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There is a growing recognition that we cannot afford the provision of all new health care technologies, even those that are proven to be beneficial. This is increasingly true in the US, where health care spending is on an unsustainable upward trajectory. US health care spending is greatly in excess of that of other countries; however, with respect to key health metrics, the US health care system performs relatively poorly. Despite this, unlike many other developed countries economic evaluation, and more specifically cost effectiveness evidence, is used sparingly in the US health care system. Notably, the Centers for Medicare and Medicaid Services (CMS), administrators of the Medicare programme, state that cost-effectiveness evidence is not relevant to coverage decisions for medical technology and interventions evaluated as part of National Coverage Determinations (NCDs). The empirical aspect of this thesis evaluates the current use and potential value of using cost-effectiveness evidence in CMS NCDs. A database was built using data obtained from NCD decision memoranda, the medical literature, a Medicare claims database, and Medicare reimbursement information. The findings of the empirical work show that, CMS’s stated position notwithstanding, cost-effectiveness evidence has been cited or discussed in a number of coverage decisions, and there is a statistically significant difference between positive and non-coverage decisions with respect to cost effectiveness. When controlling for factors likely to have an effect on coverage decisions, the availability of cost-effectiveness evidence is a statistically significant predictor of coverage. In addition, the quality of the supporting clinical evidence, the availability of alternative interventions, and the recency of the decision are statistically significant variables. Further, when hypothetically reallocating resources in accordance with cost-effectiveness substantial gains in aggregate health are estimated. It is shown that using cost-effectiveness to guide resource allocation has an effect on resource allocation across patient populations and types of technology.

This paper seeks to compare production costs of similar farms to determine competitiveness across countries. A data envelopment analysis (DEA) approach was used to calculate efficiency indices for farms producing corn, soybeans, wheat, both corn and soybeans, and both corn and wheat. Technical efficiency, allocative efficiency, and cost efficiency were compared for all farms. The data consisted of a five-year (2013-2017) panel of 24 corn-producing farms, 15 soybean-producing farms, 38 wheat-producing farms, 13 farms producing both corn and soybeans, and 17 farms producing both corn and wheat. The <i>agri benchmark</i> network at the Thünen Institute (TI) of Farm Economics manages the dataset that was used in this analysis. Outputs were measured using revenue. Input costs included direct costs, operating costs, and overhead costs.<br>

We investigate empirically the usefulness of price-cap and quality regulation in terms of allocative efficiency and welfare. An analytical framework allows us to determine sufficient conditions for an increase in welfare. We propose Malmquist productivity indices and their decomposition to check the conditions and to see whether it was a better-solved trade off between quality and costs that caused the welfare increase. The application of this method to a representative sample of Norwegian distribution system operators yields strong evidence for a positive effect of quality regulation on welfare. (author's abstract) / Series: Working Papers / Research Institute for Regulatory Economics

Studies have found substantial differences in health-related behavior and health care usage between educational groups, which may explain part of the well-documented educational gradient in health. The allocative efficiency hypothesis offers a behavioral explanation for these reported differences. According to this theory, the educated possess more health knowledge and information, allowing them to make better health choices. We perform a mediation analysis to study this mechanism using original survey data from the Philippines, a lower-middle-income country. As an extension of previous empirical research, we construct a comprehensive index that captures different dimensions of health knowledge. Using generalized propensity scores, we find strong support for the allocative efficiency argument. Schooling is significantly associated with health knowledge levels, which explain up to 69% of the education effect on health lifestyle. This corresponds to twice the mediation strength of economic resources, suggesting an important role of this factor in explaining education effects on health decisions.

In this dissertation auction formats are developed and discussed that focus on three specific economic environments. Regarding the impossibility results from mechanism design, the main task for the implementation of auction designs is to balance allocative efficiency and incentive compatibility – the main characteristics a mechanism should provide. Therefore, the dissertation investigates the limits of conceivable relaxations of allocative efficiency and incentive compatibility for complex settings such as double auctions, interdependent-valuation environments and electricity market designs. The overall aim is to carefully weigh up the advantages and disadvantages for either relaxing allocative efficiency or respectively incentive compatibility.

