crisis or opportunity economic degrowth for social equity and ecological sustainability introduction to this special issue abstract this article reviews the burgeoning emerging literature on sustainable degrowth this is defined as an equitable downscaling of production and consumption that increases human well being and enhances ecological conditions at the local and global level in the short and long term the paradigmatic propositions of degrowth are that economic growth is not sustainable and that human progress without economic growth is possible degrowth proponents come from diverse origins some are critics of market globalization new technologies or the imposition of western models of development in the rest of the world all criticize gdp accounting though they propose often different social and ecological indicators degrowth theorists and practitioners support an extension of human relations instead of market relations demand a deepening of democracy defend ecosystems and propose a more equal distribution of wealth we distinguish between depression i e unplanned degrowth within a growth regime and sustainable degrowth a voluntary smooth and equitable transition to a regime of lower production and consumption the question we ask is how positive would degrowth be if instead of being imposed by an economic crisis it would actually be a democratic collective decision a project with the ambition of getting closer to ecological sustainability and socio environmental justice worldwide most articles in this issue were originally presented at the april 2008 conference in paris on economic degrowth for ecological sustainability and social equity this conference brought the word degrowth and the concepts around it into an international academic setting articles of this special issue are summarized in this introductory article hueting d alessandro and colleagues van den bergh kerschner spangenberg and alcott discuss whether current growth patterns are un sustainable and offer different perspectives on what degrowth might mean and whether and under what conditions it might be desirable matthey and hamilton focus on social dynamics and the obstacles and opportunities for voluntary social action towards degrowth lietaert and cattaneo with gavalda offer a down to earth empirical discussion of two practical living experiments cohousing and squats highlighting the obstacles for scaling up such alternatives finally van griethuysen explains why growth is an imperative in modern market economies raising also the question whether degrowth is possible without radical institutional changes

sustainable de growth mapping the context criticisms and future prospects of an emergent paradigm article i nfo sustainable de growth is both a concept and a social grassroots northern movement with its origins in the fieldsofecologicaleconomics socialecology economicanthropologyand environmentalandsocialactivistgroups this paper introduces the concept of sustainable de growth by mapping some of the main intellectual influences fromthese fields with special focus on the francophone and anglophone thinking about this emergent notion we propose hypotheses pertaining to the appeal of sustainable de growth and compare it to the messages enclosed within the dominant sustainable development idea we scrutinize the theses contradictions and consequences of sustainable de growth thinking as it is currently being shaped by a heterogeneous body of literature and as it interacts with an ample and growing corpus of social movements we also discuss possible future paths for the de growth movement compared to the apparent weakening of the sustainable development paradigm

the proximity of nations to a socially sustainable steady state economy abstract there has been increasing interest in new economic models that aim to improve quality of life without increasing consumption this article provides the first empirical analysis of how close modern day economies are to the concept of a steady state economy and explores whether there is any relationship between a country s proximity to such an economy and its social performance the analysis is carried out using the degrowth accounts a set of 16 biophysical and social indicators that are derived from herman daly s definition of a steady state economy and the social goals of the degrowth movement these indicators are applied to 180 countries over a 10 year period the analysis reveals that the majority of countries in the world are biophysical growth economies there are only a small number of countries where resource use is relatively constant from year to year e g denmark france japan poland romania and the us and only four countries experiencing biophysical degrowth germany guyana moldova and zimbabwe there are no countries that achieve a true steady state economy defined as an economy with a stable level of resource use maintained within ecological limits however a few countries come relatively close including colombia cuba kyrgyzstan romania and south africa in general countries with stable resource use perform better on many social indicators than countries with either increasing or decreasing resource use this finding runs contrary to conventional economic thought however social performance is also higher in countries with greater per capita resource use overall these findings suggest that a steady state economy can be socially sustainable but countries need to become much more efficient at transforming natural resources into human well being if all seven billion people on earth are to lead a good life within ecological limits

does medical malpractice law improve health care quality we assess the potential for medical liability forces to deter medical errors and improve health care treatment quality identifying liability s influence by drawing on variations in the manner by which states formulate the negligence standard facing physicians using hospital discharge records from the national hospital discharge survey and clinically validated quality metrics inspired by the agency for health care research and quality we find evidence suggesting that treatment quality may improve upon reforms that expect physicians to adhere to higher quality clinical standards we do not find evidence however suggesting that treatment quality may deteriorate following reforms to liability standards that arguably condone the delivery of lower quality care similarly we do not find evidence of deterioration in health care quality following remedy focused liability reforms such as caps on non economic damages awards

does health plan generosity enhance hospital market power we test whether the generosity of employer sponsored health insurance facilitates the exercise of market power by hospitals we construct indices of health plan generosity and the price and volume of hospital services using data from truven marketscan for 601 counties from 2001 to 2007 we use variation in the industry and union status of covered workers within a county over time to identify the causal effects of generosity although ols estimates fail to reject the hypothesis that generosity facilitates the exercise of hospital market power iv estimates show a statistically significant and economically important positive effect of plan generosity on hospital prices in uncompetitive markets but not in competitive markets our results suggest that most of the aggregate effect of hospital market structure on prices found in previous work may be coming from areas with generous plans

economics psychology and the history of consumer choice theory this paper examines elements of the complex place role influence of psychology in the history of consumer choice theory the paper reviews and then challenges the standard narrative that psychology was in consumer choice theory early in the neoclassical revolution then strictly out during the ordinal and revealed preference revolutions now possibly back in with recent developments in experimental behavioural and neuroeconomics the paper uses the work of three particular economic theorists to challenge this standard narrative and then provides an alternative interpretation of the history of the relationship between psychology and consumer choice theory copyright the author 2009 published by oxford university press on behalf of the cambridge political economy society all rights reserved oxford university press

shifting priorities in degrowth research an argument for the centrality of human needs we present an argument for the deprioritization of subjective well being and a prioritization of human needs within degrowth research first we discuss empirical evidence methodological problems and theoretical shortcomings of subjective well being concepts while data for one country over time suggest a flattening of the happiness curve relative to gdp growth cross country comparisons reveal that the richest and most environmentally unsustainable countries are also the happiest methodologically we point to the issue of adaptability a limitation in the use of positional goods is unlikely to be accompanied by short term increases in subjective well being theoretically we question happiness where it helps promote growth and disguise structural relationships of inequality secondly we sketch out an alternative degrowth research agenda oriented at the satisfaction of human needs here doyal and gough s theory of human needs is especially useful due to its systematic account of environmental limits and the policy auditing approach that follows from it finally we illustrate such a needs based research agenda at the example of food by reviewing recent research on the environmental impacts of different diets and kinds of food production and on how these forms compare in terms of scale and land use

