Has PPS increased Medicare expenditures on physicians?

We use data from 1983 and 1985 on the volume of Medicare physician services to analyze whether Medicare's Prospective Payment System (PPS), which resulted in a significant decline in hospital spending, led to a partially offsetting increase in real expenditures for physician services. We also analyze the effect of increases in assignment rates, increasing incomes of the elderly, and other factors on real expenditures during this period. Our main conclusion is that PPS has at most a small positive effect on real physician expenditures. Because people spent less time in the hospital, Medicare physician spending declined; but because of incentives to shift radiology and other services out of the hospital, some of this decline was offset. We also conclude that the sharp increase in Medicare assignment rates over this period, along with the rising incomes of the elderly during this period, contributed to the observed growth.     

R before D: the case of post conflict reintegration in Tajikistan1

Reintegration was prioritised over demobilisation and disarmament in Tajikistan's peace process. Inadequate disarmament rates were disregarded, but integration of opposition fighters into military and law enforcement units was relatively swift. This created high levels of trust among the former fighters and commanders. The quick provision of incentives, such as comprehensive amnesties and the offer of government positions and economic assets created stakes in the peace process for a number of actors. Transitional justice was largely overlooked. In this way, the case of Tajikistan runs counter to key elements of what has been termed the ‘post-conflict reconstruction orthodoxy’. At the same time, Tajikistan is a rare example of the emergence of post-war stability. This article provides a detailed account of the DDR process and outlines the incentives that it created for the warring parties. It also assesses the emergence of spoilers and the government's counter strategies. The article concludes by highlighting the consolidation of President Rakhmonov's power since 2001, but also raises some questions regarding the viability of Tajikistan's long-term political and economic development.     

What Do Prosecutors Maximize? Evidence from the Careers of U.S. Attorneys

This study examines the performance of chief federal prosecutors(U.S. attorneys) and their subsequent careers. In a sample of570 attorneys in office from 1969 to 2000, the length of prisonsentences is positively related to subsequent favorable careeroutcomes for U.S. attorneys. In contrast, conviction rates donot appear to affect the careers of U.S. attorneys. These resultsare consistent with longer total prison sentences’ beingpersonally beneficial to prosecutors, and prosecutors’maximizing the length of prison sentences. Overall, the resultssuggest that sentence length, as opposed to convictions rates,is the relevant performance metric.     

RELATIONSHIP BETWEEN THE OFFENDING FREQUENCY (λ) OF IMPRISONED AND FREE OFFENDERS*

In the public debate over incarceration policy, there is considerable disagreement about what value of individual offending frequency (λ) is appropriate to use in estimating incapacitative effects. This article provides an approach for estimating the mean values of λ for diverse subsets of the total offender population, with particular emphasis on subsets generated by filtering through various stages of the criminal justice system. Sharp differences in offending frequency are displayed between robbery and burglary inmates, across three states, and particularly between resident inmates and free, active offenders. Free offenders average 1 to 3 robberies and 2 to 4 burglaries per year, while resident inmates have λ values 10 to 50 times higher. Differences result from the underlying levels of criminal activity and the sanction Levels that offenders face. A highly heterogeneous distribution of offending frequency in the total population of offenders combines with relatively Low imprisonment levels to lead to substantial selectivity of high-λ offenders among resident inmates and a correspondingly low mean value of λ among those offenders who remain free. These results have important implications for estimating incapacitative effects of an increase in incarceration, since the additional inmates will be drawn from free offenders whose mean λ is at least an order of magnitude Lower than that of the current inmate population.