This dissertation explores the behavior of health care providers and consumers, with a focus on understanding how changes in health policies affect the efficiency and quality of care of health care systems. Chapter 1 evaluates the impact of a change in Medicare reimbursements for nursing wages on hospital production decisions. Chapter 2 evaluates the impact of Medicare coverage policies on the utilization of cardiac catheterization and coronary angiography. Chapter 3 evaluates the impact of receiving treatment with antiretroviral therapy for HIV/AIDS on the demand for substance use.

In the first chapter, I measure the impact of student loan debt on young, college-educated workers' decisions regarding labor supply and enrollment in graduate school. I exploit variation in student loan debt driven by the formulas that determine Federal Student Aid in order to identify these effects. Instrumental variable estimates indicate that in the initial years following graduation student loan debt seems to raise the likelihood of employment; the effect is most pronounced for female graduates. However, the evidence does not indicate that debt causes workers to opt into different types of occupations, as has been shown to be true among certain populations. Student loan debt also seems to lower the likelihood that an individual will obtain a graduate degree. These effects are too large to be consistent with the permanent income model, which predicts that graduates will effectively spread loan repayment over their lifetimes, causing only negligible changes in behavior during any single period. In the third chapter I examine lending mechanisms in the federal student loan program. Since the passage of the Higher Education Act in 1965, American students have been able to finance post-secondary education with federally subsidized loans. Until very recently students were able to access this credit through two channels; directly from the federal government or as a guaranteed loan from a private lender. The objective of this paper is to estimate the difference in loan default rates across the two lending programs. Since the programs serve distinct groups of students quasi-experimental estimation techniques are used to estimate this difference. The estimates suggest that the moral hazard created by the loan guarantee leads private lenders to generate higher rates of student loan default than direct lending. In the final chapter, I estimate the temporal pattern of earnings losses faced by displaced workers eligible for the Trade Adjustment Assistance Program. Data from the 2001 Survey of Income and Program Participation and is used to perform an event study analysis. The resulting evidence indicates that displaced workers face decrease earnings in the months prior to displacement, a large drop in earnings during the month of displacement and losses that persist up to 6 months after displacement. Displaced workers eligible for Trade Adjustment Assistance face a similar pattern of earnings loss, but experience less loss during the period of displacement and greater losses during the period following displacement. Beyond the first month after displacement workers eligible for Trade Adjustment Assistance do not experience losses in excess of other displaced workers. I also find that workers Eligible for Trade Adjustment Assistance face higher rates of unemployment in the first three months following a displacement. By the fourth month the rate of unemployment is not different from other displaced workers. This evidence suggests that the additional benefits provided to unemployed workers under the Trade Adjustment Assistance program may not be warranted; these workers do not face persistent losses that exceed the losses experiences by other displaced workers.

The dissertation analyzes public policies of subsidization and regulation in three contexts. Chapter 1 develops a dynamic bunching empirical design and uses it to estimate the compliance cost that IRS reporting requirements impose on public charities. Chapter 2 estimates the effects of tax and enforcement provisions of the Tax Reform Act of 1969 on charitable foundations and their donors. Chapter 3 estimates the impact of Pell Grant aid on student attainment and borrowing.

This study interprets the results of research into how one college met the challenge of change brought about by the Education Reform Act 1988, with reference to appropriate social research methodologies and a wide ranging review of relevant literature. The aim was to investigate how one college, well established in a traditional pattern, would respond to educational change stemming from a political culture which relocated emphases upon financial considerations, market forces and quality controls devolving from a business-like reorientation. A review of the college's aims and intentions, with an examination of the methods managers might adopt and options they might select in moving towards a business organisation, moved the research into a detailed investigation of sub-organisational micro-politicking. The research led naturally to an in-depth examination of the nature of management and management skills training within an educational institution, raising questions about the cross-discipline transferability of educational/business skills. Interview and established techniques of participant observation have exposed the lacunae between rhetoric, supposed practice and what has become the reality of change within the organisation. The research focuses upon the myth of 'professionalism' which, in the uncertainty of change, supports the new managerialism brought about by the Education Reform Act. An alternative strategy for educational change within the institution is suggested. The conclusion is a critique of educational management training within the organisation and locates both micro- and macro-educational management preparation within some commercial systems with which it might seek to identify.

