THE EFFECT OF PROVIDER CONTROL OF BLUE SHIELD PLANS ON HEALTH CARE MARKETS

Blue Shield plans often are granted regulatory advantages by the states in which they operate. Run efficiently, such not-for-profit firms should use these lower costs to eliminate their less advantaged rivals, the commercial insurers. However, these higher-cost commercial providers have been able to offer insurance coverage at prices competitive with the Blues, as evidenced by the fact that Blue plans have, on average, less than 50 percent market share. Similar prices with lower overall costs implies that economic rents are being earned, rents which a not-for-profit firm cannot distribute to owners. In this paper we argue that when there are competing goals among the groups controlling the Blue Shield plans, the different possible "uses" of the regulatory advantage become endogenously determined, necessitating the use of simultaneous equation estimation. Testing this model we find the major effect of doctor-control of Blue Shield plans is to raise doctors' fees while lowering the amount of rents captured by both consumers and administrators.     

Individual behavior under risk and under uncertainty: An experimental study

These experiments are concerned with individual behavior under risk and under uncertainty. By exploiting the isolation effect the experiments were able to offer to 134 subjects the possibility of actually gaining or losing an important sum of money.The experimental data show that under risk as well as under complete ignorance the subjects' attitudes towards prospects of gains and towards prospects of losses are totally unrelated.The data also show that when facing prospects of gains, the subjects generally take the exact probabilities of the events into account, whereas, when facing prospects of losses many of then have only recourse to coarser categories of plausibility, or even no longer use their information at all.     

USING DUAL FRAME DESIGNS TO REDUCE NONRESPONSE IN TELEPHONE SURVEYS

This article reports on the results of a series of experimentsdesigned to improve response rates for telephone surveys. Inthree surveys telephone households were selected using bothstandard random digit dialing (RDD) techniques and lists oftelephone numbers purchased from a commercial firm. In the RDDportions of the samples "cold contact" interviewing methodswere used; in the list frame portions advance letters were mailed,and the listed household name was used in the introduction.Experiments were designed to test the effects on response ratesof the advance letters and use of the listed household nameas a means of establishing rapport. The advance letters increasedresponse rates, but no difference could be attributed to theuse of names. The mixture of RDD and list sampling techniquesis also used to evaluate the effects of relative response rateson substantive findings. The cost consequences of these dualframe designs are assessed along a number of dimensions, andthe cost and error components of these designs are discussed.     

Verbal and nonverbal communication of warmth to children,foreigners, and retarded adults

The verbal and nonverbal communication of warmth was examined in a study in which undergraduate women taught a block design task to a listener who was either a six-year-old child, a retarded adult, a peer who spoke English as a second language (foreigner), or a peer who was a native speaker of English. The degree of warmth conveyed by the speakers differed only minimally across different categories of listeners. However, these communications did vary systematically within each category, in accord with the levels of cognitive and linguistic sophistication of each particular listener. Speakers tended to fine-tune communications by conveying more warmth to the more sophisticated children and foreigners than to the less sophisticated members of these categories. To the more sophisticated retarded persons, however, they conveyed—nonverbally—less warmth than to the less sophisticated retarded persons. The relevance of these findings to the communication of expectancy effects and to the social psychology of stigma is discussed.This paper was written while the first author was visiting at the University of Florida. We thank John Neil Bohannon, Linda Caporael, Margaret Clark, William Cooper, Monica Harris, Harry Levin, and Carol Sigelman for their helpful comments on an earlier draft of this paper. For their help in conducting this research, we thank Ann Ashworth, Pamela Brown, Linda Douglas, Susan Finkelstein, Tamara Harper, Robin Johnson, Susan Kirdendol, Sheila Larkin, Sue Limber, Jose Macaranas, Ashook Nimgade, Maria Papetti, Maurice Perry, Lester Pretlow, Carissa Smith, Laura Taswell, Tina Tedeschi, Charles Valadez, and all of our listener-subjects. We also thank the students, faculty, and administration of Dunmore High School, Dunmore, Pennslyvania, for their participation and cooperation. Support from NSF, NIMH, the National Academy of Education, and a Rackham Faculty Grant was invaluable. Most importantly, we thank Roger Brown and Robert Rosenthal for their wisdom and inspiration.     

An evaluation of socially responsive planning in a new resource town

New resource towns on the Canadian frontier have presented planners with opportunities to experiment with innovative planning ideas which attempt to resolve the persistent problems of such communities. In the planning of Tumbler Ridge, a new coal mining town in British Columbia, socially responsive planning was an attempt to develop a town using principles derived from social science research. In this paper the reactions of residents to selected attributes which reflect the application of these principles are examined five years after settlement began. Ratings of community attributes offer an indication of aspects of residential satisfaction, while the results of a principal components analysis suggest the dimensionality of residents' evaluative structures and provide a useful framework within which to consider planning issues. Issues examined are: the association between employment and the community environment; the suitability of the environment for children; and the social environment. While social aspects of the new community are judged as satisfactory, less positive elements reflect the underlying influence of the economic well-being of the mining company on overall community satisfaction. When compared to indicators of community satisfaction in other western Canadian resource towns, ratings for Tumbler Ridge tend to be fairly low. It is concluded that the inability of planners to adequately control implementation or dontinuity of their ideas has resulted in a community not distinctly different from other resource towns. Efforts have been further hampered by a lack of adequate models of the distinctive dynamics of resource communities.     

Estimation of mortality from orphanhood in adulthood

This paper extends earlier research into methods for estimating adult mortality from information on the recent incidence of orphanhood. It presents a series of regression coefficients for estimating female and male mortality from synthetic cohort data on the subsequent orphanhood of those who had a living mother or father at exact age 20. Such information can be obtained either where questions about parental survival have been asked in two inquiries or by asking retrospectively about dates of orphanhood in a single survey. Although the method is somewhat sensitive to errors in the reporting of ages and dates, it is a promising source of up-to-date estimates of adult mortality that are free from bias due to the underreporting of the orphanhood of young children ("the adoption effect").     

Family ties and economic stability concerns of migrant labour families in Jordan

74 labor migrant families from various socioeconomic classes in Amman, Jordan were interviewed to examine changes in relationships among family members, extended family, and neighbors and their concerns about economic stability in the host country, Jordan, and the world market. Another purpose was to determine how current migration policies of the Arab oil-producing countries which prohibit labor migrants from bringing their families to the host country affect labor migration among families. The families consisted of either those who did or did not accompany the labor migrant. Overall labor migration affected unaccompanied families more than accompanied families, e.g., only 19% of the unaccompanied families reported increased family unity compared with 56% of accompanied families. Problems within unaccompanied families increased in 43% of the cases but in only 6% of the accompanied families. Many of these problems resulted in children dropping out of school which reflected the control fathers had within the family, separation, or divorce. Yet labor migration reduced family ties with extended family members and neighbors almost equally for both groups. Accompanied families were not as concerned about economic stability in Jordan as unaccompanied families (38% vs. 50%). Perhaps these families tended not to invest remittances received from the labor migrants working in Arab oil-producing countries in Jordan. Both groups were quite concerned about the economic stability in the host countries (66% and 72%, respectively) and the world market (59% and 62%, respectively), however. Since family unity suffers when families do not accompany labor migrants, it is suggested that oil-producing nations that depend on foreign labor should guarantee family unity as a human right.