sense and no n sense of energy security indicators energy security ranks high on the policy agenda of many countries to improve on energy security governments undertake regulatory measures for promoting renewable energy increasing energy efficiency or curbing carbon dioxide emissions the impacts of such measures on energy security are typically monitored by means of so called energy security indicators in this paper we show that the common use of wide spread energy security indicators falls short of providing a meaningful metric regulatory measures to improve on energy security trigger ambiguous effects across energy security indicators we conclude that a major pitfall of energy security indicators is the lack of a rigorous microeconomic foundation

who governs energy the challenges facing global energy governance this article conceptualizes the energy problems facing society from a global governance perspective it argues that a notion of global energy governance taken to mean international collective action efforts undertaken to manage and distribute energy resources and provide energy services offers a meaningful and useful framework for assessing energy related challenges the article begins by exploring the concepts of governance global governance and global energy governance it then examines some of the existing institutions in place to establish and carry out rules and norms governing global energy problems and describes the range of institutional design options available to policymakers it briefly traces the role of a selection of these institutions from inter governmental organizations to summit processes to multilateral development banks to global action networks in responding to energy issues and points out their strengths and weaknesses the article concludes by analyzing how the various approaches to global governance differ in their applicability to addressing the conundrums of global energy problems

measuring the energy security implications of fossil fuel resource concentration abstract economic assessments of the welfare effects of energy insecurity are typically uncertain and fail to provide clear guidance to policy makers as a result governments have had little analytical support to complement expert judgment in the assessment of energy security this is likely to be inadequate when considering multiple policy goals and in particular the intersections between energy security and climate change mitigation policies this paper presents an alternative approach which focuses on gauging the causes of energy insecurity as a way to assist policy making the paper focuses on the energy security implications of fossil fuel resource concentration and distinguishes between the price and physical availability components of energy insecurity it defines two separate indexes the energy security price index espi based on the measure of market concentration in competitive fossil fuel markets and the energy security physical availability index espai based on the measure of supply flexibility in regulated markets the paper illustrates the application of espi and espai with two case studies france and the united kingdom looking at the evolution of both indexes to 2030

oil vulnerability index of oil importing countries abstract this paper assesses the relative oil vulnerability of 26 net oil importing countries for the year 2004 on the basis of various indicators the ratio of value of oil imports to gross domestic product gdp oil consumption per unit of gdp gdp per capita and oil share in total energy supply ratio of domestic reserves to oil consumption exposure to geopolitical oil market concentration risks as measured by net oil import dependence diversification of supply sources political risk in oil supplying countries and market liquidity the approach using the principal component technique has been adopted to combine these individual indicators into a composite index of oil vulnerability such an index captures the relative sensitivity of various economies towards developments of the international oil market with a higher index indicating higher vulnerability the results show that there are considerable differences in the values of individual indicators of oil vulnerability and overall oil vulnerability index among the countries both inter and intraregional

evaluating energy security in the asia pacific towards a more comprehensive approach the energy security conundrum how to equitably provide available affordable reliable efficient and environmentally benign energy services is a technology and policy challenge perhaps unlike any other the recent article on an energy security in the asia pacific by vlado vivoda is an excellent starting point for how to best capture the unique energy security challenges facing the region this article builds on vivoda s work but also points out some shortcomings with his analysis

an evaluation of economists influence on electric utility rate reforms economists participated in the promotion of time of use tou pricing during the 1970s but analysis and evaluation of the role they played indicate that their contribution fell short of their potential influence the study examines how economists compiled analyzed and evaluated electric utility rate structures to determine how effectively they presented arguments supporting the idea that tou pricing would alter energy use patterns and would have a desirable cost benefit effect while tou now permeates us utility rate structures the author feels that professional economists could have presented more forceful arguments and should now be preparing to participate in the next step of rate decisions 14 references dck

