Thesis (D.P.H.)--University of Michigan.

Dissertation (D.P.H.)--University of Michigan.

Submitted by Eduardo Winston Silva (ewinston@uol.com.br) on 2018-01-19T14:14:57Z No. of bitstreams: 1 Versão para publicação.pdf: 1346658 bytes, checksum: 31aad2bf6648b4ad8e336be0022d9e8d (MD5) / Approved for entry into archive by Maria Almeida (maria.socorro@fgv.br) on 2018-01-30T11:45:36Z (GMT) No. of bitstreams: 1 Versão para publicação.pdf: 1346658 bytes, checksum: 31aad2bf6648b4ad8e336be0022d9e8d (MD5) / Made available in DSpace on 2018-01-30T11:46:03Z (GMT). No. of bitstreams: 1 Versão para publicação.pdf: 1346658 bytes, checksum: 31aad2bf6648b4ad8e336be0022d9e8d (MD5) Previous issue date: 2017-12-13 / Purpose - The present study aims to evaluate the impact institutional controlling mechanisms adopted by the private healthcare market on physicians’ (Medical Doctors) behavior, moreover their preference for rewards. Methodology - We proposed a survey with a preference for reward and values scale adapted from Costa; Salles and Fontes Filho (2010). Physicians were grouped according to their medical practices and the averages of their preferences were compared thru an ANOVA test. A Kurskall-Wallis test was performed to validate differences significance. Findings – research results led us to refuse the hypothesis of significative difference on the preferences of the Physicians groups. Nevertheless, we’ve found significative differences on “Cultivating friendship and friendly relations with colleagues” and “Leave a legacy to my speciality”. Research Limitations – The research didn’t dive into the motives that influence Physicians preferences for rewards and values. Additional studies can shed light on this topic. Practical Implications – By using the research results, health care administrators can revisit Physicians compensation models, considering their preferences. Social Implications – The research on the influences of the normative environment on Physicians preferences can drive the comprehension about these professional’s behaviors. Originality – This study brings a new approach to the Physicians dysfunctional behaviors. / Objetivo – Este estudo pretende avaliar o impacto dos mecanismos de controle institucionais adotados pelo sistema de saúde no comportamento dos médicos, mais especificamente em sua preferência por recompensa. Metodologia – Aplicação de survey com questionário de preferência por recompensa em valores adaptado de Costa, Salles e Fontes Filho (2010). Os respondentes foram agrupados conforme aspectos de sua prática médica para efeito de comparação de suas preferências. Utilizamos o teste estatístico ANOVA para comparação das médias com validação da significância estatística das diferenças através do teste de Kruskall-Wallis. Resultados – Os resultados da pesquisa refutaram a hipótese que haveria diferença estatisticamente significativa na preferência por recompensa para os distintos grupos de médicos. Contudo, achamos diferenças significativas nas preferências dos grupos pelos valores “Cultivar amizades e relações cordiais com colegas” e “Deixar um legado para a minha especialidade”. Limitações - A pesquisa não levanta os motivos que estariam influenciando nas preferências por recompensa e valores destes profissionais. Pesquisas futuras podem aprofundar neste sentido. Contribuições Práticas - A partir dos resultados desta pesquisa, administradores da cadeia da saúde podem revisitar os modelos de remuneração dos médicos levando em conta suas preferências expressas. Contribuições Sociais – A pesquisa acerca das influências do ambiente normativo nas preferências dos médicos pode auxiliar na compreensão acerca dos comportamentos destes profissionais. Originalidade - Este estudo oferece uma abordagem nova para comportamentos disfuncionais dos médicos.

