We begin by identifying the four major obstacles for financing the transition to a sustainable energy world: the immense size of the required financing, the need to coordinate investments in dozens of interrelated projects required for an orderly transition, the need to get the investment incentive right and to avoid crony capitalism, and the need to manage the political economics of electricity regulation and pricing. We then show that these obstacles cannot be overcome by sole reliance on either public or private finance. What is need is a creative combination of the two. In this regard, we suggest several possible policies. These include an expanded role of government guarantees of the private financing of sustainable energy projects, a focus on the funding of basic research, and an entire rethinking of the role of electricity pricing and regulation.
{"title":"Financing a Sustainable Energy Transiton","authors":"Bradford Cornell, C. Cicchetti","doi":"10.2139/ssrn.3676703","DOIUrl":"https://doi.org/10.2139/ssrn.3676703","url":null,"abstract":"We begin by identifying the four major obstacles for financing the transition to a sustainable energy world: the immense size of the required financing, the need to coordinate investments in dozens of interrelated projects required for an orderly transition, the need to get the investment incentive right and to avoid crony capitalism, and the need to manage the political economics of electricity regulation and pricing. We then show that these obstacles cannot be overcome by sole reliance on either public or private finance. What is need is a creative combination of the two. In this regard, we suggest several possible policies. These include an expanded role of government guarantees of the private financing of sustainable energy projects, a focus on the funding of basic research, and an entire rethinking of the role of electricity pricing and regulation.","PeriodicalId":11797,"journal":{"name":"ERN: Regulation (IO) (Topic)","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73853635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although cannabis is federally prohibited, a majority of U.S. states have implemented medical cannabis laws (MCLs). As more individuals consider the drug for medical treatment, they potentially substitute away from prescription drugs. Therefore, an MCL signals competitor entry. This paper exploits geographic and temporal variation in MCLs to examine the strategic response in direct-to-physician marketing by pharmaceutical firms as cannabis enters the market. Using office detailing records from 2014-2018 aggregated to the county level, we find weak evidence of a relatively small and delayed response in substitute prescription drug- and opioid-related detailing. While these effects on detailing dollars are more pronounced among smaller pharmaceutical firms, the magnitudes are economically small and likely muted at aggregate levels by the small percent of doctors that actively recommend cannabis for medical treatment.
{"title":"The Effect of Medical Cannabis Laws on Pharmaceutical Marketing to Physicians","authors":"Thomas Lebesmuehlbacher, Rhet A. Smith","doi":"10.2139/ssrn.3666454","DOIUrl":"https://doi.org/10.2139/ssrn.3666454","url":null,"abstract":"Although cannabis is federally prohibited, a majority of U.S. states have implemented medical cannabis laws (MCLs). As more individuals consider the drug for medical treatment, they potentially substitute away from prescription drugs. Therefore, an MCL signals competitor entry. This paper exploits geographic and temporal variation in MCLs to examine the strategic response in direct-to-physician marketing by pharmaceutical firms as cannabis enters the market. Using office detailing records from 2014-2018 aggregated to the county level, we find weak evidence of a relatively small and delayed response in substitute prescription drug- and opioid-related detailing. While these effects on detailing dollars are more pronounced among smaller pharmaceutical firms, the magnitudes are economically small and likely muted at aggregate levels by the small percent of doctors that actively recommend cannabis for medical treatment.","PeriodicalId":11797,"journal":{"name":"ERN: Regulation (IO) (Topic)","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90954070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There’s a widespread perception that transparent pricing would push healthcare prices downward. While this may be true in certain markets, in many others, it would have little price impact or could even push prices upward via tacit collusion. Under perfect competition, prices are universally known and vary little across buyers and sellers. Such conditions are absent in many or most American healthcare markets. The industrial organization and antitrust literatures suggest that when the number of sellers in a market is small and barriers to entry for new sellers are high—as is true of most healthcare services—public knowledge of prices can lead to tacit collusion. In such cases, sellers act on price information as though they are conspiring to restrict supply and raise prices, without any actual conspiracy, while consumers cannot or do not use prices to change their behavior. Aside from tacit collusion, providers have better information on health and care than patients do. Emergency patients can’t price-shop. Third-party payers, not patients, reap most of the benefits of price-shopping. Even when patients are provided with price-shopping tools, they fail to compare prices. These cautions do not imply a blanket condemnation of price transparency, but they do suggest that policymakers should be highly selective in issuing transparency mandates.