the labor market effects of rising health insurance premiums we estimate the effect of rising health insurance premiums on wages employment and the distribution of part time and full time work using variation in medical malpractice payments driven by the recent medical malpractice crisis we estimate that a 10 increase in health insurance premiums reduces the aggregate probability of being employed by 1 2 percentage points reduces hours worked by 2 4 and increases the likelihood that a worker is employed only part time by 1 9 percentage points for workers covered by employer provided health insurance this increase in premiums results in an offsetting decrease in wages of 2 3

defining energy security takes more than asking around abstract in undetermined the recent contribution by benjamin sovacool proposes 20 dimensions and 320 indicators of energy security in asia however the method for identifying these dimensions and indicators 64 semi structured interviews has three shortcomings first asian policy makers responsible for energy security are absent from the pool of respondents dominated by academics second no prioritization or contextualization of energy security concerns is attempted leading to an excessively long generic list third no disagreements between the interviewed experts are accounted for future attempts to define energy security based on perceptions should involve relevant social actors include mechanisms for discriminating between primary and secondary concerns and find ways to constructively report on disagreements less

equality efficiency and market fundamentals the dynamics of international medical care reform public opinion surveys uniformly show low support for medical care systems in developed countries the longstanding conflict between equal access to care and efficient service provision partly explains this dissatisfaction but the trade off is particularly acute in medical care as new technologies developed over time have increased the cost of care and made the equity commitment even more expensive countries first dealt with rising costs by maintaining equal access and restricting total spending efficiency suffered however as a result many countries are considering a move away from spending controls and toward incentive based medical care reform

future costs in cost effectiveness analysis this paper resolves several controversies in cea generalizing garber a m phelps c e 1997 economic foundations of cost effectiveness analysis journal of health economics 16 1 1 31 the paper shows accounting for unrelated future costs distorts decision making after replicating meltzer d 1997 accounting for future costs in medical cost effectiveness analysis journal of health economics 16 1 33 64 quite different conclusion that unrelated future costs should be included in cea the paper shows that meltzer s findings result from modeling the budget constraint as an annuity which is problematic the paper also shows that related costs should be included in cea this holds for a variety of models including a health maximization model cea should treat costs in the manner recommended by garber and phelps

evaluating energy security in the asia pacific region a novel methodological approach this paper establishes an energy security assessment instrument based on a new and expanded conceptualisation of energy security the instrument is a systematic interrogative tool for evaluating energy security of individual states or regions it consists of eleven broad energy security dimensions associated with the current global energy system these energy security dimensions take into account numerous quantitative and qualitative attributes of each country s energy security and policy and include both traditional energy security concerns and many new factors such as environmental socio cultural and technological another dimension largely absent from previous analyses is the existence of and the issues addressed in energy security policy in each country this instrument serves as an assessment system with which to evaluate energy security in the asia pacific region the existing studies on energy security in the asia pacific region suffer from serious limitations no study to date examines regional energy security policies by adopting a more comprehensive energy security definition as a starting point most studies also focus on a single country or issue even if they examine energy security in major regional economies they lack critical comparative analysis the instrument is valuable as it may be utilised to draw a comprehensive map of regional energy security situation which can also include comparative analysis of energy security characteristics across the asia pacific region ultimately it may be utilised to set up a framework for improved regional energy cooperation with the aim of providing regional leaders with a blueprint for improving regional energy security and policy

assessing the energy vulnerability case of industrialised countries the emergence of new big consumer countries on the energy markets and the perspective of oil and gas depletion at the end of the current century raise the concerns about fair distribution of the remaining resources for the common and sustainable wellbeing of the mankind high volatility of energy prices discourages the investment and delays the energy technology transition voluntary measures are needed mainly in industrialised countries in order to develop alternative and sustainable energy sources to enable technology transfer towards emerging and developing countries and to avoid struggle for energy procurement in this paper a composite index of energy demand supply weaknesses is defined as a proxy of energy vulnerability the proposed index is based on several indicators such as energy intensity oil and gas import dependency co2 content of primary energy supply electricity supply weaknesses and non diversity in transport fuels the assessment of this composite index for selected industrialised countries is discussed as well as the sensitivity to various factors

