts and which is seen to be present in the current data in a bivariate sense with respect to forecasts of inflation and output growth whether disagreement among point forecasts is a useful indicator of uncertainty is seen to depend on the underlying macroeconomic environment in an appendix the main findings of the paper are replicated with data from the european central bank survey of professional forecasters

on the efficiency fairness trade off this paper deals with a basic issue how does one approach the problem of designing the right objective for a given resource allocation problem the notion of what is right can be fairly nebulous we consider two issues that we see as key efficiency and fairness we approach the problem of designing objectives that account for the natural tension between efficiency and fairness in the context of a framework that captures a number of resource allocation problems of interest to managers more precisely we consider a rich family of objectives that have been well studied in the literature for their fairness properties we deal with the problem of selecting the appropriate objective from this family we characterize the trade off achieved between efficiency and fairness as one selects different objectives and develop several concrete managerial prescriptions for the selection problem based on this trade off finally we demonstrate the value of our framework in a case study that considers air traffic management this paper was accepted by yossi aviv operations management

asymmetric effects of the business cycle on bank credit risk abstract prior empirical research on the relation between credit risk and the business cycle has failed to properly investigate the presence of asymmetric effects to fill this gap we examine this relation both at the aggregate and the bank level exploiting a unique dataset on italian banks borrowers default rates we employ threshold regression models that allow to endogenously establish different regimes identified by the thresholds over below which credit risk is more less cyclical we find that not only are the effects of the business cycle on credit risk more pronounced during downturns but cyclicality is also higher for those banks with riskier portfolios

qalys and the equity efficiency trade off as the volume of research on quality adjusted life years qalys has increased concern has begun to be expressed about the equity aspects of resource allocation decisions based on the results of this research this paper suggests that a common theme running through the criticisms of the qaly approach is a concern about inequality it also suggests that the method for incorporating distributional concerns which is currently being pursued by advocates of the qaly approach will only ever capture concerns other than a concern about inequality the paper suggests a method for incorporating both sets of concerns into resource allocation decisions

discrete versus continuous state switching models for portfolio credit risk abstract dynamic models for credit rating transitions are important ingredients for dynamic credit risk analyses we compare the properties of two such models that have recently been put forward the models mainly differ in their treatment of systematic risk which can be modeled either using discrete states e g expansion versus recession or continuous states it turns out that the implied asset correlations and default rate volatilities for discrete state switching models are implausibly low compared to empirical estimates from the literature we conclude that care has to be taken when discrete state regime switching models are employed for dynamic credit risk management as a side result of our analysis we obtain indirect evidence that asset correlations may change over the business cycle

investigating the social value of health changes this survey has demonstrated that the danish public is concerned with distributional aspects of health gains they have a strong inclination to give priority to those in a more severe health state provided their expected benefits are large enough to bring them to the health level where their rival patients are without treatment results also indicated that the equity argument may not apply with equal force on all health dimensions respondents did to some extent trade off equity for greater health gains a nouvelle finding is that the valuations of health increments per se seem to be affected by whether questions are framed as individual or social choices if social decision making is the issue health gains which involve relieving patients of extreme problems are valued more highly than relief of minor ailments these discrepancies between individual and social valuations suggest that the use of qaly values elicited from an individual s perspective may not be valid in social decision making

macroeconomic uncertainty indices based on nowcast and forecast error distributions abstract we propose new indices to measure macroeconomic uncertainty the indices measure how unexpected a realization of a representative macroeconomic variable is relative to the unconditional fo

accounting for future costs in medical cost effectiveness analysis most medical cost effectiveness analyses include future costs only for related illnesses but this approach is controversial this paper demonstrates that cost effectiveness analysis is consistent with lifetime utility maximization only if it includes all future medical and non medical expenditures estimates of the magnitude of these future costs suggest that they may substantially alter both the absolute and relative cost effectiveness of medical interventions particularly when an intervention increases length of life more than quality of life in older populations current methods overstate the cost effectiveness of interventions which extend life compared to interventions which improve the quality of life