on the demise of pigovian economics much has been written on the emergence of the keynesian and hicksian research programs in the 1930s yet the demise of the marshallian research program to the extent that it was preserved extended and or amended by pigou has attracted little attention as a result arthur cecil pigou who contributed extensively to the theories of welfare economics 58 54 and unemployment 57 56 53 48 47 is seldom credited with more than discovering the divergence between social and private costs and developing such concepts as the pigovian tax or the pigou effect a broader more encompassing view of pigovian economics deserves our attention on at least two grounds first recent literature argues that modern welfare economics is no more scientific than the pigovian analysis it meant to replace 59 16 on methodological grounds therefore the advantages of modern welfare economics over its pigovian counterpart are not obvious pigovian welfare analysis however does possess a nontrivial welfare criterion2 which deals with issues concerning both equity and efficiency 3 pigou s welfare economics therefore can be found relevant to the growing literature on social choice inequality and income distribution 70 the second basis for continued interest in pigou s economic analysis is his extensive treatment of unemployment which has received much less attention than his welfare writings perhaps because it is befogged by many undeserving myths this work however is important for macro

public insurance expansions and the health of immigrant and native children abstract the costs of public insurance expansions are ordinarily justified by the claim that increased eligibility causes gains in insurance coverage which translate into improved health care and health this paper studies dramatic changes in public health insurance eligibility for immigrant and native children from 1998 to 2009 and finds that children s nativity status is crucial to understanding the impacts of recent eligibility expansions i document a significantly higher degree of take up and less crowding out of private insurance among first and second generation immigrant children than among children of u s natives eligibility expansions increased immigrant children s use of preventive and ambulatory care and decreased emergency care in hospitals while estimated effects for children of natives are negligible my results also suggest improvements in some health measures that would be expected to respond to preventive and ambulatory care

claim timing and ex post adverse selection many health care treatments are not urgent and may be delayed if patients so choose because insurance coverage is typically determined by the treatment date individuals may have incentives to strategically delay treatments to minimize out of pocket costs the strategic delay of treatment a particular form of moral hazard can be an important source of subsequent adverse selection in which ex ante identical individuals select insurance coverage based on their differing accumulation of previously delayed treatments this article investigates these forces empirically in the context of the missing market for dental insurance using rich claim level data my analysis reveals that approximately 40 of individuals strategically delay dental treatments when incentivized to do so and this flexibility in delaying treatment can explain why the market for dental insurance has largely unraveled more generally the counterfactual analysis suggests features such as open enrolment periods and contracting on pre existing conditions may be helpful tools in overcoming adverse selection in insurance contexts where the timing of uncertainty is not contractible

rational addiction and the effect of price on consumption legalization of such substances as marijuana heroin and cocaine surely will reduce the prices of these harmful addictive drugs by the law of the downward sloping demand function their consumption will rise but by how much according to conventional wisdom the consumption of these illegal addictive substances is not responsive to price however conventional wisdom is contradicted by becker and murphy s 1988 theoretical model of rational addiction the becker murphy b m analysis implies that addictive substances are likely to be quite responsive to price in this paper we summarize b m s model of rational addiction and the empirical evidence in support of it we use the theory and evidence to draw highly tentative inferences concerning the effects of legalization of currently banned substances on consumption in the aggregate and for selected groups in the population addictive behavior is usually assumed to involve both reinforcement and tolerance reinforcement means that greater past consumption of addictive goods such as drugs or cigarettes increases the desire for present consumption but tolerance cautions that the utility from a given amount of consumption is lower when past consumption is greater these aspects of addictive behavior imply

reducing energy demand a review of issues challenges and approaches most commentators expect improved energy efficiency and reduced energy demand to provide the dominant contribution to tackling global climate change but at the global level the correlation between increased wealth and increased energy consumption is very strong and the impact of policies to reduce energy demand is both limited and contested different academic disciplines approach energy demand reduction in different ways emphasising some mechanisms and neglecting others being more or less optimistic about the potential for reducing energy demand and providing insights that are more or less useful for policymakers this article provides an overview of the main issues and challenges associated with energy demand reduction summarises how this challenge is framed by key academic disciplines indicates how these can provide complementary insights for policymakers and argues that a sociotechnical perspective can provide a deeper understanding of the nature of this challenge and the processes through which it can be achieved the article integrates ideas from the natural sciences economics psychology innovation studies and sociology but does not give equal weight to each it argues that reducing energy demand will prove more difficult than is commonly assumed and current approaches will be insufficient to deliver the transformation required

capitalist diversity and de growth trajectories to steady state economies abstract growth critical scholarship has done much to both expose the environmentally unsustainable nature of the capitalist growth economies of the overdeveloped part of the world and to develop an alternative vision of a de growth transition leading to a steady state economy however this scholarship fails to adequately take into consideration that if planned de growth actually materialised it would do so in societies that differ considerably from one another and that this would have implications both for the transition processes and the nature of their outcomes in other words not enough importance is ascribed to capitalist diversity and the nature of institutional change in the growth critical literature against this background the purpose of the present article is to make the concrete utopia of de growth scholars and steady state economists more specific by utilising insights from scholarship on capitalist diversity and institutional change on the basis of a typology of different models of capitalism the article suggests that if de growth transitions took place they would take different forms and lead to a variety of types of steady state economies sses to illustrate this point three ideal typical sses are delineated

equilibrium in competitive insurance markets with ex ante adverse selection and ex post moral hazard abstract existence of pure strategy equilibria is studied in health insurance markets that exhibit both ex ante adverse selection of the rothschild stiglitz wilson type and ex post hidden information moral hazard it is found that ex post moral hazard has two offsetting effects on the existence of equilibrium and that in general it is difficult to say whether an equilibrium is more or less likely to exist numerical simulations and an analytical example confirm that moral hazard may increase the likelihood of equilibrium these results are interpreted as evidence that health maintenance organization hmo markets could be less likely to exhibit stable equilibria than are fee for service insurance markets

degrowth through income and wealth caps abstract in the degrowth literature maximum caps on wealth and or income are frequently mentioned among the policy instruments that could support transitions towards ecologically and socially sustainable societies yet an in depth discussion of concrete policy proposals has yet to be initiated to facilitate such a discussion the present paper reviews several proposals for placing caps on wealth and or income some of these proposals consider environmental limits others focus exclusively on social inequality the paper moreover raises various critical issues concerning the introduction of maximum caps on wealth and income in a degrowth context discussing the role of the state the impact on economic growth and the risk of emigration of high skilled employees and capital flight we conclude that while in an ecologically constrained world there is an argument for imposing limits on wealth and income above a certain level it is crucial not to dictate such policies as mere top down measures but to develop and deliberate them in democratic forums

measuring progress in the degrowth transition to a steady state economy article i nfo in order to determine whether degrowth is occurring or how close national economies are to the concept of a steady state economy clear indicators are required within this paper i analyse four indicator approaches that could be used 1 gross domestic product 2 the index of sustainable economic welfare 3 biophysical and social indicators and 4 a composite indicator i conclude that separate biophysical and social indicators represent the best approach but a unifying conceptual framework is required to choose appropriate indicators and interpret the relationships between them i propose a framework based on ends and means and a set of biophysical and social indicators within this framework the biophysical indicators are derived from herman daly s definition of a steady state economy and measure the major stocks and flows in the economy environment system the social indicators are based on the stated goals of the degrowth