moral hazard in insurance value based cost sharing and the benefits of blissful ignorance the conventional theory of optimal coinsurance rates for health insurance with moral hazard indicates that coinsurance should vary with the price responsiveness or price elasticity of demand for different medical services an alternative theory called value based cost sharing indicates that coinsurance should be lower for services with higher marginal benefits relative to costs this paper reconciles the two views it shows that if patient demands are based on correct information optimal coinsurance is the same under either theory if patient demands differ from informed demands optimal coinsurance depends both on information imperfection and price responsiveness value based cost sharing can be superior to providing information even if the cost of information is minimal when patient demands fall short of informed demands an extended numerical example illustrates these points

multiple dimensions of private information evidence from the long term care insurance market we demonstrate the existence of multiple dimensions of private information in the long term care insurance market two types of people purchase insurance individuals with private information that they are high risk and individuals with private information that they have strong taste for insurance ex post the former are higher risk than insurance companies expect while the latter are lower risk in aggregate those with more insurance are not higher risk our results demonstrate that insurance markets may suffer from asymmetric information even absent a positive correlation between insurance coverage and risk occurrence the results also suggest a general test for asymmetric information

energy security and sustainability in northeast asia abstract energy security has typically to those involved in making energy policy meant mostly securing access to oil and other fossil fuels with increasingly global diverse energy markets however and increasingly transnational problems resulting from energy transformation and use old energy security rationales are less salient and other issues including climate change and other environmental economic and international considerations are becoming increasingly important as a consequence a more comprehensive operating definition of energy security is needed along with a workable framework for analysis of which future energy paths or scenarios are likely to yield greater energy security in a broader more comprehensive sense work done as a part of the nautilus institute s pacific asia regional energy security pares project developed a broader definition of energy security and described an analytical framework designed to help to compare the energy security characteristics both positive and negative of different quantitative energy paths as developed using software tools such as the leap long range energy alternatives planning system

photovoltaic power stations in germany and the united states a comparative study by data envelopment analysis abstract this study compares photovoltaic pv power stations between germany and the united states to examine which country more efficiently provides renewable energy in their usages for the comparative analysis this study utilizes data envelopment analysis dea as a methodology to evaluate the performance of pv power stations from the perspective of both solar and land usages a total of one hundred sixty pv power stations eighty in germany and eighty in the united states are used for this comparison the demand for sustainable energy and energy security has been rapidly increasing over the past decade because of concerns about environment and limited resources pv solutions are one of many renewable technologies that are being developed to satisfy a recent demand of electricity germany is the world s top installer and consumer of pv power and the united states is one of the top five nations germany leads the way in installed pv capacity even though the nation has less solar resources and land area due to limited solar resources low insolation and sunshine and land area the united states should have a clear advantage over germany however the empirical result of this study exhibits that pv power stations in germany operate more efficiently than those of the united states even if the latter has many solar and land advantages the surprising result indicates that the united states has room for improvement when it comes to utilizing solar and land resources and needs to reform the solar policy for such a purpose feed in tariff fit may be an effective energy policy at the state level in the united states because the fit provides investors such as utility companies and other types of energy firms with financial incentives to develop large pv power stations and generation facilities for other renewable energy it may be true that the fit is a powerful policy tool to promote pv and other renewable installation and support a reduction of an amount of greenhouse gases however the fit poses a large financial burden to consumers with a massive increase in renewable energy installation like in germany and spain therefore it is necessary for the united states to consider how to align a policy with a speed of technology innovation to balance between the benefit and the cost derived from the policy implementation on renewable energy in addition this study discusses policy issues regarding cost allocation due to fit among stakeholders related to the electric power industry at the end this study proposes a new type of wholesale electricity market that provides simultaneous trading on electricity and greenhouse gas emissions by fully utilizing modern computer science technology that exists in universities and national laboratories of the united states