economic evaluation of health care programmes is cea better than cba it has been noted earlier that during the same period that the contingent valuation cv method evolved and became the most commonly used method of valuing environmental projects the development in health economics was instead been towards cost effectiveness analysis cea recently there has been a growing interest in the use of cea where qalys quality adjusted life years are used as a measure of effectiveness as the method of evaluation for environmental projects the purpose of this paper is to answer the question is cea a superior method to cba both theoretically and empirically to provide information to decision makers for use in decisions on resource allocation in health the paper deals with the following topics the underlying theoretical foundation for cea is cea free of income distribution considerations is qaly a superior measure to wtp the usefulness of incremental ce ratio icer to determine resource allocation the paper concludes that there is neither theoretical nor practical support for the claim about the superiority of cea

ratings migration and the business cycle with application to credit portfolio stress testing the turmoil in the capital markets in 1997 and 1998 has highlighted the need for systematic stress testing of banks portfolios including both their trading and lending books we propose that underlying macroeconomic volatility is a key part of a useful conceptual framework for stress testing credit portfolios and that credit migration matrices provide the specific linkages between underlying macroeconomic conditions and asset quality credit migration matrices which characterize the expected changes in credit quality of obligors are cardinal inputs to many applications including portfolio risk assessment modeling the term structure of credit risk premia and pricing of credit derivatives they are also an integral part of many of the credit portfolio models used by financial institutions by separating the economy into two states or regimes expansion and contraction and conditioning the migration matrix on these states we show that the loss distribution of credit portfolios can differ greatly as can the concomitant level of economic capital to be assigned

the integration of claims to health care a programming approach the paper contributes to the use of social choice and welfare theory in health economics by developing and applying the integration of claims framework to health care rationing related to sen s critique of neo classical welfare economics the integration of claims framework recognises three primitive sources of claim consequences deontology and procedures a taxonomy is presented with the aid of which it is shown that social welfare functions reflecting these claims individually or together can be specified some of the resulting social choice rules can be regarded as generalisations of health maximisation and all have normative justifications though the justifications may not be universally acceptable the paper shows how non linear programming can be used to operationalise such choice rules and illustrates their differential impacts on the optimal provision of health care following discussion of relations to the capabilities framework and the context in which rationing occurs the paper concludes that the integration of claims provides a viable framework for modelling health care rationing that is technically rigorous general and tractable as well as being consistent with relevant moral considerations and citizen preferences

eliciting people s preferences for the distribution of health a procedure for a more precise estimation of distributional weights in order to incorporate distributional concerns into cost effectiveness analysis it would be useful to elicit distributional weights that express people s valuation of marginal health gains at various levels of health distributional preferences are commonly elicited either through a person trade off pto or a gain trade off gto technique an inherent problem of the gto is that it is based on the valuation of non marginal health gains in practice many contributions using the pto also focus on non marginal health gains this paper demonstrates that the failure to distinguish appropriately between marginal and non marginal health gains may lead to seriously misleading estimates of distributional weights moreover the paper proposes a methodology for utilising information obtained through non marginal analysis more efficiently in order to obtain more reliable estimates of distributional weights the methodology was successfully applied in an empirical study of age weights

a new axiomatic approach to the evaluation of population health in this paper we explore the implications of normative principles for the evaluation of population health we formalize those principles as axioms for social preferences over distributions of health for a given population we single out several focal population health evaluation functions which represent social preferences as a result of combinations of those axioms our results provide new rationale for popular theories in health economics such as the unweighted aggregation of quality adjusted life years qalys or healthy years equivalents hyes and generalizations of the two aimed to capture concerns for distributive justice without resorting to controversial assumptions on individual preferences

