Group contingency (GC) is an effective and cost-efficient strategy that can be successfully applied to technology-based interventions. This study examined the relative effectiveness and cost efficiency of three types of technology-based group contingencies on walking among adults. Seventy two students were divided into teams of three. Each team was randomly assigned to one of three GC conditions (independent, interdependent, or dependent) and underwent 66 days of technology-based group contingency intervention. Sixty five participants completed the intervention and 61 (...) completed the follow-up assessment 2 months later. Step counts and self-reported walking activity increased after the intervention under all three conditions. The proportion of participants that met the target step counts was significantly higher under the dependent group contingency condition. However, 2 months later, intervention effects were not maintained under any condition. For cost efficiency, the increase in step count per point was significantly higher under the interdependent group contingency condition. Group cohesion and social validity (point satisfaction and point utility) were significantly higher under the dependent group contingency condition. Finally, the clinical implications and limitations of this study are discussed. (shrink)

Assumed benefits from improved reputation are often used as motives to drive corporate social responsibility (CSR) initiatives. Are improved cost efficiencies among these reputation benefits? Cost efficiencies and cost management have become more relevant as revenue streams dry up in these tough economic times. Can a good reputation aid these efforts to develop cost efficiencies specifically when managing labor costs? Prior research hypothesizes that good reputation can create labor productivity and efficiency benefits. The purpose of (...) this study is to empirically investigate reputation's relationship with labor efficiency, labor productivity, and labor cost. Using a sample of highly reputable firms from Fortune's America's Most Admired Companies list and a corresponding matched sample of firms, we find that reputation is associated with improved labor efficiency and labor productivity. However, we do not find a significant association between reputation and reduced labor costs. Our study contributes to current research hypothesizing and finding efficiency benefits associated with good reputation. Documenting these potential reputation benefits has important implications for CSR activities and initiatives. It supports recent work that incorporates reputation into a more developed model of the relationship between CSR and performance (Vilanova et al.: 2009, Journal of Business Ethics 87, 57-69). This work is useful to businesses and supports strategies focused on "doing well by doing good" and maintaining healthy reputations. (shrink)

This study employs the Porter hypothesis framework to test the moderating role of production cost in the relationship between resource-efficiency actions and financial performance for German small and medium-sized enterprises (SMEs). For this purpose, we employ the 2012, 2018, and 2021 Flash Eurobarometer surveys to analyze how consistently SMEs adopt resource-efficiency actions, and the impact of these actions on their performance and costs. We also conduct a generalized method of moments regression analysis (GMM). Among the seven resource- (...) class='Hi'>efficiency actions proposed, saving water had a significant positive (negative) influence on financial performance in 2012, 2021, and (2018). Saving energy and using renewable energy had a positive and significant (insignificant) effect on financial performance in 2018, 2021, and (2012). Finally, selling scrap material to other companies had a positive and significant impact in all years. Furthermore, increased production costs negatively moderate the relationship between eco-efficiency action scores and financial performance. The results indicate that the “strong” version of the Porter hypothesis is not supported: It only holds when the implementation of eco-efficiency actions reduces production costs and increases financial performance. (shrink)

Florida International University, USA edwardj{at}fiu.edu ' + u + '@ ' + d + ' '/ /- -> Several authors have analyzed the optimal k -majority rule based on a variety of criteria. Buchanan and Tullock argued that, in constitutional settings, the criterion should be that all changes meet the Pareto criterion; otherwise the status quo should be preferred. They then asserted that unanimity rule would be the preferred voting rule in this setting. In parliamentary settings, they claimed that a (...) near majority rule would be preferred because it minimizes the sum of decision costs and external costs. This article investigates both claims in an N -voter, two-alternative setting. We show the conditions under which unanimity rule is less likely to select BT preferred alternatives than other k -majority rules and prove that the difference in performance can be negligible when N is large and certain weak conditions are met. Furthermore, if we define external costs as the expected number of losers from a BT-inferior vote, then external costs become negligible for a range of supermajority rules. This implies that unanimity rule and a range of supermajority rules should be equally preferred when decision costs are added. Finally, we show that the external cost function can actually increase for certain populations. Many of the broader conclusions should also hold for multiple alternatives. Key Words: constitutional design • Pareto criterion • external costs • social contract. (shrink)

