Competition and The Operational Performance of Hospitals: The Role of Hospital Objectives

We examine the effect of a hospital's objective (i.e., non‐profit vs. for‐profit) in hospital markets for elective care. Using game‐theoretic analysis and queueing models to capture the operational performance of hospitals, we compare the equilibrium behavior of three market settings in terms of such criteria as waiting times and patient costs from waiting and hospital payments. In the first setting, a monopoly, patients are served exclusively by a single non‐profit hospital; in the second, a homogeneous duopoly, patients are served by two competing non‐profit hospitals. In our third setting, a heterogeneous duopoly, the market is served by one non‐profit hospital and one for‐profit hospital. A non‐profit hospital provides free care to patients, although they may have to wait; for‐profit hospitals charge a fee to provide care with minimal waiting. A comparison between the monopolistic and each of the duopolistic settings reveals that the introduction of competition can hamper a hospital's ability to attain economies of scale and can also increase waiting times. Moreover, the presence of a for‐profit sector may be desirable only when the hospital market is sufficiently competitive. A comparison across the duopolistic settings indicates that the choice between homogeneous and heterogeneous competition depends on the patients' willingness to wait before receiving care and the reimbursement level of the non‐profit sector. When the public funder is not financially constrained, the presence of a for‐profit sector may allow the funder to lower both the financial costs of providing coverage and the total costs to patients. Finally, our analysis suggests that the public funder should exercise caution when using policy tools that support the for‐profit sector—for example, patient subsidies—because such tools may increase patient costs in the long run; it might be preferable to raise the non‐profit sector's level of reimbursement.     

Partial privatisation and the role of state owned holding companies in China

China has never agreed to full privatisation of its state-owned enterprises (SOEs). This essentially means a dual role for the government—as a shareholder of privatised SOEs and a regulatory authority of the corporate sector. This begs the question—how does the government avoid being caught in the awkward state-first condition where political-economic interest overrides the commercial interest as its exercises both the shareholder and regulatory roles? This paper argues that a positive way forward is to establish state-owned holding companies (SOHs). As shareholders representative of the government, the SOHs serve to monitor the performance of partially privatised firms and see that the state receives its fair share of return. In China, the State-Owned Assets Supervision and Administration Commission (SASAC) assumes the role of the SOH. However, the relationship between the central government and SASAC is ambiguous with evidences suggesting SASAC’s commitment to political-economic goals. To play the role more effectively, this paper argues that SASAC must function independently of the government. SASAC must demarcate the government’s role as a shareholder and a regulator with SASAC assuming the role of a shareholder representative of the government.     

Finding and Implementing Energy Efficiency Projects in Industrial Facilities

This study addresses the challenges of finding and implementing profitable energy efficiency (EE) projects, a critical foundation for sustainable operations. We focus on manufacturing enterprises, but many of our findings apply also to the back office of service operations. Our starting point is that, in nearly every industrial enterprise, there are many profitable EE projects that could be implemented but are not. An oft‐cited hindrance to implementation is the lack of an internal management framework in which to find, value, and execute these projects. Using a conceptual approach, we rely on proven sustainable operations tools to develop such a framework. We identify three major value drivers of EE projects: savings intensity, “green” image, and project complexity. We then describe a framework for understanding the context of EE projects in industry, with an underlying analytic foundation in optimal portfolio analysis. A case study of a large manufacturing site is used to illustrate emerging best practices—based on Kaizen management principles—for integrating EE project management with operations, engineering, and strategy.     