an analytic approach to credit risk of large corporate bond and loan portfolios abstract we derive an analytic approximation to the credit loss distribution of large portfolios by letting the number of exposures tend to infinity defaults and rating migrations for individual exposures are driven by a factor model in order to capture co movements in changing credit quality the limiting credit loss distribution obeys the empirical stylized facts of skewness and heavy tails we show how portfolio features like the degree of systematic risk credit quality and term to maturity affect the distributional shape of portfolio credit losses using empirical data it appears that the basle 8 rule corresponds to quantiles with confidence levels exceeding 98 the limit law s relevance for credit risk management is investigated further by checking its applicability to portfolios with a finite number of exposures relatively homogeneous portfolios of 300 exposures can be well approximated by the limit law a minimum of 800 exposures is required if portfolios are relatively heterogeneous realistic loan portfolios often contain thousands of exposures implying that our analytic approach can be a fast and accurate alternative to the standard monte carlo simulation techniques adopted in much of the literature

health utility indices and equity considerations the aim of this paper is to propose methods that incorporate equity concerns into cost utility analysis the focus of the paper is on qalys but the results apply to health utility indices in general two interpretations of qalys are considered qalys as von neumann morgenstern utilities and qalys as measures of health a justification is provided for aggregating consistently scaled qalys as utilities over individuals the conditions underlying unweighted aggregation of qalys are identified these conditions exclude two common types of equity concern algorithms are proposed that take into account equity concerns and that are relatively easy to apply

equity in health the importance of different health streams this paper develops a conceptual framework in which preferences about the distribution of future health gains depend on differences in four health streams these are as follows 1 the amount of health to be gained 2 the no treatment profiles 3 the amount of health experienced thus far and 4 the amount of health gained previously as a result of public health interventions this classification puts the well established concerns for severity stream 2 and age weights stream 3 into a more complete analytical framework stream 4 has not been discussed to date and the paper suggests some moral arguments about the distributive relevance of this stream of health

options using a collective lottery to ration vaccines during an influenza pandemic for many countries the best way to counter an influenza pandemic is to provide citizens with a pandemic vaccine however since the global supply of the vaccines is far smaller than the quantity demanded how to allocate the limited vaccines can be a very challenging task for them in this study we introduce a collective lottery mechanism that allocates vaccines as fairly as the traditional lottery while also offering more options for family members or those who are close so that they can choose the joint probability of successes that can maximize their welfare this mechanism thus gives rise to a pareto improvement over the traditional lottery our empirical study uses the us and the uk as examples in sequential collective lotteries that are simulated to prove that such an improvement while maintaining fairness in fact exists

the time varying volatility of macroeconomic fluctuations we investigate the sources of the important shifts in the volatility of us mac roeconomic variables in the postwar period to this end we propose the esti mation of dsge models allowing for time variation in the volatility of the structural innovations we apply our estimation strategy to a large scale model of the business cycle and find that shocks specific to the equilibrium condition of investment account for most of the sharp decline in volatility of the last two decades jel c51 e32

the yield spread puzzle and the information content of spf forecasts while the yield spread has long been recognized as a good predictor of recessions it seems to have been largely overlooked by professional forecasters we examine this puzzle established by rudebusch and williams 2009 in a data rich environment including not just the yield spread but many other predictors as well we confirm the puzzle in this context by examining the contributions of both the spf forecasts and the yield spread in predicting recessions and by examining the information content of spf forecasts directly furthermore we take the first step towards a possible resolution of this puzzle by recognizing the heterogeneity across professional forecasters

aversion to health inequalities in healthcare prioritisation a multicriteria optimisation perspective abstract in this paper we discuss the prioritisation of healthcare projects where there is a concern about health inequalities but the decision maker is reluctant to make explicit quantitative value judgements and the data systems only allow the measurement of health at an aggregate level our analysis begins with a standard welfare economic model of healthcare resource allocation we show how under the assumption that the healthcare projects under consideration have a small impact on individual health the problem can be reformulated as one of finding a particular subset of the class of efficient solutions to an implied multicriteria optimisation problem algorithms for finding such solutions are readily available and we demonstrate our approach through a worked example of treatment for clinical depression

