comparing the performance of health care systems an alternative approach the health care system in the united states has been diagnosed as a moribund institution by a large number of media commentators and health policy analysts continually rising health care costs and inadequate health insurance coverage for approximately thirty seven million people are cited as two of the most visible symptoms supporting their diagnosis most of these individuals see little chance for the u s health care system to recover given its present design full recovery they believe requires the successful transplant of a health care system from another country the health care systems in europe and canada where government is assigned a much larger role than in the united states are argued to offer universal health care coverage and simultaneously contain health care costs simple comparative statistics appear to support the view that the performance of the u s health care system could be improved through a new health care system design infant mortality in the united states ranked twentieth among twenty four member countries of the organization for economic cooperation and development oecd in 1988 yet health care expenditures in the united states comprised 11 8 percent of gross domestic product in 1989 while the comparable average for all oecd countries was only 7 4 percent 28 these statistics portray the u s health care system as being deficient and therefore unable to offer quality medical services at a reasonable price given the limited stock of information that exists on this issue however it is ill advised to place full blame for the seemingly dismal performance on the u s health care system the simple international comparisons fail to take into account that differences in performance are not solely due to variations in health care systems while the design of a health care system including the financing scheme reimbursement method and organization of production is indeed important because it influences how various economic technological and demographic characteristics of a country are transformed into health outcomes the performance of the health care system also depends on the magnitude of these national characteristics as well a proper analysis would try to determine how the health care system itself specifically influences the performance of health

a cluster analysis on income elasticity variations and us pharmaceutical expenditures this paper examines the relationship between household income and outpatient prescribed medicines in the usa based on a sample of 2872 privately insured patients from the 1987 nmes data set the analysis is performed on regional typologies of different socioeconomic profiles of patients only a few groups show positive income elasticity

what drives health care expenditure baumol s model of unbalanced growth revisited the share of health care expenditure in gdp rises rapidly in virtually all oecd countries causing increasing concern among politicians and the general public yet economists have to date failed to reach an agreement on what the main determinants of this development are this paper revisits baumol s baumol w j 1967 macroeconomics of unbalanced growth the anatomy of urban crisis american economic review 57 3 415 426 model of unbalanced growth showing that the latter offers a ready explanation for the observed inexorable rise in health care expenditure the main implication of baumol s model in this context is that health care expenditure is driven by wage increases in excess of productivity growth this hypothesis is tested empirically using data from a panel of 19 oecd countries our tests yield robust evidence in favor of baumol s theory

examining structural breaks and growth rates in international health expenditures over the last decade there has been a growing interest in examining health expenditures in this paper we study the behaviour of health expenditures in the g3 countries usa the uk and japan and three european countries the uk switzerland and spain over the period 1960 2000 from a different perspective in that we examine 1 whether there is a common structural break in health expenditures across the g3 and european countries 2 whether structural breaks have slowed down health expenditure growth rates in these countries or vice versa our main findings are that 1 health expenditures share a common break in both bivariate and trivariate cases and structural breaks and break intervals suggest that either one or a combination of events second oil price shock the 1987 stock market crash and or recessions have contributed to the commonality of break in health expenditures in the g3 while the oil price shocks have been instrumental in the commonality of breaks for the european countries 2 except for the uk structural breaks have slowed down growth rates in health expenditures for the usa japan switzerland and spain

modelling the dynamics of a public health care system evidence from time series data the english national health service nhs was established in 1948 and has therefore yielded some long time series data on health system performance waiting time for inpatient care have been a persistent policy concern since the creation of the nhs after developing a simple theoretical framework of the dynamic interaction between key indicators of health system performance we investigate empirically the relationship between hospital activity waiting time and population characteristics using aggregate time series data for the nhs over the period 1952 to 2003 structural vector autoregression s var suggests that in the long run higher activity is associated with lower waiting times elasticity 0 9 an increase in the elderly population is associated with higher waiting time elasticity 1 3 in the short run higher lagged waiting time leads to higher activity elasticity 0 12 we also find that shocks in waiting times are countered by higher activity so the effect is only temporary

do per capita health care expenditures converge among oecd countries evidence from unit root tests with level and trend shifts this study examines the stochastic conditional convergence of per capita health care expenditures pchce among 19 oecd countries over the period 1972 2008 specifically newly developed lm and rals lm unit root tests with allowance for two endogenously determined structural breaks are employed the results indicate support for pchce convergence among most oecd countries the results are stronger in more general tests that control for two breaks and nonnormal errors panel unit root tests provide additional support for the stochastic convergence of pchce

trade ecologically unequal exchange and colonial legacy the case of france and its former colonies 1962 2015 abstract the role of trade in global environmental change is receiving increasing attention and there is a lively debate about ecologically unequal exchange eue little is known however about the role of colonial legacy for the evolution of physical trade patterns this study provides empirical evidence on the basis of a systematic evaluation of global trade data we quantify in physical and monetary terms the development of trade relations between france its former colonies and the rest the world from the immediate post colonial period until 2015 we use a set of physical trade indicators including physical trade balance and terms of trade to analyse differences in trade patterns and eue the results indicate that colonial ties were very strong in the 1960s but thereafter quickly diminished we find strong evidence for eue between france and its former colonies in the post colonial period and that the colonial factor explains eue between centre and peripheries better than income differences until the 1970s in recent decades colonial legacy increasingly vanished our findings corroborate that socio political factors and in particular colonial legacy play an important role for eue relations and that they deserve more attention in quantitative empirical research on trade

