Hospitals face serious financial challenges in the current healthcare marketplace. In response to these challenges, they may alter their service offerings, eliminating services that are perceived as money-losing or adding new services in areas where profitability is expected to be greater. Although research has examined hospital closures, the more subtle phenomenon of hospital service changes has not been systematically studied. This issue is important because different types of hospital service changes could have different effects on hospital financial viability: extensive service closures could contribute to a downward spiral leading to hospital closure, whereas adding new services might help improve a hospital's finances. This article' examines changes in hospital service availability in California general acute care hospitals between 1995 and 2002. Our major findings indicate that many California hospitals made changes in their service offerings during the study period, although few made extensive changes. Altogether, about half of the hospitals in our study population either closed or opened at least one service. Nearly one-fourth of the hospitals in our study population closed one or more services, whereas just under one-third opened one or more new services. However, the vast majority of the hospitals that closed or added a service made only one or two such changes. In addition, few hospitals both closed and opened services. The service closed most frequently was normal newborn labor and delivery (obstetrics), whereas inpatient rehabilitation was the most frequently opened service. Hospitals that made the most service changes tended to be small, rural, and financially troubled at the start of the study period. Among this group of hospitals, service closures were associated with continued financial deterioration, whereas new service openings were associated with improvements in key financial ratios.

This chapter explains the economic conception of water -how economists think about
water. It consists of two main sections. First, it reviews the economic concept of value, explains how it is
measured, and discusses how this has been applied to water in various ways. Then it considers the debate
regarding whether or not water can, or should, be treatetl as an economic commodity, and discusses the
ways in which water is the same as, or different than, other commodities from an economic point of view.
While there are some distinctive emotive and symbolic features of water, there are also some distinctive
economic features that make the demand and supply of water different and more complex than that of
most other goods.

In her opinion in Grutter v. Bollinger, Justice Sandra Day O’Connor concluded that affirmative action in college admissions is justifiable, but not in perpetuity: “We expect that 25 years from now, the use of racial preferences will no longer be necessary to further the interest [in student body diversity] approved today.”

The rate at which racial gaps in precollegiate academic achievement can plausibly be expected to erode is a matter of considerable uncertainty. In this essay, we attempt to evaluate the plausibility of Justice O’Connor’s conjecture by projecting the racial composition of the 2025 elite college applicant pool. Our projections extrapolate past trends on two important margins: Gaps between the economic resources of black and white students’ families, and narrowing of test score gaps between black and white students with similar family incomes. Just as the last decades have seen considerable narrowing of gaps on each margin, further progress can be expected over the next quarter century.
Our central question is whether this progress will plausibly be fast enough to validate Justice O’Connor’s prediction. We are well aware of the hazards inherent in our exercise: No such distant projections can be definitive. Nevertheless, by relying on reasonable historical assumptions that are arguably optimistic, we develop a baseline case for assessing the likelihood of O’Connor’s forecast.

We conclude that under reasonable assumptions, African American students will continue to be substantially underrepresented among the most qualified college applicants for the foreseeable future. The magnitude of the underrepresentation is likely to shrink—in our most optimistic simulation, somewhat over half of the gap that would be opened by the elimination of race preferences will be closed by the projected improvement in black achievement.

Still, it seems unlikely that today’s level of racial diversity will be achievable without some form of continuing affirmative action. If the Supreme Court follows through with O’Connor’s stated intention to ban affirmative action in 25 years, and if colleges do not adjust in other ways (such as reducing the importance of numerical qualifications to admissions), we project substantial declines in the representation of African Americans among admitted students at selective institutions.

Our analysis proceeds from the assumption that the most likely future course will resemble past trends. Substantial changes in educational policy, in school effectiveness, and in income inequality would all have important effects on black test score distributions and on the admissions landscape.

The University of California is the nation’s largest and most prestigious public research institution. As such, we have an opportunity and a responsibility to assume a leadership role in an emerging national movement within higher education, translating our identity as a land grant institution into 21st century terms.

On June 10, 2005, over 70 faculty, students, and administrators, representing all 10 University of California campuses as well as the Office of the President, met to discuss this timely and significant topic. This meeting provided an opportunity to examine current civic engagement activities and strategies to deepen and broaden efforts in this area as well as to explore the leadership role our system might provide. The consensus of the group was that the UC is poised to assume a leadership role in a national movement that seeks to better integrate knowledge production through engaged scholarship with clear and critical public purposes.

The New Flagship University provides an expansive vision for leading national universities and an alternative narrative to global rankings and World Class Universities that dominate the attention of many universities, as well as government ministries. The New Flagship model explores pathways for universities to re-shape their missions and academic cultures, and to pursue organizational features intended to expand their relevancy in the societies that give them life and purpose. In this quest, international standards of excellence focused largely on research productivity are not ignored, but are framed as only one goal towards supporting a university's productivity and larger social purpose—not as an end unto itself. Chapters by contributing authors detail the historical and contemporary role of leading national university in Asia, South America, Russia, and Scandinavia, and consider how the New Flagship model might be applied and expanded on. 

It has been nearly forty years since Clark Kerr was asked to create and lead the Carnegie Commission on Higher Education under the auspices of the Carnegie Corporation. The Commission was to be a national effort, unprecedented both in scope and in the freedom of its director, Kerr, to guide its research and productivity. Carnegie President Alan Pifer promised substantial funding for five years or more. Working with Pifer, and with Alden Dunham, David Robinson, and others, Kerr initiated a great array of studies and provide recommendations on the most vital issues facing American higher education in the latter part of the twentieth century. This essay reviews the origins of the Commission, its successor organization, the Carnegie Council, and the influence of a number of major reports. The essay also notes the need to revisit the work of the commission and council as a source of ideas relevant today, and suggests that there is a need for a greater national approach to supporting US higher education.

Fees will become an increasingly important funding source for public universities in the UK and throughout the OECD, caused in part by declining government subsidization and rising costs, as well as by an increasingly entrepreneurial drive by institutions themselves to increase revenues. Beginning in September 2006, universities and Further Education colleges in England and Wales will charge variable fees within limits set by a defined cap and by ministry demands for increases in institutional aid for lower income students. This essay chronicles the response of England’s universities. Not surprisingly, most will charge the maximum amount allowed; at the same time, levels of bursaries (financial aid) will vary between institutions. The response and plans of English universities, and the subsequent response of both the market and students, will likely have a significant influence on other OECD nations, particularly those in the European Union, as they gradually consider a similar variable fee scheme.