Competition versus regulation: some empirical evidence

In response to dramatic rises in health care costs, policymakers have been debating the relative merits of regulatory and competitive strategies as a means of containing costs. One major activity espoused by proponents of competition is the growth of health maintenance organizations (HMOs) which, in their opinion, will result in the market better determining efficient levels of utilization and costs. Extending this argument, the larger the percent of the population in a market area who enroll in HMOs, the greater the market-forcing effect of HMOs in reducing overall hospital expenditures; that is, if HMOs are providing lower-cost care, then the fee-for-service system will be forced to reduce costs in order to be competitive. The authors studied the 25 largest SMSAs from 1971-1981, and controlling for environmental conditions in each market, they examined the impact of both HMO growth and regulatory activity on costs and utilization. They conclude that neither competition nor regulation had a significant impact in reducing overall hospital costs. While there may have been some impact in specific communities, no generalizable effect could be observed. However, the authors did find that increases in costs and utilization were essentially driven by supply factors such as the number of hospital beds or medical specialists in a given community.     

Continuity,change, and priorities: The quality and use of regulatory analysis across US administrations

This paper compares the quality and use of regulatory analysis accompanying economically significant regulations proposed by US executive branch agencies in 2008, 2009, and 2010. We find that the quality of regulatory analysis is generally low, but varies widely. Budget regulations, which define how the federal government will spend money or collect revenues, have much lower‐quality analysis than other regulations. The Bush administration's “midnight” regulations finalized between Election Day and Inauguration Day, along with other regulations left for the Obama administration to finalize, tended to have lower‐quality analysis. Most differences between the Bush and Obama administrations depend on agencies' policy preferences. More conservative agencies tended to produce better analysis in the Obama administration, and more liberal agencies tended to do so in the Bush administration. This suggests that agencies more central to an administration's policy priorities do not have to produce as good an analysis to get their regulations promulgated.     

Improving the effectiveness of Ugandan water user committees

This article outlines issues affecting the functionality of Ugandan water user committees responsible for managing communal water and sanitation (WASH) services. Research undertaken demonstrated that their effectiveness is compromised by poor understanding of their rights and responsibilities by stakeholders within and outside the committees. Following the research, a handbook was produced that explained the rights and responsibilities in a form that is accessible to all community members. Preliminary feedback from committees that have used the handbook suggests that it has the potential to improve the functionality of the water user committees, thereby helping to improve the local management of WASH services in Uganda.     

A hidden cost of war: the impact of mobilizing reserve troops on emergency response times

This paper analyzes a hidden cost of war: the effect of the mass mobilization of reserve troops on the response times of domestic emergency services to accidents. We provide a statistical examination of this linkage following the US invasion of Iraq in 2003 and find that mobilization significantly increases response times to accidents in the United States. These mobilization-related costs are exacerbated by both legal restrictions and issues of replacing highly specialized human capital.     

Ruling the Sea: Managing Maritime Conflicts through UNCLOS and Exclusive Economic Zones

Two primary mechanisms for managing competitive interstate claims to maritime areas are evaluated: the creation of private ownership of maritime zones in the form of Exclusive Economic Zones (EEZs) and the creation of a global institution, the United Nations Convention on the Law of the Sea (UNCLOS), to establish standards for maritime claims and dispute resolution procedures. Analyses of maritime claims in the Western Hemisphere and Europe from 1900 to 2001 show that declared EEZs help states reach agreements over maritime conflicts in bilateral negotiations, while membership in UNCLOS prevents the outbreak of new maritime claims and promotes third-party management efforts of maritime conflicts. Neither mechanism influences the probability of militarized conflicts over maritime areas.     

Youth-Guided Youth Engagement: Participatory Action Research (PAR) With High-Risk,Marginalized Youth

Engaging youth who live with high-risk, marginalized conditions presents a significant challenge in our society, considering the prevalence of disconnect and distrust they often experience within their social environments/systems. Yet, meaningful youth engagement is a key concept not only for youth development, but also for a systems change to more effectively support high-risk youth and families. This article presents a framework of youth engagement developed over 9 months, using participatory action research (PAR) with 16 youth leaders in a community-based research team. Although this framework has incorporated the youth leaders’ lived experiences, talents, and voices, positive youth development (PYD) and social justice youth development (SJYD) have theoretically contextualized our research. Youth leaders guided the framework's development, including the identification of key themes/dimensions, definitions, and practical examples. The framework's three components—“Basis” (philosophy and principles), “What” (goals/outcomes), and “How” (actions/processes/pathways to change)—are supported by nine themes described in this article.