informal groups and health insurance take up evidence from a field experiment summary this paper presents the results of 20 randomized experiments aimed at understanding the low take up of in patient health insurance observed in developing countries take up does not increase when participants receive information about the product or an assistance to register or small subsidies of 2 10 or 30 take up does not increase when the same information is provided by local respected community leaders when participants are offered an in kind gift a chicken if they register when participants are offered the possibility to contribute lower and more frequent payments or the possibility to pay by cellphone a full subsidy generates a mere 45 take up with no retention after one year in contrast to these low take up rates presenting the same information without any subsidies to existing informal groups raises take up to 12 still 7 after one year as well as trust and knowledge of the product social networks play a major role in the adoption of health insurance this paper provides a cost effective way to increase take up of health insurance while subsidies are found to be largely ineffective at raising take up in the long run

environment versus growth a criticism of degrowth and a plea for a growth in recent debates on environmental problems and policies the strategy of degrowth has appeared as an alternative to the paradigm of economic growth this new notion is critically evaluated by considering five common interpretations of it one conclusion is that these multiple interpretations make it an ambiguous and rather confusing concept another is that degrowth may not be an effective let alone an efficient strategy to reduce environmental pressure it is subsequently argued that a growth i e being indifferent about growth is a more logical social aim to substitute for the current goal of economic growth given that gdp per capita is a very imperfect indicator of social welfare in addition focusing ex ante on public policy is considered to be a strategy which ultimately is more likely to obtain the necessary democratic political support than an ex ante explicit degrowth strategy in line with this a policy package is proposed which consists of six elements some of which relate to concerns raised by degrowth supporters

from constraint to sufficiency the decoupling of energy and carbon from human needs 1975 2005 abstract we investigate the relationship between human needs energy consumption and carbon emissions for several indicators of human development life expectancy literacy income and the human development index we find that high human development can be achieved at moderate energy and carbon levels increasing energy and carbon past this level does not necessarily contribute to higher living standards by conducting a novel longitudinal analysis from 1975 to 2005 we observe a previously undetected decoupling of the per capita energy and carbon required for human needs if resources were equally distributed current energy and carbon levels would be more than sufficient to satisfy global human needs at high levels of human development by projecting current trends to 2030 we demonstrate that the global energy consumption and carbon emissions required to satisfy human needs will decrease with time despite growth in population

clusters entrepreneurial ecosystem co creation and appropriability a conceptual framework extant literature on clusters underplays the role of entrepreneurs and entrepreneurial management in creating and co creating organizations markets and supporting ecosystems we employ transaction costs resource knowledge capabilities and power control based theories to provide a comparative static governance based perspective on clusters we embed this into a more general co evolutionary entrepreneurial theory of the emergence evolution and co evolution of markets ecosystems and clusters we suggest that clusters can involve advantages that help engender superior appropriation of co created value as compared to alternatives entrepreneurial managers faced with a degree of choice will help co create clusters and be part of them for as long as they can appropriate more value in this way than through alternatives

how do hospitals respond to price changes this paper examines hospital responses to changes in diagnosis specific prices by exploiting a 1988 policy reform that generated large price changes for 43 percent of medicare admissions i find hospitals responded primarily by upcoding patients to diagnosis codes with the largest price increases this response was particularly strong among for profit hospitals i find little evidence hospitals increased the volume of admissions differentially for diagnoses subject to the largest price increases despite the financial incentive to do so neither did they increase intensity or quality of care in these diagnoses suggesting hospitals do not compete for patients at the diagnosis level

from lotka s biophysics to georgescu roegen s bioeconomics abstract alfred lotka was one of the founders of modern ecology this paper explores lotka s contribution to biophysical economics resulting from the marriage of the three disciplines biology physics and economics lotka founded the concept of exosomatic evolution to characterise the economic activities in their biophysical environment as a continuation of biological processes like vernadsky he adopted a holistic perspective of planet system the biosphere georgescu roegen was one of the founders of ecological economics he explained the entropic nature of evolution and adopted lotka s exosomatic evolution concept in his bioeconomic approach georgescu roegen had several warnings for economists about the irrevocability of the entropic degradation of matter energy and the pressure on natural resources that goes hand in hand with economic processes in general this article aims at drawing a parallel between lotka s contribution and georgescu roegen s bioeconomics by shedding light not only on their similarities but also on the divergences that testify the novelty of georgescu roegen s approach

much ado about two reconsidering retransformation and the two part model in health econometrics in health economics applications involving outcomes y and covariates x it is often the case that the central inferential problems of interest involve e y x and its associated partial effects or elasticities many such outcomes have two fundamental statistical properties y 0 and the outcome y 0 is observed with sufficient frequency that the zeros cannot be ignored econometrically this paper 1 describes circumstances where the standard two part model with homoskedastic retransformation will fail to provide consistent inferences about important policy parameters and 2 demonstrates some alternative approaches that are likely to prove helpful in applications

the sustainable development index measuring the ecological efficiency of human development in the anthropocene abstract when the human development index hdi was introduced in the 1990s it was an important step toward a more sensible measure of progress one defined less by gdp growth and more by social goals but the limitations of hdi have become clear in the 21st century given a growing crisis of climate change and ecological breakdown hdi pays no attention to ecology and retains an emphasis on high levels of income that given strong correlations between income and ecological impact violates sustainability principles the countries that score highest on the hdi also contribute most in per capita terms to climate change and other forms of ecological breakdown in this sense hdi promotes a model of development that is empirically incompatible with ecological stability and impossible to universalize in this paper i propose an alternative index that corrects for these problems the sustainable development index sdi the sdi retains the base formula of the hdi but places a sufficiency threshold on per capita income and divides by two key indicators of ecological impact co2 emissions and material footprint both calculated in per capita consumption based terms and rendered vis a vis planetary boundaries the sdi is an indicator of strong sustainability that measures nations ecological efficiency in delivering human development

the effect of double coverage on health care utilization of children double coverage refers to a situation in which a person is covered by more than one health plan in a family in which the husband and wife are both offered employer provided insurances it is possible for one or more family members to be double covered this article is the first to examine double coverage of children and quantify the effects of double coverage on health care utilization for any population results show that double coverage does not affect the frequency at which children consume medical services but rather double coverage leads children to consume more expensive forms of health care

insurance induced moral hazard a dynamic model of within year medical care decision making under uncertainty health insurance may lead individuals to overconsume medical care many studies explore this moral hazard using models that aggregate medical care decisions up to the annual level using employer employee matched data from the medical expenditure panel survey meps i estimate moral hazard using a dynamic model of within year medical care consumption that allows for endogenous health transitions variation in medical care prices and individual uncertainty within a health insurance year i then estimate moral hazard under a second set of conditions that are consistent with the assumptions of most annual decision making models the within year decision making model produces a moral hazard estimate that is 19 2 larger than the alternative model i highlight the importance of controlling for within year dynamics in a model of medical care consumption using a counterfactual policy simulation that implements the individual mandate provision of the 2010 patient protection and aordable care act i nd that full implementation of the policy decreases the percentage of uninsured individuals in the population being analyzed from 11 8 to 6 0 furthermore when all uninsured individuals are forced into coverage their predicted annual medical care expenditure increases by 45 5

