Policy Bulletin Research Articles

Passports, Prisons, and Every Space Between

In 2016 long-standing activism culminated in the implementation of Bill C-16, which added “gender and gender expression” to the protected classes of the Canadian Human Rights Act. Despite a commitment to consistency across federal policy, wide discrepancies occurred between the changes to the passport and those to the prison. On the one hand, Citizenship Canada announced that “people who do not identify as female (‘F’) or male (‘M’)” could change their passport sex to be an X. On the other hand, the Correctional Service of Canada (CSC) begrudgingly introduced Interim Policy Bulletin 584, which provides accommodation based “on gender identity or expression” within the binary system. Through a comparative analysis, this article queries the enactment of nonbinary recognition between two foundational sites of Canadian federal control: a site of mobility (the passport) and a site of immobility through mass incarceration (the prison). Arguing against expanding prisons or the creation of nonbinary correctional institutions, this article traces the racial geographies that X is both embedded within and enacts, exposing the violence that ushers forth new forms of trans citizenship reliant on anti-Blackness, captivity, and fungibility. Building from these case studies, this article mobilizes the state deployment of gendered expression and determination to nuance theories of gender self-determination. Specifically, this article considers how the theoretical application of the term may dissimulate distinctions in (in)violability, vulnerability, and capacity between and within Blackness and transness.

(218) Emerging Data Regarding Disparities in Insurance Coverage of Male Sexual Health Conditions

Abstract Introduction Medical policy bulletins (also known as clinical policy bulletins) are insurance company guidelines for administering plan benefits. These documents purport to summarize current research, evidence-based guidelines, regulatory status, and physician opinion to determine whether insurers consider procedures and services to be medically necessary. These bulletins, along with member benefit plans, determine which services are covered. We have previously explored the lack of uniformity that exists for insurance payer coverage for penile prostheses. Here, we sought to expand this investigation to determine insurance coverage criteria for medical and surgical management of common men’s health conditions. Objective To determine covered benefits for sexual medicine conditions among the top United States healthcare insurers. Methods A list of common sexual medicine conditions was generated, including Peyronie’s disease, hypogonadism, erectile dysfunction, premature ejaculation, incontinence, and buried penis. The most common treatment modalities for each condition were identified (see Table I). Securities and Exchange Commission (SEC) filings were used to identify the top ten largest private insurers in the United States by member enrollment. This list was cross-referenced with the National Association of Insurance Commissioners (NAIC) 2020 Market Share Report (ref 1). The following list of the largest private US health insurers was thus developed: United, Anthem, Centene, Kaiser, Humana, CVS, Healthcare Service Corporation (HCSC), Cigna, Molina, and Independence Health Group (IBX). Kaiser and Centene were excluded due to lack of nationwide medical policy bulletins. We reviewed medical policy bulletins from the remaining 8 insurers to determine whether the specific treatments were identified as medically necessary, experimental/investigational, or cosmetic. Services and procedures deemed medically necessary were coded as “covered,” and those listed as investigational, or cosmetic were coded as “not covered.” If information about a specific condition or treatment modality was not found in a company’s policy bulletin, it was coded as “unknown.” Results In total, we recorded 143 data points, across the 8 insurance providers. Our review of medical policy bulletins yielded 60 (41.9%) instances where services were considered medically necessary and/or “covered”, 18 (12.6%) non-covered or investigational/cosmetic services, and 65 (45.5%) services with unknown coverage (Table I; covered=1, non-covered=0, unknown=2). Conclusions We encountered substantial difficulty in navigating and interpreting insurance coverage for various sexual medicine treatments and conditions based on review of policy bulletins from the topic insurance providers in the US. There was no readily identifiable coverage information for >45% of the data points that we collected, and instances of “unknown” coverage exceeded covered services across the collective of the largest private insurers. While 76.9% of conditions for which there was available data were covered, we are unable to draw generalizable conclusions for most conditions as there are significant deficits in the availability of policy information from online insurance sources. Further challenges in determining coverage include the additional layers of limitations in member plan benefits (i.e. plan exclusions), which could compound confusion for both physicians and patients. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast.