a nonparametric elicitation of the equity efficiency trade off in cost utility analysis we performed an empirical elicitation of the equity efficiency trade off in cost utility analysis using the rank dependent quality adjusted life year qaly model a model that includes as special cases many of the social welfare functions that have been proposed in the literature our elicitation method corrects for utility curvature and therefore our estimated equity weights are not affected by diminishing marginal utility we observed a preference for equality in the allocation of health the data suggest that the elicited equity weights were jointly determined by preferences for equality and by insensitivity to group size a procedure is proposed to correct the equity weights for insensitivity to group size finally we give an illustration how our method can be implemented in health policy

comparing the point predictions and subjective probability distributions of professional forecasters we use data from the survey of professional forecasters spf to compare point predictions of gross domestic product gdp growth and inflation with the subjective probability distributions held by forecasters we find that most spf point predictions are quite close to the central tendencies of forecasters subjective distributions tend to be asymmetric with spf forecasters tending to report point predictions that give a more favorable view of the economy than do their subjective means medians modes

forecast uncertainty ex ante and ex post u s inflation and output growth survey respondents who make point predictions and histogram forecasts of macro variables reveal both how uncertain they believe the future to be ex ante as well as their ex post performance macroeconomic forecasters tend to be overconfident at horizons of a year or more but overestimate i e are underconfident regarding the uncertainty surrounding their predictions at short horizons ex ante uncertainty remains at a high level compared to the ex post measure as the forecast horizon shortens there is little evidence of a link between individuals ex post forecast accuracy and their ex ante subjective assessments

the measurement of individual utility and social welfare it has been suggested by a number of economists that decisions about how to allocate scarce health care resources should be informed by the cost per quality adjusted life years qalys of the different alternatives one of the criticisms of the qaly approach is that it is based on the measurement of individual utility yet the values elicited are used to inform social choice in this respect it is argued that the qaly approach fails to take account of distributional issues that are known to be important in the context of health care this paper addresses this issue and presents an approach grounded in microeconomic theory that is flexible enough to deal with a wide range of efficiency equity trade offs while making the nature of the trade off transparent in addition it is an approach that is relatively simple to investigate empirically and the results of a preliminary study are presented as illustration of this

the normative economics of health care finance and provision whereas in many countries the crisis in medical care has been seen in terms of excess spending on health services in the uk it has been seen at least by most of those who manage and work in the nhs as a crisis of underfunding this has come about as the result of the government s successful attempts to restrain the rate of growth of real spending on the nhs which in turn reflects the government s belief that its principal effective weapon against what it perceives to be inefficiency in the nhs is to challenge management itself reformed and to some extent liberated by systematic financial squeezes the same concern has given rise to a host of proposals for reform of the nhs most of which involve a much greater role for private insurance private finance of other kinds such as out of pocket payments and private provision of health care itself

measurement of health state utilities for economic appraisal health status measurement for use in economic appraisal of health care programmes is reviewed in this paper with particular emphasis on utility measurement a framework for economic appraisal is presented displaying the various components that must be measured and showing how the three forms of analysis cost effectiveness analysis cost benefit analysis and cost utility analysis relate to the framework and to each other one of the components in the framework is health status it can be measured using ad hoc numeric scales willingness to pay receive or health state utilities the determination of health state utilities is reviewed covering the following issues alternative sources of utilities health state descriptions multi attribute utility approach determination of appropriate subjects utility aggregation and accuracy three measurement techniques for health state utilities are described in detail rating scale standard gamble and time trade off the use of these methods is described for both chronic and temporary health states and for both health states considered better than death and those considered worse than death

uncertainty and consumer durables adjustment we characterize infrequent durables stock adjustment by consumers who also derive utility from non durable consumption flows in the presence of idiosyncratic income uncertainty the data we analyse include subjective future income uncertainty measures which we use as instruments in the estimation of relevant parameters of heterogeneous consumers dynamic adjustment problems the data feature two conceptually distinct sources of variation cross sectional heterogeneity of the sampled households dynamic problems and history dependent heterogeneity in their situation during the observation period we note that the latter should affect the likelihood but not the size of stock adjustment decisions and find broad support for theoretical predictions in formal selection controlled regressions based on this insight