globalizing carbon lock in this paper extends the arguments surrounding carbon lock in elaborated in unruh energy policy 28 2000 817 30 2002 317 to countries currently undergoing industrialization it argues that for numerous reasons industrializing countries are unlikely to leapfrog carbon intensive energy development on the contrary carbon lock in may be globalizing and could further constrain climate change mitigation options it is then argued that many policy recommendations ignore carbon lock in possibly limiting their potential for successful implementation the paper then discusses four policy approaches that appear to have advantages given lock in conditions it is recognized however that relative ease of implementation does not necessarily equate with superiority instead it is merely a path dependent outcome of past development decisions pursuing policies on the basis of relative implementation ease may help address the issue of climate change but could also result in sub optimal outcomes along other dimensions of sustainable development

making inferences from controlled income maintenance experiments nationally this paper addresses a question whose answer is essential for interpreting the results of such experiments if an experiment of limited duration is conducted under ideal conditions what can be inferred from the experimental results about behavior in a world where nit is adopted permanently by ideal conditions we mean that a individuals or households 2 in the experiment are conventional utility maximizers given the structure of the experiment and b the experiment is sufficiently well designed to permit the differential responses of individuals to be identified 3 the

the nature of the firm and peculiarities of the corporation i must thank the independent social research foundation for generous funding of the research on which this paper draws

shifted deductibles for high risks more effective in reducing moral hazard than traditional deductibles in health insurance a traditional deductible i e with a deductible range 0 d is in theory not effective in reducing moral hazard for individuals who know ex ante that their expenditures will exceed the deductible amount d e g those with a chronic disease to increase the effectiveness this paper proposes to shift the deductible range to si si d with starting point si depending on relevant risk characteristics of individual i in an empirical illustration we assume the optimal shift to be such that the variance in out of pocket expenditures is maximized results indicate that for the 10 percent highest risks in our data the optimal starting point of a 1000 deductible is to be found far beyond 1200 which corresponds with a deductible range of 1200 2200 or further we conclude that compared to traditional deductibles shifted deductibles with a risk adjusted starting point lower out of pocket expenditures and may further reduce moral hazard

in defence of degrowth abstract this article defends the proposal of sustainable degrowth a starting premise is that resource and co2 limits render further growth of the economy unsustainable if degrowth is inevitable the question is how it can become socially sustainable i e a prosperous and stable rather than a catastrophic descent pricing mechanisms alone are unlikely to secure smooth adaptation a full ensemble of environmental and redistributive policies is required including among others policies for a basic income reduction of working hours environmental and consumption taxes and controls on advertising policies like these that threaten to harm the economy are less and less likely to be implemented within existing market economies whose basic institutions financial property political and redistributive depend on and mandate continuous economic growth an intertwined cultural and political change is needed that will embrace degrowth as a positive social development and reform those institutions that make growth an imperative sustainable degrowth is therefore not just a structuring concept it is a radical political project that offers a new story and a rallying slogan for a social coalition built around the aspiration to construct a society that lives better with less

the human development index a critical review since 1990 the united nations development programme undp has published a series of annual human development reports hdrs in which the human development index hdi is computed for each country this index has become an important alternative to the traditional unidimensional measure of development i e the gross domestic product although the index still fails to include any ecological considerations it has broadened the discussion surrounding the evaluation of development unfortunately over the years the hdrs seem to have become stagnant repeating the same rhetoric without necessarily increasing the hdi s utility this paper evaluates how well these reports have lived up to their own conceptual mandate and assesses the ability of the hdi to further the development debate we find that the reports have lost touch with their original vision and the index fails to capture the essence of the world it seeks to portray in addition the index focuses almost exclusively on national performance and ranking but does not pay much attention to development from a global perspective we propose the incorporation of three simple modifications for the index as a first step to overcome these shortcomings 1998 elsevier science b v all rights reserved

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

human needs consumerism and welfare adam smith considered consumption the sole end and purpose of all production this presupposes a sound connection between consumption and welfare the consumerist conceptualization of this connection suggests that the amount of consumption equals welfare and the level of production can consequently be an indicator for welfare the limits and problems of production measures are widely accepted yet indicators like gdp remain the focus of mainstream economic theory and policy we trace the origin of this lock in back to the axiom of authentic and stable preferences the suggested alternative stems from literature about human needs in heterodox economics and psychology this literature incorporates the relevance of social aspects and cultural change for welfare it turns out that consumerism can be a threat to well being and welfare rather than a requirement for it

public insurance and child hospitalizations access and efficiency effects abstract the 1983 1996 period saw enormous expansions in access to public health insurance for low income children we explore the impact of these expansions on child hospitalizations while greater access to inpatient care may increase hospital utilization improved efficiency of care for children who are also newly eligible for primary care could lower hospitalization rates we use a large sample of child discharges from the national hospital discharge survey nhds to assess the net impact of medicaid expansions on hospitalizations during this period we find that total hospitalizations increased significantly with each 10 percentage point rise in eligibility leading to an 8 4 increase in hospitalizations thus the access effect strongly outweighs any efficiency effect produced by expanded coverage however we find some support for an efficiency effect the increase in hospitalizations for unavoidable conditions is much larger than that for avoidable conditions that are most sensitive to outpatient care indeed the increase in avoidable hospitalizations is less than half that of unavoidable hospitalizations and it is not statistically significant we also find that expanded medicaid eligibility reduced the average length of stay but increased the utilization of inpatient procedures so that the net impact on total costs per stay is ambiguous

climate change and sustainable welfare the centrality of human needs since climate change threatens human well being across the globe and into the future we require a concept of well being that encompasses an equivalent ambit this article argues that only a concept of human need can do the work required it compares need theory with three alternative approaches preference satisfaction theory is criticised on the grounds of subjectivity epistemic irrationality endogenous and adaptive preferences the limitlessness of wants the absence of moral evaluation and the non specificity of future preferences the happiness approach is found equally wanting the main section shows how these deficiencies can be addressed by a coherent theory of need human needs are necessary pre conditions to avoid serious harm and are universalisable objective empirically grounded non substitutable and satiable they are broader than material needs since a need for personal autonomy figures in all theoretical accounts whilst needs are universal need satisfiers are most often contextual and relative to institutions and cultures the satiability and non substitutability of needs is critical for understanding sustainability finally it is argued that human needs provide an indispensable foundation for many current ethical arguments for global and inter generational justice in the face of threats from climate change an appendix compares this theory with the capability approaches of sen and nussbaum and argues it to be more fundamental