Отношения между Азербайджанской Демократической Республикой и Францией: к вопросу признания независимости Азербайджана на Парижской мирной конференции 1919—1920 годов

The subject of the article is the relations between Azerbaijan Democratic Republic (ADR) and France during the Paris Peace Conference of 1919-1920. The author reveals the key events of the ADR foreign policy (1918-1920), the first state in the Muslim world with a Republican form of government, and France, which plays a leading role in the world order after the First world war. The methodological basis of the study is a historical and genetic method, which allows to trace the causation and patterns of development of foreign policy of ADR and France in the context of recognition of ADR independence at the Paris Peace Conference. The scientific novelty of the research is to attract new sources not previously introduced into scientific circulation. A special place is occupied by the documents of the head of delegation of ADR at the Paris Peace Conference Ali Mardan Bey Topchibashev, published in 2016 in the collection of documents “Paris archive.” Issues of the French foreign policy Bulletin “Correspondence d’Orient” for 1918, 1919, 1920 are also involved. In Russian science, the topic is practically undisclosed. The study concluded that ADR was able to keep its independence only with the support of Western countries, including France. However, the categorical position of the French government in relation to the ADR contributed to the rapid fall of the newly formed Republic in the East.

Influence of Institutional Guidelines on Oral Hygiene Practices in Intensive Care Units.

Maintaining oral hygiene is a key component of preventing ventilator-associated pneumonia; however, practices are inconsistent. To explore how characteristics of institutional guidelines for oral hygiene influence nurses' oral hygiene practices and perceptions of that practice. Oral hygiene section of a larger survey study on prevention of ventilator-associated pneumonia. Critical care nurses at 8 hospitals in Northern California that had more than 1000 ventilator days in 2009 were recruited to participate in the survey. Twenty-one questions addressed oral hygiene practices and practice perceptions. Descriptive statistics, analysis of variance, and Spearman correlations were used for analyses. A total of 576 critical care nurses (45% response rate) responded to the survey. Three types of institutional oral hygiene guidelines existed: nursing policy, order set, and information bulletin. Nursing policy provided the most detail about the oral hygiene care; however, adherence, awareness, and priority level were higher with order sets (P < .05). The content and method of disseminating these guidelines varied, and nursing practices were affected by these differences. Nurses assessed the oral cavity and used oral swabs more often when those practices were included in institutional guidelines. The content and dissemination method of institutional guidelines on oral hygiene do influence the oral hygiene practices of critical care nurses. Future studies examining how institutional guidelines could best be incorporated into routine workflow are needed.

G292 Are we doing it right? counselling for radiological imaging in non-accidental injury

Aims Children undergoing radiological investigations for child protection are exposed to radiation. Good communication is vital if the child is to be properly and safely investigated. A requirement of obtaining informed consent for these investigations is to understand and be able to explain the risk / benefit of the procedures. We aim to identify how this is carried out nationwide and discuss attitudes and practice around full informed consent in child protection imaging. Methods We carried out an online survey of all paediatric doctors in the UK. The survey was advertised in the RCPCH Wales e-bulletin and the RCPCH Health Policy bulletin. Results From Wales and England, 61 paediatric doctors completed the survey. Of which, 44% of responders were consultants. Consent is taken for radiological imaging by 67%. Verbal consent only is taken by 58%. Only 36% provide information on the radiation exposure caused by the radiological imaging. Despite this, 80% of responders thought it was important to explain the radiation risk of doing such investigations. Conclusion Although paediatricians consider it important to explain the risk/benefit of radiological procedures for child protection imaging, less than half undertake full written informed consent with fewer consenting for specific radiation exposure risks. Is this reluctance to take full informed consent due to a fear of not gaining consent, due to a lack of understanding about radiation doses or not knowing how to present this information to parents/carers? We present information on radiation doses from different radiological images and propose a dose counselling model to help doctors overcome these challenges.

Shocks to the Broadband Ecosystem: Implications for Competition and Market Structure

