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  • Author: Martin Gaynor, Nirav Mehta, Seth Richards-Shubik
  • Publication Date: 05-2020
  • Content Type: Working Paper
  • Institution: Centre for Human Capital and Productivity (CHCP), Western University
  • Abstract: We study physician agency and optimal payment policy in the context of an expensive medication used in dialysis care. Using Medicare claims data we estimate a structural model of treatment decisions, in which physicians differ in their altruism and marginal costs, and this heterogeneity is unobservable to the government. In a novel application of nonlinear pricing methods, we theoretically characterize the optimal unrestricted contract in this screening environment with multidimensional heterogeneity. We combine these results with the estimated model to construct the optimal contract and simulate counterfactual outcomes. The optimal contract is a flexible fee-for-service contract, which pays for reported treatments but uses variable marginal payments instead of constant reimbursement rates, resulting in substantial health improvements and reductions in costs. Our structural approach also yields important qualitative findings, such as rejecting the optimality of any linear contract, and may be employed more broadly to analyze a variety of applications.
  • Topic: Economics, Government, Health, Health Care Policy, Human Capital, Productivity, Medicare
  • Political Geography: United States
  • Author: Amanda Michaud, David Wiczer
  • Publication Date: 12-2018
  • Content Type: Working Paper
  • Institution: Centre for Human Capital and Productivity (CHCP), Western University
  • Abstract: We evaluate the contribution of changing macroeconomic conditions and demographics to the increase in Social Security Disability Insurance (SSDI) over recent decades. Within our quantitative framework, multiple sectors differentially expose workers to health and economic risks, both of which affect individuals’ decisions to apply for SSDI. Over the transition, falling wages at the bottom of the distribution increased awards by 27% in the 1980s and 90s and aging demographics rose in importance thereafter. The model also implies two-thirds of the decline in working-age male employment from 1985 to 2013, three-fourths of which eventually goes on SSDI.
  • Topic: Economics, Government, Health, Disability, Human Capital, Social Security, Insurance , Productivity, Health Insurance
  • Political Geography: United States
  • Author: Nancy Gallagher, Charles Harry
  • Publication Date: 04-2017
  • Content Type: Working Paper
  • Institution: Center for International and Security Studies at Maryland (CISSM)
  • Abstract: Faced with a rapidly growing volume and range of cyber attacks, policymakers and organizational leaders have had difficulty setting priorities, allocating resources, and responding effectively without a standard way to categorize cyber events and estimate their consequences. Presidential Policy Directive 41 laid out the Obama administration’s principles for executive branch responses to significant cyber incidents in the public or private sector. But it neither drew important distinctions between different types of cyber incidents, nor gave a standard way to determine where a particular incident falls on its 0-5 point severity scale. This policy brief demonstrates how an analytical framework developed at the Center for International and Security Studies at the University of Maryland (CISSM) can help address these problems. It first differentiates between low-level incidents and more significant cyber events that result in either exploitation of information and/or disruption of operations. It categorizes five types of disruptive events and analyzes 2,030 cyber events in a dataset developed from media sources, showing that cyber exploitation remains more common than disruption, and that most disruptive activity fits into two categories: message manipulation and external denial of service attacks. Finally, the brief offers a standard method to assess the severity of different categories of disruptive attacks against different kinds of organizations based on the scope, magnitude, and duration of the event. This Cyber Disruption Index (CDI) is then applied to survey data on Distributed Denial of Service (DDoS) attacks in the private sector to assess severity within a common category of disruptive events. Of 3,900 cases reported, only 5 events (less than 1% of the DDoS cases) had a combined scope, magnitude, and duration severe enough to be a priority for prevention and potentially warrant government involvement.
  • Topic: Government, Cybersecurity, Media
  • Political Geography: United States, Washington, D.C.
  • Author: Emily Taylor
  • Publication Date: 04-2015
  • Content Type: Working Paper
  • Institution: Centre for International Governance Innovation
  • Abstract: This paper addresses the proposed transfer of Internet Assigned Numbers Authority (IANA) oversight away from the US government. The background section explores how the technical architecture of critical Internet resources has certain governance implications, introduces the Internet Corporation for Assigned Names and Numbers (ICANN) and its relationship with the US government through the IANA function and the Affirmation of Commitments. After discussing why the relationship has caused controversy, the paper describes the work underway within ICANN to find a successor oversight mechanism and provides a short critique of the proposals so far. The majority of the paper is taken up with more general issues relating to ICANN's accountability. It explains how the IANA transition was recognized to be dependent on ICANN's wider accountability, and the trust issues between community and leadership that this exposed. There follows an analysis of ICANN's strengths and weaknesses in relation to accountability and transparency, followed by conclusions and recommendations.