human development means and ends from growth to basic needs sometimes the change in the fashions of thinking about development appears like a comedy of errors a lurching from one fad to another economic growth employment creation jobs and justice redistribution with growth basic needs bottom up development participatory development sustainable development market friendly development liberation liberalisation human development thus goes the carousel of the slogans but this would not be a correct record there has been an evolution in our thinking about development both internal logic and new evidence have led to the revision of our views previous and partly discarded approaches have taught us much that is still valuable and our current approach will surely be subject to criticisms a brief survey of the evolution of our thinking may be helpful the discussion started in the 1950s influenced by arthur lewis 1955 and others who emphasised economic growth as the key to poverty eradication even at this early stage sensible economists and development planners were quite clear in spite of what is now often said in caricature of past thought that economic growth is not an end in itself but a performance test of development arthur lewis defined the purpose of development as widening our range of choice exactly as the human development reports of the united nations development programme do today three justifications were given for the emphasis on growth as the principal performance test one justification assumed that through market forces such as the rising demand for labour rising productivity rising wages lower prices of the goods bought by the people economic growth would spread its benefits widely and speedily and that these benefits are best achieved through growth even in the early days some sceptics said that growth is not necessarily so benign they maintained that in certain conditions such as increasing returns restrictions to entry monopoly power unequal distribution of income and assets growth gives to those who already have it tends to concentrate income and wealth in the hands of the few this is where the second assumption came in it was that governments especially democratic ones are concerned with the fate of the poor therefore progressive taxation social services and other government interventions would

will history repeat itself economic convergence and convergence in energy use patterns in this paper a difference in differences estimator on panel data for 30 developing and 21 industrialized countries is employed over the period 1971 2005 to examine how patterns of energy use characterized by the consumption of primary energy carriers sectoral energy use and carbon emissions are changing in the process of economic development for the average developing country in our sample the results indicate that economic catch up has been accompanied by above average growth of the use of most primary energy carriers the consumption of final energy in most sectors and total co2 emissions for industrialized countries we find that economic growth is partially decoupled from energy consumption and that above average rates of economic growth were accompanied by larger improvements in energy efficiency these results emphasize the need to identify the relevant engines of economic growth their implications for energy use and possibilities to achieve low carbon growth centered on productivity and efficiency improvements rather than on capital accumulation

strong sustainable consumption governance precondition for a degrowth path this paper aims to link two debates and literatures at the cutting edge of sustainable development research and governance sustainable consumption and degrowth interestingly these literatures have only recently started to exchange and integrate insights despite their similar interest in the fundamental systemic challenges to sustainable development the paper argues that this lack of connection is due to a predominance of perspectives in sustainable consumption governance that focus almost exclusively on questions of efficiency gains this weak sustainable consumption governance however is not able to address the challenges to sustainable development arising from overconsumption in general or the rebound effect and distributive issues in particular in contrast a strong sustainable consumption perspective provides a basis for a promising inquiry into the linkages between consumption and sustainable development as well as a fruitful exchange with degrowth specifically it allows the delineation of relevant insights on the role of values in governance obstacles to political reform and promising political strategies for the degrowth debate and literature

growth in global materials use gdp and population during the 20th century the growing industrial metabolism is a major driver of global environmental change we present an assessment of the global use of materials since the beginning of the 20th century based on the conceptual and methodological principles of material flow accounting mfa on the grounds of published statistical data data compilations and estimation procedures for material flows not covered by international statistical sources we compiled a quantitative estimate of annual global extraction of biomass fossil energy carriers metal ores industrial minerals and construction minerals for the period 1900 to 2005 this period covers important phases of global industrialisation and economic growth the paper analyses the observed changes in the overall size and composition of global material flows in relation to the global economy population growth and primary energy consumption we show that during the last century global materials use increased 8 fold humanity currently uses almost 60 billion tons gt of materials per year in particular the period after wwii was characterized by rapid physical growth driven by both population and economic growth within this period there was a shift from the dominance of renewable biomass towards mineral materials materials use increased at a slower pace than the global economy but faster than world population as a consequence material intensity i e the amount of materials required per unit of gdp declined while materials use per capita doubled from 4 6 to 10 3 t cap yr the main material groups show different trajectories while biomass use hardly keeps up with population growth the mineral fractions grow at a rapid pace we show that increases in material productivity are mostly due to the slow growth of biomass use while they are much less pronounced for the mineral fractions so far there is no evidence that growth of global materials use is slowing down or might eventually decline and our results indicate that an increase in material productivity is a general feature of economic development

patient cost sharing in low income populations economie theory suggests that a natural tool to control medical costs is increased consumer cost sharing for medical care while such cost sharing reduces full insurance wherein patients are indifferent between falling sick or remaining healthy a greater reliance on coinsurance and copayments can in theory stem patient and provider incentives to engage

medicaid expansions for the working age disabled revisiting the crowd out of private health insurance disabled individuals under 65 years old account for 15 of medicaid recipients but half of all medicaid spending despite their large cost few studies have investigated the effects of medicaid expansions for disabled individuals on insurance coverage and crowd out of private insurance using an eligibility expansion that allowed states to provide medicaid to disabled individuals with incomes less than 100 of the federal poverty level i address these issues crowd out estimates range from 49 using an ordinary least squares procedure to 100 using two stage least squares analysis this potentially large degree of crowd out could have fiscal implications for the affordable care act which has greatly expanded medicaid eligibility in 2014

energy poverty alleviation and climate change mitigation is there a trade off energy poverty alleviation has become an important political issue in the most recent years several initiatives and policies have been proposed to deal with poor access to modern sources of energy in many developing countries given the large number of people lacking basic energy services an important question is whether providing universal access to modern energy could significantly increase energy demand and associated co2 emissions this paper provides one of the few formal assessments of this problem by means of a simple but robust model of current and future energy consumption the model allows mapping energy consumption globally for different classes of energy use quantifying current and future imbalances in the distribution of energy consumption our results indicate that an encompassing energy poverty eradication policy to be met by 2030 would increase global final energy consumption by about 7 roughly 20 ej the same quantity of energy could be saved by reducing by 15 energy consumption of individuals with standards above current european levels the additional energy infrastructure needed to eradicate energy poverty would produce 44 183 gtco2 over the 21st century and contribute at most 0 13 c of additional warming

choosing children s environmental risk a model of endogenous risk provides a foundation to study a parent s child care decisions when the child could be exposed to an environmental hazard e g toxic substance foodborne pathogen the parent invests in childcare quality and quantity to reduce the likelihood of a hazard exposure occurring and to reduce its severity if the exposure is realized we supply conditions to sign unambiguously the effects on a child s hazard exposure of an increased probability a parent fails to access or have command over a technique of exposure prevention or that a technique is ineffective in preventing exposure also we consider these effects when the parent is unsure what a technique can do to reduce the child s probability of exposure we conclude public policies designed to encourage use of a particular childcare technique if childcare quality and quantity are stochastic substitutes can reduce parental use of other techniques the net impact of the policy could increase the chance the child suffers

have countries moved towards sustainable development or not definition criteria indicators and empirical analysis abstract have countries moved towards sustainable development sd or not to answer the question first a new sd definition i e achieving higher and more equally distributed well being levels within ecological limits is proposed second based on the definition and from a global perspective four criteria are established to judge whether countries have moved towards sd which are 1 well being levels have been higher and more equally distributed 2 levels of ecological consumption have been lower 3 ecological capacities have strengthened and 4 the ultimate efficiency which is the efficiency of transforming ecological consumption into human well being has improved developing countries with ecological consumption below global average do not have to meet the second criterion third the happy and equal human development index the ecological footprint and the biocapacity are selected to measure human well being ecological consumption and ecological capacities respectively and two consistent methods are used to measure the ultimate efficiency the empirical analysis of 102 countries during 2011 2016 demonstrates that 19 countries have met the required four or three criteria and moved towards sd and that 12 countries have met none of the required criteria and moved against sd the main contribution is to provide a clear sd definition specific criteria and reliable indicators for measuring national performance and informing decision making on moving towards sd therefore whether countries have moved towards sd or not can be judged and measured continuously and regularly future research needs to detailedly explore why countries have met or not met one certain criterion