For decades, economists have encouraged regulators to implement more efficient telephone pricing policies in order to eliminate the pervasive cross-subsidies from usage-based services to basic connections. Slowly, and reluctantly, regulators have moved in this direction. The most recent significant reform was implemented by the Federal In this POLICY BULLETIN, we evaluate the consequences to broadband service providers (“BSPs”) from the tremendous innovation in Internet applications and devices. Our findings reveal that as consumers continue to flock to network agnostic devices and over-the-top services, they are less wedded to any particular broadband service provider. The problem appears particularly acute for mobile wireless networks where much of the innovation is directed. As a result of this “commoditization” of broadband services, network operators are likely to intensify price competition with each other to the benefit of consumers. However, given the high fixed and sunk costs required to build and operate broadband networks, increasing the intensity of price competition could also result in lower profit margins, thus potentially shrinking the equilibrium number of firms that could profitably serve the market. This possible result is of interest for policymakers because it could mean that in an inter-related broadband ecosystem, prices fall even as markets become more concentrated. These complex responses also suggest that if the ecosystem analogy is appropriate for the broadband marketplace, then public policy must contemplate the full and wide-ranging effects of structural changes across the entire ecosystem, particularly if such changes are driven, in part or whole, by regulatory intervention. A disturbance to one part of an ecosystem, whether of natural or of contrived origins, inevitably flows to other parts of the system and may, in some cases, threaten the overall health and sustainability of the broadband sector. Understanding, and perhaps quantifying, the flow of costs and benefits across the ecosystem is essential to sound policymaking.

Outliving its Usefulness: A Law and Economics Argument for Sunset of Section 629

As part of the sweeping Telecommunications Act of 1996, Congress directed the Federal Communications Commission to adopt regulations to promote the commercial availability of cable set-top boxes. To date, the agency’s efforts to implement Section 629 of the Act have been a total failure, despite considerable effort and at least a billion dollars spent. While some continue to encourage the Commission to pursue implementation of this statute by imposing rigid technological standards on the multichannel video industry via the agency’s new “AllVid” paradigm, there is little hope for a successful implementation of such heavy-handed interventions. The video marketplace is presently highly dynamic and increasingly competitive, and the regulatory created retail market envisioned by Section 629 is today an inefficient market organization. Section 629, now fifteen years old, has outlived its usefulness. In this POLICY BULLETIN we set forth what we believe to be sound economic, legal and evidentiary arguments to support a sunset of Section 629 under that section’s unique statutory provisions. Sunset hinges on the definition of “fully competitive,” which we define as a condition where market forces are sufficiently strong to eliminate the need for government regulation. After a review of the evidence using this definition, we find that there is a plausible legal and evidentiary case for sunset.

Regulatory Expenditures, Economic Growth and Jobs: An Empirical Study

With sluggish economy, high unemployment, and unprecedented deficit spending, growing the economy and curbing federal spending are top priorities in Washington. A now-popular target for reform is regulation, which even President Obama claims to have stifled innovation and to have had a chilling effect on growth and In this POLICY BULLETIN, we use fifty years of data and modern econometric methods to provide an estimate of the relationship between government spending on regulatory activity and economic growth and job recovery. We estimate that reducing the size of the regulatory bureaucracy may grow the economy and invigorate the labor market. Even small 5% reduction in the regulatory budget (about $2.8 billion) is estimated to result in about $75 billion in expanded private-sector GDP each year, with an increase in employment by 1.2 million jobs annually. On average, eliminating the job of single regulator grows the American economy by $6.2 million and nearly 100 private sector jobs annually. Conversely, each million dollar increase in the regulatory budget costs the economy 420 private sector jobs. Accordingly, as Congress and the President struggle with the difficult decisions of how to shrink federal spending, an excellent place to start would be to investigate responsible cuts in the size of the federal regulatory budget. That said, while regulation imposes costs, regulation may also have social benefits, and this fact should be considered.

