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L’industrie pharmaceutique est un secteur dynamique à fort coefficient de recherche, obéissant à tout un réseau de réglementations destinées à a) promouvoir la recherche et l’innovation au stade de la conception et de la production des médicaments, b) protéger les consommateurs des effets potentiellement dommageables des médicaments, et c) limiter les dépenses publiques et privées consacrées aux produits pharmaceutiques. Ces objectifs sont parfois conflictuels et peuvent exiger un rééquilibrage des intérêts des producteurs et des consommateurs. Dans la mesure où ils bénéficient en grande majorité d’une forme ou d’une autre d’assurance-maladie, les consommateurs ne sont guère incités à réduire leurs achats de produits pharmaceutiques ou à se les procurer chez le pharmacien pratiquant les meilleurs prix. Les organismes d’assurance-maladie cherchent à maîtriser les dépenses pharmaceutiques de diverses manières, notamment en laissant une partie des frais à la charge de l’assuré, en dressant des listes de médicaments approuvés et en fixant des plafonds de remboursement pour les différents médicaments. Si les niveaux de rémunération des pharmaciens sont fixés au plan national ou régional, l’ouverture de nouvelles officines est excessivement encouragée dans certains endroits, ce qui conduit généralement à des restrictions à l’entrée du marché. Une réforme bien pensée de ce secteur pourrait permettre de réduire les dépenses pharmaceutiques tout en maintenant la qualité des médicaments consommés.
In Italy, as well as in other Southern European countries, low labor market participation rates of married women are observed together with low birth rates. Our proposed explanation for this apparent anomaly involves the Italian institutional structure, particularly as reflected in rigidities and imperfections in the labor market and characteristics of the publicly-funded child care system. These rigidities tend to simultaneously increase the costs of having children and to discourage the labor market participation of married women.
We analyze a model of labor supply and fertility, using panel data from the Bank of Italy which have been merged with regional data describing the available opportunities in each sample household’s environment. The empirical results show that the availability of child care and part time work increase both the probability of working and having a child. Policies which would provide more flexible working hours choices and greater child care availability ...
In some ways, the Russian telecommunications industry is a paradox. Parts of the industry are highly competitive – the number of operators in this market is in the thousands – but the existing regulatory regime is weak, particularly in ensuring access to essential facilities, and the longdistance market is dominated by the company Rostelecom. In spring 2001, experts from OECD countries met with senior Russian officials to discuss their experiences with regulatory reform in telecommunications. The issues discussed include tariff reform, promoting universal service and ensuring access to non-competitive services. Traditionally, in Russia, prices for local fixed telephone service have been held very low, leading to a shortage of supply and significant cross-subsidies from long-distance services. The cross-subsidies from long-distance services are being eroded by new entry, leaving local operators unable to expand the network to meet demand. As in other Russian industries, tariff rebalancing is essential, while putting in place programmes to ensure access to telecommunications services in remoter areas. Competition could be deepened and broadened through a stronger and more effective system of access to the remaining non-competitive services such as local loops.
Since its creation in 1993, the Czech Republic has experienced a period of broad and deep changes to the legal structure and institutional frameworks that were necessary to ensure transition to a market economy. This chapter focuses on energy (gas and electricity) and transportation (road and rail freight) sectors, which are important in final consumption expenditure, and as inputs to other sectors, impact on overall economic competitiveness. Substantial progresses have been made over the past decade, the regulatory environment has been liberalised and some competition emerged. Reform, however, remains incomplete with the state still significantly involved in these sectors. Also, improvements are needed in the regulatory framework to build market confidence by improving clarity and transparency in the regulatory process. It is expected that prospects for Czech accession to the EU will encourage the authorities to establish such a framework in accordance with the relevant EU directives.
The pharmaceutical sector is a dynamic, research-intensive industry that is fundamentally influenced by a web of regulations designed to a) promote research and innovation in the design and production of drugs, b) protect consumers from potentially harmful effects of drugs, and c) to control public and private expenditure on drugs. These objectives are sometimes in conflict and may require a balancing of the interests of producers and consumers. Since most consumers have some form of health insurance, their incentives to control their purchasers of pharmaceuticals or to purchase from the most efficient pharmacist are limited. Health insurers seek to control pharmaceutial expenditure through various policies such as co-payments, lists of approved drugs and maximum reimbursement levels for different drugs. If reimbursement levels for pharmacists are set at a national or regional level, incentives for entry by new pharmacists are excessive in certain locations, typically leading to restrictions on the establishment of new pharmacies. Wellthought out reform of this industry has the potential to reduce pharmaceutical expenditures while maintaining the quality of the drugs consumed.
