Eye of the Beholder: Participation and Impact in Telecommunication Deregulation

Note from the Digital Editor: In order to highlight the high-level of research and scholarship from the authors who have published in the William & Mary Policy Review’s peer-reviewed print journal, we have reproduced the abstracts from Volume 6, Issue 2 along with a link to an electronic copy of the full form of the piece.

The California Public Utilities Commission (CPUC) addressed both pricing deregulation and universal service in telecommunications during the last decade. Both decisions had a similar cast of characters and similarly elaborate processes. In relation to price deregulation, the utilities’ positions were accepted on every issue addressed; in relation to universal service, consumer organizations’ positions were accepted in about 60 percent of the issues. This article tells the story of how those decisions were made and examines the reasons for the difference in impact. The article examines and rejects an explanation of capture, accepts in part a focus on the influence of the commissioner in charge of the decision, and suggests that the most important factor in determining impact was the perceptions and expectations of CPUC commissioners and staff. This reminds us of the importance of agency personal and their profound impact on regulatory results.

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Professor Dorit Rubinstein Reiss is an Associate Professor at the University of California’s Hastings College of Law. 

A Discussion of the ACA’s Provider Mergers and Hospital Pricing

Note from the Digital Editor: In order to highlight the high-level of research and scholarship from the authors who have published in the William & Mary Policy Review’s peer-reviewed print journal, we have reproduced the abstracts from Volume 6, Issue 2 along with a link to an electronic copy of the full form of the piece. 

In her article “The ACA, Provider Mergers and Hospital Pricing: Experimenting with Lower Cost Health Insurance Options,” Professor Susan Channick of the California Western School of Law explores whether the Affordable Care Act (ACA) and a rise in health provider mergers have led to an increase in prices in the commercial health insurance market. The timeliness and importance of this topic led the editorial board of the William & Mary Policy Review to organize a panel that brought together experts in health care policy. They discussed the landscape of health care policy in the United States following the implementation of the ACA, as well as the pricing issues raised by Professor Channick in her article. The panel featured two speakers: Dr. Jennifer M. Mellor, Professor of Economics and Director of the Schroeder Center for Health Policy at the College of William & Mary and Ms. Claire Winiarek, the Disability Policy Engagement Director at Anthem, Inc. Both speakers agreed to offer comments on the article, which are included below. Following their comments, select questions from the symposium were included in a verbatim transcription. The Policy Review hopes this panel will contribute to ongoing conversation about changes in the field of health policy. We would like to thank Professor Channick for her inspiring article, Dr. Mellor and Ms. Winiarek for their participation on the panel, and the Public Policy Program at the College of William & Mary for its support. All views expressed in these comments are those of the respective individual, and do not necessarily represent the opinion of the Policy Review or the College of William & Mary Public Policy Program.

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The ACA, Provider Mergers and Hospital Pricing

Note from the Digital Editor: In order to highlight the high-level of research and scholarship from the authors who have published in the William & Mary Policy Review’s peer-reviewed print journal, we have reproduced the abstracts from Volume 6, Issue 2 along with a link to an electronic copy of the full form of the piece.

This paper addresses the issue of whether the recent significant uptick in provider mergers and the implementation of the Affordable Care Act have a particularly adverse effect on provider pricing in the commercial insurance market. Uncompetitive provider markets exacerbate already existing high cost issues such as lack of transparency in provider pricing, patient behavior that conflates reputation and quality, and payers’ inability, or at least reluctance, to exclude high-price providers from their networks. The ACA’s incentives for providers to coordinate patient care and hospitals’ revenue losses from reductions in Medicare reimbursement create further rationales for consolidation. The burden of finding solutions to high non-transparent provider pricing is on all stakeholders who should be experimenting in earnest with remedies for the harms that high health care costs create for patients. But no stakeholders have more incentive to find solutions than those who ultimately pay for health care: the insurers, the employers, governments and individuals. The recent literature is replete with payer experiments in insurance design that are intended to provide smart, lower-cost options for consumers and may influence provider behavior as well. More experimentation with remedial measures is warranted and appears to be ongoing even among providers who also see the proverbial handwriting on the wall. The ACA promises health care security by creating near- universal, affordable, adequate health care. The work continues to achieve these goals.

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Susan Adler Channick is a Professor at California Western School of Law. 

Defectors and the Moral Hazard Problem

Note from the Digital Editor: In order to highlight the high-level of research and scholarship from the authors who have published in the William & Mary Policy Review’s peer-reviewed print journal, we have reproduced the abstracts from Volume 6, Issue 2 along with a link to an electronic copy of the full form of the piece. 

In the case of the decision to go to war with Iraq in 2003, indications of pluralist democracy were robust with interest group advocacy and with defectors providing sourcing for Iraq’s alleged weapon breaches. Defector claims flowed directly to the media, the Executive Branch, and the American Intelligence Community. To assess the rational choices of the Executive and defectors regarding the information flow, the hypothesis asserted in this article is that defectors would likely provide knowingly accurate data and information of uncertain validity to a potential attacking state when the personal, professional, and altruistic interests of defectors (in the event of an invasion) plus the probability that the target possesses illegal weapon programs multiplied by the security benefit, exceed the probability that prohibited weapons are not possessed multiplied by the anticipated cost imposed on defectors for furnishing untrue accounts.

The Executive would likely construe individual defector accounts with credibility when there is a higher aggregate likelihood that a target state has breached weapon proscriptions and when defectors perceive that a potential cost will be sufficiently high to overcome the moral hazard problem. With respect to majoritarian democracy norms, if the Executive-agent objectively perceives that defectors will contribute accurate information about weapons, the public-principal’s utility is heightened awareness of a security threat and more informed assent, but if data are inaccurate, the public may become less informed and be more likely to support a less rational policy with lower utility. However, the facts suggest that in the case of the Iraq War, one might consider relaxing assumptions of a non-cooperative interaction between the Bush Administration and defectors and assume that both actors held the same policy goals of going to war from the beginning or even that the Bush Administration used defectors for its own predetermined policy choices.

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Robert Bejesky has taught international law courses for the Department of Political Science at the University of Michigan. He holds Masters degrees in Political Science, Applied Economics and International Law.