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

health insurance and the demand for medical care evidence from a randomized experiment we estimate how cost sharing the portion of the bill the patient pays affects the demand for medical services the data come from a randomized experiment a catastrophic insurance plan reduces expenditures 31 percent relative to zero out of pocket price the price elasticity is approximately 0 2 we reject the hypothesis that less favorable coverage of outpatient services increases total expenditure for example by deterring preventive care or inducing hospitalization

indicators of energy security in industrialised countries energy security has become a popular catch phrase both in the scientific arena as well as in the political discussion yet in general the applied concepts of energy security are rather vague this paper sheds some light on concepts and indicators of energy security first we conceptually discuss the issue of energy supply security and explain why it is not to handle by one science alone and what economics may contribute in order to structure the topic after providing a brief survey of existing attempts to define or measure energy security we suggest an additional dimension along which indicators of energy security may be classified ex post and ex ante indicators finally we illustrate our concept on the basis of several simplified indicators while ex post indicators are mostly based on price developments ex ante indicators are to a greater extent aimed at illustrating potential problems our illustration suggests that it is worthwhile to take into account the market structure along with the political stability of exporting countries

incumbent innovation and domestic entry this paper analyzes the escape entry incentive for innovation by incumbent firms the threat posed by the possibility of leading edge firms entering the market influences incumbent innovation to overcome problems of endogeneity we apply an instrumental variable approach to analyze a rich firm level dataset 1987 2000 for germany we find evidence that domestic entry has a negative effect on incumbent product innovation which is a strong indication of new entrants comparative advantage in commercializing new ideas in contrast domestic entry has a positive effect on incumbent process innovations an effect also known as the escape entry effect

are medical prices declining evidence from heart attack treatments we address long standing problems in measuring medical inflation by estimating two types of price indices the first a service price index prices specific medical services as does the current cpi the second a cost of living index measures a quality adjusted cost of treating a health problem we apply these indices to heart attack treatment between 1983 and 1994 more frequent reweighting and accounting for price discounts lowers the measured price change for heart attacks by three percentage points annually accounting for quality change lowers it further we estimate that the real cost of living index fell about 1 percent annually

the methodological challenges of creating a comprehensive energy security index this short article defends the methods utilized in creating an energy security index it explains why an energy security index is needed and then justifies research interviews as a data collection tool next it responds to the three strands of professor cherp s critique before offering a few general conclusions for readers concerned about energy security

home care reimbursement long term care utilization and health outcomes abstract using a substantial change in medicare reimbursement policy to study the market for home health care i find that the introduction of tightly binding average per patient reimbursement caps led to a large drop in the provision of home care particularly to the least healthy beneficiaries this decline in home health utilization was not offset by increases in institutional long term care or other medical care and there were no associated adverse health consequences however approximately one quarter of the decline in medicare spending was offset by increases in out of pocket expenditures for home health care with the offset concentrated in higher income populations

differing cultures of energy security an international comparison of public perceptions this study reviews how energy users perceive the importance of energy security dimensions it asks how does the sense of energy security vary with culture its primary source of data is a summary of survey distributed in eight languages to almost 2500 respondents in brazil china denmark germany india kazakhstan japan papua new guinea saudi arabia singapore and the united states it utilizes an energy literacy test in denmark as a secondary data tool the survey results are used to test nine hypotheses about national economic political professional and epistemic cultures the study concludes by affirming the complexity of energy security as a cultural topic by emphasizing how answers among respondents tended to converge more than diverge and by calling for further research

evaluating energy security of resource poor economies a modified principle component analysis approach abstract this study proposes to aggregately measure energy security performance with the principal component analysis in its application of the methodology to four resource poor yet economically advanced island economies in east asia singapore south korea japan and taiwan this study establishes a novel framework to conceptualize energy security the framework incorporates three dimensions vulnerability efficiency and sustainability three indicators being allocated to each dimension the study finds that all the three dimensions are critical for the resource poor economies but have different weights in each of them an urgent task for these four economies is to implement energy efficiency and conservation measures liberalization of electricity sector can be a helpful tool to reduce energy consumption and increase efficiency all of them have been committed to promoting renewable energy development which shall be further expanded in these economies