{"title":"Price Transparency in Healthcare: Apply with Caution","authors":"Robert F. Graboyes, Jessica McBirney","doi":"10.2139/ssrn.3684790","DOIUrl":"https://doi.org/10.2139/ssrn.3684790","url":null,"abstract":"There’s a widespread perception that transparent pricing would push healthcare prices downward. While this may be true in certain markets, in many others, it would have little price impact or could even push prices upward via tacit collusion. Under perfect competition, prices are universally known and vary little across buyers and sellers. Such conditions are absent in many or most American healthcare markets. The industrial organization and antitrust literatures suggest that when the number of sellers in a market is small and barriers to entry for new sellers are high—as is true of most healthcare services—public knowledge of prices can lead to tacit collusion. In such cases, sellers act on price information as though they are conspiring to restrict supply and raise prices, without any actual conspiracy, while consumers cannot or do not use prices to change their behavior. Aside from tacit collusion, providers have better information on health and care than patients do. Emergency patients can’t price-shop. Third-party payers, not patients, reap most of the benefits of price-shopping. Even when patients are provided with price-shopping tools, they fail to compare prices. These cautions do not imply a blanket condemnation of price transparency, but they do suggest that policymakers should be highly selective in issuing transparency mandates.","PeriodicalId":11797,"journal":{"name":"ERN: Regulation (IO) (Topic)","volume":"53 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90675697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study provides a survey of research that uses cross-country comparisons to examine how economic regulation affects growth. Studies in the peer-reviewed literature tend to rely on either World Bank or Organisation for Economic Co-operation and Development measures of regulation. Those studies seem to reflect a consensus that entry regulation and anticompetitive product and labor market regulations are generally harmful to growth. The results from this cross-country research, taken in conjunction with economic theory as well as other country specific studies of economic regulation, support the hypothesis that economic regulation tends to reduce welfare in competitive markets. Given the continued use of certain types of economic regulation, the findings may offer important lessons for policymakers.
{"title":"The Impact of Economic Regulation on Growth: Survey and Synthesis","authors":"James Broughel, R. Hahn","doi":"10.2139/ssrn.3684759","DOIUrl":"https://doi.org/10.2139/ssrn.3684759","url":null,"abstract":"This study provides a survey of research that uses cross-country comparisons to examine how economic regulation affects growth. Studies in the peer-reviewed literature tend to rely on either World Bank or Organisation for Economic Co-operation and Development measures of regulation. Those studies seem to reflect a consensus that entry regulation and anticompetitive product and labor market regulations are generally harmful to growth. The results from this cross-country research, taken in conjunction with economic theory as well as other country specific studies of economic regulation, support the hypothesis that economic regulation tends to reduce welfare in competitive markets. Given the continued use of certain types of economic regulation, the findings may offer important lessons for policymakers.","PeriodicalId":11797,"journal":{"name":"ERN: Regulation (IO) (Topic)","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82748744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evaluating network effects and two-sidedness is critical for merger control in the digital economy. To examine the impact of network effects on the welfare properties of mergers, this study analyzes a model of multiproduct-firm oligopoly with firm-level direct and indirect network externalities using an aggregative-games approach. The analysis shows that network externalities increase both the consumer benefits of mergers through network expansion and the cost of accompanying market power. The former justifies mergers involving small firms, but the latter makes mergers between dominant firms more likely to hurt consumers. In two-sided markets, the effect of mergers on consumer surplus depends on merging parties' pre-merger price structures. In particular, when a consumer group is subsidized through two-sided pricing by merging parties, such consumers are likely to benefit from mergers. These results provide theoretical guidance on merger policy toward platforms.