structural changes and sustainability a selected review of the empirical evidence abstract the paper offers a review of selected topics in the empirical literature on structural change and sustainability we focus on aspects of structural change that directly affect emissions and energy intensity changes of the sectoral composition of economies trade and international fragmentation of production technological change and innovation and demand we identify several empirical facts first only a few countries have experienced a decoupling between growth and emissions due to proportionately faster growth rather than greater energy efficiency second the long term shift from manufacturing to services has not led in all cases to the de materialisation of economies and a lower environmental burden exploitation of energy efficiency increases depends on the ability of the service sectors to incorporate technical changes to reduce energy intensity third global trade and energy and emissions intensity trends support the pollution haven hypothesis which predicts displacement of the environmental burden from developed to emerging countries the pursuit by developing countries of a long term strategy of trading jobs for emissions is likely to exacerbate the asymmetry related to emissions intensities between developed and less developed economies the review should inform debate on environmental policy within the broader context of innovation and development policies

do individual preferences explain the environmental kuznets curve abstract some economists maintain the optimistic view that individual preferences of rich people eventually lead to a virtuous circle relationship between rising income and environmental degradation in this article i review some of the models that establish a relationship between individual preferences and environmental quality these models provide a basis for discussion of the key role played by two factors individual preferences and technology they do not however capture the distributive conflicts that occur between different social groups in the process of defining environmental policy neither do they provide a good basis for distinguishing between environmental costs caused by the decisions of particular consumers and those which affect the same consumers this point is related to the various manners in which environmental costs are displaced displacement often occurs within a country for current costs and is even clearer and more relevant when costs are transferred across a great distance or to a remote future in such cases there are few incentives to reduce consumption or alter its composition displacement moreover can become a strategy pursued more or less consciously for maintaining high and rising levels of consumption without dealing with the associated environmental costs

the determinants of health expenditures evidence from us state level data most macro studies of what determines health expenditures have used the same panel of oecd country level data based on a more homogeneous panel data set of us states we constructed this note applies the model selection procedure to identify the determinants of health expenditures at the state level we find that the four key factors are gross state products the proportion of the population over the age of 65 the degree of urbanization and the number of hospital beds the cross section income elasticity of health care is around 0 7 implying that health care is a necessity rather than a luxury good at the state level the relative price of health care varies significantly across states but does not appear to have real effects on the amount of resources measured in real dollars a state devotes to health care

on stationarity and cointegration of international health expenditure and gdp this paper examines stationarity and cointegration of health expenditure and gdp for a sample of 21 oecd countries using data for the period 1960 1997 by applying a test battery that allows robust inference to be made on the stationarity and cointegration issue trend stationarity and no cointegration are tested using new country by country and panel tests not previously applied in this setting new results for country by country and panel tests of non stationarity and cointegration are presented our unit root and trend stationarity results indicate that both health expenditure and gdp are non stationary the no cointegration and cointegration results indicate that health expenditure and gdp are cointegrated

from production based to consumption based national emission inventories abstract under the united national framework convention of climate change unfccc countries are required to submit national emission inventories nei to benchmark reductions in greenhouse gas ghg emissions depending on the definition and system boundary of the nei the mitigation options and priorities may vary the territorial system boundary used by the unfccc has been critiqued for not including international transportation and potentially causing carbon leakage to address these issues past literature has argued in favour of using consumption based nei in climate policy this article discusses several issues in moving from the standard production based nei to consumption based nei first two distinct accounting approaches for constructing consumption based nei are presented the approaches differ in the allocation of intermediate consumption of imported products second a consistent method of weighting production based and consumption based nei is discussed this is an extension of the previous literature on shared responsibility to nei third due to increased uncertainty and a wide system boundary it may be difficult to implement consumption based nei directly into climate policy several alternative options for incorporating consumption based inventories into climate policy are discussed

health system effects on cost efficiency in the oecd countries this paper investigates the effects of different health systems on cost efficiency in inpatient health care among the oecd countries the results indicate that public contract systems are more efficient and that public integrated systems are less efficient than public reimbursement systems

trade environment and development the issues in perspective abstract this special issue on trade and the environment brings together a number of papers that are constructively critical of the conventional economic wisdom on the topic we think that this criticism is warranted because of the decidely uncritical way in which free trade has been advocated in much of the literature and especially in policy the papers analyse the validity of the underlying assumptions on which the conventional wisdom is based and provide suggestions for ways to facilitate trade that is also adequately protective of the environment sustainability and other social values in this introductory piece we discuss trade the environment and sustainability summarizing arguments in the papers included in this issue and adding a few additional points not covered by them

can baumol s model of unbalanced growth contribute to explaining the secular rise in health care expenditure an alternative test in a recent paper i argued that baumol s model of unbalanced growth offers a ready explanation for the observed secular rise in health care expenditure hce in rich countries baumol s model implies that hce is driven by wage increases in excess of productivity growth i tested this hypothesis empirically using data from a panel of 19 organization for economic cooperation and development oecd countries and found robust evidence in favour of baumol s theory an alternative way to test baumol s theory is to check whether its implication that variations in the relative price of medical care contribute significantly to explaining variations in health expenditure in the same direction has an empirical grounding earlier studies although mostly not in an explicit attempt to test baumol s theory have occasionally rejected this hypothesis despite poor data quality of the available medical price indices i perform the alternative test using data for nine oecd countries my findings suggest that the relat