Made available in DSpace on 2010-04-20T21:00:48Z (GMT). No. of bitstreams: 3 joaomarceloferreiraturma2003.pdf.jpg: 14925 bytes, checksum: df498c91cdb430c463307b2d17171402 (MD5) joaomarceloferreiraturma2003.pdf: 341537 bytes, checksum: 05d5e2e600196fc209a92cab8cd98d1b (MD5) joaomarceloferreiraturma2003.pdf.txt: 138094 bytes, checksum: 9b39a668792a751b0cf2901bddcc8005 (MD5) Previous issue date: 2006-02-06T00:00:00Z / Empirical studies on the determinants of private investments in development countries, including several studies in Brazil, have shown that there is a negative impact of high inflation on private investments. However, the recent Brazilian experience shows clearly that stabilization by itself is not sufficient to generate higher investments ratios. The main goal of this thesis is to find empirical evidence that explains why private investment and the investment ratio did not recover after the Real-plan, even though inflation was under control in the 1995-2004 period. In order to achieve this goal econometric estimations were done for long-term private investiments and also of the crowding-out effect of public investments in other areas than infrastructure on private investments. In order to find empirical evidence of the negative impact of both increased government revenues as well as the increase of relative prices of capital goods on private investments since 1995 a model using quarterly data for 1995-2004 was estimated. A more datailed analysis of the Brazilian tax burden and its composition has shown that the tax burden is, not only ever high but also not optimally allocated. Tax revenue comes mainly from taxing production (goods and services) and less from taxing income and property. Moreover, although tax revenue has increased over the last ten years, government spending has become more inefficient, largely in the form of low or non-productive spending while productive government expediture, including government spending on infrastructure, has fallen. / Estudos empíricos sobre os determinantes de investimentos privados em países em desenvolvimento, incluindo vários estudos para o Brasil, mostraram o impacto negativo de elevadas taxas de inflação sobre os investimentos privados. No entanto, a experiência brasileira recente mostra claramente que a estabilização por si só não é capaz de fazer com que as taxas de investimento se recuperem. Este trabalho objetiva a busca de respostas em evidências empíricas sobre quais teriam sido os principais fatores responsáveis pela não recuperação dos investimentos no Brasil pós-plano Real, apesar do controle inflacionário, no período 1995-2004. Para isso, foi estimado um modelo de investimento privado em nível de longo prazo (1970-2003) com dados anuais. Estas estimações mostram evidência empírica de crowding-in dos investimentos públicos em infra-estrutura sobre os investimentos privados e do efeito de crowding-out dos demais investimentos públicos (que não são em infra-estrutura) sobre os investimentos privados. Para obter evidências empíricas do impacto negativo da carga tributária e dos preços relativos dos bens de capital sobre as taxas de investimento foi estimado um modelo trimestral com dados de 1995-2004. Uma análise mais detalhada sobre a carga tributária brasileira e sua composição mostrou ainda que, além de sua magnitude elevada, a carga tributária brasileira tem uma alocação desfavorável ao investimento privado, pois seu peso é muito maior sobre o setor produtivo do que sobre renda e patrimônio. Além disso, a despeito da arrecadação crescente nos últimos 10 anos, os gastos do governo têm se concentrado em gastos pouco ou não produtivos e tem diminuído a participação relativa dos investimentos públicos em infra-estrutura, que são gastos produtivos e estimuladores de investimentos privados (efeito de crowding-in).

