Abstract
In a healthcare industry with capacity constraints, the best healthcare providers are often congested after quality information disclosure. This congestion can lead to the reallocation of urgent patients to low-quality healthcare providers. The reallocation can have a detrimental impact on the overall patient survival rate if sicker patients benefit more from the best providers. This paper provides the first empirical evidence regarding this problem in the context of the publication of cardiac surgery report cards. I find that these report cards can have a negative impact on positive assortative matching between patients and surgeons because of a reallocation of high-risk patients to low-quality surgeons. Despite the quality improvement in response to these report cards, such patient reallocation can still be a problem, conditional on the improved quality, and, thus, should not be ignored.
Abstract
We examine how local newspaper closures affect public finance outcomes for local governments. Following a newspaper closure, municipal borrowing costs increase by 5 to 11 basis points, costing the municipality an additional $650 thousand per issue. This effect is causal and not driven by underlying economic conditions. The loss of government monitoring resulting from a closure is associated with higher government wages and deficits, and increased likelihoods of costly advance refundings and negotiated sales. Overall, our results indicate that local newspapers hold their governments accountable, keeping municipal borrowing costs low and ultimately saving local taxpayers money.