sticker shocks using vat changes to estimate upper level elasticities of substitution we estimate the upper level elasticity of substitution between goods and services of a nested aggregate ces preference specification we show how this elasticity can be derived from the long run response of the relative price of a good to a change in its vat rate we estimate this elasticity using new data on changes in vat rates across 74 goods and services for 25 european union countries from 1996 through 2015 depending on the level of aggregation we find a vat pass through rate between 0 4 and 0 7 this implies an upper level elasticity of 3 at the lowest level of aggregation with 74 categories and 1 cobb douglas preferences at a high level of aggregation that distinguishes 10 categories of goods and services

beyond gdp measuring and achieving global genuine progress article i nfo while global gross domestic product gdp has increased more than three fold since 1950 economic wel fare as estimated by the genuine progress indicator gpi has actually decreased since 1978 we synthesized estimates of gpi over the 1950 2003 time period for 17 countries for which gpi has been estimated these 17 countries contain 53 of the global population and 59 of the global gdp we compared gpi with gross domestic product gdp human development index hdi ecological footprint biocapacity gini coefficient and life satisfaction scores results show a significant variation among these countries but some major trends we also estimated a global gpi capita over the 1950 2003 period global gpi capita peaked in 1978 about the same time that global ecological footprint exceeded global biocapacity life satisfaction in almost all countries has also not improved significantly since 1975 globally gpi capita does not increase beyond a gdp capita of around 7000 capita if we distributed income more equitably around the planet the current world gdp 67 trillion yr could support 9 6 billion people at 7000 capita while gpi is not the perfect economic welfare indicator it is a far better approximation than gdp development policies need to shift to better account for real welfare and not merely gdp growth

rational behavior in the presence of coverage ceilings and deductibles consumers of health care services with insurance plan features such as deductibles copayments and coverage ceilings in which the price of health care depends upon expenditures accumulated during a single year should rationally anticipate the impact of current consumption decisions on the price of health care later in the year we show that in the absence of wealth effects and risk aversion a utility maximizing consumer should base current consumption decisions on the expected end of year price of health care in a specific model with risk aversion and lumpy consumption decisions we show that the expected end of year price remains close to the true shadow price of health carefor plausible insurance plan and demand parameters we use this result in an econometric model of the demand for ambulatory mental health services

need entitlement and desert a distributive justice framework for consumption degrowth abstract post growth societies seek socio ecological transformations towards a just and sustainable redistribution and reduced consumption of natural capital there is no one universally just and ecologically sustainable way of fulfilling these redistribution and consumption objectives it depends on the criteria used and their underlying ethical teleology we suggest three distribution criteria borrowed from the foundations of the environmental justice ej movement need entitlement and desert by juxtaposing and problematising the needs entitlements and deserts of nature and society these criteria comprise an ethical framework for consumption degrowth praxis in communities we present arguments for how each distribution criterion fulfils the aims articulated in the degrowth corpus based on these arguments we propose seven justice based community action principles for redistribution under degrowth in our discussion of these derived principles we demonstrate that like ej degrowth seeks consequential as well as deontological justice underscoring their deep complementarity therefore our need entitlement desert framework may serve as a useful guiding frame to include ethical distribution considerations in societies pursuit of post growth futures

at the origin of the industrial district alfred marshall and the cambridge school this paper investigates the origin and evolution of the concept of the industrial district the idea of industrial district is quite spread in modern industrial economics and in business studies with a variety of meanings and typologies indeed the true first original conceptualisation dates back to alfred marshall and the economists of the so called cambridge school quite often the concept of industrial district is considered as synonymous of agglomeration localisation and clustering but according to the meaning given originally by marshall these processes of industry territorialisation are quite different from the more compound localisation that is the marshallian industrial district therefore the aim of our contribution is focused on disentangling its original meaning from other subsequent interpretations referring particularly to the debate on this subject arisen among the economists of the cambridge school in the early fifties of the xx century

the consumption of a finite planet well being convergence divergence and the nascent green economy a variety of global metrics indicate the earth has overshot its capacity to supply source and sink resources without substantial negative feedback here the relationship between consumption indicators oil freshwater vehicle and meat consumption gdp mathrm co 2 emissions and well being is analysed latitudinally across 189 countries and longitudinally over 60 years within three affluent countries all latitudinal analyses show the characteristic consumption cliff and affluent uplands shape e g at low per capita gdp life satisfaction increases sharply up the cliff with rising gdp after a threshold well being is independent of gdp across the affluent uplands longitudinal analyses of japan uk and usa since the 1950s show per capita gdp has grown between 3 and 8 fold but mean levels of well being remained unchanged consumption patterns are now converging on those typical in affluent countries indicators for seven baskets of countries affluent north america europe oceania affluent asia fast developing brics and civets high income resource extractors poor with green peaks and the poorest show the factors of consumption between the poorest and affluent 5 to 100 fold and the fast developing and affluent 2 to 10 fold a finite planet cannot resource such convergence one indicator climate change grows more of a concern as evidence emerges yet denial remains strong a priority is to create opportunities for divergent ways of living although material culture has been sought as the means to meet personal well being it has failed both the affluent and poorest a green economy will require human attachments to both place and possessions thus reducing disposal and damage such entanglement produces high affiliation that improves life satisfaction as does much non material consumption as yet most political and economic systems are far from recognising these imperatives though there have been notable policy innovations a shift to a green economy is inevitable it is simply whether it occurs before or after the world becomes locked into severe climate change and other consequences of harm to natural capital

the energetic metabolism of societies and the degrowth paradigm analyzing biophysical constraints and realities the belief that it is possible to have a perpetual economic growth based on fossil energy has been challenged since the 1970s however only in the last decade is this issue re emerging once again because of the predicaments of climate change and peak oil many finally start to perceive that an economic degrowth entailing a downscaling of the current size and pattern of socio economic systems seem unavoidable in this paper we analyze the implications the feasibility and the desirability of possible trajectories of downscaling from an energetic perspective the quantitative analysis is based on the methodological approach of societal metabolism and it provides a dynamic accounting of the profile of energy flows required and consumed by societies in relation the expression of a given set of societal functions this analysis makes it possible to check two types of constraints external constraints supply and sink side limits for the whole and internal constraints the feasibility of energy budget of the various parts of the society expressing the required functions the analysis of the metabolic pattern of a sample of developed countries is used to discuss possible implications of i demographic changes ii the declining supply of net energy sources and iii the effects of the jevons paradox within such an analysis a few assumptions and recipes of the degrowth movement seem problematic i population is and will remain as a relevant variable to be considered ii the proposed reduction in working hours seem to be impractical unless a major catastrophe will reset current civilization to pre industrial standards and iii voluntary reduction of personal energy consumption even if a welcome adjustment alone will not solve the existing problems in the final part of the paper future energetic road maps are questioned within the realm of post normal science can we plan degrowth if we are serious about the need of doing something completely different societies will have to learn how to deliberate under uncertainty within the realms of flexible management and stop planning for either growth or degrowth moreover before suggesting policies it would be wise first to try to understand the option space