Tinnitus Evaluation and Intervention

You have accessThe ASHA LeaderBottom Line1 Mar 2009Tinnitus Evaluation and Intervention Steven WhitePhD, CCC-A Steven White Google Scholar More articles by this author , PhD, CCC-A https://doi.org/10.1044/leader.BML.14032009.3 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In Audiologists often call ASHA with questions on coding and reimbursement for audiological services involving tinnitus evaluation and intervention. The following Q&A answers the most common questions. Q: Which International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes should be used for tinnitus? ICD-9-CM 2009 codes for tinnitus are 388.30: tinnitus, unspecified; 388.31: subjective tinnitus; and 388.32: objective tinnitus. Q: Which Current Procedural Terminology (CPT)® code should be used for tinnitus assessment? Use CPT code 92625: assessment of tinnitus (includes pitch, loudness matching, and masking). Q: What are these tinnitus assessment components? Pitch (frequency) matching is intended to match the stimulus closest in pitch to the patient’s tinnitus. Loudness matching testing is performed to obtain loudness matches between the audiometric stimulus and the patient’s tinnitus. The masking procedure involves determination of the minimum masking level (MML) and testing for tinnitus suppression (residual inhibition). If only one ear is tested using the tinnitus assessment procedure, the modifier -52 (reduced service) should be applied. This modifier would also be used if only part of the tinnitus assessment battery is performed. Q: Which CPT code should be used when evaluating a client with a tinnitus masker? You can consider using CPT 92590 (hearing aid examination and selection: monaural) or 92591 (hearing aid examination: binaural). Q: How do I code the masker itself? A tinnitus masker could be coded using Level II Health Care Procedure Coding System National Codes (HCPCS), which are required for reporting most medical services and supplies provided to Medicare and Medicaid patients and by most private payers. There is not a code for a tinnitus masker, but V5299 is for hearing service, miscellaneous. HCPCS instructions note that this code should be used only if a more specific code is unavailable. Hearing services fall under V5000–V5999. Q: Can the various interventions used for the treatment of tinnitus be reimbursed? Most third-party payers view tinnitus treatment claims based on the procedure. For example, Aetna’s Clinical Policy Bulletin 0406 states that Aetna considers transcutaneous electrical nerve stimulation (TENS) medically necessary durable medical equipment (DME) for members with severe tinnitus when all of the following criteria are met: “(1) Member has experienced severe tinnitus for more than 6 months, and (2) Medically correctable causes of tinnitus have been ruled out, and (3) Member has tried and failed conservative tinnitus treatments, including counseling and reassurance, dietary modifications, and drug therapy.” Aetna limits coverage to no more than 10 TENS sessions per year “because of a lack of evidence that more frequent TENS treatments provides additional clinically significant benefits for this condition.” Aetna denies coverage for tinnitus instruments, ear canal magnets and electromagnetic stimulation, and tinnitus retraining therapy because they are experimental, investigational, or the effectiveness has not been established. Medicare will cover a tinnitus evaluation performed by an audiologist if the patient is referred by a physician. However, Medicare states in its Coverage Issues Manual that tinnitus masking is considered “an experimental therapy” and does not cover that procedure. Q: Is there no specific CPT code for tinnitus intervention? That’s correct. There is no such code. For tinnitus intervention you can consider using 92507: treatment of speech, language, voice, communication, and/or auditory processing disorder, individual. CPT code 92633: auditory rehabilitation, postlingual hearing loss, does not include tinnitus intervention. Q: Where can I find more information about CPT codes and HCPCS? A good place to start is the ASHA Web page on billing and reimbursement; it includes a specific section on coding. The American Medical Association (AMA) CPT and HCPCS books are available through the AMA Press. The Coders’ Desk Reference, designed for the lay person, is available through Ingenix Companies (800-765-6588). ASHA’s Private Health Plans Handbook also has a list of the CPT codes commonly used by members, and is available through ASHA Product Sales. Author Notes Steven White, PhD, CCC-A, director of health care economics and advocacy, can be reached at [email protected]. Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 14Issue 3March 2009 Get Permissions Add to your Mendeley library History Published in print: Mar 1, 2009 Metrics Current downloads: 2,158 Topicsasha-topicsleader_do_tagasha-article-typesleader-topicsCopyright & Permissions© 2009 American Speech-Language-Hearing AssociationLoading ...

Coding and Reimbursement for Auditory Rehabilitation

Coding and Reimbursement for Auditory Rehabilitation

United States – Anti-Dumping Measures on Oil Country Tubular Goods (OCTG) from Mexico: a legal-economic assessment of sunset reviews

AbstractThis paper reviews the WTO Appellate Body Report on United States – Anti-Dumping Measures on Oil Country Tubular Goods (OCTG) from Mexico (WT/DS282/AB/R 2 November 2005). This dispute concerns the disciplines imposed by the Anti-Dumping Agreement on WTO Members seeking to extend their anti-dumping measures beyond the original five-year period through a so-called sunset review. Our analysis focuses on the Appellate Body's finding in this case that no causation analysis is required in sunset reviews, and addresses the AB's approach towards the legal instrument that provides for the US policy in terms of sunset reviews, the Sunset Policy Bulletin. We conclude that the Anti-Dumping Agreement, as interpreted by the Appellate Body in this and other similar cases, imposes only minimal disciplines of a general nature on Members wishing to extend the anti-dumping measure beyond its original five-year period. We argue that the ‘textual’ argument relied on to support this deferential approach is weak and has resulted in undermining the practical effect of, what was considered to be, one of the major achievements of the Uruguay Round Anti-Dumping Agreement: limiting the life span of an anti-dumping measure to five years. From an economic perspective, Panels and the Appellate Body are simply debating the wrong type of questions. The prospective nature required by a sunset review analysis raises questions such as why exporters engaged in dumping in the first place, and what the conditions of the industry were so that the dumped imports caused injury. At the moment, sunset reviews seem adrift as panels and the Appellate Body fail to give guidance to Members on how to do a more economically sound and informed review.