A presente tese realiza uma análise interdisciplinar dos contratos de aliança, arranjos colaborativos desenvolvidos a partir do início da década de 90, cujo objetivo é a implantação de projetos complexos industriais e de infraestrutura. Este trabalho investiga a percepção do autor de que o modelo proposto pelos contratos de aliança, em regra, promove um esvaziamento voluntário da função do contrato como ferramenta de aplicação, ainda que potencial, de sanções a comportamentos culposos, justamente com o fim de não prejudicar a construção natural de uma relação cooperativa. Busca-se ainda compreender a função desempenhada pelo contrato e pelo direito contratual, nesse contexto colaborativo, e qual a relação entre os mecanismos formais e informais de garantia de cumprimento contratual. Sustenta-se que, nesse universo, o aparato formal do contrato auxilia as ferramentas informais de enforcement, fornecendo o arcabouço de troca de informações essencial à criação endógena de confiança. Ademais, a fim de não prejudicar o ambiente cooperativo, sustenta-se a aplicação de sanções contratuais formais somente em situações excepcionais, geralmente caracterizadas pelo elemento de quebra de confiança. Sugere-se, ao longo da tese, que uma abordagem processual de regulação do contrato a qual permite sanção de comportamentos que descumpram o procedimento contratual acordado seria mais adequada do que uma abordagem estritamente substantiva que proteja a relação inicial de troca. Ao final, amparada pelas percepções construídas ao longo da pesquisa, é realizada uma reflexão jurídico-dogmática, na qual, após a contextualização jurídica dos contratos de aliança, lhes são sugeridas interpretações de aplicação de conceitos da teoria obrigacional, e de ferramentas de organização de interesses intracontratuais, como a boa-fé, o conflito de interesses e os deveres fiduciários. / This thesis conducts an interdisciplinary analysis of project alliancing, collaborative arrangements developed as of the beginning of the 90s, whose goal is the implementation of complex industrial and infrastructure projects. This work investigates the perception of the author that the model proposed by alliance contracts, in general, promotes a voluntary emptying of the role of the contract in punishing, even potentially, unintentional contractual defaults, as a means of not harming the natural construction of a cooperative relation. The work seeks to understand the role played by the contract and the contractual law, in such collaborative environment, and what is the relation between formal and informal mechanisms of contractual enforcement. It argues that, in this universe, formal contractual apparatus supports informal contractual enforcement mechanisms, providing a governance framework that allows information exchange, which is essential to the endogenous creation of trust. Moreover, in order not to jeopardize the cooperative environment, this thesis suggests the suitability of formal contractual punishment only in exceptional circumstances, often characterized by the breach of trust. It is suggested, along the thesis, that a procedural approach of contract regulation which allows punishment of behaviors that deviates from agreed contractual procedures may be more suitable than a strictly substantive approach that protects the initial exchange relation. At the end, supported by the perceptions constructed along the research, some legal-dogmatic considerations are made, in which, after legally qualifying the alliance contracts, it is suggested to it some applicative interpretations of concepts of obligational theory, and organizational tools of intracontractual interests, such as good faith, conflicts of interest and fiduciary duties.

Chapter one: The influence of charitable activity on Indigenous communities’ well-being and other socio-economic outcomes Hitherto and within the Canadian context, no one has investigated the role played by the charitable sector on the economic well-being for “on-reserve” First Nations and Inuit communities. On the one hand, Indigenous peoples face longstanding and complex social problems and economic hardships. On the other hand, there are charities which provide public goods and services and benefits to communities by helping to fill needs. This is the first study to examine how the presence of charities may affect some measurable socio-economic outcomes of Indigenous communities and their people, by triangulating data from multiple sources: administrative data from the Canada Revenue Agency (CRA) on registered charities, the 2001 and 2006 Census Surveys, the 2011 National Household Survey and the Community Well-Being (CWB) Index developed by the Aboriginal Affairs and Northern Development Canada (AANDC). My findings indicate that having access to at least one charity is associated with increases in a community well-being measure of 3 points on a 100-point scale, in household income (5.1%) and in individual’s wages (6.9%). When the number of charities increases in a reserve by one unit, the CWB rises by 1.1 points (on the 100-point scale), household income by 2.7%, individuals’ total income by 1.9% and individuals’ wages by 3.4%. Chapter two: Government funding to Indigenous charities The government is an important revenue source for charitable organizations in Canada. Big differences in public funding can be observed across registered charities that serve Indigenous peoples and all other registered charities. Using charitable organizations’ tax returns, the T3010 Registered Charity Information Return for the years 2003 to 2017 I investigate these government-funding patterns. I test different hypothesis on financial support from government sources by discerning first between Indigenous and non-Indigenous charities, and second between Indigenous charities on reserve and off reserve. I also analyze the relationship between the funding across levels to see if one level of government funding is contingent on other levels. The results of my study point to a higher likelihood of Indigenous charities receiving government support as compared to non-Indigenous charities, with a 24% increase in the predicted probability of funding. Indigenous charities on reserve have a predicted probability of receiving government funding that is almost 17% lower than those off reserve. From the exploration of the link between the three levels of Canadian government funding for Indigenous and non-Indigenous charities two insights emerge. Firstly, the federal government is more likely to support Indigenous charities if they do not receive any other public funds, and the provincial government supports them if they do not get any municipal funding. Secondly, Indigenous charities are more likely than non-Indigenous charities to get both federal and provincial funding, and federal and municipal funding. The comparison between Indigenous charities off reserve and on reserve reveals that the on-reserve ones are less likely to be funded simultaneously by two levels of government. Chapter three: The causal relationship between government funding and donations to Indigenous charities While billions of dollars are donated annually to charitable organizations, relatively modest amounts go to charities that specifically serve Indigenous populations. In comparison to their non-Indigenous counterparts, these charities get fewer private donations, have less fundraising revenue and receive less gifts from other charities. This chapter studies the causal relationship between public funding and these three types of revenues, focusing on the Indigenous charities and distinguishing between on-reserve and off-reserve charities. I use the large T3010 dataset with financial information for over 95,000 registered charities, covering a 15-year period from 2003 to 2017. The estimation and identification strategy relies on novel instruments using a 2SLS model. The results indicate a crowding out effect of public funding on donations for Indigenous charities; I also find evidence that the level of government funding matters. With the preferred instrument, a one dollar increase in government funding crowds out seven cents of private contributions; the three levels of federal, provincial and municipal funding decrease private donations by 15, 6 and 46 cents respectively. Government funding negatively affects fundraising effort and gifts from other charities. For every dollar in public support the former decreases by one to seven cents and the latter by three to 12 cents. These reductions imply an economically substantial effect on charities’ revenue. Little evidence is found that government grants impact differently Indigenous charities on reserve compared to those off reserve. The area and programs in which charities operate matter though, which is critical for how governments structure grants to Indigenous charities.