modelling multi period inflation uncertainty using a panel of density forecasts this paper examines the determinants of inflation forecast uncertainty using a panel of density forecasts from the survey of professional forecasters spf based on a dynamic heterogeneous panel data model we find that the persistence in forecast uncertainty is much less than what the aggregate time series data would suggest in addition the strong link between past forecast errors and current forecast uncertainty as often noted in the arch literature is largely lost in a multi period context with varying forecast horizons we propose a novel way of estimating news and its variance using the kullback leibler information and show that the latter is an important determinant of forecast uncertainty our evidence suggests a strong relationship of forecast uncertainty with level of inflation but not with forecaster discord or with the volatility of a number of other macroeconomic indicators copyright 2006 john wiley sons ltd

equity weights in the allocation of health care the rank dependent qaly model this paper introduces the rank dependent quality adjusted life years qaly model a new method to aggregate qalys in economic evaluations of health care the rank dependent qaly model permits the formalization of influential concepts of equity in the allocation of health care such as the fair innings approach and it includes as special cases many of the social welfare functions that have been proposed in the literature an important advantage of the rank dependent qaly model is that it offers a straightforward procedure to estimate equity weights for qalys we characterize the rank dependent qaly model and argue that its central condition has normative appeal

aversion to health inequalities and priority setting in health care traditionally aversion to health inequality is modelled through a concave utility function over health outcomes bleichrodt et al bleichrodt h diecidue e quiggin j 2004 equity weights in the allocation of health care the rank dependent qaly model journal of health economics 23 157 171 have suggested a dual approach based on the introduction of explicit equity weights the purpose of this paper is to analyze how priorities in health care are determined in the framework of these two models it turns out that policy implications are highly sensitive to the choice of the model that will represent aversion to health inequality

real time density forecasts from bayesian vector autoregressions with stochastic volatility central banks and other forecasters are increasingly interested in various aspects of density forecasts however recent sharp changes in macroeconomic volatility including the great moderation and the more recent sharp rise in volatility associated with increased variation in energy prices and the deep global recession pose significant challenges to density forecasting accordingly this paper examines with real time data density forecasts of u s gdp growth unemployment inflation and the federal funds rate from bayesian vector autoregression bvar models with stochastic volatility the results indicate that adding stochastic volatility to bvars materially improves the real time accuracy of density forecasts this article has supplementary material online

implications of basing health care resource allocations on cost utility analysis in the presence of externalities abstract cost utility analysis is increasingly being advocated as a tool for helping to establish funding priorities among programs and services in the health care sector as currently conducted however cost utility analysis is problematic as a basis for achieving allocative efficiency because it excludes externalities the exclusion of externalities may bias program ranking in unpredictable ways leading to a non optimal allocation of resources consideration of externalities also raises a number of distributional issues for the evaluation of health services and highlights the importance of developing economic evaluation methods that are consistent with the conceptual basis for allocating resources

equity and equality in health and health care this paper explores four definitions of equity in health care equality of utilization distribution according to need equality of access and equality of health we argue that the definitions of need in the literature are inadequate and propose a new definition we also argue that irrespective of how need and access are defined the four definitions of equity are in general mutually incompatible in contrast to previous authors we suggest that equality of health should be the dominant principle and that equity in health care should therefore entail distributing care in such a way as to get as close as is feasible to an equal distribution of health

theories of justice and their implications for priority setting in health care abstract the paper aims to show how three theories of distributive justice utilitarianism egalitarianism and maximin can provide a clearer understanding of the normative basis of different priority setting regimes in the health service the paper starts with a brief presentation of the theories followed by their prescriptions for distribution as illustrated with their respective preferred points on a utility possibility frontier after this general discussion attention is shifted from utils to health the paper discusses how the recent norwegian guidelines for priority setting can be understood in the light of the theories

