Designing Competition in Health Care Markets

In this paper we propose a simple, market based mechanism to set prices in health care markets, namely a system where the patients are auctioned out to the hospitals. Our aim is to characterize principles as to how such an auction should be designed. In the case of elective treatment, health authorities thus organize a competition between hospitals. The hospital with the lowest price signs a contracts with authority (or the insurer) that commits him to treat a given number of patients within a predetermined period. However, this is not a simple mechanism that identi…es the hospital with the lowest treatment cost. Due to potentially rapid and unpredictable shifts in demand, treatment capacity may be hard to know in advance. There is always a risk that treatment must be canceled due to arrival of patients that require acute treatment. This calls for a market design that accounts for the risk of default. Our main result is that the expected cost for the government is reduced if the government chooses to ”subsidize” default. This could be thought of as a system in which the government buys treatment in the spot market in the case of default, and let the hospital pay a default fee that is lower than the spot price. The reason why this reduces expected costs for the government is that the e¤ect on the bids is asymmetric: The second lowest bid is on average reduced more than the winning bid. Hence, the winner’s profit tends to shrink. This is due to what we characterize an endogenous correlation. Since the cost of treatment increases in the default risk (as the hospital must pay a penalty if it defaults), high cost hospitals typically have larger default risks than low costs hospitals.Health care markets; health care; hospitals; competition

Politicians and soft budget constraints

We study soft budget constraints from the perspective of political economics. A partly partisan government confronts a budget crisis in a politically important sector, e.g. like the health care sector. To what extent the government wants to make additional grants to the sector depends on economic conditions and on the preferences of the government, both unknown to the electorate. Thus, the government’s budget response gives a signal of its preferences, and may thereby influence the probability that the government is re-elected. As a result, the handeling of a budget crisis becomes inefficient even from an ex post point of view, in the sense that it does not react adequately to changing economic conditions.Political economics; budget constraints; budget crisis

Public Ownership as a Signalling Device

We study public ownership from the perspective of political economics. A partly partisan government runs a state-owned firm. The number of employees the government wants to hire depends both on economic conditions and on the preferences of the government, both unknown to the electorate. The government's policy towards the state-owned firm gives a signal of its preferences, and may thereby influence the probability that the government is re-elected. As a result, the governance of the firm becomes inefficient and static, in the sense that it does not react adequately to changing economic conditions.

Extinction by Miscalculation:

Species at Risk Act, Sakinaw sockeye, Cultus sockeye, fisheries management, extinction.

A note on light velocity anisotropy

It is proved that in experiments on or near the Earth, no anisotropy in the one-way velocity of light may be detected. The very accurate experiments which have been performed to detect such an effect are to be considered significant tests of both special relativity and the equivalence principleComment: 8 pages, LaTex, Gen. Relat. Grav. accepte

Experimental investigation of cut-off phenomena in non-linear photonic crystal fibers

The modal cut-off is investigated experimentally in a series of high quality non-linear photonic crystal fibers. We demonstrate a suitable measurement technique to determine the cut-off wavelength and verify it by inspecting the near field of the modes that may be excited below and above the cut-off. We observe a double peak structure in the cut-off spectra, which is attributed to a splitting of the higher order modes. The cut-off is measured for seven different fiber geometries with different pitches and relative hole size, and a very good agreement with recent theoretical work is found.Comment: 3 pages including 1 table and 4 figures. Accepted for Optics Letter

Sublingual grass allergen tablet immunotherapy provides sustained clinical benefit with progressive immunologic changes over 2 years

Background: This is an interim analysis of a randomized, double-blind, placebo-controlled phase III trial with 3 years of daily treatment with grass tablet immunotherapy (GRAZAX; ALK-Abello A/S, Horsholm, Denmark) or placebo, followed by 2 years of follow-up to assess the persistent efficacy. Objective: We sought to evaluate the efficacy and safety of specific immunotherapy with grass allergen tablets compared with placebo after treatment covering 2 consecutive grass pollen seasons. Methods: The interim analyses included 351 adult participants with moderate-to-severe allergic rhinoconjunctivitis caused by grass pollen. Participants were treated with active (n = 189) or placebo (n = 162) tablets for an average of 22 months. All participants were allowed to use symptomatic rescue medication. Results: The primary efficacy analysis showed highly significant mean reductions of 36% in rhinoconjunctivitis symptom score (P Conclusion: Grass allergen tablet immunotherapy showed progressive immunologic changes and highly significant efficacy over 2 years of continued treatment

Resonance phenomena in ultracold dipole-dipole scattering

Elastic scattering resonances occurring in ultracold collisions of either bosonic or fermionic polar molecules are investigated. The Born-Oppenheimer adiabatic representation of the two-bodydynamics provides both a qualitative classification scheme and a quantitative WKB quantization condition that predicts several sequences of resonant states. It is found that the near-threshold energy dependence of ultracold collision cross sections varies significantly with the particle exchange symmetry, with bosonic systems showing much smoother energy variations than their fermionic counterparts. Resonant variations of the angular distributions in ultracold collisions are also described.Comment: 19 pages, 6 figures, revtex4, submitted to J. Phys.

An Atom Laser with a cw Output Coupler

We demonstrate a continuous output coupler for magnetically trapped atoms. Over a period of up to 100 ms a collimated and monoenergetic beam of atoms is continuously extracted from a Bose- Einstein condensate. The intensity and kinetic energy of the output beam of this atom laser are controlled by a weak rf-field that induces spin flips between trapped and untrapped states. Furthermore, the output coupler is used to perform a spectroscopic measurement of the condensate, which reveals the spatial distribution of the magnetically trapped condensate and allows manipulation of the condensate on a micrometer scale.Comment: 4 pages, 4 figure