Abstract of "Ethical Issues When Insurance Companies Falsely Label Certain Surgical Treatments as Experimental and Investigational"

In the area of TMJ reconstructive surgery, there can be major ethical issues in treatment selections, treatment failure rates, and patients and surgeons being given false information by insurance companies. As an example, Aetna, in its Clinical Policy Bulletin #0028, alleges TMJ Implants' devices are experimental and investigational. Subsequently, during an approval process for a TMJ implant operation, they steer their insured away from a successful and proper treatment option, i.e., alloplastic hemiarthroplasty of the TMJ using the Christensen partial joint prosthesis. In their bulletin they suggest they will cover multiple autologous grafts (which have a 69%−90% failure rate) for hemiarthroplasty of this joint. They state that the Christensen devices are experimental and investigational, even though they have been implanted successfully for nearly 50 years. These implants have been used around the United States and some other areas of the world for many years, and a premarket approval process for FDA clearance has been successfully completed. TMJ Implants, Inc. was never placed by FDA in its Experimental and Investigational pre-approval category, usually required as a precondition for final FDA approval, since it was grandfathered in at the passage of the Medical Device Act of May 28, 1976. This then becomes an ethical issue for the patient and the surgeons in being able to have a successful treatment, and even in how the medical device company might overcome such a fraudulent directive.

An Economic Approach for Evaluating a National Wireless Regulatory Framework

In this Policy Bulletin, we provide a focused economic analysis of the welfare effect of state and local regulation on communications services and, in particular, on the wireless segment of the telecommunications industry. We find that when local regulation in one jurisdiction has sufficiently large extra-jurisdictional effects in other locations, overall social welfare can be reduced even if state and local governments act as efficient regulators. This finding is important because it shows that the debate over the proper regulatory framework for the wireless industry need not be driven by an assessment of which set of regulators, federal or state, is more competent. Accordingly, because state and local regulation in the wireless industry has the tendency to spill across borders, our analysis suggests that society is likely better to be off with a single, national regulatory framework for wireless services.

Franchise Fee Revenues after Video Competition: The 'Competition Dividend' for Local Governments

In response to federal efforts to reform the local cable franchise process, state and local governments have argued that proposed legislation will reduce local franchise fee revenues by at least $300 million per year. As demonstrated in this POLICY BULLETIN, however, the introduction of for multichannel video services promises to significantly increase gross industry revenues and therefore could substantially increase local franchise fee collections. Specifically, this POLICY BULLETIN finds that if wireline, local telephone company entry into the multichannel video industry is successful, then gross taxable revenues from the wireline multichannel video industry will increase by an estimated 30%. Commensurately, effective proentry video policies would allow the local franchise fee percentage cap to be lowered (or the revenue base narrowed) significantly without doing any harm to local government franchise collections. This POLICY BULLETIN estimates that a reduction in the franchise fee cap from 5% to 3.7% would be revenue neutral. However, this competition dividend will only occur if wireline entry happens and, therefore, reform of the cumbersome and anticompetitive video franchising process is crucial to ensuring that such entry occurs.

The Efficiency Risk of Network Neutrality Rules

In this Policy Bulletin, we evaluate Network Neutrality proposals from the standpoint of consumer welfare and economic efficiency by presenting a cost/benefit analysis framework for examining the effect on consumers of Network Neutrality proposals that would limit operators from injecting intelligence into broadband Internet access networks. For a Network Neutrality proposal to be justified, the purported benefits of that proposal must exceed the costs, including the inefficiency in network design as well as the risk of increased industry concentration and market power. Publicly available cost studies show that if IP video services increase in popularity, the cost of providing a residential subscriber a network that is video-capable could reach $300 to $400 per month more than an intelligent network, which would certainly put broadband out of the reach of many Americans. We also present a simple model which shows that voluntary investments in network efficiency always improve consumer and social welfare - even if, as some Network Neutrality proponents contend, stupid networks are otherwise preferred by consumers.