{"title":"Horizontal Mergers in the Presence of Network Externalities","authors":"Susumu Sato","doi":"10.2139/ssrn.3461769","DOIUrl":"https://doi.org/10.2139/ssrn.3461769","url":null,"abstract":"Evaluating network effects and two-sidedness is critical for merger control in the digital economy. \u0000To examine the impact of network effects on the welfare properties of mergers, this study analyzes a model of multiproduct-firm oligopoly with firm-level direct and indirect network externalities using an aggregative-games approach. The analysis shows that network externalities increase both the consumer benefits of mergers through network expansion and the cost of accompanying market power. The former justifies mergers involving small firms, but the latter makes mergers between dominant firms more likely to hurt consumers. In two-sided markets, the effect of mergers on consumer surplus depends on merging parties' pre-merger price structures. In particular, when a consumer group is subsidized through two-sided pricing by merging parties, such consumers are likely to benefit from mergers. These results provide theoretical guidance on merger policy toward platforms.","PeriodicalId":11797,"journal":{"name":"ERN: Regulation (IO) (Topic)","volume":"34 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77963735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Are dominant online search engines monopolies enjoying low contest-ability, due to high barriers to entry, or innovative first-movers? This paper argues that dominant online search engines maintain their leadership through an “innovation feedback loop”: a process whereby increasing R&D expenses allow dominant online search engines to maintain superior quality and achieve greater earnings over time, which in turn allow them to further increase R&D expenses to maintain leadership. Dominant online search engines use the innovation feedback loop to maintain their first-mover advantages, as entry barriers in the form of either economies of scale, switching costs or network effects do not protect their rents from technological discontinuities by potential or fringe competitors. Furthermore, first-mover advantages are also maintained via entry into adjacent markets, through either acquisition or organic growth. This allows dominant online search engines to increase advertising monetization, through collecting differentiated user data, and to improve their position against entry from potential competitors and competition from the fringe. We argue that when dominance is derived from first-mover advantages and innovation feedback loops, rather than high and non-transitory barriers to entry, competition policy and regulation should avoid undermining first-mover advantages through access regulation, as this is likely to result in trade-offs on innovation by all market players. We support instead a focus on prohibiting exclusionary behavior by first movers to avoid leadership derived from anti-competitive foreclosing abuses rather than from competition on the merits.
{"title":"Online Search Engine Competition with First-Mover Advantages, Potential Competition and a Competitive Fringe: Implications for Data Access Regulation and Antitrust","authors":"Jordi Casanova","doi":"10.2139/ssrn.3647092","DOIUrl":"https://doi.org/10.2139/ssrn.3647092","url":null,"abstract":"Are dominant online search engines monopolies enjoying low contest-ability, due to high barriers to entry, or innovative first-movers? This paper argues that dominant online search engines maintain their leadership through an “innovation feedback loop”: a process whereby increasing R&D expenses allow dominant online search engines to maintain superior quality and achieve greater earnings over time, which in turn allow them to further increase R&D expenses to maintain leadership. Dominant online search engines use the innovation feedback loop to maintain their first-mover advantages, as entry barriers in the form of either economies of scale, switching costs or network effects do not protect their rents from technological discontinuities by potential or fringe competitors. Furthermore, first-mover advantages are also maintained via entry into adjacent markets, through either acquisition or organic growth. This allows dominant online search engines to increase advertising monetization, through collecting differentiated user data, and to improve their position against entry from potential competitors and competition from the fringe. We argue that when dominance is derived from first-mover advantages and innovation feedback loops, rather than high and non-transitory barriers to entry, competition policy and regulation should avoid undermining first-mover advantages through access regulation, as this is likely to result in trade-offs on innovation by all market players. We support instead a focus on prohibiting exclusionary behavior by first movers to avoid leadership derived from anti-competitive foreclosing abuses rather than from competition on the merits.","PeriodicalId":11797,"journal":{"name":"ERN: Regulation (IO) (Topic)","volume":"94 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82324825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Big Tech's unregulated roll-out out of experimental AI poses risks to the achievement of the UN Sustainable Development Goals (SDGs), with particular vulnerability for developing countries. The goal of financial inclusion is threatened by the imperfect and ungoverned design and implementation of AI decision-making software making important financial decisions affecting customers. Automated decision-making algorithms have displayed evidence of bias, lack ethical governance, and limit transparency in the basis for their decisions, causing unfair outcomes and amplify unequal access to finance. Poverty reduction and sustainable development targets are risked by Big Tech's potential exploitation of developing countries by using AI to harvest data and profits. Stakeholder progress toward preventing financial crime and corruption is further threatened by potential misuse of AI. In the light of such risks, Big Tech's unscrupulous history means it cannot be trusted to operate without regulatory oversight. The article proposes effective pre-emptive regulatory options to minimize scenarios of AI damaging the SDGs. It explores internationally accepted principles of AI governance, and argues for their implementation as regulatory requirements governing AI developers and coders, with compliance verified through algorithmic auditing. Furthermore, it argues that AI governance frameworks must require a benefit to the SDGs. The article argues that proactively predicting such problems can enable continued AI innovation through well-designed regulations adhering to international principles. It highlights risks of unregulated AI causing harm to human interests, where a public and regulatory backlash may result in over-regulation that could damage the otherwise beneficial development of AI.