public health insurance and medical treatment the equalizing impact of the medicaid expansions abstract we investigate the impact of expanding public health insurance on the medical treatment received by women at childbirth using vital statistics data on every birth in the us over the 1987 1992 period the effects of insurance status on treatment are identified using the tremendous variation in eligibility for public insurance coverage under the medicaid program over this period among low education mothers who were largely uninsured before being made eligible for medicaid eligibility for this program was associated with significant increases in the use of a variety of obstetric procedures among women with more education however there is a countervailing effect on procedure use most of these women had private insurance before becoming medicaid eligible and some may have been crowded out onto the public program moving from insurance which reimburses medical care more generously to insurance with much less generous reimbursement this movement was accompanied by reductions in procedure use thus on net the medicaid expansions had an equalizing effect increasing the treatment intensity of the previously uninsured while lowering it among the previously insured

discursive synergies for a great transformation towards sustainability pragmatic contributions to a necessary dialogue between human development degrowth and buen vivir abstract there is a growing awareness that a whole societal great transformation of polanyian scale is needed to bring global developmental trajectories in line with ecological imperatives the mainstream sustainable development discourse however insists in upholding the myth of compatibility of current growth based trajectories with biophysical planetary boundaries this article explores potentially fertile complementarities among trendy discourses challenging conventional notions of un sustainable development human development degrowth and buen vivir and outlines pathways for their realization human development presents relative transformative strengths in political terms while degrowth holds keys to unlocking unsustainable material structural entrenchments of contemporary socio economic arrangements and buen vivir offers a space of cultural alterity and critique of the euro atlantic cultural constellation the weaknesses or blind spots achilles heels of each discourse can be compensated through the strengths of the other ones creating a dialogical virtuous circle that would open pathways towards a global new great transformation as one of the main existing platforms for pluralist and strong sustainability discussions ecological economics is in a privileged position to deliberately foster such strategic discursive dialogue a pathway towards such dialogue is illuminated through a model identifying and articulating key discursive docking points

how do hospitals respond to managed care evidence from at risk newborns abstract medicaid has increasingly transitioned from a government run fee for service system ffs to a managed care system mmc administered by private insurers to examine the effect of mmc i exploit an arbitrary determinant of mmc enrollment in new york state infants weighing less than 1200 g were excluded from mmc and were instead served through ffs i find evidence that mmc reduces hospital costs at birth which is driven by infants born in new york city the hospital cost reductions arise from shortening the lengths of stay and encouraging inter hospital transfers these results are consistent with health plans influencing hospitals to reduce the intensity of treatment and steering patients away from high cost hospitals

potentials for prosperity without growth ecological sustainability social inclusion and the quality of life in 38 countries recent contributions to ecological economics and related social sciences indicate that issues such as climate change resource depletion and environmental degradation cannot be effectively addressed under conditions of continued economic growth this paper aims at empirically identifying structural potentials and policy challenges for prosperity at scales where economic development remains within ecological carrying capacities building on the growing literature that interprets prosperity beyond economic growth the paper presents a three dimensional concept to operationalise prosperity in terms of ecological sustainability social inclusion and the quality of life these dimensions are measured using data from sources such as the world bank the global footprint network and the oecd the results of cluster and correspondence analyses indicate the existence of five prosperity regimes and demonstrate that all aspects of prosperity including unsatisfactory ecological performance are linked to economic development however our findings also indicate that in order to achieve a decent minimum of prosperity moderate levels of the material living standard are sufficient further increases in the material living standard do not lead to significant additional prosperity instead they cause greater environmental harms the paper concludes by highlighting potentials for prosperity for each of the prosperity regimes and corresponding policy challenges

the effect of child health insurance access on schooling evidence from public insurance expansions although a sizable literature analyzes the effects of public health insurance programs on short run health outcomes little prior work has examined their long term effects we examine the effects of public insurance expansions among children in the 1980s and 1990s on their future educational attainment we find that expanding health insurance coverage for low income children increases the rate of high school and college completion these estimates are robust to only using federal medicaid expansions and mostly are due to expansions that occur when the children are not newborns our results indicate that the long run benefits of public health insurance are substantial

implicit contracts a survey 7mplicit contracts resolve the distribution of uncertainty and utilization of specific human capital between risk averse workers and less risk averse firms incomplete contracts are required to yield involuntary layoffs in contract markets otherwise contracts are efficient and pareto optimal by construction there is a close relation between contract theory and neoclassical labor market theory contracts smooth consumption but increase the volatility of labor supply and labor utilization to demand disturbances because contractural insurance eliminates the income effects of socially diversifiable risks this result is similar to the intertemporal substitution hypothesis however the price mechanism in a contract is substantially different contracts embody a nonlinear two part pricing scheme the lump sum part allocates the income consumption consequences of risks and the marginal pricing part allocates production and labor utilization this implicit pricing mechanism is in all respects flexible though the observed average hourly wage combines both parts and may give the outward appearanceof rigidity furthermore the observed average wage rate in a contract does not reflect marginal conditions necessary for structural econometric estimation indivisibilities appear necessary to account for the split between work sharing and layoffs contracts with private information are also considered in the nonlinear pricing context this abstract was borrowed from another version of this item

pigou on expectations and the cycle 3 asymmetrical errors due to psychological causes could be a separate source of fluctuations and what is mqre could be set up in response to the monetary factors in 2 in order to establish these points it will be necessary to quote from pigou s more substantial works on macro economics industrial fluctuations if the theory of unemployment tu and employrn nt and equilibrium ee his treatment of expectations was by no means incidental for

the economic and financial dimensions of degrowth abstract we respond to the call for future research on degrowth and specifically analyze the implications of economic degrowth on the monetary and financial system we argue that any early indications of degrowth would cause the stock market to crash which would trigger further deleveraging contagion and a deflation as a result the economy would implode which would eventually allow for a new rapid growth cycle given the likely extraordinary fiscal and monetary policy response during the implosion thus in our view degrowth as an explicit strategy option is economically unsustainable and unfeasible as a limitation our analysis centers on the examples of unplanned crisis leading to an economic implosion which imperfectly represent the idea of planned voluntary degrowth

regulation via the polluter pays principle we consider the problem of regulating an economy with environmental pollution we examine the distributional impact of the polluter pays pp principle which requires that any agent compensates all other agents for the damages caused by his or her pollution emissions with constant marginal damages we show that regulation via the pp principle leads to the unique welfare distribution that induces non negative individual welfare change and renders each agent responsible for his or her pollution impact we extend both the pp principle and this result to increasing marginal damages due to pollution we also compare the pp principle with the vickrey clark groves scheme