polices for increasing energy efficiency thirty years of experience in oecd countries energy efficiency improvement was an important phenomenon in the global energy balance over the past 30 years without energy efficiency improvements the oecd nations would have used approximately 49 more energy than was actually consumed as of 1998 this paper first reviews energy intensity trends for the major oecd nations since 1973 considering how much of the overall reduction in e gdp was due to energy efficiency improvement and how much was due to structural change the bulk of the paper examines the energy efficiency policies and programs adopted in japan united states and western europe commenting on their effectiveness and energy savings impacts where possible the paper also reviews the energy efficiency policies and programs adopted in california this experience shows that well designed policies can result in substantial energy savings as demonstrated in the united states where nine specific policies and programs reduced primary energy use in 2002 by approximately 11 substantial energy savings also occurred in japan some european countries and in the electricity sector in california

the aggregate effects of health insurance evidence from the introduction of medicare this paper investigates the effects of market wide changes in health insurance by examining the single largest change in health insurance coverage in american history the introduction of medicare in 1965 i estimate that the impact of medicare on hospital spending is over six times larger than what the evidence from individual level changes in health insurance would have predicted this disproportionately larger effect may arise if market wide changes in demand alter the incentives of hospitals to incur the fixed costs of entering the market or of adopting new practice styles i present some evidence of these types of effects a back of the envelope calculation based on the estimated impact of medicare suggests that the overall spread of health insurance between 1950 and 1990 may be able to explain about half of the increase in real per capita health spending over this time period

technology growth and expenditure growth in health care in the united states health care technology has contributed to rising survival rates yet health care spending relative to gdp has also grown more rapidly than in any other country we develop a model of patient demand and supplier behavior to explain these parallel trends in technology growth and cost growth we show that health care productivity depends on the heterogeneity of treatment effects across patients the shape of the health production function and the cost structure of procedures such as mris with high fixed costs and low marginal costs the model implies a typology of medical technology productivity i highly cost effective home run innovations with little chance of overuse such as anti retroviral therapy for hiv ii treatments highly effective for some but not for all e g stents and iii gray area treatments with uncertain clinical value such as icu days among chronically ill patients not surprisingly countries adopting category i and effective category ii treatments gain the greatest health improvements while countries adopting ineffective category ii and category iii treatments experience the most rapid cost growth ultimately economic and political resistance in the u s to ever rising tax rates will slow cost growth with uncertain effects on technology growth

long term energy services security what is it and how can it be measured and valued abstract the paper reviews some recent approaches towards measuring the extent of long term energy security and security externality valuation it starts out to discuss the contextual connotations of notions of energy security in medium to long term time frames and reviews some indicators that have been proposed to quantify it special attention is paid to two of these approaches which the authors helped to develop i e diversity based indices and the supply demand index the paper takes issue with conventional welfare economic approaches that neglect i the scope on the demand side for raising security and ii negative feedback mechanisms of socio political impacts of international rent transfers in fossil fuels exporting countries the concept of energy services security is proposed with a demand side focus this enables application of an integrated approach to gauge the resilience of a society to meet the needs of its population for energy services over longer timescales ahead from various interrelated perspectives propositions are made on the attribution of security externalities to the use of fossil fuels policies and suggestions for further improvements of measures for energy services security

multi objective optimization of a multiregional electricity system in an archipelagic state the role of renewable energy in energy system sustainability indonesia the world s largest archipelagic state has sizeable fossil and substantial renewable energy resources however high disparity in population density infrastructure economic level and distance between energy sources and consumers inflict a discrepancy in electricity system performance among regions in the present study a multi objective optimization model was developed to support decision makers in selecting the most sustainable scenario for indonesian power generation planning through 2050 to capture regional characteristics more accurately the model was developed with a multiregional approach by dividing indonesia into six regions and a single regional approach is set as a reference for comparison five development scenarios based on economic environmental trade off were proposed and four policy options were incorporated to evaluate the scenario preferences within various priority sets generation mixes obtained from the optimization model were input into a sustainability assessment model consisting of eleven indicators representing three sustainability aspects economic social and environmental the results show that for most policy options the most sustainable electricity system can be achieved by the highest orientation on environmental protection which results in significant advantages regarding most indicators of sustainability however this scenario shows high economic disadvantages relative to the social and environmental benefits the results indicate that optimization with a multiregional approach can capture regional characteristics of an archipelagic state better than that of a single regional approach thereby providing more realistic scenarios for the archipelagic state