  • Topic: Government
  • Political Geography: United States
  • Author: Ming Zhang
  • Publication Date: 03-2015
  • Content Type: Working Paper
  • Institution: Centre for International Governance Innovation
  • Abstract: Due to the 2008-2009 global financial crisis, the Chinese government began to promote renminbi (RMB) internationalization in order to raise its international status, decrease reliance on the US dollar (USD) and advance domestic structural reform. RMB internationalization has achieved progress not only in cross-border trade settlement, but also in the offshore RMB markets. However, the rampant cross-border arbitrage and the relatively slow development of RMB invoicing compared to RMB settlement are becoming increasingly problematic. RMB internationalization has exerted significant influence on not only the Chinese economy but also other emerging market economies. RMB internationalization complicates domestic monetary policy, exacerbates the currency mismatch on China's international balance sheet and increases both the scale and volatility of short-term capital flows. It offers emerging economies another alternative for pricing domestic currency and investing foreign exchange reserves. Its overall impact on the international monetary system's stability will depend on how the capital account is liberalized and the consistency and transparency of Chinese monetary policy. This paper concludes with five recommendations for Chinese policy makers to promote RMB internationalization in a sustainable way that is conducive to international stability.
  • Topic: Development, Economics, Government
  • Political Geography: United States, China
  • Publication Date: 02-2015
  • Content Type: Working Paper
  • Institution: Atlantic Council
  • Abstract: We face a critical juncture in Ukraine. There is no real ceasefire; indeed, there was a significant increase in fighting along the line of contact in eastern Ukraine in mid-January, with Russian/separatist forces launching attacks on the Donetsk airport and other areas. Instead of a political settlement, Moscow currently seeks to create a frozen conflict in eastern Ukraine as a means to pressure and destabilize the Ukrainian government. Russians continue to be present in the Donetsk and Luhansk oblasts in substantial numbers and have introduced significant amounts of heavy weapons. This could be preparation for another major Russian/ separatist offensive.
  • Topic: NATO, Government
  • Political Geography: Russia, United States, Ukraine, Moscow
  • Author: Stephanie Sanok Kostro, Garrett Riba
  • Publication Date: 11-2014
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: The increased frequency and intensity of natural disasters, the rising amount of economic losses, and the mounting costs of providing relief indicate the growing importance of disaster resilience. Disasters have far- reaching consequences, ranging from the most basic physical injuries and property losses to long- term psychological, economic, and cultural damage. Merely supplementing resources to address the aftermath of disasters— rather than mitigating risks and putting in place key elements in advance of a disaster— is not a sustainable model for community resilience. Additionally, failure to utilize the resources of all public- and private- sector stakeholders to develop long- term planning mechanisms leaves communities vulnerable to repeated, high levels of damage and destruction.
  • Topic: Disaster Relief, Government, Terrorism, Natural Disasters
  • Political Geography: United States
  • Author: Sheila A. Smith
  • Publication Date: 07-2014
  • Content Type: Working Paper
  • Institution: Council on Foreign Relations
  • Abstract: Electoral reform in the early 1990s ended single-party dominance in Japan and promised an era of new politics in which political parties would alternate control of the government. In the two decades that followed, Japan's foreign and domestic policy priorities were subjected to greater scrutiny and debate as Japan, like so many other nations around the globe, sought to reorient itself in a new post-Cold War world. The U.S.-Japan alliance that anchored Japan's postwar foreign policy was not immune to these domestic political reforms. For half a century, the conservative Liberal Democratic Party (LDP) prided itself on managing the relationship with Washington. But its ouster in 2009 by the reformist Democratic Party of Japan (DPJ) led many to expect that even Japan's alliance with the United States would be subject to serious review.
  • Topic: Government, Bilateral Relations
  • Political Geography: United States, Japan, Asia
  • Publication Date: 02-2014
  • Content Type: Working Paper
  • Institution: The Carter Center
  • Abstract: This report outlines constitutional and legislative options for a political transition in Syria under the umbrella of the Final Geneva Communiqué, issued by the Action Group on Syria on 30 June 2012, and revived in early May 2013 at a meeting in Moscow between the U.S. and Russia. The Communiqué embodies the greatest degree of consensus that the international community has been able to achieve regarding the Syrian conflict, detailing a potentially viable path to a negotiated end to the civil war. Since May 2013, efforts by UN and Arab League Joint Special Envoy Lakhdar Brahimi and others to host a peace conference on Syria (dubbed "Geneva II"), have reinforced the importance of developing possible constitutional and legislative modalities for a transition.
  • Topic: Civil War, Government, International Cooperation, Armed Struggle
  • Political Geography: Russia, United States, Middle East, Syria
  • Author: Peter Haynes
  • Publication Date: 10-2014
  • Content Type: Working Paper
  • Institution: Atlantic Council
  • Abstract: In a world of near-infinite computing power, ubiquitous connectivity, cloud-based services, and big data, the fact that the vast majority of countries holds elections using paper ballots appears an anomaly.
  • Topic: Government, Science and Technology, Reform
  • Political Geography: United States