implications of spillover effects within the family for medical cost effectiveness analysis medical cost effectiveness analyses traditionally treat patients as isolated individuals and neglect the effects of improvement in patients health on the welfare of their family members we use a model based on a family utility function with altruistic linkages to show that there can be direct and indirect effects on the welfare of all family members we focus specially on a model of how the spillover effects to the spouse in a two person family might affect choice of treatments for prostate cancer we then test the predictions of this model by analyzing treatment choices of prostate cancer patients using the linked seer medicare database we find that our results are consistent with the model s predictions we conclude that cost effectiveness analyses may better reflect the full costs and benefits of medical interventions if they incorporate these family effects however concerns about equity present a dilemma for the practice of cea from the societal perspective

optimal medical treatment under asymmetric information a model is developed of patient doctor interaction under asymmetric information it examines how both the probability of consulting and initial health status are semi endogenously determined by a potential patient determining a threshold health level below which he demands a consultation it is shown that the demand elasticity with respect to socio economic variables is lower the more severe the illness the paper also offers a model of the supply side a distinction is established between uncertainty and asymmetric information between the patient and the doctor after deriving the conditions for an equilibrium of the patient doctor interaction payment systems for achieving medical adequacy and pareto efficiency are analysed

are people inequality averse or just risk averse individuals preferences for risk and inequality are measured through choices between imagined societies and lotteries the median relative risk aversion which is often seen to reflect social inequality aversion is between 2 and 3 most people are also found to be individually inequality averse reflecting a willingness to pay for living in a more equal society left wing voters and women are both more risk and inequality averse than others the model allows for non monotonic swfs implying that welfare may decrease with an individual s income at high income levels which is illustrated in simulations based on the empirical results

cost effectiveness utility analyses do current decision rules lead us to where we want to be despite the growing literature on economic evaluation of health care programmes little attention has been paid to the theoretical foundations of cost effectiveness and cost utility analyses and the validity of the decision rules adopted as methods of achieving the stated goals we show that although applications of the techniques can be used to pursue some managerial objectives in the context of highly constrained environments such applications are inconsistent with both welfare economic objectives and the interpretations of the findings of these applications alternative strategies are identified as potential and practical methods for pursuing welfare economic objectives

do bonds span the fixed income markets theory and evidence for unspanned stochastic volatility most term structure models assume bond markets are complete that is that all fixed income derivatives can be perfectly replicated using solely bonds however we find that in practice swap rates have limited explanatory power for returns on at the money straddles portfolios mainly exposed to volatility risk we term this empirical feature unspanned stochastic volatility usv while usv can be captured within an hjm framework we demonstrate that bivariate models cannot exhibit usv we determine necessary and sufficient conditions for trivariate markov affine systems to exhibit usv for such usv models bonds alone may not be sufficient to identify all parameters rather derivatives are needed

recovery rates uncertainty certainly matters abstract previous studies identify default rate as the main systematic determinant of bond recovery rates we revisit this paradigm by investigating the impact of another factor economic uncertainty based on a wide sample of american default issues and relying on beta regression models well suited for the bounded heteroskedastic and skewed sample of recovery rates we analyze the determinants of recovery rate distributions we find economic uncertainty to be of paramount importance as it proves to be the most important systematic determinant of recovery rate distributions significant for both their mean and dispersion by contrast default rate remains a key determinant of the dispersion of these distributions but not for their means considering this evidence is critical to the sound implementation of stochastic recovery rate models used by financial institutions for the computation of regulatory capital

on the economic foundations of cea ladies and gentlemen take your positions abstract there are still many ongoing debates about several aspects of the methodology of economic evaluations of health care interventions some of the disparities in recommendations on methodological issues may be traced back to different viewpoints on cost effectiveness analysis cea in general two important views are the welfarist approach which aims at embedding cea into traditional welfare economics and the decision maker s approach which takes a broader and more pragmatic view on cea the focus in welfarism may be on utility while that of the decision maker s approach may be considered to be on health in this paper it is examined how these two views differ and how these differences may subsequently lead to debates in methodological areas it is indicated that embedding the practical operationalisation of cea in welfare economics seems impossible in a strict welfarist approach it is necessary to view qalys as being utilities although one may question whether such an approach to qalys is appropriate also equity considerations may play an important role in cost effectiveness analysis and these should preferably be taken into account in a way that reflects societal attitudes towards an equitable distribution of health care these equity considerations may not always be directly related to utility or efficiency furthermore both camps may prefer different methods for cost measurement in areas such as productivity costs and informal care a better recognition of the contents and origins of controversies and disputes may enhance the clarity of discussions