the value of life and the rise in health spending over the past half century americans spent a rising share of total economic resources on health and enjoyed substantially longer lives as a result debate on health policy often focuses on limiting the growth of health spending we investigate an issue central to this debate is the growth of health spending a rational response to changing economic conditions notably the growth of income per person we develop a model based on standard economic assumptions and argue that this is indeed the case standard preferences of the kind used widely in economics to study consumption asset pricing and labor supply imply that health spending is a superior good with an income elasticity well above one as people get richer and consumption rises the marginal utility of consumption falls rapidly spending on health to extend life allows individuals to purchase additional periods of utility the marginal utility of life extension does not decline as a result the optimal composition of total spending shifts toward health and the health share grows along with income in projections based on the quantitative analysis of our model the optimal health share of spending seems likely to exceed 30 percent by the middle of the century

indicators for energy security the concept of energy security is widely used yet there is no consensus on its precise interpretation in this research we have provided an overview of available indicators for long term security of supply sos we distinguished four dimensions of energy security that relate to the availability accessibility affordability and acceptability of energy and classified indicators for energy security according to this taxonomy there is no one ideal indicator as the notion of energy security is highly context dependent rather applying multiple indicators leads to a broader understanding incorporating these indicators in model based scenario analysis showed accelerated depletion of currently known fossil resources due to increasing global demand coupled with increasing spatial discrepancy between consumption and production international trade in energy carriers is projected to have increased by 142 in 2050 compared to 2008 oil production is projected to become increasingly concentrated in a few countries up to 2030 after which production from other regions diversifies the market under stringent climate policies this diversification may not occur due to reduced demand for oil possible benefits of climate policy include increased fuel diversity and slower depletion of fossil resources

an international assessment of energy security performance energy security has in recent years grown as a salient policy and political issue to better understand energy security and sustainability concerns this study s main objective is to present an energy security index which measures national performance on energy security over time based on three years of research involving interviews surveys and an international workshop this study conceptualizes energy security as consisting of the interconnected factors of availability affordability efficiency sustainability and governance it then matches these factors with 20 metrics comprising an energy security index measuring international performance across 18 countries from 1990 to 2010 it offers three case studies of japan top performer laos middle performer and myanmar w orst performer to provide context to the index s results it then presents four conclusions first a majority of countries analyzed have regressed in terms of their energy security second despite the near total deterioration of energy security a great disparity exists between countries with some clear leaders such as japan third tradeoffs exist within different components of energy security fourth creating energy security is as much a matter of domestic policy from within as it is from foreign policy without

patient cost sharing and hospitalization offsets in the elderly in the medicare program increases in cost sharing by a supplemental insurer can exert financial externalities we study a policy change that raised patient cost sharing for the supplemental insurer for retired public employees in california we find that physician visits and prescription drug usage have elasticities that are similar to those of the rand health insurance experiment hie unlike the hie however we find substantial offset effects in terms of increased hospital utilization the savings from increased cost sharing accrue mostly to the supplemental insurer while the costs of increased hospitalization accrue mostly to medicare

environmental support energy security and economic growth in japan this study investigates the resource consumption of japanese society since 1979 and its subsequent effects on the economic output of the nation and the environment in order to quantify resource appropriation and trends in production and consumption the concept of emergy synthesis is employed our results show a significant increase in the total amount of emergy consumed by 66 9 between 1979 and 2003 which comes hand in hand with an increase in the level of environmental stress by 93 7 quantified as the environmental loading ratio on the other hand the emergy required to produce 1 usd of economic output has been gradually decreasing which denotes an increase in the efficiency of the conversion of natural capital into economic output what is most interesting though is the growing dependence of the japanese economy on imported emergy increasingly from developing nations that severely affects the potential for unhindered economic growth this can prove to be a big barrier that could affect the resource security of the japanese economy and render it susceptible to risks associated with access to natural resources which in turn can jeopardise its long term economic sustainability

