潇湘渌水 @ 2011-02-23 11:40 又是一篇PP(Public and Private)的文章，看完后我不禁莞尔。 谁说私人营利医疗效果不好，事实上，它不仅可以效果好，又可以成本低，作者甚至还建议（出人意料地）：要求私人医疗服务那些保险不足的人群是有效果的。paper的发现是虽然私人医疗会挑选相对低风险的患者，但是在“慈善要求法案（Hill Burton Act）”的约束下，私人医疗会多快好省的对待病人，减少侵入性治疗（也就等于低成本了），一旦符合法案要求了，又会马上转到公立医院去。这时候就可能出现两种情况了：一种是效果不行，public要继续提供服务，二种是不必要。paper的发现是后者，public的后续服务对患者健康产出没有边际效用了。Great -- private，赞一个。 Back to writing of this paper，我真想说gorgeous，以前我有个“我是粉丝”的收藏夹，赫然Prof Almonda就是其中一员，哈哈 偶像那，致敬！ Public vs. private provision of charity care? Evidence from the expiration of Hill–Burton requirements in Florida Douglas Almonda, b, Janet Curriea, b, This paper explores the consequences of the expiration of charity care requirements imposed on private hospitals by the Hill–Burton Act. We examine delivery care and the health of newborns using the universe of Florida births from 1989 to 2003 combined with hospital data from the American Hospital Association. We find that charity care requirements were binding on hospitals, but that private hospitals under obligation “cream skimmed” the least risky maternity patients. Conditional on patient characteristics, they provided less intensive maternity services but without compromising patient health. When obligations expired, private hospitals quickly reduced their charity caseloads, shifting maternity patients to public hospitals. The results in this paper suggest, perhaps surprisingly, that requiring private providers to serve the underinsured can be effective. Keywords: Infant health; Charity care; Cesarean section; Prematurity; Hill–Burton JEL classification codes: I12; I18 source: doi:10.1016/j.jhealeco.2010.11.004 |
潇湘渌水 @ 2011-02-17 22:51 我因为一直对公私部门感兴趣，自然不会放过这篇文章：讲的是公私部门在药物创新中的各自地位，作者研究的数据是88-05年的通过的药物信息，他们发现政府直接资助发展的药物在优先审查“priority-review”药物名单（相当于与最具创新的新药）中更重要，相比较与那些标准审查的药物，由此作者认为这可以提供一条线索来思考是否存在药物利润向公部门输送。我觉得这篇文章很有利于我思考以前我对比的另一个问题--即公私部门的HRH--很有借鉴参考意义。 What Are The Respective Roles Of The Public And Private Sectors In Pharmaceutical Innovation? Bhaven N. Sampat1, Frank R. Lichtenberg Abstract What are the respective roles of the public and private sectors in drug development? This question is at the heart of some policy proposals, such as those that would give the government a share of profits from drugs at least partly developed with federal research dollars. This paper provides empirical data on these issues, using information included in the patents on drugs approved between 1988 and 2005. Overall, we find that direct government funding is more important in the development of “priority-review” drugs—sometimes described as the most innovative new drugs—than it is for “standard-review” drugs. Government funding has played an indirect role—for example, by funding basic underlying research that is built on in the drug discovery process—in almost half of the drugs approved and in almost two-thirds of priority-review drugs. Our analyses should help inform thinking about the returns on public research funding—a topic of long-standing interest to economists, policy makers, and health advocates. source: http://content.healthaffairs.org/content/30/2/332.full 在药物研发中公共和私人部门究竟分别处于什么样的角色呢？这个问题是某些政策提案的核心内容，比如某些提案认为至少部分由联邦研究经费发展出来的药物应该给政府一部分利润。本文使用了1988-2005年的通过的药物及包括专利的信息为这些议题提供经验证据。总之我们发现政府直接资助在“优先审查”药物名单（有时被认为是最具创新的新药）中比那些“标准审查”的药物更重要。政府资助已经在大部分通过审查的药物以及三分之二的优先审查药物中扮演了应该间接的角色--比如通过资助药物发现过程中的基础研究。我们的分析应该可以帮助引发关于公共研发资助回报的思考--这是一个经济学家、政策制定者和健康倡导者长期的兴趣话题。 |
2011年2月25日
公私部门的角色PPP
