London School of Economics and Political Science

About: London School of Economics and Political Science is a education organization based out in London, United Kingdom. It is known for research contribution in the topics: Population & Politics. The organization has 8759 authors who have published 35017 publications receiving 1436302 citations.

Health Care Spending in the United States and Other High-Income Countries

Abstract: Importance Health care spending in the United States is a major concern and is higher than in other high-income countries, but there is little evidence that efforts to reform US health care delivery have had a meaningful influence on controlling health care spending and costs. Objective To compare potential drivers of spending, such as structural capacity and utilization, in the United States with those of 10 of the highest-income countries (United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland, and Denmark) to gain insight into what the United States can learn from these nations. Evidence Analysis of data primarily from 2013-2016 from key international organizations including the Organisation for Economic Co-operation and Development (OECD), comparing underlying differences in structural features, types of health care and social spending, and performance between the United States and 10 high-income countries. When data were not available for a given country or more accurate country-level estimates were available from sources other than the OECD, country-specific data sources were used. Findings In 2016, the US spent 17.8% of its gross domestic product on health care, and spending in the other countries ranged from 9.6% (Australia) to 12.4% (Switzerland). The proportion of the population with health insurance was 90% in the US, lower than the other countries (range, 99%-100%), and the US had the highest proportion of private health insurance (55.3%). For some determinants of health such as smoking, the US ranked second lowest of the countries (11.4% of the US population ≥15 years smokes daily; mean of all 11 countries, 16.6%), but the US had the highest percentage of adults who were overweight or obese at 70.1% (range for other countries, 23.8%-63.4%; mean of all 11 countries, 55.6%). Life expectancy in the US was the lowest of the 11 countries at 78.8 years (range for other countries, 80.7-83.9 years; mean of all 11 countries, 81.7 years), and infant mortality was the highest (5.8 deaths per 1000 live births in the US; 3.6 per 1000 for all 11 countries). The US did not differ substantially from the other countries in physician workforce (2.6 physicians per 1000; 43% primary care physicians), or nursing workforce (11.1 nurses per 1000). The US had comparable numbers of hospital beds (2.8 per 1000) but higher utilization of magnetic resonance imaging (118 per 1000) and computed tomography (245 per 1000) vs other countries. The US had similar rates of utilization (US discharges per 100 000 were 192 for acute myocardial infarction, 365 for pneumonia, 230 for chronic obstructive pulmonary disease; procedures per 100 000 were 204 for hip replacement, 226 for knee replacement, and 79 for coronary artery bypass graft surgery). Administrative costs of care (activities relating to planning, regulating, and managing health systems and services) accounted for 8% in the US vs a range of 1% to 3% in the other countries. For pharmaceutical costs, spending per capita was $1443 in the US vs a range of $466 to $939 in other countries. Salaries of physicians and nurses were higher in the US; for example, generalist physicians salaries were $218 173 in the US compared with a range of $86 607 to $154 126 in the other countries. Conclusions and Relevance The United States spent approximately twice as much as other high-income countries on medical care, yet utilization rates in the United States were largely similar to those in other nations. Prices of labor and goods, including pharmaceuticals, and administrative costs appeared to be the major drivers of the difference in overall cost between the United States and other high-income countries. As patients, physicians, policy makers, and legislators actively debate the future of the US health system, data such as these are needed to inform policy decisions.

“Electoral Institutions and the Politics of Coalitions: Why Some Democracies Redistribute More than Others”

