In the course of the liberalization of European energy markets, the German government opted-diverging from all other European countries-for Negotiated Third-Party Access. In this article we analyze if, theoretically, this institutional regime can be superior to regulation. We review empirically whether certain aspects of the actual implementation, in particular publication of the network access charges for each network supplier, facilitated or inhibited competition. In the first place we reconsider previous research, showing that NTPA can-under certain conditions-be economically effective. Our empirical analysis shows that the duty of publishing access charges supported market transparency and imposed a regulatory threat, particularly to suppliers with significantly aboveaverage charges. On the other hand observable price adjustments over time serve as an indicator of tacit collusion. Although the expensive suppliers cut their prices, the cheaper ones raised theirs.

The biceps femoris has a long and a short head. The proximal long head is inserted at the tuber ischiadicum and the short head at the linea aspera. Distal it inserts at the lateral side of the head of the fibula. It helps in the extension, external rotation of the hip, and flexion of the knee. 1 A rupture of the distal insertion of this muscle is a very rare injury. In the literature, we were only able to find some disparate case reports. 2-5 Thus, it is in our interest to report this case. Case PresentationA 65-year-old man as he was moving a carpet had stretched his right leg and felt a stabbing pain in the laterodorsal distal tight. He could walk but felt instability in the knee. In the clinical exam, there was a depression in regard to the dorsolateral lateral epicondylus. A strength of two-fifth of the flexion of the knee was also there. There was no intraarticular swelling, no meniscus pathology, no pathological drawer, and the collateral ligaments were stable. An ultrasound was performed but due to the intramuscular hematoma, it was not possible to identify the injury. Therefore, a magnetic resonance imaging (MRI) was performed.On the MRI (►Fig. 1), we could follow cranially the distal biceps femoris during 3 cm before a complete rupture of the tendon around the knee. There is a 6-cm dehiscence and tendon retraction with an extended hematoma. The other structures of the knee were intact. With this pathology and the strength deficit, we decided to repair the tendon. After suture with FiberWire of the tendon, we were able to totally stretch the knee with the hip a 0-degree flexion (►Figs. 2 and 3). Postoperatively, we limited the knee extension to 30 degrees with a free flexion in a splint for 6 weeks and with only a 20 kg weight bearing. OutcomeThe patient did not follow the 20 kg weight bearing. After 6 weeks, the patient was able to walk again without limitation or instability. The tendon was difficult to palpate as there was a persistence of a swelling in the operative site. DiscussionAn isolated rupture of the biceps femoris is extremely rare. It is often associated with complex injury of the knee or injury of the posterolateral capsular ligament complex. 6 Most of the hamstring injury are proximal or in muscle belly. 7 Other isolated distal hamstring injury such as the semimembranosus is even more rare. This can be explained as the biceps femoris is the strongest flexor muscle, biomechanical study measured a 75% loss of strength of the knee flexion by resection of the muscle. 5 With these elements, we could conclude that an operative treatment is the best solution, but as stated previously, there are very few studies about this injury, not enough to have a consensus. There are also studies of a conservative treatment which can lead to full recovery. 5 Kusma et al 8 tried to summarize the outcome of nine case reports, where only one study was treated conservatively. The conservative case had a Keywords ► biceps femoris knee joint ► rupture ► suture AbstractIsolated biceps femoris rupture is a rare inju...

Recent healthcare reforms have sought to increase efficiency by introducing managed care (MC) while respecting consumer preferences by admitting choice between MC and conventional care. This article proposes an institutional change designed to let German consumers choose between the two settings through directing payments from the Federal Health Fund to social health insurers (SHIs) or to specialized MC organizations (MCOs). To gauge the chance of success of this reform, a game involving a SHI, a MCO, and a representative insured (RI) is analyzed. In a “three-player/three-cake” game the coalitions {SHI, MCO}, {MCO, RI}, and {SHI, RI} can form. Players’ possibility to switch between coalitions creates new outside options, causing the conventional bilateral Nash bargaining solution to be replaced by the so-called von Neumann-Morgenstern triple. These triples are compared to the status quo (where the RI has no threat potential) and related to institutional conditions characterizing Germany, the Netherlands, and Switzerland.

ZusammenfassungAn die Zulassung der SARS-CoV-2-Impfstoffe knüpft sich die Hoffnung, die Pandemie schnellstmöglich überwinden zu können. Befragungen zeigen jedoch eine begrenzte Impfbereitschaft, die für eine Herdenimmunität eventuell nicht ausreicht. Im vorliegenden Beitrag wird spieltheoretisch untersucht, wie die einzelne Impfentscheidung im Hinblick auf das Impfverhalten der anderen ausfällt. Es zeigt sich, dass sich impfen zu lassen keine dominate Strategie ist. Die Wahrscheinlichkeit sich impfen zu lassen, nimmt jedoch mit den langfristigen Kosten der Pandemie zu. Demnach könnte die Impfbereitschaft erhöht werden, wenn die Politik stärker über die Folgekosten aufklären würde. Dann könnte eine Impfpflicht vermieden werden.

Gasoline prices in Germany fluctuate significantly within one day. Price ranges of 15 euro cent per day are not uncommon. Consumers therefore often perceive that market power is exercised in the retail fuel market. Especially high surcharges in the late evening are considered to be price gouging. The German Federal Cartel Authority used these price mark-ups as evidence for oligopoly market power in four metropolitan regions between 2007 and 2010. Data for eight metropolises and 65 medium-sized cities from May 2016 to June 2019 show that the lowest price level in the day is reached in the early evening and then rises sharply. We use the well-known Lerner Index to measure market power in these evening hours. Our descriptive analysis shows that the Lerner Indices of the premium brands Aral, Shell, and Total S.A. rise after 10 p.m., that is, after a large part of the price-aggressive gas stations have closed. The results were about 0.1 for diesel and 0.08 for gasoline. Other companies achieve lower values of 0.05–0.07. Compared to other international studies that deal with the fuel market, we find a similar level of Lerner Indices, but only for few hours and not for the whole day. Multivariate estimations cannot show that a larger market share of the analyzed brand or a lower market share of price-aggressive firms increases the index. Influences of weekdays, different cities or wholesale prices cannot be proven either. Therefore, the gasoline market seems to be competitive, at least in a higher dimension as it is publicly perceived. Hence, pricing behavior in the evening and at night cannot be used as evidence of a serious abuse of market power by petrol stations, which could be relevant for the evaluation of future mergers in the petrol market.