A Response to Drs. Hazlett, Havenner and Bazelon

In July 2003, the Phoenix Center released POLICY BULLETIN NO. 5, Competition and Bell Company Investment in Telecommunications Plant: The Effects of UNE-P (July 2003) that evaluated, using a simple economic and econometric model, the short-run relationship between UNE-P and Bell Company investment in telecommunications plant at the state level. For the analysis, data from the Automated Reporting and Management Information System (ARMIS) and other publicly-available data were used. From the results of this econometric analysis, we concluded that UNE-P had a positive and sizeable effect on BOC investment in telecommunications plant, with each UNE-P line increasing on average BOC net investment by about $759.00. Subsequently, two formal responses to the analysis set forth in POLICY BULLETIN NO. 5 were released. On one hand, in a document filed in Verizon's Forbearance Petition (WC Docket No. 03-157), Verizon employed Drs. Thomas Hazlett (the Manhattan Institute), Arthur Havenner (Univ. California - Davis), and Coleman Bazelon (Analysis Group) to comment on the empirical analysis contained in the BULLETIN. Verizon's advocates proposed several modifications to our model, and presented a few alternate specifications. On the other hand, Z-Tel Communications, Inc. asked Dr. Carter Hill (Louisiana State University) to review the declaration of Hazlett, Havenner, and Bazelon as well as provide comments on the econometric model in POLICY BULLETIN NO. 5. Although the Phoenix Center, as a non-profit research institution under Section 501(c)(3) of the U.S. Internal Revenue Code, does not seek to influence the political process by participating as a party in any regulatory proceeding or engaging in lobbying of legislatures, we nonetheless believed it appropriate to respond to the comments of Hazlett, Havenner and Bazelon (HHB I) and to Carter Hill (Hill) in the interest of academic debate. This response was issued as POLICY BULLETIN No. 6, UNE-P Drives Bell Investment: A Synthesis Model (September 2003), where we summarized an extensive effort to evaluate the robustness of the empirical results reported in POLICY BULLETIN NO. 5. While these new specifications represented a synthesis of the modeling preferences of the Phoenix Center and the aforementioned economists, they nonetheless remained true to the neoclassical model of investment and valid econometric practice, to the extent allowed by the data. Despite wide variations in model specification, all our new empirical models confirmed that UNE-P competition a positive relationship between Bell Company investment in local telecommunications plant. As such, our new models affirmed both the results and specification of the empirical models in POLICY BULLETIN NO. 5. Notwithstanding, Verizon again hired Drs. Hazlett, Havenner and Bazelon to file a formal critique of POLICY BULLETIN No. 6 as part of Verizon's comments to the FCC's pending TELRIC proceeding. Again, although the Phoenix Center as a non-profit research institution under Section 501(c)(3) of the U.S. Internal Revenue Code does not seek to influence the political process by participating as a party in any regulatory proceeding or engaging in lobbying of legislatures, we nonetheless believe it appropriate to consider formally the comments of Hazlett, Havenner and Bazelon (now HHB II) as there is always the possibility that critical review, even when adversarial rather than academic in nature, may prove useful in improving our analyses or, in some cases, reveal trivial or substantial flaws that we may have inadvertently committed or overlooked. Moreover, such comments are also useful in providing direction for future research. After review, we believe the additional efforts by Verizon advocates Drs. Thomas Hazlett, Art Havenner, and Coleman Bazelon to discredit the statistical analysis summarized in POLICY BULLETIN NOS. 5 and 6 to be uncompelling. The nature of HHB's criticisms frequently relate to what cannot be estimated (given limited data), rather than what we have or can estimate. Much of their criticism is also directed at a statistical problem for which our models did not suffer (i.e., heteroscedasticity). This line of attack is unpersuasive and, in many cases, irrelevant. As such, we find no reason to alter or change our analysis or interpretation of it as summarized in the POLICY BULLETINS. We leave it to the discerning public, armed with the POLICY BULLETINS and all relevant documents (all made freely available at the Phoenix Center website), to make an educated decision on the validity of the analysis and the criticisms of it. As always, we appreciate the attention (adversarial or not), which signifies the relevance of our work.

