Assisting altruism: evaluating legally binding consent in organ donation policy

The growing need for organ and tissue transplants has led a number of states to enforce a policy that views a donor's declared intent to be an organ donor as legally binding. This allows health officials to harvest organs without the permission of the next of kin. Legally binding consent is controversial because of concerns that it may anger family members, lead to negative publicity, and discourage potential donors. We use interviews and a pooled time-series data set of cadaveric donation rates in U.S. states to evaluate the effectiveness of this policy. Our research indicates that enforcement of legally binding consent has marginally increased cadaveric donations while not significantly affecting donor registration. We also find evidence that the effect of the policy might be greater if it were more fully implemented and coordinated with efforts to improve public acceptance and awareness.     

Medicare prospective payment: anticipated effect on hospitals, other community agencies, and families

The switch to prospective payment for hospitals under Medicare is expected to have ramifications in a number of different areas. This paper addresses a select number of those areas: hospital organization and management, other community agencies, and families. Questions are raised as to the capacity to provide adequate care in response to the increased demand for care outside the hospital setting that will result from the new payment system.     

Sales and Use Tax Simplification and Voluntary Compliance

Because of difficulties collecting sales taxes on Internet sales, several states have engaged in an effort (the Streamlined Sales Tax Project, SSTP) to simplify their sales tax systems. One hope among SSTP proponents is that a simplified system will result in Internet vendors voluntarily collecting the sales tax. We address two issues:

• ? Will states adopt the extensive reforms proposed by the SSTP?
• ? Will vendors voluntarily collect the sales tax?

We argue that states are unlikely to adopt extensive reforms, but if they did, many vendors would voluntarily collect sales taxes.