Several authors have analyzed the optimal k-majority rule based on a variety of criteria. Buchanan and Tullock argued that, in constitutional settings, the criterion should be that all changes meet the Pareto criterion; otherwise the status quo should be preferred (we call this the BT criterion). They then asserted that unanimity rule would be the preferred voting rule in this setting. In parliamentary settings, they claimed that a near majority rule would be preferred because it minimizes the sum of decision (...) costs and external costs. This article investigates both claims in an N-voter, two-alternative setting. We show the conditions under which unanimity rule is less likely to select BT preferred alternatives than other k-majority rules and prove that the difference in performance can be negligible when Nis large and certain weak conditions are met. Furthermore, if we define external costs as the expected number of losers from a BT-inferior vote, then external costs become negligible for a range of supermajority rules. This implies that unanimity rule and a range of supermajority rules should be equally preferred when decision costs are added. Finally, we show that the external cost function can actually increase for certain populations. Many of the broader conclusions should also hold for multiple alternatives. (shrink)

We study the selection of adjustment sets for estimating the interventional mean under an individualized treatment rule. We assume a non-parametric causal graphical model with, possibly, hidden variables and at least one adjustment set composed of observable variables. Moreover, we assume that observable variables have positive costs associated with them. We define the cost of an observable adjustment set as the sum of the costs of the variables that comprise it. We show that in this setting there exist adjustment (...) sets that are minimum cost optimal, in the sense that they yield non-parametric estimators of the interventional mean with the smallest asymptotic variance among those that control for observable adjustment sets that have minimum cost. Our results are based on the construction of a special flow network associated with the original causal graph. We show that a minimum cost optimal adjustment set can be found by computing a maximum flow on the network, and then finding the set of vertices that are reachable from the source by augmenting paths. The optimaladj Python package implements the algorithms introduced in this article. (shrink)

Efficiency has become of central importance in health care and is seen as wholly laudable. It appears to offer a precise and objective means of evaluating and comparing institutions, practices and individuals, and is a principle that underlies techniques of cost-benefit analysis and other methods of option appraisal. However, there is a need to examine the concept of efficiency and explore the problems of its application within health care. Efficiency is a value laden notion and it (...) cannot be used as a means of making value judgements from purely factual premises. We have to choose the inputs and outputs in our calculations, and what limits to set on their scope. Efficiency calculations may require us to measure what cannot be quantified, and to treat as commensurable what is incommensurable. There are circumstances in which considerations of efficiency are inappropriate or even immoral. (shrink)

Many countries tightly ration access to publicly funded fertility treatments such as in vitro fertilisation. One basis for excluding people from access to IVF is their body mass index. In this paper, I consider a number of potential justifications for such a policy, based on claims about effectiveness and cost-efficiency, and reject these as unsupported by available evidence. I consider an alternative justification: that those whose subfertility results from avoidable behaviours for which they are responsible are less deserving (...) of treatment. I ultimately stop short of endorsing or rejecting such a justification, though highlight some reasons for thinking it is unlikely to be practicable. (shrink)

This essay examines certain epistemic problems facing administrative states’ efforts to draft efficient regulations for their societies. I argue that a basic feature of the administrative state’s authority, namely its monopoly over the production of legally binding rules for all members of a geographically defined society, creates epistemic problems that impede efficient rule-making. Specifically, the administrative state’s monopoly over the production of legally binding rules prevents multiple public policies from being simultaneously implemented and compared. The resulting singularity of administrative states’ (...) regulatory decisions prevents observation of the counterfactual effects of policies that were possible but which were not implemented. The absence of observable policy counterfactuals frustrates efforts to assess the efficiency of administrative states’ decisions, as it is impossible to determine whether different policies would have generated greater benefits at lower cost than the policy the state implemented. As these epistemic problems are derived from the singularity of administrative states’ decisions, they exist independently of principal agent problems, suboptimal incentives, or the preferences and capabilities of administrative personnel. (shrink)

In response to rapidly rising health care costs in the United States, federal and state governments and private industry are instituting numerous and diverse cost-containment plans. As devices for coping with a scarcity of resources, such plans present serious challenges to physicians' traditional single-minded devotion to patient welfare. Those which contain costs by directly limiting medical options or by controlling physicians' daily clinical decisions can threaten the quality of medical care by allowing economic authorities to make essentially medical judgments. (...) In contrast, other plans coax compliance by arranging incentives, e.g., offering financial rewards for successful cost containment. While they allow for clinical freedom, these plans create conflicts between physicians' fiduciary obligations to their patients and the competing interests of the payers. Such conflicts arise as physicians try to work within governmental or corporate cost containment policies, and also as they attempt to streamline clinical efficiency. Throughout, issues of justice emerge as physicians seek to reconcile their own patients' claims upon limited common resources with others' equally legitimate claims. (shrink)

We contend that if efficiency and reliability are important factors in neural information processing then distributed, not localist, representations are “evolution's best bet.” We note that distributed codes are the most efficient method for representing information, and that this efficiency minimizes metabolic costs, providing adaptive advantage to an organism.