the growth of public health expenditures in oecd countries do government ideology and electoral motives matter this paper empirically evaluates whether government ideology and electoral motives influenced the growth of public health expenditures in 18 oecd countries over the 1971 2004 period the results suggest that incumbents behaved opportunistically and increased the growth of public health expenditures in election years government ideology did not have an influence these findings indicate 1 the importance of public health in policy debates before elections and 2 the political pressure towards re organizing public health policy platforms especially in times of demographic change

social security income and health care spending evidence from the social security notch the paper exploits social security legislation changes to identify the causal effect of social security income on out of pocket medical expenditures of the elderly using the 1986 1994 consumer expenditure survey and an instrumental variables strategy the empirical results show that health care expenditures are responsive to changes in social security income for elderly individuals with less than a high school education the estimated income elasticities are between 1 41 and 3 47 depending on the outcome measures and are statistically significant at conventional levels the findings are in contrast to existing studies that find a small income elasticity at the individual household level this article is protected by copyright all rights reserved

health care expenditures and gdp panel data unit root test results abstract this short paper presents unit root test results for time series on per capita national health care expenditures and gross domestic product in the oecd unlike the country by country test used by hansen p king a 1996 the determinants of health care expenditure a cointegration approach j health econ 15 127 137 the test we employ exploits the panel nature of the oecd data using this approach we are able to reject the null hypothesis that these series contain unit roots no single test is likely to be definitive in this rapidly evolving area of econometric research however our results help to mitigate concern that panel data analyses of national health care expenditures are misspecified

the granger causality between health care expenditure and output a panel data approach this study investigates the granger causality relationship between real per capita gdp and real per capita health care expenditure by employing a large macro panel data set with a var representatio

the determinants of canadian provincial health expenditures evidence from a dynamic panel this article seeks to reveal the magnitude of the income elasticity of health expenditure and the impact of non income determinants of health expenditure across canada for this purpose panel data on gross domestic product the relative price of health care the share of publicly funded health expenditure the share of senior population and the life expectancy at birth have been used to investigate the determinants of canadian provincial health expenditures over a 28 year period dynamic models of health expenditure are analysed via generalized instrumental variables giv and generalized method of moments gmm results indicate that the long run income elasticity of health expenditure is substantially lower than one thus health care is far from being a luxury in canada

demand for medical care consumption and cointegration abstract this paper considers a generalized version of grossman s health capital model and derives a cointegration restriction the restriction is tested using aggregate us data and the results are consistent with the prediction of the model

a new test for supplier inducement and application to the canadian market for dental care abstract the hypothesis that dentists do not induce demand for their services is tested using reduced form estimates of the price elasticity of demand if demand is autonomous shifts in supply for whatever reason should generate equivalent estimates provided access costs change proportionately with shifts in supply if demand inducement is present demand can appear to be very elastic or very inelastic depending on what is causing the shift in supply each of three applications of this test conducted in the context of jointly estimated fee and quantity equations using annual canadian data for 1956 1989 rejects the no inducement hypothesis

price and quantity in international comparisons of health care expenditure an important omission from earlier cross national comparisons of health care expenditure has been the failure to distinguish between price and quantity using recent data on purchasing power parities the purpose of this article is to report some preliminary results regarding health care expenditure and quantity across 22 oecd countries the article concludes that contrary to what has been suggested in some recent articles the relative price of health care is not correlated to the aggregate per capita income the fraction of the national income that is devoted to health care provision increases with the per capita income regardless of whether health care is measured in terms of expenditure or quantity the relative price of health care has a rationing effect on the quantity of health care that is offered with a price alasticity close to minus one the latter finding means that the health care expenditure is not greater in countries with higherprices furthermore the differences in health care expendit

austria s co2 responsibility and the carbon content of its international trade abstract seeking to limit global warming to 2 c puts narrow restrictions on the remaining carbon budget while the prevalent accounting framework for carbon emissions is production based production based principle pbp we here quantify the co2 emissions on the basis of the consumption based principle cbp for austria at a methodological level a multi regional input output model with full linkages is used to account for austria s co2 responsibility on a global scale estimates are carried out for the years 1997 and 2004 results show that during 1997 co2 responsibility based on cbp were 36 larger than those based on pbp this relation has increased through time the cbp indicator of 2004 was 44 larger than the pbp in terms of carbon emission location for each euro spent on austrian final demand in 2004 it is estimated that two thirds of the co2 emissions occur outside austrian borders regarding the origin of the emissions embodied in imports it is estimated that about one fourth originated in non annex i countries in 1997 this proportion increased to one third by 2004 due to this divergence between cbp and pbp indicators there is a need to re think current accounting bases in order to properly assign co2 responsibilities

health care expenditure and integration in the countries of the european union national health care differs between the member states of the european union in the quality and quantity demanded and supplied reflecting different economic structures and health care organization and delivery systems since health care expenditure depends primarily on the level of economic development and the structure of the population only convergence in economic performance and the standards of living can lead to convergence of health expenditure standards

determinants of health care expenditure in africa a cross sectional study the paper presents some quantitative evidence on the relationship between certain socioeconomic and demographic factors and per capita health care expenditure in africa first gnp per capita percentage of births attended by health staff and foreign aid received per capita together explained 78 3 of the variance in health care expenditure second per capita gnp is the most significant factor explaining differences in health care expenditure contrary to what has been found in comparisons of health care expenditure in the organization for economic cooperation and development oecd countries we found that the income elasticity is close to unity furthermore aid was consistently significant and positive in the three models estimated third variables such as crude birth rate and the population under 15 years of age as percentage of total population were not significant