priority setting in health care an axiomatic bargaining approach abstract this paper examines how axiomatic bargaining theory can be used to analyze different rules for dividing the health care budget between two patients this approach allows an explicit statement of the assumptions underlying the division rules and also provides a general characterization of the consequences of using these rules when the opportunity set or number of patients changes jel 118

a note on eliciting distributive preferences for health while in theory the strength of preferences for equity in health can be expressed in an inequality aversion parameter in practice analysts would have to obtain them from people s choices we are faced with a number of methodological problems when turning to this type of empirical research this note investigates which types of preference could explain the choices people make when responding to equity efficiency questions of this kind respondents may be heavily influenced by concerns that are not related to their equity preferences something which may lead them to choose distributions that are not consistent with models on the equity efficiency trade off specifically a threshold effect is identified which could explain why some people would rather prefer to concentrate than to diffuse health gains the second aim of this note is to offer some lessons from a survey which was designed for eliciting people s distributive preferences for health gains

welfare evaluations in contingent valuation experiments with discrete response data comment in the case of private goods individuals reveal their preferences in the market place no similar market mechanism exists in the case of public goods however one obvious possibility is to ask people about their maximal willingness to pay for public goods or government expenditure johansson 1987 1990 miller in some recent contingent market valuation studies people instead have been asked to accept or reject a specified amount of money for a change in the provision of a public good different subsamples are confronted with different bids the resulting yes and no responses usually are analyzed by logit or probit techniques e g johansson and kristrom this raises the question of how to compute the average willingness to pay when only yes and no responses are available this point was advanced by hanemann in his seminal 1984 paper on welfare evaluations with discrete responses see also hanemann 1987 however we believe a minor imperfection in hanemann s presentation may confuse and mislead practitioners hanemann s approach assumes that negative bids cannot occur but at the same time gives the impression that it also applies to models that allow for negative bids we also extend hanemann s discussion of the choice of money measure in cost benefit analysis

pricing derivatives on financial securities subject to credit risk this article provides a new methodology for pricing and hedging derivative securities involving credit risk two types of credit risks are considered the first is where the asset underlying the derivative security may default the second is where the writer of the derivative security may default we apply the foreign currency analogy of jarrow and turnbull 1991 to decompose the dollar payoff from a risky security into a certain payoff and a spot exchange rate arbitrage free valuation techniques are then employed this methodology can be applied to corporate debt and over the counter derivatives such as swaps and caps the purpose of this article is to provide a new theory for pricing and hedging derivative securities involving credit risk two sources of credit risk are identified and analyzed the first is where the asset underlying the derivative security may default paying off less than promised this is the case for example with imbedded options on corporate debt the second is the credit risk introduced by the writer of the derivative security who may also default examples include over the counter writers of options on eurodollar futures swaps and swaptions for pricing derivative securities involving credit risk there are currently two approaches the first views these derivatives as contingent claims not on the financial securities themselves but as compound options on the assets underlying the financial securities this is the case for example with the pricing of imbedded options on corporate debt see merton 1974 1977 black and cox 1976 ho and singer 1982 chance 1990 and kim ramaswamy and sundaresan 1993 or the pricing of vulnerable options see johnson and stulz 1987 in practice however this valuation methodology is difficult to use first the assets underlying the financial security are often not tradeable and therefore their values are not observable this makes application of the theory and estimation of the relevant parameters problematic second as in the case of corporate debt all of the other liabilities of the firm senior to the corporate debt must first and simultaneously be valued this generates significant computational difficulties as a result this approach has not