Fifty years after the famous essay “The Problem of Social Cost” (1960) by the Nobel laureate Ronald Coase, Law and Economics seems to have become the lingua franca of American jurisprudence, and although its influence on European jurisprudence is only moderate by comparison, it has also gained popularity in Europe. A highly influential publication of a different nature was the Brundtland Report (1987), which extended the concept of sustainability from forestry to the whole of the economy and society. According (...) to this report, development is sustainable when it “meets the needs of the present without compromising the ability of future generations to meet their own needs”. A key requirement of sustainable development is justice to future generations. It is still a matter of fact that the law as well as the theories of justice are generally restricted to the resolution of conflicts between contemporaries and between people living in the same country. This in turn raises a number of questions: what is the philosophical justification for intergenerational justice? What bearing does sustainability have on the efficiency principle? How do we put a policy of sustainability into practice, and what is the role of the law in doing so? The present volume is devoted to these questions. In Part One, “Law and Economics”, the role of economic analysis and efficiency in law is examined more closely. Part Two, “Law and Sustainability”, engages with the themes of sustainable development and justice to future generations. Finally, Part Three, “Law, Economics and Sustainability”, addresses the interrelationships between the different aspects. (shrink)

This study aims to examine the main determinants of efficiency of both conventional and Islamic Saudi banks and then choose the best fit model among machine learning prediction models, Chi-squared automatic interaction detector, linear regression, and neural network ). The data were collected from the annual financial reports of Saudi banks from 2014 to 2018. The Saudi banking sector consists of 11 banks, 4 of which are Islamic. In this study, the major financial ratios are subgrouped into the profitability (...) ratios, managerial practices, asset and loans, capital adequacy ratios, and liquidity. First, regression analysis is implemented with efficiency ratio as a dependent variable and the proxies of banks’ profitability, liquidity, asset quality, management ratios, and capital adequacy ratios as independent variables. Next, the feature selection is applied for different prediction models. Subsequently, 4 prediction models were developed to choose the best fit. The performance metrics have also been evaluated. Regression results exhibit that the efficiency of both conventional and Islamic banks is highly affected by profitability, liquidity, and managerial practices. Finally, we choose the best prediction model with the highest R2 in the training and the testing phases with/out feature selection that is the CHAID model. The best predictors of cost efficiency for Saudi banks are the capital ratios, namely, CAR total and CAR tier 1. Findings are theoretically and practically important to academics, investors, and policymakers. Policymakers can benefit from the novelty of this study in building an early warning system using the CHAID model to predict different financial distress scenarios. (shrink)

This book is a comprehensive account of what it means to try to quantify health in distributing resources for health care. It examines the concept of QALYs which supposedly makes it more accurate to talk about life in terms of both quality and quantity of years lived when referring to health care policy. It offers an elegant new approach to comparing the costs and benefits of medical interventions. Cost-Utility Analysis is a method designed by economists to aid decision makers (...) distribute scarce resources to areas of health care where they will yield the greatest benefits. Erik Nord questions the feasibility of measuring patients' quality of life meaningfully in numerical terms, as CUA presupposes. He presents an alternative approach called cost-value analysis in which representative samples of the general public express preferences between different health-care programs. In this approach, subjects are allowed to include concerns for fairness that go beyond concerns for efficiency of conventional health economics. (shrink)

The inferences that can be drawn from Izard’s article are unclear. Izard (2010) suggests that his data raise questions concerning inconsistencies, confusion, and costs in emotion research. I suggest that his data do not speak to the issues of confusion and costs, and that the choice of distinguished scientists may have been inappropriate to meet the goals of Izard’s study. Of course, questions concerning the efficiency of research in emotion studies are interesting. I describe more appropriate ways of addressing (...) such issues. (shrink)

Efficient markets are alienating if they inhibit us from recognizably caring about one another in our productive activities. I argue that efficient market behaviour is both exclusionary and fetishistic. As exclusionary, the efficient marketeer cannot manifest care alongside their market behaviour. As fetishistic, the efficient marketeer cannot manifest care in their market behaviour. The conjunction entails that efficient market behavior inhibits care. It doesn’t follow that efficient market behavior is vicious: individuals might justifiably commit to efficiency because doing so (...) serves the common good. But efficient market systems nevertheless have significant opportunity costs. The discussion yields a range of desiderata for non-alienated economic organization. (shrink)