This paper analyses the postponement of first births of the 1990s compared to the 1980s, using panel data from four countries, namely, Germany (GSOEP), Great Britain (BHPS), the Netherlands (OSA) and Sweden (HUS). We find substantial postponement of maternity in all four countries for all educational groups with the most pronounced postponement among highly educated women in all four countries. However the mean age of the mother when giving birth to the first child reamained the lowest in Great among the four countries in both decades.
Theoretically we can distinguish two motives for postponing maternity, namely, the consumptionsmoothing motive and the career-planning motive. In this paper we concentrate on an important determinant of the maternal time costs: the time spent out of paid employment.
We make use of longitudinal information about the number of months elapsed since first birth until the mother is observed working in the labour market. We estimate parametric duration ...
Public spending is very high in Norway, partly reflecting an extensive coverage of the welfare system and ambitious regional development objectives. Moreover, several institutional features contribute to dampening the cost-effectiveness of many public-spending programmes. Abundant oil revenues have so far mitigated strains on public finance. However, coping with the depletion of oil resources and the fiscal consequences of ageing would require to increase the cost-effectiveness of many public spending programmes, while leaving some room to cut the high tax-to-GDP ratio. This paper identifies the main sources of inefficiencies and suggests policy options. These include: supplementing the existing deficit rule by an expenditure rule; increasing flexibility in public sector wages and job tenure; reforming the funding system of local governments; raising the contestability of public service provision; intensifying the use of price signals and improving incentives to reduce the ...
The paper attempts to explain why single factor explanations of the poverty of nations are usually found to be unsatisfactory. Middle- and low-income countries excluding sub-Saharan Africa, for instance, have an income per head which stands at about one third of the rich countries’ income per head. Yet each of the three items of the Solow model, namely human capital, physical capital (appropriated weighted) and total factor productivity, are each equal to about 70 per cent of the corresponding levels of rich countries. But 70 per cent to the power of three is 35 per cent! Multiplying small or relatively benign handicaps can yield dramatic effects on a country’s income. The paper then moves on to explain each of the three items. It argues that the Lucas paradox on why capital is scarce can readily be solved, once market prices rather than PPP prices are used to assess the return to capital mobility, and on the same ground it argues that PPP calculations bias downwards the TFP of ...
Latin American sovereign bonds represent a significant share of the emerging debt class (50 per cent by early 2001) and so have considerably shaped the dynamics of this market. Recent financial turmoil, contagion episodes and investors’ renewed concerns with debt default call for a better understanding of sovereign bond pricing (spreads) and its determinants, either macro fundamentals, contagion or other external variables. This paper addresses two important questions not fully tackled in the existing literature: i) to what extent do permanent or transitory changes in fundamentals affect sovereign risk perception, i.e. default risk, once contagion is controlled for? ii) how can a relatively high and volatile spread be the cause of unsustainable public debt accumulation? In order to answer these questions, we estimate long-term structural equations to pin down country risk determinants for Argentina, Chile and Mexico, using a time series framework spanning 1994-2000. Unlike former ...
This paper investigates the consequences of Basel II for international capital flows to emerging markets. The paper shows that the magnitude of effects critically depends on a number of assumptions, including: the mapping of risk weights to ratings, assumptions about required return on capital, assumptions about competition and diversion effects and the assumption that minimum capital requirements are binding constraints. The paper provides evidence on each of these assumptions and estimates their effect on interest margins and bank flows. Overall the results suggest that Basel II — taking into account the “Potential Modifications” of November 2001 — will have only a moderate impact on international capital flows ...
The debate about whether fixed or flexible exchange-rate regimes are better suited to guaranteeing stability has received added stimulus from the macroeconomic crisis in Argentina. This paper argues that it is misleading solely to concentrate on exchange-rate policy to assess the preconditions for stability in an international surrounding. Instead, the exchange-rate regime and the institutional setting have to be compatible to increase the former’s credibility and to contribute to stability. This hypothesis is empirically tested for Latin American countries.
The exchange-rate regime and the institutional setting are linked to form an ex ante proxy for the credibility of the exchange-rate arrangement. We specify the exchange-rate regimes and institutions in Latin America from 1975 to the late 1990s prior to an empirical assessment of the hypothesis. Finally, the Argentine case is discussed specifically. Policy conclusions round off the paper ...
These technical opinion papers represent the consensus of risk analysts and experts in NEA Member countries on the current state of the art in Fire Probabilistic Safety Assessment (PSA) for nuclear power plant design and operation and Seismic PSA for nuclear facilities. The objective is to present clear technical opinions to decision makers in the nuclear community. As such, the intended audience is primarily nuclear safety regulators, senior researchers and industry leaders. Government authorities, nuclear power plant operators and the general public may also be interested.
Also included: Seismic Probabilistic Safety Assessment for Nuclear Facilities (No. 2)