the real time predictive content of money for output abstract data on monetary aggregates are subject to periodic redefinitions presumably in part to improve their link to measures of output money data are also revised on a regular basis taking these data imperfections into account we reassess the evidence on the marginal predictive content of m1 and m2 for real and nominal output in particular first by using the latest version of the data that is available and then using sequences of historical time series that would have been available to forecasters in real time we are able to provide a comprehensive assessment of whether money is useful for predicting output we conclude that the generally significant marginal predictive content of m1 or m2 for output that is found using a recently revised data set is not duplicated in a real time setting although m2 is shown to remain useful when 1 year ahead forecasts are constructed using fitted vector autoregressive models

exploring social welfare functions and violation of monotonicity an example from inequalities in health the social welfare function swf has been used within the economics literature to study trade offs between equality and efficiency these swfs are characterised by properties determined by traditional welfare economics one of these properties the monotonicity principle is explored in this paper in the context of health there may be occasions when the monotonicity principle is violated as there may be circumstances where distributional issues dominate efficiency concerns when this is the case conventional swfs are not flexible enough to represent such social preferences therefore we propose a swf with an alternative specification which is general enough to accommodate preferences that are not necessarily monotonic a survey of the spanish general public was undertaken to estimate preferences regarding equality in health relative to efficiency in health the results with 973 usable responses give strong support to the existence of public preferences which violate the monotonicity principle and thus to the usefulness of the alternative specification proposed here

measurement errors and monetary policy then and now should policymakers and applied macroeconomists worry about the difference between real time and final data we tackle this question by using a bayesian var with time varying parameters and stochastic volatility to show that the distinction between real time data and final data matters for the impact of monetary policy shocks the impact on final data is substantially and systematically different in particular larger in magnitude for different measures of real activity from the impact on real time data these differences have persisted over the last 40 years and should be taken into account when conducting or studying monetary policy

qalys versus hyes what s right and what s wrong a review of the controversy abstract the paper uses an axiomatic approach to the description of individual preferences for health status sequences to resolve the major issues at stake in the recent controversy over qalys versus hyes while the hye accounts for an individual s time preference for health qaly scores based on the time trade off method will generally differ from the number of hyes hyes do not represent preferences for health under risk unless the utility function for reference flows of health is linear collapsing the two step hye assessment procedure into a single step entails a loss of information as regards the utility of a health status sequence although the procedure does represent preferences for health it fails to supply a description in terms of hyes in the case of risk as a remedy a modified hye approach is proposed

assessing international commonality in macroeconomic uncertainty and its effects this paper uses a large vector autoregression var to measure international macroeconomic uncertainty and its effects on major economies using two datasets one with gdp growth rates for 19 industrialized countries and the other with a larger set of macroeconomic indicators for the u s euro area and u k using basic factor model diagnostics we first provide evidence of significant commonality in international macroeconomic volatility with one common factor accounting for strong comovement across economies and variables we then turn to measuring uncertainty and its effects with a large var in which the error volatilities evolve over time according to a factor structure the volatility of each variable in the system reflects time varying common global components and idiosyncratic components in this model global uncertainty is allowed to contemporaneously affect the macroeconomies of the included nations both the levels and volatilities of the included variables in this setup uncertainty and its effects are estimated in a single step within the same model our estimates yield new measures of international macroeconomic uncertainty and indicate that uncertainty shocks surprise increases lower gdp and many of its components adversely affect labor market conditions lower stock prices and in some economies lead to an easing of monetary policy

uncertainty shocks and unemployment dynamics in u s recessions abstract what are the effects of uncertainty shocks on unemployment dynamics we answer this question by estimating non linear smooth transition vars with post wwii u s data the relevance of uncertainty shocks is found to be much larger than that predicted by standard linear vars in terms of i magnitude of the reaction of the unemployment rate to such shocks and ii contribution to the variance of the prediction errors of unemployment at business cycle frequencies the ability of different classes of dsge models to replicate our results is discussed