first do no harm tort reform and birth outcomes in the 1980s and 1990s many states adopted tort reforms it has been argued that these reforms have reduced the practice of defensive medicine arising from excess tort liability we find that this does not appear to be true for a large and important class of cases childbirth in the united states using data from national vital statistics natality files on millions of individual births from 1989 to 2001 we ask whether specific tort reforms affect the types of procedures that are performed and the health outcomes of mothers and their infants we find that reform of the joint and several liability rule or the deep pockets rule reduces complications of labor and procedure use whereas caps on noneconomic damages increase them we show that these results are consistent with a model of tort reform that explicitly allows for variations in patient condition

routinization of innovation in german manufacturing the david goliath symbiosis revisited small and medium sized firms frequently are viewed as the drivers of radical innovation however they often do not have the focus and commitment necessary for improving and extending the innovation tasks better accomplished by routinized large firms using a uniquely rich industry level data set for german manufacturing industries during 1991 2004 this article finds evidence for this david goliath symbiosis although small and medium sized firm innovation rates can explain the within industry variation of productivity growth it is the large firm process innovation rate that explains differences in the level of productivity growth between industries i e differences in the degree of routinization of innovation

productivity growth technical progress and efficiency change in industrialized countries this paper analyzes productivity growth in 17 oecd countries over the period 1979 1988 a nonparametric programming method activity analysis is used to compute malmquist productivity indexes these are decomposed into two component measures namely technical change and efficiency change we find that u s productivity growth is slightly higher than average all of which is due to technical change japan s productivity growth is the highest in the sample with almost half due to efficiency change jel c43 d24 in this paper we apply recently developed

an economic evaluation of the war on cancer for decades the us public and private sectors have committed substantial resources towards cancer research but the societal payoff has not been well understood we quantify the value of recent gains in cancer survival and analyze the distribution of value among various stakeholders between 1988 and 2000 life expectancy for cancer patients increased by roughly four years and the average willingness to pay for these survival gains was roughly 322 000 improvements in cancer survival during this period created 23 million additional life years and roughly 1 9 trillion of additional social value implying that the average life year was worth approximately 82 000 to its recipient health care providers and pharmaceutical companies appropriated 5 19 of this total with the rest accruing to patients the share of value flowing to patients has been rising over time in terms of economic rates of return r d investments against cancer have been a success particularly from the patient s point of view

energy policymaking in denmark implications for global energy security and sustainability denmark is arguably the most energy secure and sustainable country in the organization of economic cooperation and development oecd the country has reduced its dependence on foreign sources of energy to zero and become self sufficient in its own energy production and use offering important lessons for other nations around the world this study explores the core of denmark s successful approach a commitment to energy efficiency prolonged taxes on energy fuels electricity and carbon dioxide and incentives for combined heat and power chp and wind turbines through these commitments the study shows how denmark transitioned from being almost 100 percent dependent on imported fuels such as oil and coal for their power plants in 1970 to becoming a net exporter of fuels and electricity today the country leads the world in terms of exportation of wind energy technology with a hold on roughly one third of the world market for wind turbines it was able to phase out the use of virtually all oil fired power plants in less than five years and implemented a progressive moratorium on future coal fired power plants in the 1990s their most recent strategy seeks to achieve 30 percent of total energy supply from renewable energy by 2025