a comparison of alternative models for the demand for medical care we have tested alternative models of the demand for medical care using experimental data the estimated response of demand to insurance plan is sensitive to the model used we therefore use a split sample analysis and find that a model that more closely approximates distributional assumptions and uses a nonparametric retransformation factor performs better in terms of mean squared forecast error simpler models are inferior either because they are not robust to outliers e g anova anocova or because they are inconsistent when strong distributional assumptions are violated e g a two parameter box cox transformation

which countries avoid carbon intensive development abstract this paper explores the underlying development outcomes and cumulative emissions trajectories of 20 middle income countries from eastern europe latin america north africa and south asia first well being outcomes are assessed defined in terms of access to education democratic and legal rights and the infrastructures that support physical health second emissions trajectories are estimated to 2050 taking into account current trends in energy consumption and carbon intensity a likely start date for stringent climate policy arising from the paris agreement 2020 and maximum feasible rates of mitigation comparing these estimates to a per capita allocation from the global carbon budget associated with 2 c ten countries have low carbon development trends that will not exceed their allocation of these costa rica and uruguay are achieving very high well being outcomes while many more are delivering good outcomes in at least two domains of human need however most are seriously deficient in terms of social well being education democratic and legal rights these results call into question the socio economic convergence of developing countries with industrialised countries but they also reaffirm the low emissions cost of extending good infrastructure access and physical health outcomes to all demonstrated by the existence of multiple countries that continue to avoid carbon intensive development

outsourcing decisions product innovation and the spatial dimension evidence from the spanish footwear industry recent studies in developed countries frequently emphasise the importance of outsourcing as a strategy for manufacturing industries to survive however there is little qualitative evidence that specifically describes outsourcers in mature industries with competitive problems particularly in southern europe this paper attempts to fill this gap by investigating the distinctive traits of firms located in the most important spanish footwear industrial districts from a sample of 401 spanish firms surveyed in january and february 2006 it was found that size design and product innovation prior institutional networks and location in specific industrial districts favour the development of outsourcing strategies by contrast clients prior networks are negatively related with contracting out productive activities these results are relevant in several dimensions however the positive impact of some districts in the externalisation decision should be specifically mentioned such evidence seems to confirm t

optimal departures from marginal cost pricing focuses on departures from marginal cost pricing optimal allocation or resources level of tax revenue that will be collected by the government theorems developed for resource allocation ebsco

efficiency of health care delivery systems effects of health insurance coverage health insurance expansions may increase the demand for care creating incentives for health systems to increase input consumption the possibility remains that added capacity and personnel will have little effect on health outcomes decreasing the technical efficiency of health care delivery systems we estimate that a 1 percentage point increase in health insurance coverage decreases the technical efficiency of health care delivery by 1 3 percentage points translating into approximately 50 billion dollars in additional health expenditures this finding uncovers a previously unexplored consequence of changes in health insurance on the supply side of health care markets suggesting one avenue through which health care costs growth may occur

decoupling global environmental pressure and economic growth scenarios for energy use materials use and carbon emissions in recent decades economic growth and increased human wellbeing around the globe have come at the cost of fast growing natural resource use including materials and energy and carbon emissions leading to converging pressures of declining resource security rising and increasingly volatile natural resource prices and climate change we ask whether well designed policies can reduce global material and energy use and carbon emissions with only minimal impacts on improvements in living standards we use a novel approach of combined economic and environmental modelling to assess the potential for decoupling for 13 world regions and globally we apply a production territorial and consumption approach to discuss regional differences in natural resource use and carbon emissions across three stylized policy outlooks a reference case with no significant changes to environment and climate policies a high efficiency outlook involving a global carbon price rising from 50 to 236 constant price per tonne of co2 between 2010 and 2050 and improvements in resource efficiency rising from 1 5 historically to between 3 5 and 4 5 in the scenarios and a medium efficiency outlook midway between the no change and high outlooks we find that global energy use will continue to grow rapidly under all three scenarios from 17 billion tonnes of oil equivalent toe in 2010 to between 30 and 36 billion toe carbon emissions would be considerably lower with a global carbon price less than half the level of the reference case 29 37 billion tonnes of co2 instead of 74 billion tonnes and also material use would grow much more slowly under a carbon price and significant investment to increase resource efficiency 95 instead of 180 billion tonnes of materials we find that oecd economies have significant potential to reduce their material throughput and carbon emissions with little impact on economic growth and that developing economies such as china could expand their economies at much lower environmental cost globally the effects of very strong abatement and resource efficiency policies on economic growth and employment until 2050 are negligible our study suggests that decarbonization and dematerialization are possible with well designed policy settings and would not contradict efforts to raise human wellbeing and standards of living the research demonstrates the usefulness of scenarios for unpacking environmental and economic outcomes of policy alternatives the findings have important implications for future economic opportunities in a highly resource efficient and low carbon global economy to set human development and achieving the sustainable development goals on a more resilient path

the prerequisites for a degrowth paradigm shift insights from critical political economy abstract what would it take for a degrowth paradigm shift to take place drawing on contemporary critical political economy scholarship this article identifies four prerequisites for socio economic paradigm shifts deep crisis an alternative political project a comprehensive coalition of social forces promoting the project in political struggles and broad based consent it is argued that on the one hand there is much to suggest that current crises cannot be resolved under existing institutional frameworks and that degrowth is a political project that provides solutions to some of the key problems currently facing humanity on the other hand the prospects for a degrowth paradigm shift remain bleak unlike political projects that became hegemonic in the past degrowth has neither support from a comprehensive coalition of social forces nor any consent to its agenda among the broader population

health insurance eligibility utilization of medical care and child health two economists applied data from the current population survey and the national health interview survey and state level data on child mortality to a simulation model of utilization of medical care that varies only with the states legislative environment to examine the utilization of medical care and health effects of medicaid eligibility on low income children the models took into consideration the recent expansions of medicaid to low income children 38 of those ineligible for medicaid in 1984 who became eligible due to changes during 1984 1992 were uninsured between 1984 and 1992 expansions of the medicaid program increased the proportion of children eligible for medicaid almost two fold 16 1 vs 31 2 yet coverage rates were always lower than eligibility rates 13 2 vs 16 1 in 1984 and 20 3 vs 31 2 in 1992 and the increase in coverage rates was only about 50 of the increase in eligibility rates during 1984 1992 the probability that a child was eligible for medicaid increased the probability of health insurance coverage by 29 77 when the model considered bias in variables e g a recession in a state the take up rate was only 22 73 nevertheless medicaid markedly increased use of medical care for example eligibility for medicaid increased the likelihood of making a visit to a physicians office in the last two weeks by about 50 it also increased the probability of a child visiting the hospital suggesting inefficiency in the way that providers deliver care to medicaid enrollees medicaid eligibility had a significant effect on reducing child mortality the 15 1 percentage point increase in eligibility during 1984 1992 reduced child mortality by 4 5 when the researchers examined parent assessed subjective health measures medicaid eligibility had no effect on child health medicaid eligibility reduced race and education based disparities in the number of visits and racial differences in mortality yet it may actually intensify current disparities in health care delivery site