O objetivo desta tese é discutir, sob a ótica da multimodalidade, os impactos na economia brasileira decorrentes da redução de custos de transportes. Para atingir este objetivo, um modelo inter-regional de equilíbrio geral computável denominado BR-Transport foi implementado, inspirado na teoria da escola australiana. Os dados calibrados para o modelo foram desagregados conforme quatro modais de transporte: rodoviário, ferroviário, hidroviário e dutoviário. Para a desagregação da atividade de transporte e estimação das elasticidades de substituição preço cruzado, usou-se a base de dados dos Planos Nacionais de Logística e Transportes do Brasil, a qual dispõe de informações sobre os fluxos de transporte entre 551 pontos distribuídos pelas 27 unidades federativas do país e o exterior, incluindo custos e volume de transporte por tipo de modal, discriminados em 29 grupos de produtos. Na estrutura teórica do modelo BR-Transport, introduziram-se mecanismos que se baseiam na racionalidade dos agentes, que minimizam custos, e contemplam as elasticidades de substituição preço cruzado entre os modais de transporte, as quais foram estimadas econometricamente. Foram admitidas duas abordagens para a estimação da função de demanda: a translog do tipo Constant Elasticity of Substitution, que corresponde à especificação teórica das funções de produção implementadas no modelo de equilíbrio geral computável; e a Multinomial Conditional Logit, tipicamente usada em modelos de escolha de modos de transporte. Ambas as estimações contaram com controles adicionais, como atributos do modal, efeitos fixos e variáveis instrumentais. As elasticidades obtidas a partir das diferentes formas funcionais permitiram realizar uma análise de sensibilidade dos resultados do modelo de equilíbrio geral, com base no uso dos diferentes vetores de elasticidades. Os resultados indicaram que choques generalizados de redução de custos no sistema de transporte brasileiro geram um aumento das exportações e importações inter-regionais e beneficiam principalmente os produtos regionais brutos dos estados das regiões Norte e Nordeste do país. Tais resultados estão diretamente associados à melhoria de acesso desses estados aos principais mercados consumidores e fornecedores, localizados nas regiões Sudeste e Sul, e revelam o potencial de redistribuição regional de renda das políticas de reduções de custos de transportes. Em uma análise dos impactos específicos dessas reduções de custos em cada modal, notou-se a preponderância do transporte rodoviário na economia nacional, em todos os estados e setores. Simulando uma redução de custos generalizada no modal ferroviário, o estado mais beneficiado seria o Pará, sobretudo porque ligações específicas por este modal entre os estados do Pará, de São Paulo e Minas Gerais estão entre as vinte mais importantes em termos de benefícios ao Produto Interno Bruto e às exportações nacionais. Melhorias no modal hidroviário, por sua vez, teriam impactos relevantes nos estados da região Norte do país. Já o modal dutoviário ainda mostra pequena expressão em relação a impactos regionais e setoriais / The objective of this thesis is to discuss, from the perspective of multimodality, the impacts on the Brazilian economy resulting from the retrenchment of transportation. To achieve this goal, an interregional computable general equilibrium model named BR-Transport was implemented, inspired by the theory of the Australian school. The calibrated data used in the model were disaggregated according to four modes of transport: roads, rails, waterways and pipelines. For the disaggregation of the transport activity and the estimation of the cross-price elasticities of substitution, the Brazilian National Plan for Logistics and Transport database was used; it contains information about traffic flows between 551 points over the 27 Brazilian states and the rest of the world, including costs and volume of transport for each mode of transportation, discriminated in 29 different product groups. In the theoretical structure of the BR-Transport model, mechanisms were introduced based on the rationality of agents, which minimize costs; they include the cross-price elasticities of substitution between modes of transport, which were econometrically estimated. Thus, two distinct functional forms were admitted: the first one was the Constant Elasticity of Substitution, a translog which corresponds to the theoretical specification of the production functions implemented in the computable general equilibrium model; and the second one was the Multinomial Conditional Logit, which is typically used in choice models of modes of transportation. Both estimations were made using additional controls, such as modal attributes, fixed effects and instrumental variables. The elasticities obtained from the different functional forms allowed the implementation of a sensitivity analysis of the general equilibrium model results, based on the use of different elasticities vectors. Results show that general shocks of retrenchment in the Brazilian transportation system increase inter-regional exports and imports and especially benefit gross regional products in Brazil\'s North and Northeast regions. These results are directly related to the improvement of the accessibility of these states to big markets and suppliers, located in the Southeast and South regions, and they demonstrate that politics of retrenchment of transport improve regional income redistribution. An analysis of the specific impacts of retrenchment in each mode indicates a preponderance of road transport in the national economy, in all states and sectors. A simulation of a general retrenchment of the railway mode shows that the state of Pará would have more benefits due to the fact that specific railway links between this state and the states of São Paulo and Minas Gerais are among the 20 most important ones in terms of benefits to the national Gross Domestic Product and the national exports. On the other hand, improvements in waterways would have significant impacts on the states of the North region. Finally, pipelines still show little expression with respect to regional and sectoral impacts.