Pre-natal-diagnosis technologies allow parents to discover whether their child is likely to suffer from serious disability. One argument for state funding of access to such technologies is that doing so would be “cost-effective”, in the sense that the expected financial costs of such a programme would be outweighed by expected “benefits”, stemming from the births of fewer children with serious disabilities. This argument is extremely controversial. This paper argues that the argument may not be as unacceptable as is often (...) assumed. In doing so, it sets out a more general framework for assessing the relevance of efficiency calculations to policy-making. The final section also investigates the relationship between the paper’s arguments and claims about parental responsibility for child-bearing and rearing, with reference to Scanlon’s work on “substantive responsibility”. (shrink)

Pre-natal-diagnosis technologies allow parents to discover whether their child is likely to suffer from serious disability. One argument for state funding of access to such technologies is that doing so would be “cost-effective”, in the sense that the expected financial costs of such a programme would be outweighed by expected “benefits”, stemming from the births of fewer children with serious disabilities. This argument is extremely controversial. This paper argues that the argument may not be as unacceptable as is often (...) assumed. In doing so, it sets out a more general framework for assessing the relevance of efficiency calculations to policy-making. The final section also investigates the relationship between the paper’s arguments and claims about parental responsibility for child-bearing and rearing, with reference to Scanlon’s work on “substantive responsibility”. (shrink)

Many studies show that punishment, although able to stabilize cooperation at high levels, destroys gains which makes it less efficient than alternatives with no punishment. Standard public goods games (PGGs) in fact show exactly these patterns. However, both evolutionary theory and real world institutions give reason to expect institutions with punishment to be more efficient, particularly in the long run. Long-term cooperative partnerships with punishment threats for non-cooperation should outperform defection prone non-punishing ones. This article demonstrates that fieldwork data from (...) hunter-gatherers, common pool resource management cases and even PGGs support this hypothesis. Although earnings in PGGs with a punishment option may be lower at the beginning, efficiency increases dramatically over time. Most ten-period PGGs cannot capture this change because their time horizon is too short. (shrink)

With the development of mobile communication technology, location-based services are booming prosperously. Meanwhile privacy protection has become the main obstacle for the further development of LBS. The k-nearest neighbor search is one of the most common types of LBS. In this paper, we propose an efficient private circular query protocol with high accuracy rate and low computation and communication cost. We adopt the Moore curve to convert two-dimensional spatial data into one-dimensional sequence and encrypt the points of interest information (...) with the Brakerski-Gentry-Vaikuntanathan homomorphic encryption scheme for privacy-preserving. The proposed scheme performs the secret circular shift of the encrypted POIs information to hide the location of the user without a trusted third party. To reduce the computation and communication cost, we dynamically divide the table of the POIs information according to the value of k. Experiments show that the proposed scheme provides high accuracy query results while maintaining low computation and communication cost. (shrink)

A rule for the acceptance of scientific hypotheses called 'the principle of cost-benefit dominance' is shown to be more effective and efficient than the well-known principle of the maximization of expected utility. Harvey 's defense of his theory of the circulation of blood in animals is examined as a historical paradigm case of a successful defense of a scientific hypothesis and as an implicit application of the cost-benefit dominance rule advocated here. Finally, various concepts of 'dominance' are considered (...) by means of which the effectiveness of our rule may be increased. (shrink)

Alasdair MacIntyre described the late modern West as driven by two moral values: efficiency and effectiveness. Regardless of whether you accept MacIntyre's overarching story, it seems clear that efficiency and effectiveness have achieved a zenith in institutional health care structures, such that these two aspects of care become the final arbiters of what counts as “good” care. At the very least, they are dominant in many clinical contexts and act as the interpretative lens for the judgments of successful (...) health care managers. The drive of efficiency can also be seen in “lean” management methods (originally imported from the automotive manufacturing industry) increasingly deployed in the intensive care unit. This drive gives us pause. The high stress of the ICU is exacerbated by the enormous complexity of technological interventions designed to maintain physiological functioning as the body heals, as well as the ever‐present concerns related to cost, effectiveness, and efficiency. The ICU, therefore, provides an illustrative view of the challenges facing clinicians, as well as resource managers, in terms of delivering care. In short, the goal of technocratic efficiency often ends up at odds with humane purposes. To better understand these contemporary health care dynamics, we conducted a limited series of focus group discussions and interviews with residents experienced in the challenges of delivering care in the ICU environment. In what follows, we highlight some narrative observations drawn from these focus groups. We found a recurrent and disconcerting refrain among our informants that has not been adequately described or addressed in the literature: technocratic management techniques have crept into and bifurcated clinical care strategies in the ICU. Specifically, we highlight the influence of concerns around efficiency and effectiveness and the ways in which these foci have contributed to a bifurcation in care in the ICU along two trajectories: either compassionate care or curative care. (shrink)