free entry and social inefficiency our goal is to provide a simple yet general exposition of the conditions under which the number of entrants in a free entry equilibrium is excessive insufficient or optimal our analysis compares the number of firms that enter a market when there is free entry with the number that would be desired by a social planner who is unable to control the behavior of firms once they are in the market that is we consider the second best problem of choosing the welfare maximizing number of firms while we take as given their noncompetitive behavior after entry we demonstrate that the crucial conditions for establishing the presence of an entry bias can be stated quite simply in terms of the outcome of the postentry game played by entrants in contrast to previous work we do not need to model this postentry game explicitly

aggregate health care expenditure in the united states evidence from cointegration tests unlike recent studies that are based on international cross sectional series this paper attempts to quantify the role of the determinants of aggregate health care expenditure per capita using time series data for the period of 1960 87 for the united states the paper applies the relatively new procedures of unit root testing cointegration and error correction modelling the evidence supports cointegration although the results indicate that per capita income age of the population number of practising physicians and public financing of health care are important determinants the age structure of the population and number of practising physicians emerge as the major determinants of aggregate health care expenditure in the united states

fiscal decentralization and spillover effects of local government public spending the case of italy abstractfiscal decentralization and spillover effects of local government public spending the case of italy regional studies this paper investigates the presence of spatial interdependencies in the regional public expenditure decision process and the impact of fiscal decentralization on its determinants the analysis refers to the constitutional reform concluded in italy in 2001 that redefined the legislative powers of the regions and their sectoral competence the results highlight the opportunistic behaviour of regional governments in sectors where they can benefit from neighbours public expenditure spillovers other findings comprise the presence of congestion and mobility effects a shift in demand to the private sector except for education and the mobility of individuals towards richer regions

aggregate health care expenditures and national income is health care a luxury good it is well known that a strong relationship exists between national expenditures on health care and national income this has been used to suggest that health care is a luxury good and that factors such as the type of health care delivery system in a country are of little importance in determining expenditure levels this paper argues that these implications rely upon the application of microeconomic analysis to macroeconomic data and that this is not appropriate as well as raising questions about the inferences drawn from previous studies new empirical evidence is presented which casts some doubts on previous findings international comparisons are based on purchasing power parity rather than exchange rate conversions underlining the importance of prices as well as quantities in the relationship and leading to the conclusion that the aggregate data show health care to be if anything a necessity rather than a luxury good

medical care costs how much welfare loss hardly a week goes by without a front page newspaper article on rising health care costs and the uninsured in this article i focus mainly on costs arguing that the issue has been somewhat misconceived while the level of medical care spending in the u s is a cause for concern the welfare losses associated with rises in that level of spending may not be as large as the public rhetoric can make them seem in fact cost containment may not be as urgent as is widely supposed and some proposed cost containment policies may result in welfare losses for the insured and even increase the number of uninsured

the economics of moral hazard revisited pauly s 1968 pauly m 1968 the economics of moral hazard comment american economic review 58 531 537 analysis of the welfare loss from insurance assumes that medical care consumption is not determined by income but recent studies suggest it is this study argues that 1 pauly s analysis overstates the welfare loss because it includes the effect of income on consumption 2 the relevant income effect is derived from income transfer from the healthy to the ill that occur when the probability of illness is less than 1 and 3 the welfare loss can be considered the transaction cost of insurance

fixed costs and the product market treatment of preference minorities we clarify the sense in which the market outcome may be biased against preference minorities and estimate the degree of bias using an empirical model of entry into american radio broadcasting markets listening model estimates are used to infer fixed costs and these estimates are then used to compute optimal station configurations as well as the welfare weights on different groups that rationalize the observed configuration welfare weights are 2 to 3 times higher for whites than for blacks and 1 5 to 2 times higher for non hispanic than for hispanic listeners we explore the role of importing and exporting patterns in generating these findings

public private mix of health expenditure a political economy and quantitative analysis this paper constructs a simple model to examine decisions on public and private health spending under majority voting in the model agents with heterogeneous incomes choose how much to consume and spend on health care and vote for public health expenditure the health status of an agent is determined by a ces composite of public and private health expenditure the existence and uniqueness of the voting equilibrium are established a quantitative exercise reveals the importance of the relative effectiveness of public and private health expenditure and their substitutability in determining the public private mix of health expenditure and in accounting for the observed differences across a sample of 22 advanced democratic countries

equity in the finance and delivery of health care some tentative cross country comparisons textabstractequity is widely acknowledged to be an important goal in the field of health care indeed mclachlan and maynard 1982 have gone so far as to suggest that the vast majority of the population would elect for equity to be the prime consideration p 556 a view endorsed by mooney 1986 p 145 several researchers have investigated how successful their own country s delivery and or financing system is in achieving its stated equity goals in general the strategy of these studies is to compare the current situation with some ideal or target situation le grand 1978 for example in what has become a classic study in the field compares the distributions across socio economic groups of illness and public expenditure on health care in britain in 1972 and concludes that the national health service nhs has failed to achieve equity in the delivery of health care