O objetivo desta tese é discutir, sob a ótica da multimodalidade, os impactos na economia brasileira decorrentes da redução de custos de transportes. Para atingir este objetivo, um modelo inter-regional de equilíbrio geral computável denominado BR-Transport foi implementado, inspirado na teoria da escola australiana. Os dados calibrados para o modelo foram desagregados conforme quatro modais de transporte: rodoviário, ferroviário, hidroviário e dutoviário. Para a desagregação da atividade de transporte e estimação das elasticidades de substituição preço cruzado, usou-se a base de dados dos Planos Nacionais de Logística e Transportes do Brasil, a qual dispõe de informações sobre os fluxos de transporte entre 551 pontos distribuídos pelas 27 unidades federativas do país e o exterior, incluindo custos e volume de transporte por tipo de modal, discriminados em 29 grupos de produtos. Na estrutura teórica do modelo BR-Transport, introduziram-se mecanismos que se baseiam na racionalidade dos agentes, que minimizam custos, e contemplam as elasticidades de substituição preço cruzado entre os modais de transporte, as quais foram estimadas econometricamente. Foram admitidas duas abordagens para a estimação da função de demanda: a translog do tipo Constant Elasticity of Substitution, que corresponde à especificação teórica das funções de produção implementadas no modelo de equilíbrio geral computável; e a Multinomial Conditional Logit, tipicamente usada em modelos de escolha de modos de transporte. Ambas as estimações contaram com controles adicionais, como atributos do modal, efeitos fixos e variáveis instrumentais. As elasticidades obtidas a partir das diferentes formas funcionais permitiram realizar uma análise de sensibilidade dos resultados do modelo de equilíbrio geral, com base no uso dos diferentes vetores de elasticidades. Os resultados indicaram que choques generalizados de redução de custos no sistema de transporte brasileiro geram um aumento das exportações e importações inter-regionais e beneficiam principalmente os produtos regionais brutos dos estados das regiões Norte e Nordeste do país. Tais resultados estão diretamente associados à melhoria de acesso desses estados aos principais mercados consumidores e fornecedores, localizados nas regiões Sudeste e Sul, e revelam o potencial de redistribuição regional de renda das políticas de reduções de custos de transportes. Em uma análise dos impactos específicos dessas reduções de custos em cada modal, notou-se a preponderância do transporte rodoviário na economia nacional, em todos os estados e setores. Simulando uma redução de custos generalizada no modal ferroviário, o estado mais beneficiado seria o Pará, sobretudo porque ligações específicas por este modal entre os estados do Pará, de São Paulo e Minas Gerais estão entre as vinte mais importantes em termos de benefícios ao Produto Interno Bruto e às exportações nacionais. Melhorias no modal hidroviário, por sua vez, teriam impactos relevantes nos estados da região Norte do país. Já o modal dutoviário ainda mostra pequena expressão em relação a impactos regionais e setoriais / The objective of this thesis is to discuss, from the perspective of multimodality, the impacts on the Brazilian economy resulting from the retrenchment of transportation. To achieve this goal, an interregional computable general equilibrium model named BR-Transport was implemented, inspired by the theory of the Australian school. The calibrated data used in the model were disaggregated according to four modes of transport: roads, rails, waterways and pipelines. For the disaggregation of the transport activity and the estimation of the cross-price elasticities of substitution, the Brazilian National Plan for Logistics and Transport database was used; it contains information about traffic flows between 551 points over the 27 Brazilian states and the rest of the world, including costs and volume of transport for each mode of transportation, discriminated in 29 different product groups. In the theoretical structure of the BR-Transport model, mechanisms were introduced based on the rationality of agents, which minimize costs; they include the cross-price elasticities of substitution between modes of transport, which were econometrically estimated. Thus, two distinct functional forms were admitted: the first one was the Constant Elasticity of Substitution, a translog which corresponds to the theoretical specification of the production functions implemented in the computable general equilibrium model; and the second one was the Multinomial Conditional Logit, which is typically used in choice models of modes of transportation. Both estimations were made using additional controls, such as modal attributes, fixed effects and instrumental variables. The elasticities obtained from the different functional forms allowed the implementation of a sensitivity analysis of the general equilibrium model results, based on the use of different elasticities vectors. Results show that general shocks of retrenchment in the Brazilian transportation system increase inter-regional exports and imports and especially benefit gross regional products in Brazil\'s North and Northeast regions. These results are directly related to the improvement of the accessibility of these states to big markets and suppliers, located in the Southeast and South regions, and they demonstrate that politics of retrenchment of transport improve regional income redistribution. An analysis of the specific impacts of retrenchment in each mode indicates a preponderance of road transport in the national economy, in all states and sectors. A simulation of a general retrenchment of the railway mode shows that the state of Pará would have more benefits due to the fact that specific railway links between this state and the states of São Paulo and Minas Gerais are among the 20 most important ones in terms of benefits to the national Gross Domestic Product and the national exports. On the other hand, improvements in waterways would have significant impacts on the states of the North region. Finally, pipelines still show little expression with respect to regional and sectoral impacts.