{"title":"Governing Artificial Intelligence to benefit the UN Sustainable Development Goals","authors":"J. Truby","doi":"10.1002/sd.2048","DOIUrl":"https://doi.org/10.1002/sd.2048","url":null,"abstract":"Big Tech's unregulated roll-out out of experimental AI poses risks to the achievement of the UN Sustainable Development Goals (SDGs), with particular vulnerability for developing countries. The goal of financial inclusion is threatened by the imperfect and ungoverned design and implementation of AI decision-making software making important financial decisions affecting customers. Automated decision-making algorithms have displayed evidence of bias, lack ethical governance, and limit transparency in the basis for their decisions, causing unfair outcomes and amplify unequal access to finance. Poverty reduction and sustainable development targets are risked by Big Tech's potential exploitation of developing countries by using AI to harvest data and profits. Stakeholder progress toward preventing financial crime and corruption is further threatened by potential misuse of AI. In the light of such risks, Big Tech's unscrupulous history means it cannot be trusted to operate without regulatory oversight. The article proposes effective pre-emptive regulatory options to minimize scenarios of AI damaging the SDGs. It explores internationally accepted principles of AI governance, and argues for their implementation as regulatory requirements governing AI developers and coders, with compliance verified through algorithmic auditing. Furthermore, it argues that AI governance frameworks must require a benefit to the SDGs. The article argues that proactively predicting such problems can enable continued AI innovation through well-designed regulations adhering to international principles. It highlights risks of unregulated AI causing harm to human interests, where a public and regulatory backlash may result in over-regulation that could damage the otherwise beneficial development of AI.","PeriodicalId":11797,"journal":{"name":"ERN: Regulation (IO) (Topic)","volume":"114 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79924296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of this paper is to analyze the economic impact of telecommunications in the Republic of Guinea. The empirical analysis conducted suggests that the sector generates a significant direct and indirect economic impact, contributing to 6.02% of the country’s 2019 GDP. From a direct effect standpoint, the Guinean telecommunications companies have generated in 2019 US$ 581 million in revenues, which represent 5.04% of the country’s GDP. On the other hand, the sector generates approximately 1,413 direct jobs and 1.03% of total salaries in the Guinean workforce. Beyond the direct effects, the telecommunications industry has indirectly contributed US$ 113 million on average per year to the whole economy since 2010 (0.98% of the 2019 GDP). This contribution is driven by mobile services (voice and data), but does not consider fixed broadband, which has no impact, due to the limited number of subscribers. Sectors mostly impacted by telecommunications were found to be business services (43.04% of the indirect economic impact), financial services (15.81%), trade (12.28%), other services (mainly entertainment, 9.42%), the electricity, gas and water sector (9.25%), and manufacturing industries (5.98%). Given the economic importance of telecommunications, public policies and regulatory frameworks need to be defined to maximize investment in network deployment, particularly in mobile broadband.
{"title":"The Economic Impact of Telecommunications in the Republic of Guinea","authors":"Raul L. Katz, Juan Jung","doi":"10.2139/ssrn.3652571","DOIUrl":"https://doi.org/10.2139/ssrn.3652571","url":null,"abstract":"The purpose of this paper is to analyze the economic impact of telecommunications in the Republic of Guinea. The empirical analysis conducted suggests that the sector generates a significant direct and indirect economic impact, contributing to 6.02% of the country’s 2019 GDP. From a direct effect standpoint, the Guinean telecommunications companies have generated in 2019 US$ 581 million in revenues, which represent 5.04% of the country’s GDP. On the other hand, the sector generates approximately 1,413 direct jobs and 1.03% of total salaries in the Guinean workforce. Beyond the direct effects, the telecommunications industry has indirectly contributed US$ 113 million on average per year to the whole economy since 2010 (0.98% of the 2019 GDP). This contribution is driven by mobile services (voice and data), but does not consider fixed broadband, which has no impact, due to the limited number of subscribers. Sectors mostly impacted by telecommunications were found to be business services (43.04% of the indirect economic impact), financial services (15.81%), trade (12.28%), other services (mainly entertainment, 9.42%), the electricity, gas and water sector (9.25%), and manufacturing industries (5.98%). Given the economic importance of telecommunications, public policies and regulatory frameworks need to be defined to maximize investment in network deployment, particularly in mobile broadband.","PeriodicalId":11797,"journal":{"name":"ERN: Regulation (IO) (Topic)","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75673837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The European Commission (hereinafter “the Commission”) recently released two Inception Impact Assessments (IIA) and public consultations on a possible new competition tool and a possible ex-ante regulation of large online platforms (so-called “gatekeepers”). After the publication of many reports on the topic “competition law in the digital economy”, the Commission is ready to act by adapting its antitrust law and by regulating large digital players before the end of the year (Q4-2020). To regulate or not to regulate is not anymore a Shakespearian issue. A regulation is inevitable. If the why seems obvious the how is still an open question. Should the regulation be symmetric (applicable to all firms equally) or asymmetric (applicable only to large online platforms against objective criteria)? From a law and economics point of view, an ex-ante asymmetric regulation may not only be inefficient but also unfair. Section I provides a brief summary of why a regulation is necessary and section 2 explains why an ex-ante asymmetric regulation is not an efficient and fair solution.
