Assessing the Effectiveness of Health Care Cost Containment Measures

Using SOEP panel data and difference-in-differences methods, this study is the first to empirically evaluate the effectiveness of four different health care cost containment measures within an integrated framework. The four measures investigated were introduced in Germany in 1997 to reduce moral hazard and public health expenditures in the market for convalescent care. Doubling the daily copayments was clearly the most effective cost containment measure, resulting in a reduction in demand of about 20 percent. Indirect measures such as allowing employers to cut statutory sick pay or paid vacation during health spa stays did not significantly reduce demand.copayment, cost containment measures, health expenditures, convalescent care, SOEP

Approximate Waveforms for Extreme-Mass-Ratio Inspirals in Modified Gravity Spacetimes

Extreme-mass-ratio inspirals, in which a stellar-mass compact object spirals into a supermassive black hole, are prime candidates for detection with space-borne milliHertz gravitational wave detectors, similar to the Laser Interferometer Space Antenna. The gravitational waves generated during such inspirals encode information about the background in which the small object is moving, providing a tracer of the spacetime geometry and a probe of strong-field physics. In this paper, we construct approximate, "analytic-kludge" waveforms for such inspirals with parameterized post-Einsteinian corrections that allow for generic, model-independent deformations of the supermassive black hole background away from the Kerr metric. These approximate waveforms include all of the qualitative features of true waveforms for generic inspirals, including orbital eccentricity and relativistic precession. The deformations of the Kerr metric are modeled using a recently proposed, modified gravity bumpy metric, which parametrically deforms the Kerr spacetime while ensuring that three approximate constants of the motion remain for geodesic orbits: a conserved energy, azimuthal angular momentum and Carter constant. The deformations represent modified gravity effects and have been analytically mapped to several modified gravity black hole solutions in four dimensions. In the analytic kludge waveforms, the conservative motion is modeled by a post-Newtonian expansion of the geodesic equations in the deformed spacetimes, which in turn induce modifications to the radiation-reaction force. These analytic-kludge waveforms serve as a first step toward complete and model-independent tests of General Relativity with extreme mass-ratio inspirals.Comment: v1: 28 pages, no figures; v2: minor changes for consistency with accepted version, 2 figures added showing sample waveforms; accepted by Phys. Rev.

Determining Energy Balance in the Flaring Chromosphere from Oxygen V Line Ratios

The impulsive phase of solar flares is a time of rapid energy deposition and heating in the lower solar atmosphere, leading to changes in the temperature and density structure of the region. We use an O V density diagnostic formed of the 192 to 248 line ratio, provided by Hinode EIS, to determine the density of flare footpoint plasma, at O V formation temperatures of 250,000 K, giving a constraint on the properties of the heated transition region. Hinode EIS rasters from 2 small flare events in December 2007 were used. Raster images were co-aligned to identify and establish the footpoint pixels, multiple-component Gaussian line fitting of the spectra was carried out to isolate the diagnostic pair, and the density was calculated for several footpoint areas. The assumptions of equilibrium ionization and optically thin radiation for the O V lines were found to be acceptable. Properties of the electron distribution, for one event, were deduced from earlier RHESSI hard X-ray observations and used to calculate the plasma heating rate, delivered by an electron beam adopting collisional thick-target assumptions, for 2 model atmospheres. Electron number densities of at least log n = 12.3 cm-3 were measured during the flare impulsive phase, far higher than previously expected. For one footpoint, the radiative loss rate for this plasma was found to exceed that which can be delivered by an electron beam implied by the RHESSI data. However, when assuming a completely ionised target atmosphere the heating rate exceeded the losses. A chromospheric thickness of 70-700 km was found to be required to balance a conductive input to the O V-emitting region with radiative losses. The analysis shows that for heating by collisional electrons, it is difficult, or impossible to raise the temperature of the chromosphere to explain the observed densities without assuming a completely ionised atmosphere.Comment: Accepted to A&A 14th September 201

The Effects of Expanding the Generosity of the Statutory Sickness Insurance System

In 1999, in Germany, the statutory sick pay level was increased from 80 to 100 percent of foregone earnings for sicknessepisodes of up to six weeks. We show that this reform has led to an increase in average absence days of about 10 percent or one additional day per employee, per year. The estimates are based on SOEP survey data and parametric, nonparametric, and combined matching-regression difference-in-differences methods. Extended calculations suggest that the reform might have increased labor costs by about EUR1.8 billion per year and might have led to the loss of around 50,000 jobs.Sickness absence, statutory sick pay, natural experiment, Socio-Economic Panel Study (SOEP)

In Absolute or Relative Terms?: How Framing Prices Affects the Consumer Price Sensitivity of Health Plan Choice

This paper provides field evidence on (a) how price framing affects consumers' decision to switch health insurance plans and (b) how the price elasticity of demand for health insurance can be influenced by policymakers through simple regulatory efforts. In 2009, in order to foster competition among health insurance companies, German federal regulation required health insurance companies to express price differences between health plans in absolute Euro values rather than percentage point payroll tax differences. Using individuallevel panel data, as well as aggregated health plan-level panel data, we find that the reform led to a sixfold increase in an individual's switching probability and a threefold demand elasticity increase.Health insurance, health plan switching, price competition, price elasticity, SOEP

Lensed: a code for the forward reconstruction of lenses and sources from strong lensing observations

Robust modelling of strong lensing systems is fundamental to exploit the information they contain about the distribution of matter in galaxies and clusters. In this work, we present Lensed, a new code which performs forward parametric modelling of strong lenses. Lensed takes advantage of a massively parallel ray-tracing kernel to perform the necessary calculations on a modern graphics processing unit (GPU). This makes the precise rendering of the background lensed sources much faster, and allows the simultaneous optimisation of tens of parameters for the selected model. With a single run, the code is able to obtain the full posterior probability distribution for the lens light, the mass distribution and the background source at the same time. Lensed is first tested on mock images which reproduce realistic space-based observations of lensing systems. In this way, we show that it is able to recover unbiased estimates of the lens parameters, even when the sources do not follow exactly the assumed model. Then, we apply it to a subsample of the SLACS lenses, in order to demonstrate its use on real data. The results generally agree with the literature, and highlight the flexibility and robustness of the algorithm.Comment: v2: major revision; accepted by MNRAS; lens reconstruction code available at http://glenco.github.io/lensed