Utilisant des données sur les expéditions de robots industriels, ce document constate que les secteurs volatils sont automatisés de façon disproportionnée dans les pays avec des règles strictes sur le licenciement. L'idée derrière le résultat empirique est que contrairement aux travailleurs humains, les entreprises peuvent disposer librement des robots, tout comme avec tout autre bien de capital. Puisque les droits des robots ne sont pas protégés par la loi, ils fournissent des services de main d’œuvre à volonté. L'incitation à l'automatisation apportée par la réglementation est plus forte dans les secteurs volatils, où l'incertitude sur les conditions d'affaires augmente les exigences de flexibilité des entreprises. Mes estimations prédisent que dans les secteurs incertains, le pays le plus réglementé (l'Italie) devrait être deux fois plus automatisé que le plus réglementé (États-Unis). Les données montrent que le nombre de robots par employé en Italie est 90% plus élevé qu'aux États-Unis. La stratégie d'identification consiste à exploiter le calendrier différent dans les réformes du travail entre les pays. L'identification provient de l'effet avant-après sur l'investissement sectoriel dans les robots dans les pays réformés (le "groupe de traitement"), vis-à-vis de l'effet avant-après dans les pays où l'EPL n'a pas changé (le "groupe témoin"). Ce document explique pourquoi les entreprises investissent dans l'automatisation. Contrairement à la sagesse conventionnelle, les robots n'augmentent pas la productivité parce qu'ils sont meilleurs ou plus rapides à faire les choses, mais plutôt parce qu'ils augmentent l'efficacité de la répartition. Le lien entre réglementation et automatisation implique que la politique du marché du travail peut être utilisée pour atténuer l'effet perturbateur de la technologie. / Using data on shipments of industrial robots, this paper finds that volatile sectors are disproportionally automated in countries with strict rules on employment dismissal. The idea behind the empirical result is that unlike for human workers, firms can freely dispose of robots, just as with any other capital good. Since robot’s rights are not protected by law, they deliver labor services at will. The incentive to automate induced by regulation is stronger in volatile sectors, where uncertainty about business conditions increase the flexibility requirements of firms. My estimates predict that in uncertain sectors, the most regulated country (Italy) should be twice as automated as the least regulated one (the United States). Data show that the number of robots per employee in Italy is 90% higher than in the United States. The identification strategy consists in exploiting different timing in labor re-forms across countries. Identification comes from the before-after effect on sectorial investment in robots in reformed countries (the \treatment group"), vis-a-vis the before-after effect in countries where EPL did not change (the \control group").This paper sheds light on why firms invest in automation. In contrast to conventional wisdom, robots do not increase productivity because they are better or faster at doing things, but rather because they increase allocative efficiency. The link between regulation and automation implies that labor market policy can be used to mitigate the disruptive effect of technology.

This paper surveys the theoretical and empirical research on the efficient assignment of policy tasks to different levels of government and applies the results on the delimitation of competences within the European Union. The main results are: (i) A precise derivation of an optimal degree of decentralisation is not possible because of mixed theoretical suggestions. The adequate degree of decentralisation has to be detected case-by-case. (ii) Systematic evidence on direct relationships between economic performance and fiscal decentralisation is ambiguous and scarce. (iii) Comparing the de facto delimitation of EU-competences with the normative recommendations, remarkable discrepancies arise in the fields of agriculture and defence. (iv) The establishment of a flexible assignment-scheme by the European Convention is an undeniable necessity in order to guarantee reversibility and to cope efficiently with changing general conditions. (author's abstract) / Series: EI Working Papers / Europainstitut