review of the literature on the determinants of healthcare expenditure this study reviews the literature on determinants of healthcare expenditure for the period 1998 to 2007 the methodology combines searches in the mesh database of pubmed with the search in the principal journals of health economics 20 primary studies were found that met the criteria for inclusion no single pattern of results is clearly identified among the 20 articles four consider income to be the principal determinant of healthcare expenditure two of them jointly with population ageing six highlight population ageing as against six others that emphasize the proximity to death the remaining six do not focus on a specific variable or focus on another variable e g technological progress or territorial decentralization 11 of the 20 articles calculate the income elasticity of demand only two of them obtaining a value greater than 1 thus cataloguing healthcare expenditure as a luxury good there is therefore no unanimity in the variables and econometric regressions of healthcare expenditure in

colombian international trade from a physical perspective towards an ecological prebisch thesis abstract prebisch s approach to economic development was based on the notion that there is an international historical division of labour peripheral countries are specialised in exporting primary goods while centre countries export industrial goods the terms of trade for peripheral countries tend to deteriorate this approach can be extended to ecological issues the international centre periphery division does not only involve the monetary exchange of goods and capital but also the physical exchange in which southern countries provide materials and energy so that northern countries can develop their socioeconomic metabolism this metabolic process is guaranteed through cheap prices for primary goods this paper aims to apply and extend prebisch s thought on unequal exchange both monetary and ecological in relation to colombian trade in the period 1970 2002 using material flow analysis

trade and the environment from a southern perspective the relationship between free trade and the environment is one of the main issues of contention between environmental and ecological economics environmental economics assumes a positive relationship between free trade economic growth and environmental policies environmental externalities may cause important damage however trade is not to be blamed for this instead the fault lies with policy inadequacies at the national level on the other hand some ecological economists criticise the assumptions of environmental economics especially the immobility of production factors and the positive correlation between income and environmental quality they plead for measures to prevent deterioration of northern environmental standards in a race to the bottom due to ecological dumping from the south in this paper we argue that neither environmental economics nor northern ecological economics take into account the structural conditions determining the international trade system based on some new empirical evidence on material flows we stress the notion of environmental cost shifting if physical and political ecology perspectives are adopted a southern approach to the trade and environment issue may arise 2001 elsevier science b v all rights reserved

does environmental quality influence health expenditures empirical evidence from a panel of selected oecd countries in this paper we examine the role of environmental quality in determining per capita health expenditures we take a panel cointegration approach in order to explore the possibility of estimating both short run and long run impacts of environmental quality our empirical analysis is based on eight oecd countries namely austria denmark iceland ireland norway spain switzerland and the uk for the period 1980 1999 we find that per capita health expenditure per capita income carbon monoxide emissions sulphur oxide emissions and nitrogen oxide emissions are panel cointegrated while short run elasticities reveal that income and carbon monoxide emissions exert a statistically significant positive effect on health expenditures in the long run in addition to income and carbon monoxide we find that sulphur oxide emissions have a statistically significant positive impact on health expenditures

the theory of reform and indian indirect taxes abstract given a set of value judgements an initial state and a model of the economy one can ask whether some feasible tax change would increase welfare we do this by defining the marginal cost in terms of welfare of raising an extra rupee from the i th good the inverse optimum problem is the calculation of non negative welfare weights on households which imply that the initial state is optimum if no such welfare weights exist then a pareto improvement is possible we illustrate the concepts and results using data from the indian economy for 1979 1980 directions of tax reform for a number of specific social welfare functions and for pareto improvements are presented

is social protection a necessity or a luxury good new multivariate cointegration panel data results the aim of this paper is to test the claim that social protection is a luxury good therefore gdp elasticity of selected social protection expenditure is estimated using a new econometric approach developed first by kao and chiang advances in econometrics 15 179 222 2000 time series properties of selected social expenditure in 18 oecd countries from 1981 to 1998 are examined using panel data cointegration tests and ols fmols and dols estimators results were found which differ from previous analyses reporting substantially higher income elasticities with the fmols selected social expenditure has income elasticities smaller than one but greater than one with the dols it is noteworthy that whether selected social expenditure is stationary or nonstationary may have critical implications for researchers and policy makers desiring to model and explain the impact of this expenditure on a country economic system

estimation of a model of entry in the airline industry this paper considers the effect of an airline s scale of operation at an airport on the profitability of routes flown out of that airport the empirical methodology uses the entry decisions of airlines as indicators of underlying profitability the results extend the empirical literature on airport presence by providing a new set of estimates of the determinants of city pair profitability these estimates imply that city pair profits increase in airport presence and decrease rapidly in the number of entering firms the literature on empirical models of oligopoly entry is also extended via a focus on the role of differences between firms

is health care really a luxury much of the work which has led to a widely held view that the income elasticity of health care spending exceeds one has been based on international cross section data or on pooled cross sections and time series in this paper we re examine this view in the context of long run equilibrium relationships between non stationary time series possibly including autonomous trends our results cast doubt upon the usefulness of pooling and upon the notion of an elasticity above one