A number of studies have suggested that the management of national parks might be best served if undertaken according to the principles of ecotourism, a concept that potentially provides a ‘win-win’ solution to the conflicting aspects of conservation and recreation in protected areas. Therefore, the purpose of this study is to critically appraise the potential of ecotourism as a framework for implementing tourism in a national park. More specifically, it seeks to explore the implications of actors’ values for the effective implementation of ecotourism policy. Many studies overlook the importance of the understanding and response of different values as fundamental aspects in the process of policy-making. Based on a case study of Sebangau National Park, Kalimantan, Indonesia, and using Schwartz’s theory as the fundamental conceptual framework, this research progresses the argument that the development of ecotourism policy should be seen in terms of the values espoused by relevant actors by seeking to identify the values and behaviours of the actors involved in ecotourism development in the park and the subsequent management implications. This study adopts the philosophy of pragmatism and mixed methods as its methodological approach, and is carried out in three phases: interviews (qualitative), focus group discussions (qualitative) and a survey (quantitative), followed by appropriate methods of analysis, such as performing ANCOVA and performing grounded theory to analyse qualitative data, supported by NVivo software. The results show that the Indonesian people, from the tourists’ perspective, embrace the culture of embeddedness with a tendency towards the value of Conformity that implies they are willing to follow regulations because they are aware of the importance of the local community and of the natural resources in the park. Meanwhile, the value of Benevolence should be the value espoused by policy makers because it is exerts a more significant influence on the concept of ecotourism in comparison with the other nine Schwartz’s values. In addition, even though several studies show that the value of Power tends not to be pro-environment, the involvement of actors who embrace it cannot be ignored in the policy-making process because it is required to demonstrate leadership, participation, self-determination, competence and self-efficacy behaviour. Moreover, the importance of the Hedonism value based on tourists’ perspective implies that tourists have the potential to behave in an anti-conservation manner for the sake of personal satisfaction; thus, it will lead to consumptive behaviour at tourist locations, even for ecotourism destinations.

<p> Bitcoins were conceptualized in 2008, which revolutionized the digital transfers of value within payment systems (Nakamoto, 2008). The advent of digital currencies revealed problems concerning anonymity embedded in bitcoins, consequently raising money laundering concerns. Regulators and law enforcement agencies struggle with addressing the money laundering issues inherent with bitcoin and digital currencies (Ajello, 2025). In response to these threats, agencies have issued various opinions regarding defining digital currencies within a financial framework. Regulator opinions concerning the applicability of bitcoins existing as currency, property, a commodity and commodity money contradict each other. Moreover; prosecutorial agencies attempt to fit digital currency exchangers under the regulations pertinent to money service businesses (MSB) (Mandjee, 2015; Sonderegger, 2015). This project provided an analysis of scholarly material, government publications, case law, and current trade information to examine a solution to the problem of money laundering through digital currency. This project revealed a need for a clear definition of bitcoin and digital currency within the context of U.S. laws and regulation to assist with investigations concerning illicit uses of digital currency. Furthermore, a need exists for new U.S. legislation specific to digital currency, which addresses money laundering and terrorist finance risks. Research revealed that digital currency regulations should mirror MSB regulations to curb peer-to-peer digital currency exchanges (Kirby, 2014). Additionally, FinCENs purview with financial crimes provides a unique position to assist law enforcement with digital currency investigations (FinCEN, 2014). A need exists for FinCEN to develop a blockchain analysis tool for law enforcement agencies and to assist with complex digital currency investigations (DHS, 2014). Keywords: Economic Crime Management, Financial Crime and Compliance Management, Paul Pantiani, virtual currency, cryptocurrency.</p>

<p> Medicare Part B is one of the federal health insurance programs available to senior citizens in the United States. Unlike Medicare Part A, Part B enrollment is not automatic, and those missing their initial enrollment period are assessed a 10% or more penalty in addition to their monthly premium rate for the rest of their lives. This problematic enrollment policy has impacted senior citizens who have missed Part B enrollment windows, creating for them an added financial burden when many are transitioning to fixed incomes. Guided by social construction theory and using a nonprobability, convenience sampling approach, the likelihood coefficient values associated with Medicare Part B enrollee awareness, stress, and income of 112 residents of a suburban city in a northeastern state who were 65 years and older were examined. Sequential <i>Forward: LR</i> methodology yielded a significant, negative (<i>b</i> = &ndash;1.21, Wald <i>_X</i>²(1) = 7.56, <i>OR</i> = .298, <i>p</i> = .006, CI [.126, .707]) and a significant, positive (<i>b</i> = 2.16, Wald <i>_X</i>²(1) = 6.29, <i>OR</i> = 8.678, <i>p</i> = .012, CI [1.60, 46.99]) likelihood of predicting Medicare Part B late enrollment penalties for awareness and stress; income was not a significant model predictor. Participants who reported higher stress levels were 8.7 times more likely to be classified in the Medicare Part B late enrollment penalty than those reporting lower stress. Participants who were aware of enrollment needs were 3.4 times more likely to have no late enrollment penalties than those who were unaware. Positive social change centers on increasing Medicare Part B consumer awareness, reducing stress of enrollment deadlines, and providing information to federal policy makers to simplify enrollment policies to reduce or end late enrollment penalties.</p><p>

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