Political integration in the European Union creates the need for a common means of communication among the various linguistic communities in Europe. One way of meeting this need is unilingualism: the use of a single language as a "lingua franca". While this option has been thought to be efficient, this does not mean that we should necessarily choose it. This paper argues that a unilinual Europe will inevitably be unfair despite recent attempts to show otherwise, since non-native speakers of the (...) lingua franca will pick up the costs of learning it while native speakers can free-ride on their efforts. This unfairness provides a reason for preferring alternative means of facilitating communication. In particular, multilingualism - communication through translators and interpreters - may be preferable. (shrink)

Effectiveness, efficiency and equity in health care are discussed in this article against the background of concerns that cost containment may lead to reductions in quality of care. It is suggested that effectiveness is best seen from the patient's point of view and that it relates to more than simply improved health status. Efficiency and equity are better viewed from a societal stance.The paper discusses the role of the medical profession in effectiveness, efficiency and equity and (...) argues that the role of medical doctors needs to be constrained. (shrink)

Adaptation to the impacts of climate change is a rapidly emerging, new area of knowledge and policy that is coevolving with political negotiations in the UN Framework Convention on Climate Change. As such, it offers the opportunity to study the coproduction of knowledge and social order within the climate change regime. A subset of adaptation knowledge relates to cost estimates of adaptation policy. Here the methodology of the adaptation cost studies are reviewed and compared to economic theory. Although (...) presented as technical and apolitical applications of economic theory, this analysis shows that these studies in fact differ significantly and consistently from theory in that they largely ignore autonomous adaptation and almost universally cost complete adaptation rather than an efficient level of adaptation. It is suggested that these differences are related to the political nature of adaptation cost estimates, which are closely connected with normative claims for both adaptation funding for developing countries and compensation for the unavoidable climate change impacts. As such, adaptation cost estimates are an example of boundary objects, used to manage normative and highly politicized claims for restitution using scientific and therefore apolitical language and framings. (shrink)

Sensory feedback, which can be presented in different modalities - single and combined, aids task performance in human-robot interaction (HRI). However, combining feedback modalities does not always lead to optimal performance. Indeed, it is not known how feedback modalities affect operator performance under stress. Furthermore, there is limited information on how feedback affects neural processes differently for males and females and under stress. This is a critical gap in the literature, particularly in the domain of surgical robotics, where surgeons are (...) under challenging socio-technical environments that burden them physiologically. In the present study, we posited operator performance as the summation of task performance and neurophysiological cost of maintaining that performance. In a within-subject design, we used functional near-infrared spectroscopy (fNIRS) to assess cerebral activations of 12 participants who underwent a 3D manipulation task within a virtual environment with concurrent feedback (visual and visual + haptic) in the presence and absence of a cognitive stressor. Cognitive stress was induced with the serial-7 subtraction test. We found that while task performance was higher with visual than visual + haptic feedback, it degraded under stress. The two feedback modalities were found to be associated with varying neural activities and neural efficiencies, and these were stress- and gender-dependent. Our findings engender further investigation into effectiveness of feedback modalities on males and females under stressful conditions in HRI. (shrink)

Abstract:Standard lessons from economics tell us that an externality creates inefficiency, and that this inefficiency can be removed by internalizing the externality. This papers considers how successfully these lessons can be extended to intergenerational externalities such as emissions of greenhouse gas. For intergenerational externalities, the standard lessons involve comparisons between states whose populations of people differ, either in their identities or their numbers. Common notions of efficiency break down in these comparisons. This paper supplies a new notion of (...) class='Hi'>efficiency that allows the lessons to survive, but at the cost of reducing their practical significance. (shrink)

Cooperative behaviors within a group face the risk of being exploited by `free-riders,' individuals that reap the benefits produced by cooperators without paying the costs of cooperating. Free-riders are often perceived as a burden to the group, since the group's survival depends on tasks performed by cooperators. However, this paper challenges this perspective, arguing that an excess of cooperators may actually lower the efficiency and persistence of groups. The perspective presented in this paper has ramifications to broader issues in (...) philosophy, particularly the challenge of how to balance self-interest with the collective interests of the group. Ultimately, this paper seeks to highlight some of the subtle ways free-riders positively impact their groups, an aspect of free-riding that is often overlooked in discussions about cooperation. (shrink)