The government of Ghana borrows from both domestic and foreign sources to finance the budget deficit. By the year 2013, the domestic debt was 55% of the public debt. Government domestic borrowing is competitive and can potentially crowd out the private corporate sector. Therefore, the specific research problem addressed in this study was whether the Ghanaian government's domestic debt (DEBT) caused financial crowding out (FCO) in Ghana. FCO theory is not conclusive and not proven specifically for Ghana, so the purpose of this research was to investigate its presence in Ghana. The neoclassical theory of FCO underpinned the research. The 2 research questions investigated FCO along the quantity and cost channels. The research examined the relationship between DEBT as the independent variable, the quantity of private sector credit (PSCREDIT), and the net interest margin (NIM) of banks as dependent variables. Covariates were macroeconomic and banking industry variables. The research population was the banking sector of the financial services industry. The research was correlational, and it used time series data from the Bank of Ghana and the World Bank. Data analysis used the autoregressive distributed lag method. The analysis returned a negative relationship between DEBT and PSCREDIT, and a positve relationship between NIM and DEBT. These results indicated the presence of FCO along both the quantity and cost channels. The research provides policymakers a means of quantifying the extent and effects of fiscal policies. The study may contribute to positive social change by promoting the revision of fiscal policies to favor the private corporate sector to invest, create jobs, and grow the Ghanaian economy.

This thesis is composed of two essays that study behavioral economics to motivate health-promoting behaviors. The first paper, "Does Nutrition Education Reduce Delay Discounting?," studies delay discounting, or delayed gratification, which is an important research topic because it plays a role in producing numerous health outcomes, such as obesity. It is important to understand how the delay discounting process relates to unhealthy diets. People who discount the value of future outcomes prefer immediate rewards (e.g., enjoyment/taste) even though a larger reward from delaying exists (e.g., good health status). In this paper, we aim to provide evidence over whether nutrition education reduces delay discounting. Our analysis, therefore, provides guidance for designing more effective interventions to help increase overall health. The second paper, "Are We Reaching Those Most In Need?: Motivation Profiles and Willingness-to-Participate," explores the potentially negative psychological spillover effects (i.e., "crowding out" effects), which can complicate incentives' effectiveness because it can make targeted behavior (i.e., the aim to improve one's health) less desirable. To understand this "crowding out" effect, our paper examines how different types of motivations (i.e., intrinsic and extrinsic motivations) influence people's willingness-to-participate in a weight control program with and without incentives. This analysis provides further guidance for designing more effective interventions by considering different recruitment strategies to target different individuals, which can minimize the negative spillover of incentives. / Master of Science