towards an ecological theory of unequal exchange articulating world system theory and ecological economics abstract the focus of this paper is on how an ecological perspective might provide us with an analytically more precise way of defining unequal exchange it is only by looking at the ecological conditions of human economies that we can adequately conceptualize the mechanisms which generate inequalities in distribution considerations of market power aside neoclassical economic ideology has dispelled all possible criteria for assessing a market transaction as unequal or unfair one way to assess the occurrence of unequal exchange may be to look at the direction of net flows of energy and materials concrete productive potential but without falling into the trap of equating productive potential with economic value on the contrary it can be analytically demonstrated that unequal exchange emerges from a kind of inverse relationship between productive potential and economic value the notion of a reasonable market price conceals the fact that what is being exchanged are intact resources for products representing resources already spent if we consider longitudinally along the production process any given set of fuels and raw materials destined to be transformed into a given product plus waste its content of available energy will be inversely related to its utility or price in other words the more of its original energy that has been dissipated the higher its price this means that production i e the dissipation of resources will continuously be rewarded with ever more resources to dissipate generating ecological destruction and global core periphery inequalities as two sides of the same coin

price elasticity of expenditure across health care services policymakers in countries around the world are faced with rising health care costs and are debating ways to reform health care to reduce expenditures estimates of price elasticity of expenditure are a key component for predicting expenditures under alternative policies using unique individual level data compiled from administrative records from the chilean private health insurance market i estimate the price elasticity of expenditures across a variety of health care services i find elasticities that range between zero for the most acute service appendectomy and 2 08 for the most elective psychologist visit moreover the results show that at least one third of the elasticity is explained by the number of visits the rest is explained by the intensity of each visit finally i find that high income individuals are five times more price sensitive than low income individuals and that older individuals are less price sensitive than young individuals

an empirical model of firm entry with endogenous product type choices i describe a model of entry with endogenous product type choices these choices are formalized as the outcomes of a game of incomplete information in which rivals differentiated products have nonuniform competitive effects on profits i estimate the model for location choices in the video retail industry using a nested fixed point algorithm solution the results imply significant returns to product differentiation simulations illustrate the tradeoff between demand and intensified competition and the extent to which markets with more scope for differentiation support greater entry

disentangling the heterogeneous income elasticity and dynamics of health expenditure in this article we empirically study the impact of per capita income on health care expenditure and its dynamics over time in a sample of 14 oecd countries for the period 1971 to 2009 a simple model built upon one developed by newhouse 1977 suggests that health care is a necessity in the short run but it cannot be rejected to be a luxury good in the long run our findings provide strong empirical evidence that a year s health expenditure is conditioned by the previous one interestingly our results reveal increasing income inelasticity over time along with huge heterogeneity across countries finally this article supports the hypothesis of conditional convergence in health care spending among countries in designing policies which facilitate the sustainability of national health systems we emphasize that ceteris paribus the greater the participation of public health the lower the growth rate of health spending high share of children and elderly over working age population opposite influences w

on the effect of income and relative price on demand for health care ec evidence this paper demonstrates that the relative price of health care could be used to explain the conflicting results of the empirical studies which attempt to measure the income elasticity of demand our empirical results based on a conventional model and cross national data set for the ec show that whereas health care may be labelled as a luxury good the large income effect can be interpreted as merely offsetting the price effect

household production of health investment analysis and applications michael grossman s health investment model provides significant insights into allocations between both leisure and income and health and nonhealth goods our geometric extension i integrates labor leisure choice with the consumer s production of both health and nonhealth goods and ii distinguishes between medical expenditures and healthcare investment this provides a framework for examining the effects of changes in incomes and wages alternative insurance arrangements including managed care travel times waiting times and schooling observed differences between the income elasticities for health goods and health investment can be resolved through relative resource intensities in the production of health and nonhealth goods

comparing french and us hospital technologies a directional input distance function approach french and us hospital technologies are compared using directional input distance functions the aggregation properties of the directional distance function allow comparison of hospital industry level performance as well as standard firm level performance with regard to productive efficiency in addition the underlying constituents of efficiency in the short run congestion and technical inefficiency and in the long run scale inefficiency are analysed by decomposing the overall measure by virtue of using the directional distance function it is also possible to obtain an estimate of a lower bound on allocative inefficiency it is found that french and us hospitals use quite different technologies long run scale inefficiencies cause most of the french hospitals inefficiency while short run technical inefficiency is the main source of overall productive inefficiency in the us hospitals

evidence on the determinants of canadian provincial government health expenditures 1965 1991 abstract real per capita provincial government expenditures on health care over the period 1965 1991 are examined using pooled time series cross section regression analysis key determinants of real per capita provincial government expenditures on health care over the period 1965 1991 are real provincial per capita income the proportion of the provincial population over age 65 and real provincial per capita federal transfer revenues established program financing had a negative and significant impact on real per capita provincial government health expenditures in newfoundland and quebec an income elasticity of 0 77 implies that health care is not a luxury good

conversion factor instability in international comparisons of health care expenditure parkin mcguire and yule 1987 hereafter pmy report that a regression of per capita health care expenditure on per capita income using different conversion factors exchange rates gdp ppps health ppps gave rise to different results in this note we apply updated data to the same empirical relationship in contrast to pmy we find no noticeable conversion factor instability in that relationship either with respect to the health care income elasticity or with the magnitude of multiple correlation coefficient

public monopoly and economic efficiency evidence from the pennsylvania liquor control board s entry decisions we estimate a spatial model of liquor demand to analyze the impact of government controlled retailing on entry patterns in the absence of the pennsylvania liquor control board the state would have roughly 2 5 times the current number of stores higher consumer surplus and lower payments to liquor store employees with just over half the number of stores that would maximize welfare the government system is instead best rationalized as profit maximization with profit sharing government operation mitigates but does not eliminate free entry s bias against rural consumers we find only limited evidence of political influence on entry jel d42 d72 l11 l12 l43 l81