A Response to Drs. Crandall and Singer

In October 2003, the Phoenix Center released its POLICY BULLETIN NO. 7 entitled The Positive Effects of Competition on Employment in the Telecommunications Industry. This Bulletin included an analysis of employment trends in the telecommunications industry before and after the 1996 Telecommunications Act. A number of figures and statistical tests revealed that employment in the wireline telecommunications sector grew substantially, and almost immediately, after the 1996 Act. BellSouth hired Robert W. Crandall and Hal J. Singer (Criterion Economics) to respond to POLICY BULLETIN NO. 7 in their paper An Accurate Scorecard of the Telecommunications Act of 1996: Rejoinder to the Phoenix Center Study No. 7 (January 2004) (hereinafter the Rejoinder). The authors claim that the analysis presented in Figure 1 of Policy Bulletin No. 7 was flawed (at 1). Although the majority of the Rejoinder does not go to the merits of Policy Bulletin No. 7, but is instead a polemic against the Federal Communications Commission's unbundling policies of the last eight years, in an effort to ensure the accuracy and legitimacy of all analysis performed and released by the Phoenix Center, we have evaluated carefully the Rejoinder to see if the document contains any legitimate criticisms or offers any material improvements to the analysis in Policy Bulletin No. 7. After review, we find that by incorporating the Rejoinder's plausibly legitimate suggestions into our empirical analysis in a theoretically appropriate manner does not materially alter the estimated employment effects summarized in Policy Bulletin No. 7. We also find that the methods used in Policy Bulletin No. 7 are preferred, in a statistical sense, to those proposed in the Rejoinder. Second, we were somewhat surprised the number of factual inaccuracies and logical inconsistencies in the Rejoinder, and some of these are listed in Section III. Finally in Section IV, although completely unrelated to anything contained in Policy Bulletin No. 7, we discuss Crandall's and Singer's contention that a UNE-Loop entry strategy is a non sustainable business plan (at 13). We do so because based on the arguments in the Rejoinder related to investment and cash flow, Crandall's and Singer's analysis appears to call for policies aimed at increasing the availability of UNE-P while reducing the opportunities for UNE-L and facilities-based entry (the latter, according to Crandall and Singer, includes only entry that replicates the local loop in some way).

Fixed-Mobile 'Intermodal' Competition in Telecommunications: Fact or Fiction?

The purpose of this Policy Bulletin is to determine whether wireline and wireless telephone services are close enough substitutes to be effective intermodal competitors. Using the standard tools of antitrust economics, this Policy Bulletin presents evidence indicating that wireless is not an effective intermodal competitor to wireline telephone service - at least to the extent that wireless offers a meaningful constraint on the market power of a wireline monopoly. The lack of effective intermodal competition between fixed and wireless telephony suggests that efforts to promote intramodal competition (e.g., unbundling mandates) remain necessary because consumer savings in wireline telephony since the passage of the Telecommunications Act of 1996 - which are estimated to exceed $10 billion annually - are likely the result of intramodal competition between wireline carriers.

Federalism in Telecommunications Regulation: Effectiveness and Accuracy of State Commission Implementation of TELRIC in Local Telecoms Markets

This Policy Bulletin makes use of regression analysis to demonstrate that differences in UNE-P prices both across States and within States are due to genuine cost differences and differences in TELRIC, and are not because of regulatory failure by the States. These findings confirm an obvious principle of Federalism: the States are clearly in a much better position than bureaucrats in Washington to ensure that any government intervention in the market has a true nexus to those consumers and businesses directly affected by such regulation. The analysis also shows that over time unbundled loop prices are converging to TELRIC and not to some other cost standard. Thus, findings presented in this Policy Bulletin show clearly that the States are well qualified to implement the FCC's TELRIC rules and have done so with accuracy.

The $10 Billion Benefit of Unbundling: Consumer Surplus Gains from Competitive Pricing Innovations

This Policy Bulletin measures the gains to consumer welfare of the new all distance/all you can eat competition produced by the market-opening provisions of the Telecommunications Act of 1996. Analysis reveals that the consumer welfare gain amounts to approximately $10 billion per year, and those American households that have switched to these all-distance plans are, on average, saving approximately $429 every year - more than a dollar a day. As such, great care must be taken to ensure that policymakers stand by the pro-competitive bargain codified by the 1996 Act (i.e., Bell company long distance entry in exchange for unbundling the last mile).