In a recent essay in this journal, Tom O’Shea defends socialist republicanism, marrying the value of freedom as nondomination to public ownership of the means of production. In this reply, I argue that the efficiency costs that often attach to public ownership may undercut the ability of the socialist republic to combat domination by public agents. I provide two reasons in support of this claim. First, the economic gains provided by efficiency can insulate individuals from the discretionary power (...) of other agents. Put briefly, the more wealth you have, the less the discretionary power threatens your basic interests. Second, the efficiency costs of public ownership also make it more difficult to hold accountable the managers of economic organizations. This shortcoming of O’Shea’s argument reveals a point hitherto neglected in the republican literature—caring about nondomination implies caring about efficiency. (shrink)

Since sending explicit messages can be costly, people often utilize “what is not said,” i.e., informative silence, to economize communication. This paper studies the efficient communication rule, which is fully informative while minimizing the use of explicit messages, in cooperative environments. It is shown that when the notion of context is defined as the finest mutually self-evident event that contains the current state, the efficient use of informative silence exhibits the defining property of indexicals in natural languages. While the efficient (...) use of silence could be complex, it is also found that the efficient use of silence can be as “simple” as the use of indexicals in natural languages if and only if the information structure satisfies some centrality and dominance properties. (shrink)

This book is a comprehensive account of what it means to try to quantify health in distributing resources for health care. It examines the concept of QALYs which supposedly makes it more accurate to talk about life in terms of both quality and quantity of years lived when referring to health care policy. It offers an elegant new approach to comparing the costs and benefits of medical interventions. Cost-Utility Analysis is a method designed by economists to aid decision makers (...) distribute scarce resources to areas of health care where they will yield the greatest benefits. Erik Nord questions the feasibility of measuring patients' quality of life meaningfully in numerical terms, as CUA presupposes. He presents an alternative approach called cost-value analysis in which representative samples of the general public express preferences between different health-care programs. In this approach, subjects are allowed to include concerns for fairness that go beyond concerns for efficiency of conventional health economics. (shrink)

Cost-benefit analysis —understood as a technique for evaluating governmental policies in light of individual well-being—rests upon a preference view of welfare. A policy’s effect on a given individual is measured, on a money scale, with reference to her preferences as between money and other goods, captured in her “utility” function. This chapter describes the methodology of CBA, and discusses the various conditions on individual preferences that are required for the existence of an individual utility function, for the use of (...) money as a scale for measuring policy effects, and for a nexus between an individual’s preference-satisfaction and her well-being. The chapter then turns to the topic of interpersonal welfare comparisons. Although CBA is often defended with reference to the criterion of Kaldor-Hicks efficiency, which eschews such comparisons, a more plausible defense embraces them and sees CBA as an approximation to a social welfare function. (shrink)

There has been considerable debate over regulated organ markets. Especially current markets, where people sell one of their kidneys while still alive, have received increased attention. Futures markets remain an interesting and under-discussed alternative specification of a market-based solution to the organ shortage. Futures markets pertain to the sale of the right to procure people’s organs after they die. There is a wide range of possible specifications of the futures market. There are, however, some major unaddressed efficiency concerns. This (...) article presents this class of concerns and discusses the implication for organ futures markets. It identifies a number of inefficiency sources pertaining to crowding out, bad organs, costs and missed opportunities, family refusals, moral hazard and strength of the provided incentive. However, a complete assessment of futures market requires better knowledge regarding the potential reaction from donors, families and health professionals. (shrink)

In this paper I argue that economic theories have never been able to provide a coherent explanation of the causation requirement in tort law. The economic characterization of this requirement faces insurmountable difficulties, because discourse on tort liability cannot be reduced to a cost-benefit analysis without a loss of meaning. More seriously, I try to show that by describing causation in economic terms, economic theories offer an image of the practice in which the participants incur in logical contradictions and (...) develop patterns of inference that are far from intuitive. For this reason, efficiency cannot be the fundamental principle underlying tort law. Finally, I suggest that economic analysis of law can provide a genuine explanation of certain aspects of legal practice if it relinquishes its reductionist claims. (shrink)