is health care a luxury the debate revisited with new evidence from emerging economies abstractthis paper studies the long run relationship between health care expenditure and income using a panel data set of emerging economies over the period 1995 2012 the results show that expenditure on health care and income are non stationary and cointegrated after controlling for cross sectional dependence and unobserved heterogeneity among different countries we find that the income elasticity of health care is less than 1 indicating that health care is a necessity and not a luxury government expenditure and out of pocket expenditure turn out to be important determinants of health care expenditure among non monetary factors results show that old age dependency and female education seem to have significant bearings on health care expenditures policy recommendations suggest that government should increase spending on health care in emerging economies since higher incomes may not automatically translate into higher health care spending by the people of these countries

granger causality between total expenditure on health and gdp in oecd evidence from the toda yamamoto approach abstract in this paper a modified version of the granger causality test proposed by toda and yamamoto is used to investigate causality between gdp and healthcare expenditure in oecd countries the findings indicate that bidirectional granger causality is predominant

an econometric analysis of health care expenditure a cross section study of the oecd countries this paper is an empirical examination of the determinants of aggregate health care expenditure the paper presents a systematic analysis of relationships across 19 oecd countries showing the effects of aggregate income institutional and socio demographic factors on health care expenditure the results indicate that institutional factors of the health systems in addition to per capita gross domestic product gdp contribute significantly to the explanation of the health care expenditure variation between countries for example the way physicians in outpatient care are paid and the mixture of public private funding and inpatient outpatient care

on the determination of the us aggregate health care expenditure per capita real health care expenditure is examined against three major groups of explanatory variables economic demographic and health stock and it is found that the three groups of variables have an impact on real health care spending other subcategories such as real private and government health care pharmaceutical dental home nursing ambulatory personal medical consumption and in patient expenditures have also been examined and have been found to be affected by the explanatory variables for several subcomponents there is evidence of supplier inducement of the demographic group of variables the ageing population had an impact only on the per capita real overall and private health care outlay and pharmaceutical spending also cointegrating relationships were found and consistent estimators of the elasticities found

the biophysical perspective of a middle income economy material flows in mexico abstract we analyse natural resource use dynamics in the mexican economy during the last three decades despite low and uneven economic growth the extraction and use of materials in the mexican economy has continuously increased during the last 30 years in this period population growth rather than economic growth was the main driving force for biophysical growth in addition fundamental changes have taken place in the primary sectors in manufacturing and in household consumption and these are reflected in an increasing emphasis on the use of fossil fuels and construction materials mexico s economy has been strongly influenced by international trade since the country commenced competing in international markets in the 1970s mexico mainly exported primary resources this pattern has changed and manufactured goods now have a much greater importance due to a boom in assembling industries in contrast with other latin american countries mexico has achieved a diversification of production moving towards technology intensive products and a better mix in its export portfolio however crude oil exports still represent the single most important export good mexico s material consumption is still well below the oecd average but is growing fast and the current resource use patterns may well present serious social and environmental problems to the medium and long term sustainability of mexico s economy and community information on natural resource use and resource productivity could provide valuable guidance for economic policy planning in mexico

is health care really a luxury a demand and supply approach many studies have found strong and positive relationship between per capita income and health care expenditure these studies usually adopt the assumptions that 1 the relationships among the variables are constant and or 2 the supply side market for health care could be treated by using standard demand functions models to take into account of the supply side of health care we use the demand and supply approach with the cointegration model to re examine this issue by using taiwan health care expenditure data our results show that the real income elasticity is smaller than unity and the health care expenditures are primarily for curing rather than caring

population and income is there a puzzle abstract this note presents wide evidence on the relationship between population and income for 125 countries for which data was available for the period 1950 2000 the main result is that there is a weak but negative relationship between population growth and per capita gdp as income increases population expands at a slower rate this relationship appears to be stronger for african countries and for asian countries before 1970

manufacturing exports mining exports and growth cointegration and causality analysis for chile 1960 2001 this study examines the export led growth hypothesis using annual time series data from chile in a production function framework it addresses the problem of specification bias under which previous studies have suffered and focuses on the impact of manufactured and mining exports on productivity growth in order to investigate if and how manufactured and mining exports affect economic growth via increases in productivity the study uses johansen cointegration technique the estimation results can be interpreted as evidence of productivity enhancing effects of manufactured exports and of productivity limiting effects of mining exports

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

public health capital and productivity in the spanish regions a dynamic panel data model abstract this paper investigates the impact of public health expenditure and variations in the composition of this expenditure on economic growth we develop an extension of the solow model that includes health as a publicly provided input in order to explain variations in productivity the paper reports the results of an empirical investigation using panel data for the spanish regions the results suggest that current government health spending has consistently positive effects while governmental investment in health care has no effect on productivity

biophysical structure of the ecuadorian economy foreign trade and policy implications abstract at the core of this paper lays the notion that a systematic analysis of material flow accounts enables us to discuss the sustainability of an economic model ecuador is going through a socio ecological transition from an agrarian towards an industrial regime based on the use of nonrenewable sources of materials and energy direct material flow indicators are used in this article to analyze the ecological dimension of the economy of ecuador during 1970 2007 this approach enables the concept of societal metabolism to become operative the paper compares societal metabolic profiles showing that per capita use of materials is still at about one fifth of the average in the high income countries of the world physical flows of trade indicate that there is an ecologically unequal exchange whereas a positive trade balance is desirable from an economic policy its counterpart in physical units has been a persistent net outflow of material resources the extraction of which causes environmental impacts and social conflicts