{"title":"Regulation in the Digital Economy. Is Ex-Ante Regulation of 'Gatekeepers' An Efficient and Fair Solution?","authors":"Christophe Carugati","doi":"10.2139/ssrn.3705928","DOIUrl":"https://doi.org/10.2139/ssrn.3705928","url":null,"abstract":"The European Commission (hereinafter “the Commission”) recently released two Inception Impact Assessments (IIA) and public consultations on a possible new competition tool and a possible ex-ante regulation of large online platforms (so-called “gatekeepers”). After the publication of many reports on the topic “competition law in the digital economy”, the Commission is ready to act by adapting its antitrust law and by regulating large digital players before the end of the year (Q4-2020). To regulate or not to regulate is not anymore a Shakespearian issue. A regulation is inevitable. If the why seems obvious the how is still an open question. Should the regulation be symmetric (applicable to all firms equally) or asymmetric (applicable only to large online platforms against objective criteria)? From a law and economics point of view, an ex-ante asymmetric regulation may not only be inefficient but also unfair. Section I provides a brief summary of why a regulation is necessary and section 2 explains why an ex-ante asymmetric regulation is not an efficient and fair solution.","PeriodicalId":11797,"journal":{"name":"ERN: Regulation (IO) (Topic)","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78099818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Because of the limited supply of health care providers relative to the demand for health care services, increases in provider autonomy are believed to improve access to health care by reducing barriers to the provision of certain services. However, research on the impact of scope of practice laws for health and dental professionals is limited. We investigate the effects of regulations governing the practice autonomy of dental hygienists on dental care use and expenditure using the 2001–2014 Medical Expenditure Panel Survey. We measure the strength of autonomy regulations by extending the Dental Hygiene Professional Practice Index to the years 2001–2014, allowing us to capture changes in regulations within states over time. Using a difference-in-differences framework, we find that relaxing supervision requirements to provide dental hygienists greater autonomy results in higher levels of dental care utilization in areas with a shortage of dental care providers. Moreover, expanding dental hygienist autonomy increased the use of many services that dental hygienists perform, such as cleanings, fluoride treatments, sealant applications, and fillings. We also find that greater autonomy reduces costs associated with dental treatment for both individuals and third-party payers.
{"title":"The Effects of Dental Hygienist Autonomy on Dental Care Utilization","authors":"Jie Chen, C. Meyerhoefer, E. Timmons","doi":"10.2139/ssrn.3635762","DOIUrl":"https://doi.org/10.2139/ssrn.3635762","url":null,"abstract":"Because of the limited supply of health care providers relative to the demand for health care services, increases in provider autonomy are believed to improve access to health care by reducing barriers to the provision of certain services. However, research on the impact of scope of practice laws for health and dental professionals is limited. We investigate the effects of regulations governing the practice autonomy of dental hygienists on dental care use and expenditure using the 2001–2014 Medical Expenditure Panel Survey. We measure the strength of autonomy regulations by extending the Dental Hygiene Professional Practice Index to the years 2001–2014, allowing us to capture changes in regulations within states over time. Using a difference-in-differences framework, we find that relaxing supervision requirements to provide dental hygienists greater autonomy results in higher levels of dental care utilization in areas with a shortage of dental care providers. Moreover, expanding dental hygienist autonomy increased the use of many services that dental hygienists perform, such as cleanings, fluoride treatments, sealant applications, and fillings. We also find that greater autonomy reduces costs associated with dental treatment for both individuals and third-party payers.","PeriodicalId":11797,"journal":{"name":"ERN: Regulation (IO) (Topic)","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82374937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：