In the past ten years the Foreign Direct Investment (FDI) has become a phenomenon, which is nowadays considered to be one of the major future perspectives of an economy. For many economists and politicians, the FDI is perceived as a saving instrument, which should help solve problems such as structure, regional discrepancies and most importantly a high unemployment rate especially under the conditions of global economic and financial crisis. The inflow of the FDI to host economy brings many positive effects that cannot be substituted. In fact, it is considered as a positive externality that must be paid. In order to attract the FDI in a country, the investment incentives are proposed and current incentives are being rebuilt. But attracting FDI at all costs can also be counterproductive. The intended aim of this thesis is to analyze positive and negativ effects of the FDI.

Das Transfer-Einkommens-Derivativ ist einer der wichtigsten ökonomischen Parameter zur Beantwortung der Frage, ob Sozialrenten den unter Armut leidenden Älteren in voller Höhe zu Gute kommen oder ob politisch unerwünschte Verdrängungseffekte auftreten. Eine Verdrängung privater intergenerationeller Transfers durch die Vergabe von Sozialrenten wird dabei als Schwächung familiärer Strukturen angesehen, da erwachsene Kinder ihre vorherigen privaten finanziellen Unterstützungsleistungen an ihre bedürftigen Eltern kürzen oder gar aussetzen. Die staatlichen Leistungen kämen damit nicht vollständig den Bedürftigen zugute, weshalb die Wirksamkeit von Sozialrenten zur Bekämpfung von Altersarmut in Frage gestellt wird. Der aktuelle internationale Forschungsstand bestätigt die Existenz solcher Verdrängungseffekte bei Sozialtransferprogrammen in Entwicklungs- und Schwellenländern. Die der Dissertation zugrundeliegende empirische Erhebung zu Intrahaushaltstransfers in Mehrgenerationenhaushalten in drei Regionen Nordindiens (Himachal Pradesh, Uttar Pradesh und Delhi) hat jedoch gezeigt, dass theoretische Annahmen der Modelle und landestypische Gegebenheiten Indiens, wie etwa korrupte Vergabemuster bei den Sozialrenten, die Aussagekraft des Transfer-Einkommens-Derivativs zur Beurteilung der Effizienz der Sozialrenten stark einschränken. Die Daten zeigen überdies, dass der Nettotransferstrom abwärts verläuft, von den älteren zu den jüngeren Haushaltsmitgliedern. Dies steht im Gegensatz zu der gängigen Annahme, dass in Entwicklungs- und Schwellenländern die Älteren überwiegend Empfänger privater Transfers sind. / The transfer income derivative is one of the most important economic parameters in understanding whether social pensions serve the elderly poor, as the intended beneficiaries, or whether social pensions crowd out private transfers from family members. The crowding out effect of private transfers by public transfers is seen as weakening traditional family ties because adult children reduce or even cease private transfers to the needy elderly. In that case, public transfers may have no net effect on the income of the elderly calling into question the efficacy of public pension schemes in fighting old age poverty. The current state of international research provides evidence for these crowding out effects in developing or industrializing countries. Drawing on empirical research of intra-household transfers in households with elderly co-residence in three selected north Indian regions (Himachal Pradesh, Uttar Pradesh, and Delhi), this dissertation shows that theoretical assumptions of the models as well as country specific circumstances of India, such as corruption in the allocation of social pensions, limit the explanatory power of the transfer income derivative in judging the efficacy of such pensions. Additionally the data shows that private net transfers flow downward, from the elderly to the younger members of the household. This is in stark contrast to the common assumption that in developing and industrializing countries the elderly are mainly recipients of private transfers.