the determinants and effects of health expenditure in developed countries previous studies of international differences in health spending have been restricted to the use of relatively small samples of cross sectional data our objective here is to re examine the results of previous work using a sample of 560 pooled time series and cross section observations results confirm the importance of gdp as a determinant of health spending with an estimated income elasticity at or around unity but also suggest that oecd countries should not be regarded as a single homogeneous group the importance of some non income variables is also confirmed although the direct effect of these factors appears to be small

public financing of health expenditures insurance and health outcomes the effects of public financing of health expenditures insurance coverage and other factors on health outcomes are examined within health production models estimated using 1960 1992 data across 20 oecd countries mortality rates are found to depend on the mix of health care expenditures and the type of health insurance coverage increases in the publicly financed share of health expenditures are associated with increases in mortality rates increases in inpatient and ambulatory insurance coverage are associated with reduced mortality the effects of gdp health expenditures and age structure on mortality are similar to those in previous studies tobacco use alcohol use fat consumption female labour force participation and education levels are also significantly related to overall mortality rates increases in income inequality are associated with lower mortality rates suggesting that the negative relationship between inequality and health outcomes suggested by some previous studies does not remain w

is health care really a luxury in oecd countries evidence from alternative price deflators this article examines whether real health care expenditure he is a luxury or necessity for organization for economic co operation and development oecd countries over the period 1972 to 2004 within a panel unit root and panel cointegration framework to realize this objective we regress he on real gross domestic product gdp the proportion of the population aged over 65 p65 and a time trend t we first present results for 18 countries where real he per capita is obtained using a general gdp deflator for these countries we find that health care is a luxury for just one country next we present results for eight countries where real he is obtained using a specific health care price index when the general gdp deflator is replaced with a specific health care price index at least one of the gdp p65 or t coefficients for the eight countries changes in a reasonably dramatic fashion suggesting that the use of the gdp deflator introduces bias into the regression we find that he is a necessity in

replication in empirical economics the journal of money credit and banking project this paper examines the role of replication in empirical economic research it presents the findings of a two year study that collected programs and data from authors and attempted to replicate their published results the research provides new and important information about the extent and causes of failures to replicate published results in economics the findings suggest that inadvertent errors in published empirical articles are a commonplace rather than a rare occurence copyright 1986 by american economic association

uncovering regulators social welfare weights this article describes a procedure that can be used to infer interesting information about the preferences of regulators from the pricing decisions they make this is done by using an adaptation of the familiar ramsey pricing model which allows benefits derived from the consumption of different goods or derived by different consumers to carry different social weights these weights are then exposed by inverting the first order conditions of the constrained maximum problem

health care is an individual necessity and a national luxury applying multilevel decision models to the analysis of health care expenditures health care is neither a necessity or a luxury it is both since the income elasticity varies with the level of analysis with insurance individual income elasticities are typically near zero while national health expenditure elasticities are commonly greater than 1 0 the debate over whether health care is or is not a luxury good arises primarily from the failure to specify levels of analysis clearly so as to distinguish variation within groups from variation between groups apparently contradictory empirical results are shown to be consistent with a simple nested multilevel model of health care spending

financial deregulation and the dynamics of money prices and output in new zealand and australia effects of financial deregulation in the 1980s on the dynamic interactions among money prices and output in new zealand and australia are evaluated prior to deregulation the series appear to be nonstationary and cointegrated based on johansen s maximum likelihood tests with money proportional to prices but less than proportional to output in the long run the series also appear cointegrated in new zealand through the 1980s when the effects of deregulation are accounted for with a deterministic shift parameter the cointegrating coefficients are similar for the pre liberalization and full sample periods and dynamic responses are evaluated for error correction models incorporating the estimated long run relationships copyright 1993 by ohio state university press

on the north south trade in the americas and its ecological asymmetries there has been a long and intensive debate within the scientific community about the role of international trade in the development of countries during the last decades the focus of attention has moved from the pure economic level to the environmental aspects of international trade establishing a simplified system of north south trade for one reference period 2003 this paper attempts to test empirically the extent of potential asymmetries with regard to extracted material flows and contrasts the results with the economic benefits from trade in terms of value added the south is thereby represented by a selection of latin american countries brazil chile colombia ecuador and mexico the north comprises one of their main commercial partners the united states at the methodological level a multi regional input output analysis is used as the tool of investigation results generally support the hypothesis that the south was feeding the north s societal metabolism south north material exports were 1 6 times larger than north south material exports resulting in a net deficit for the south of 324 million tons moreover material intensity of exported commodities from the south was twice as high as that from the north it is worth highlighting however that part of the north south hypothesis fails for the sample of countries since the larger part of the economic surplus has remained in the south contrarily to what would have been expected

stationarity of health expenditures and gdp evidence from panel unit root tests with heterogeneous structural breaks this paper re examines the stationarity of national health care expenditures and gdp in a panel setting utilizing data from 20 oecd countries over the period from 1960 to 1997 previous research in this area has recognized the drawback of not allowing for structural breaks in their unit root tests and noted that their empirical results may not be robust we advance the literature by utilizing a recently developed panel lm unit root test that allows for heterogeneous level shifts in contrast to previous analyses that did not consider breaks our results reject the unit root null hypothesis for both series