At first glance, it may seem that climate policy based on estimates of the social cost of carbon (SCC) presupposes a set of controversial assumptions, especially about what detailed knowledge regulators have about the impacts of climate change, and what the proper role of government and policy is in responding to those impacts. However, I explain why the SCC-based approach need not actually have these problematic presuppositions as well as why SCC estimates may provide the best guide to climate (...) policy when implemented in a way that incorporates a healthy dose of humility. The SCC-based approach can be used in a way that is ecumenical between the wide range of reasonable but incompatible views about the proper goals of government and policy, ranging from views that aim only at market-efficiency, to utilitarian views, to rights-based and other deontological views, to libertarian views, to virtue ethics views, and others. Beyond this, I suggest that the SCC-based approach can help us find an overlapping consensus on a particular climate policy given the range of reasonable but incompatible normative views endorsed in diverse societies. Finally, I consider a number of specific objections to the SCC-based approach that are especially prominent in contemporary discourse and policy debates. I suggest that even if we agree that all of these objections to existing SCC-based analyses have an important kernel of truth, nonetheless the correct response to climate change still involves substantial emissions reductions to be achieved via policy, and the best methods for deciding the magnitude of those reductions still depend essentially on the SCC-based approach. (shrink)

This book presents startling evidence that state monopolies can produce better outcomes than the free market. It provides an empirical comparison of the property insurance market in five European countries: Britain, Spain, France, Switzerland, and Germany. The market and cost structures of insurers in each country are described, and particular features of each market and the outcomes for customers examined. The regulatory frameworks vary widely from country to country and so do the market outcomes, both in terms of premium (...) level and in terms of available insurance cover.In view of the increase in major floods and other forms of natural damage over the last decades, the non-availability of insurance cover in many competitive insurance systems is likely to become a major political issue. This book shows that state monopoly is an adequate policy response. Competitive insurance systems are shown to provide incomplete cover at a substantially higher cost. In mixed systems, where the private sector can obtain reinsurance from the state the state tends to end up paying most of the costs while the private insurance companies keep most of the premium income.The book will be of interest to academic economists interested in privatization, regulation, the theory of the firm, and insurance; Policy-makers concerned with regulation and privatization; Insurance companies, regulators, and analysts. (shrink)

This paper reviews the severe visual focus problems of health economists–they have developed a one-sided fixation with equity issues, neglecting the efficiency agenda. The problems of meeting need are not just about access–they will vary with cost and supply. Economists in fact developed a more balanced agenda in the 1970s but have failed to follow it up. The paper defines the triple nationalisation of the National Health Service , and presents evidence that pluralism, using the purchaser/provider split, has (...) become more efficient in long term care, home care and services for people with learning difficulties. Health economics has failed to explore options for using the dynamic forces of choice and competition for improving health services. The paper makes the case for a decision rule that “we should seek the process of health care service supply and development which maximises the delivery of high quality, lower cost user relevant services”. (shrink)

Pulmonary rehabilitation has demonstrated patients’ physiological and psychosocial improvements, symptoms reduction and health-economic benefits whilst enhances the ability of the whole family to adjust to illness. However, PR remains highly inaccessible due to lack of awareness of its benefits, poor referral and availability mostly in hospitals. Novel models of PR delivery are needed to enhance its implementation while maintaining cost-efficiency. We aim to implement an innovative community-based PR programme and assess its cost-benefit. A 12-week community-based PR will (...) be implemented in primary healthcare centres where programmes are not available. Healthcare professionals will be trained. 73 patients with CRD and their caregivers will compose the experimental group. The control group will include dyads age- and disease-matched willing to collaborate in data collection but not in PR. Patients/family-centred outcomes will be dyspnoea, fatigue, cough and sputum, impact of the disease, emotional state, number of exacerbations, healthcare utilisation, health-related quality of life and family adaptability/cohesion. Other clinical outcomes will be peripheral and respiratory muscle strength, muscle thickness and cross sectional area, exercise capacity, balance and physical activity. Data will be collected at baseline, at 12 weeks, at 3- and 6-months post-PR. Changes in the outcome measures will be compared between groups, after multivariate adjustment for possible confounders, and effect sizes will be calculated. A cost-benefit analysis will be conducted. This study will enhance patients access to PR, by training healthcare professionals in the local primary healthcare centres to conduct such programmes and actively involving caregivers. The cost-benefit analysis of this intervention will provide an evidence-based insight into the economic benefit of community-based PR in chronic respiratory diseases. The trial was registered in the ClinicalTrials. gov U.S. National Library of Medicine, on 10th January, 2019. (shrink)

