Health Care Capital Financing Agencies: The Intergovernmental Roles of Quasi-Government Authorities and the Impact on the Cost of Capital

During the decade 1983-1992, approximately $1.4 trillion of municipal bonds were sold in 87,000 in separate issues, primarily to finance capital projects for education, electric power, transportation, health care, housing, and other public and private purpose activities. Approximately two-thirds of these financings were originated by financing authorities, quasi-government agencies which are the creation of state legislature. Despite the growing role played by quasi-public authorities in capital finance, their impacts have not been studied systematically. We first describe the issuers of tax-exempt debt in the health sector and then derive measures for describing the mix of issuers between state and local levels, and between both government and quasi-government sectors. We present abbreviated test results of the impact that different mixes have on the cost of capital. First, competition is good: using a Herfindahl index analysis we show that states with less concentrated issuers have a lower cost of capital than those with a more concentrated market, including state-level finance monopolies. On the other hand, we cannot assert unequivocally that market deconcentration, in and of itself, should be a goal. For instance, there are economies of scale in the health care finance industry that allow larger (often state-level) issuers to lower the cost of capital.     

Patriotic Virtue

Some philosophers argue that the state and its citizens stand in a morally privileged position vis-à-vis one another, but not towards other states or citizens. However, many of those people, particularly philosophical liberals, also hold that morally insignificant differences, such as place of birth, sex or ethnicity, should not affect rights, liberties and life prospects. On the face of it, these two sets of ideas appear incompatible and point to a conflict in some liberal thought. Liberal philosophers, like John Rawls, have attempted to reconcile these conflicting ideas. His attempt has attracted a great deal of criticism, especially from those liberals attracted to a more cosmopolitan point of view. In this article, we use Aristotelian virtue ethics as the basis upon which to reconcile liberalism and patriotism. We argue that the state should be understood as an agent that stands in a special relationship to its citizens (of philia ). The state's virtue depends, in part, on it giving those citizens preferential treatment with regard to justice compared to citizens of other countries. Similarly, if citizens are to be just in their relations with their own state, they must behave in special ways towards that state as compared to other states. Certain forms of justice only arise in relationships of particular kinds.     

All Aboard? Evidence-Based Management and the Future of Management Scholarship

ABSTRACT

The research-practice gap has emerged as an acute problem in management scholars' internal professional debates. Evidence-based management (EBM) has been proposed as a remedy, and it is gaining adherents. This article offers a critical examination of the EBM proposal and its justification. The proposal is found to be poorly conceived and justified. Therefore, a search for a different response to the same concerns is in order. The direction of search is to understand how existing scholarly practices offer advice to actors in managerial roles. While advice-giving scholarly practices are diverse and disconnected, a commonality is that they define design issues and offer value- and knowledge-based argumentation schemes for resolving them. An alternative to EBM can be envisioned: to strengthen the management field's network of design-oriented approaches to advice-giving. By employing the unorthodox style of a dialogue, this article shows how common ground about EBM and its alternatives can be established among management scholars who identify with conflicting intellectual traditions.     

Prospects for Vietnam after the agreement is signed

Abstract

As this is being written — on December 4, 1972 — there is little public activity around the potential peace agreement. This appears due to a general feeling of confusion and frustration over actual events; and a supposition that the agreement will be signed no matter what. In addition, what remains of the anti-war movement, which has traditionally been the source of anti-war pressure on the government, has had little enthusiasm for the agreement, interpreting it somewhat sadly as a “defeat” for the Vietnamese.