Abstract: Standard political economy models of redistribution, notably that of Meltzer and Richard (1981), fail to account for the remarkable variance in government redistribution across democracies. We develop a general model of redistribution that explains why some democratic governments are more prone to redistribute than others. We show that the electoral system plays a key role because it shapes the nature of political parties and the composition of governing coalitions, hence redistribution. Our argument implies (1) that center-left governments dominate under PR systems, whereas center-right governments dominate under majoritarian systems; and (2) that PR systems redistribute more than majoritarian systems. We test our argument on panel data for redistribution, government partisanship, and electoral system in advanced democracies. W hy do some countries redistribute more than others? Most work on the politics of redistribution starts from the premise that democratic institutions empower those who stand to benefit from redistribution. The basic logic is succinctly captured in the Meltzer‐Richard (1981) model, where the voter with the median income is also the decisive voter. With a typical right-skewed distribution of income, the median voter will push for redistributive spending up to the point where the benefit of such spending to the median voter is outweighed by the efficiency costs of distortionary taxation. This argument implies that redistibution is much greater in democracies than in nondemocracies (at least of the right-authoritarian variety), and that, among the latter, inegalitarian societies redistribute more than egalitarian ones. There is some evidence to supportthefirstimplication,althoughitisdisputed(see Ross 2005), but most of the variance in redistribution is probably within the same regime type. According to datafromtheLuxembourgIncomeStudy,forexample, the reduction in the poverty rate in United States as a result of taxation and transfers was 13% in 1994, whereas the comparable figure for Sweden was 82% (thepovertyrateisthepercentageofhouseholdsbelow 50% of the median income). To explain this variance, we have to look at political and economic differences

Research Commentary---Digital Infrastructures: The Missing IS Research Agenda

Abstract: Since the inauguration of information systems research (ISR) two decades ago, the information systems (IS) field's attention has moved beyond administrative systems and individual tools. Millions of users log onto Facebook, download iPhone applications, and use mobile services to create decentralized work organizations. Understanding these new dynamics will necessitate the field paying attention to digital infrastructures as a category of IT artifacts. A state-of-the-art review of the literature reveals a growing interest in digital infrastructures but also confirms that the field has yet to put infrastructure at the centre of its research endeavor. To assist this shift we propose three new directions for IS research: (1) theories of the nature of digital infrastructure as a separate type of IT artifact, sui generis; (2) digital infrastructures as relational constructs shaping all traditional IS research areas; (3) paradoxes of change and control as salient IS phenomena. We conclude with suggestions for how to study longitudinal, large-scale sociotechnical phenomena while striving to remain attentive to the limitations of the traditional categories that have guided IS research.

Social Networks and Technology Adoption in Northern Mozambique

Abstract: Despite their potentially strong impact on poverty, agricultural innovations are often adopted slowly. Using a unique household dataset on sunflower adoption in Mozambique, we analyse whether and how individual adoption decisions depend upon the choices of others in the same social networks. Since farmers anticipate that they will share information with others, we expect farmers to be more likely to adopt when they know many other adopters. Dynamic considerations, however, suggest that farmers who know many adopters might strategically delay adoption to free-ride on the information gathered by others. We present empirical evidence that shows that the relationship between the probability of adoption and the number of known adopters is shaped as an inverse-U. In line with information sharing, the network effect is stronger for farmers who report discussing agriculture with others. The data contains information which is needed to ameliorate the identification issues that commonly arise in this context. In particular social networks are precisely identified, and in addition we can control for village heterogeneity and endogenous group formation.

Consequences of the psychological contract for the employment relationship: a large scale survey

Abstract: The renewed interest in the concept of the psychological contract has come to the fore in attempts to describe, understand and predict the consequences of changes occurring in the employment relationship. Recognizing that the employment relationship includes two parties to the exchange process, we set out to examine the content and state of the psychological contract from both the employee and employer perspective. The two perspectives permit an examination of the mutuality of obligations, which has not received much empirical attention to date. The research methodology consists of two surveys conducted in a large local authority directly responsible and accountable for a range of public services including education, environmental health and social care to the local population. The key findings suggest that the majority of employees have experienced contract breach. This view is also supported by managers, as representatives of the employer, who further indicate that the organization, given its external pressures, is not fulfilling its obligations to employees to the extent that it could. Overall, the results indicate that employees are redressing the balance in the relationship through reducing their commitment and their willingness to engage in organizational citizenship behaviour when they perceive their employer as not having fulfilled its part in the exchange process.