DO HMO PLANS REDUCE HEALTH CARE EXPENDITURE IN THE PRIVATE SECTOR?

The cost containment performance of health maintenance organization (HMO) plans relative to non‐HMOs is examined using data from the 2000 Medical Expenditure Panel Survey. When various compounding factors are controlled for, among the privately insured, nonelderly population, HMO enrollment is found to contain neither total health care spending nor total insurance payment, though it reduces total out‐of‐pocket expenditure. We further find that this result is not attributed to selectivity in health plan choice due to health risk. The favorable cost sharing for enrollees and the distinct reimbursement schemes in HMO plans seem to account for no significant overall cost saving. (JEL I11, C25)     

THE ROLE OF HOSPITAL COMPETITION ON TREATMENT EXPENDITURE AND OUTCOME: EVIDENCE FROM STROKE AND CARDIAC TREATMENT IN TAIWAN

This article examines whether market competition affects treatment expenditure and health outcomes of stroke and cardiac treatment in Taiwan. Our measure of treatment expenditure is the hospital expenditure paid at the index admission (short term) and the sum of inpatient and outpatient expenditures paid in the subsequent year (long term). Our measure of health outcome is the probability of death in 1 and 12 months after the hospital's discharge. Our measure of competition follows the method developed by Kessler and McClellan that calculates the Herfindal index based on the predicted patient flows using exogenous variables (e.g., traveling distance to hospitals). Using data of patients hospitalized for new stroke and cardiac treatment between 1997 and 2001 in Taiwan, we find that an increase of market competition results in an insignificant impact on a patient's mortality. In terms of treatment expenditure, our results indicate that hospitals facing more competition incur higher expenditures, either the short‐ or long‐term expenditure. Finally, we find evidence showing that an increase of treatment expenditure at admission is due to a raise of length of stay and treatment intensity per day as well as the usage of expensive equipment. (JEL I11, L13, L41)     

AN ECONOMIC THEORY OF WORKAHOLICS AND ALCOHOLICS

This paper considers the role of alcohol in agency problems in order to provide an economic rationale for alcoholics and workaholics. In our model, alcohol reduces productivity, but also can make imbibers blurt private information. We show that in the optimal contract, low‐productivity workers are compelled to over‐indulge in alcohol, while high‐productivity workers overproduce output. Thus, workers are made into “alcoholics” and “workaholics” depending on their productivity. We conclude that excessive drinking (working) may be the result, not the cause, of low (high) productivity of workers. (JEL D82, VSOP)     

整合营销传播战略评估指标体系研究

随着信息技术的迅速发展和市场竞争日趋激烈,企业更加以市场为导向,整合营销传播成为企业营销的新理念,构建适合整合营销传播战略的营销绩效指标体系是整合营销传播战略面临的主要难题.针对实践中整合营销传播战略实施的制约因素构建适应整合营销传播战略的绩效评估指标体系,对企业营销传播实践很有必要.