Previous research on the neural basis of cognitive control processes has mainly focused on cortical areas, while the role of subcortical structures in cognitive control is less clear. Models of basal ganglia function as well as clinical studies in neurodegenerative diseases suggest that the striatum (putamen and caudate nucleus) modulates the inhibition of interfering responses and thereby contributes to an important aspect of cognitive control, namely response interference control. To further investigate the putative role of the striatum in the control (...) of response interference, 23 patients with stroke-induced lesions of the striatum and 32 age-matched neurologically healthy controls performed a unimanual version of the Simon task. In the Simon task, the correspondence between stimulus location and response location is manipulated so that control over response interference can be inferred from the reaction time costs in incongruent trials. Results showed that stroke patients responded overall slower and more erroneous than controls. The difference in response times (RTs) between incongruent and congruent trials (known as the Simon effect) was smaller in the ipsilesional/-lateral hemifield, but did not differ significantly between groups. However, in contrast to controls, stroke patients exhibited an abnormally stable Simon effect across the reaction time distribution indicating a reduced efficiency of the inhibition process. Thus, in stroke patients unilateral lesions of the striatum did not significantly impair the general ability to control response interference, but led to less efficient selective inhibition of interfering responses. (shrink)

This paper points to some limitations of law and economics as both an explanative and a normative theory. In explaining law as the result of efficiency promoting decisions, law and economics theorists often dismiss the reasons actors in the legal system give for their behavior. Recognizing that sometimes actors may be unaware of why institutions evolve as they do, I argue that the case for dismissing reasons for action is weaker when those reasons make reference to rules of practices (...) that constitute the meaning of actions within those practices, or when they have otherwise been given well-considered defenses. In criticizing law and economics as a normative theory, I acknowledge that economic considerations are often important in deciding how to act in the personal sphere and how government should allocate its scarce resources. I argue that while the use of institutions to promote our ideals forces us to take their costs into account, it is a mistake to infer from this that the question of determining social policy is a purely economic problem, and that we should acknowledge the non-utilitarian moral ideals our law and practices promote. This is the basis of both an internal criticism--law and economics theorists have not sufficiently evaluated and weighed the value of fairness and other ideals in their utility calculations--and an external criticism-- these ideals are important in ways that can not be measured in utiles. (shrink)

This article evaluates effectiveness and costs of external regulation, in particular the Sarbanes-Oxley Act of 2002 (SOX) in restricting managerial malfeasance and safeguarding shareholder interests. It discusses the role of managerial ethics as an alternative corporate governance mechanism to protect shareholder value. This article builds a mathematical model to illustrate shareholders' choices of best corporate governance mechanisms, taking into account the influence of managerial ethics, effectiveness and costs of monitoring. We suggest that the best corporate governance design and the optimal (...) monitoring expenses are influenced by managerial types, monitoring efficiency, and effectiveness of ethics education. We conclude that stringent regulation and monitoring may not always enhance shareholder value. When managerial ethics could be improved by ethics education or social norms, ethics education may be a better alternative than stringent regulation. (shrink)

Efficiency as quantified and promoted by cost-effectiveness analysis sometimes conflicts with equity and other ethical values, such as the “rule of rescue” or rights-based ethical values. We describe the utilitarian foundations of cost-effectiveness analysis and compare it with alternative ethical principles. We find that while fallible, utilitarianism is usually superior to the alternatives. This is primarily because efficiency – the maximization of health benefits under a budget constraint – is itself an important ethical value. Other ethical (...) frames may be irrelevant, incompatible with each other, or have unacceptable implications. When alternatives to efficiency are considered for precedence, we propose that it is critical to quantify the trade-offs, in particular, the lost health benefits associated with divergence from strict efficiency criteria. Using an example from HIV prevention in a high-prevalence African country, we show that favoring a rights-based decision could result in 92–118 added HIV infections per $100,000 of spending, compared to one based on cost-effectiveness. (shrink)

In this article, we present a new approach for frequent pattern mining that runs fast for both sparse and dense databases. Two algorithms, FEM and DFEM, based on our approach are also introduced. FEM applies a fixed threshold as the condition for switching between the two mining strategies; meanwhile, DFEM adopts this threshold dynamically at runtime to best fit the characteristics of the database during the mining process, especially when minimum support threshold is low. Additionally, we present optimization techniques for (...) the proposed algorithms to speed the mining process, reduce the memory usage, and optimize the I/o cost. We also analyze in depth the performance of FEM and DFEM and compare them with several existing algorithms. The experimental results show that FEM and DFEM achieve a significant improvement in execution time and consume less memory than many popular FPM algorithms including the well-known Apriori, FP-growth, and Eclat. (shrink)