the productivity of physician specialization evidence from the medicare program there is increasing concern in the united states with the growth of health care expenditures the rapid rise in expenditures is particularly troubling given that different areas seem to produce the same amount of health care at very different costs in fact a large body of literature documents both wide variation across the country in the quality and quantity of health care produced and the complete absence of a positive relationship between expenditures and the quality of care john wennberg and meagan cooper 1996 jonathan skinner et al 2001 wennberg et al 2002 elliott fisher et al 2003a b baicker and chandra 2004 understanding the factors that drive these differences in use of inputs and productivity in health care is fundamental to designing efficient health care policy potential efficiency gains are particularly important in the context of the aging u s population and the medicare program s mounting fiscal crisis many different inputs contribute to the production of health care including medical personnel technology and patient characteristics one dimension in which the production of health care in different parts of the country varies widely is the use of physician specialists e g cardiologists gastroenterologists those doctors who are not pediatricians or general practitioners for example the hospitals serving the population around louisville kentucky have 30 percent more medical specialists per capita than those serving lexington kentucky but 5 5 percent fewer family practitioners per capita even though the cities have similar geography and demographics and each has a teaching hospital these differences are driven by supply and demand factors in the market both for specialists and for health care more generally gary becker and kevin murphy 1992 develop a general model of specialization which suggests that the degree of specialization in a market should be driven by an equalization of the positive marginal return to specialized knowledge and the growing marginal cost of coordinating specialists this model has testable predictions all else equal areas with the advantage of low costs of coordination such as dense cities should have a higher degree of specialization produce more health care and consequently exhibit better health there are a number of factors that may interfere with the socially efficient use of specialization in the production of health care medicare a major purchaser of health services reimburses physicians using administrative pricing that is often criticized for being out of line with market valuation of the services they provide more directly several federal policies aim to increase the fraction of medical students going into primary care including the specialty of internal medicine the council on graduate medical education 2002 has guidelines on the number and distribution of residencies by specialty and the federal government subsidizes areas with a shortage of primary care physicians through medicare and the national health service corps these policies may introduce distortions that increase the number of specialists furthermore each individual specialist may not take into account the externality that coordination failure imposes by adding congestion to the provision of health care each specialist may compromise the quality of care provided by other physicians a negative spillover that may also lead to too much specialization by contrast if a social planner were making a decision baicker and chandra department of economics dartmouth college hanover nh 03755 dartmouth medical school and national bureau of economic research e mail kbaicker dartmouth edu and achandra dartmouth edu respectively this research was funded by nia grant p01 ag19783 02 we are grateful to elliott fisher jonathan skinner douglas staiger and john wennberg for helpful comments and to dan gottlieb for data support

the japanese energy sector current situation and future paths abstract as the world s third leading economy and a major importer of fuels the choice of future energy paths and policies that japan makes in the next few years will have a significant influence on the energy security of the world as a whole and of the northeast asia region in particular in this article we describe the current status of and recent trends in the japanese energy sector including energy demand and supply by fuel and by sector we then discuss the current energy policy situation in japan focusing on policies related to climate change targets renewable energy development and deployment liberalization of energy markets and the evolution of the japanese nuclear power sector the final section of the article presents the structure of the japan leap long range energy alternatives planning software system dataset describes several alternative energy paths for japan with an emphasis on alternative paths for nuclear power development and ghg emission abatement and touches upon key current issues of energy policy facing japan as reflected in the modeling inputs and results

the pragmatist s guide to comparative effectiveness research following an acrimonious health care reform debate involving charges of death panels in 2010 congress explicitly forbade the use of cost effectiveness analysis in government programs of the patient protection and affordable care act in this context comparative effectiveness research emerged as an alternative strategy to understand better what works in health care put simply comparative effectiveness research compares the efficacy of two or more diagnostic tests treatments or health care delivery methods without any explicit consideration of costs to economists the omission of costs from an assessment might seem nonsensical but we argue that comparative effectiveness research still holds promise first it sidesteps one problem facing cost effectiveness analysis the widespread political resistance to the idea of using prices in health care second there is little or no evidence on comparative effectiveness for a vast array of treatments for example we don t know whether proton beam therapy a very expensive treatment for prostate cancer which requires building a cyclotron and a facility the size of a football field offers any advantage over conventional approaches most drug studies compare new drugs to placebos rather than head to head with other drugs on the market leaving a vacuum as to which drug works best finally the comparative effectiveness research can prove a useful first step even in the absence of cost information if it provides key estimates of treatment effects after all such effects are typically expensive to determine and require years or even decades of data costs are much easier to measure and can be appended at a later date as financial armageddon draws closer