A CRITIQUE OF PROFESSOR CHURCH'S REPORT ON THE IMPACT OF VERTICAL AND CONGLOMERATE MERGERS ON COMPETITION

We discuss Professor Jeffrey Church's report to the EuropeanCommission in 2004 on the effects of vertical restraints andmergers. Although thorough and accurate, the report could bemisinterpreted by practitioners, as it does not emphasize thatmarket power is only a necessary condition for harm to competition,and that most vertical mergers that present the possibilityof competitive harm also present economic efficiencies thatare intrinsic to the integration.     

Regime transformation from below: Decentralization,local governance,and democratic reform in Nigeria

How realistic are democratic-governance strategies that emphasize local governance as a key component? Using Nigeria’s experience in local government and primary health care in the 1980s and 1990s as a case example, the article finds there were substantial shortfalls in local participation and program performance. These were caused by problems in the local political environment and local institutional design, in the national policy environment (particularly in the funding system), and by the stresses of structural adjustment, resource shortfalls, the natural physical environment, and weak leadership. These combined to create poor and inappropriate reward structures and lack of accountability. However, even though the Nigerian case was not successful, most of the specific problems that hurt it are remediable through policy changes at the national level. Several of these were under consideration at the time of the coups of 1992 and 1993.     

Columbia: Neglected dimensions of violence

Editor's note: Rosa Del Olmo has recently written on the same theme in: The Attack on the Supreme Court of Columbia: A Case Study of Guerrilla and Government ViolenceViolence. Aggression and Terrorism 2 (1988): 57–84.     

Effects of positional restraint on oxygen saturation and heart rate following exercise

This report assesses the effects on peripheral oxygen saturation and heart rate that positional restraint induces when a person is prone, handcuffed, and "hog-tied." Peripheral oxygen saturation and heart rate were monitored at rest, during exercise, and during recovery from exercise for 10 adult subjects. The effects of positional restraint produced a mean recovery time that was significantly prolonged. Consequently, the physiological effects produced by positional restraint should be recognized in deaths where such measures are used.     

PPS waivers: implications for Medicare, Medicaid, and commercial insurers

This paper compares the Medicare prospective payment system (PPS) to four all-payer rate-setting systems that operated under HCFA waiver authority. The study examines the experience of Medicare, Medicaid, and commercial insurers under the two approaches. Data from several American Hospital Association surveys and from Medicaid 2082 report forms are analyzed. The paper concludes that the all-payer waiver programs have been as successful as PPS in controlling the rate of growth in Medicare costs. In addition, Medicaid programs are more successful in controlling their outlays in all-payer rate-setting environments than when they "go alone." Finally, there is no evidence to suggest that hospitals can increase charges in response to greater financial need under either PPS or the state waivers. Nevertheless, it appears that commercial insurers are better able to compete with Blue Cross plans in all-payer rate-setting states than elsewhere.