Governmentality and Lifestyle Studies

In recent years, a research focus on lifestyles has drawn considerable attention from many quarters. Within this area, the influence of several European and continental intellectual currents not widely embraced in American sociology can be detected, some traceable to the work of Michel Foucault. This article will provide a summary and overview of one area of lifestyle sociology that is touched by Foucault's broad influence on the social sciences, particularly his theories on governmentality. Governmentality studies consider the manner in which personal autonomy and self-responsibility is conveyed to individuals as an ongoing life-project. Through the lens of governmentality studies, everyday lifestyle choices of individuals are viewed as elements of larger projects of self-development, implemented by therapeutic discourses of risk management, self-realization, and enhanced personal well-being. After a summary of debates within the sociology of lifestyle informed by governmentality theories, commentary and recommendations will be offered on new directions in governmentality research focusing on subjective well-being or 'happiness' as a feature of contemporary lifestyles and as an object of sociological research. A brief survey of new research comprising the interdisciplinary field of 'happiness studies' suggests a new direction not only for lifestyle research, but for governmentality studies as well.     

The abortion issue and Title VII employment discrimination: The microcosm of the law

This paper presents a discussion of a 1989 United States federal appeals court ruling in the case of Doe v. First National Bank. The case is the first ruling on the federal appellate level involving a claim of Title VII employment discrimination based upon alleged employer knowledge of and animus towards an employee who had undergone an abortion. Doe raises the ethical questions of how a highly charged, national social issue can be reduced to interpersonal dealings between a supervisor and her subordinate in the workplace. The facts of the case are presented in a chronological manner, followed by a discussion of both the court rulings in the case and the utility of employing this case as an excellent tool in the teaching of business ethics and society.     

A lower-bound oracle inequality for a blockwise-shrinkage estimate

Efromovich-Pinsker and Stein blockwise-shrinkage estimates are traditionally studied via upper-bound oracle inequalities, which bound the estimate's risk from above by the oracle's risk plus a remainder term. These bounds allow one to establish sufficient conditions for attaining the oracle's risk. To explore necessary conditions, this article develops a lower-bound oracle inequality, which bounds the estimate's risk from below by the oracle's risk minus a remainder term. In particular, the lower bound implies that thresholds must vanish for attaining the oracle's risk.     

Exploring the Hierarchical Structure of Pacific Identity and Wellbeing

To understand outcomes for Pacific peoples in New Zealand we need to further our psychological knowledge of the relationship between Pacific identity and wellbeing. We map the hierarchical organization of Pacific identity and wellbeing using a novel top-down factor analytic approach applied to the Pacific Identity and Wellbeing Scale (PIWBS; N = 586). Analyses indicated that Pacific identity experiences were organized within two broad dimensions reflecting Identity Engagement and Cultural Wellbeing. Critically, our analysis showed that Religious Centrality and Embeddedness emerged jointly from these dual broad domains. Religious identification provides a bridging link between identity and wellbeing for Pacific peoples. Identifying the relationships of Pacific identity and wellbeing factors, and how religious identification emerges jointly from these two broad domains, provides valuable information in how the Pacific self may be cognitively organized and may assist in future research directions in this area. We assert that this general statistical model provides broad conceptual insights into how Pacific peoples experience their identity and culture, and how this relates to various social indicators of health and wellbeing at a broad, theoretical level. In particular, we offer a conceptual analysis of possible insights from our hierarchical model of identity and wellbeing for understanding Pacific suicide in New Zealand.     

The contributions of welfare typologies to international social work practices

This paper is concerned with the link between studies of welfare typologies and studies of international social work. Its objective is to show how welfare typologies could be used to strengthen the role of international social work practices to support international exchange of ideas on welfare issues. To meet this objective, three analytical tasks are implemented. The first task is to show that professional imperialism could weaken the potential of international social work practices to promote international exchange of ideas on welfare issues. The second task is to discuss the importance of welfare typologies in supporting the development of international social work by challenging professional imperialism. The third task is to discuss a research project on a defamilization typology. This project provides empirical evidence of the contributions made by welfare typologies to international social work practices.     

The Functional Analysis of Psychological Terms: The Symmetry Problem

The Analysis of Verbal Behavior - Skinner (1945) proposed an empirical research program in which subjective, mentalistic, or psychological terms from ordinary language could be analyzed in terms of...