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san franciscobetriebliche sozialleistungenemployee benefitsevidence sanhealth caresan francisco calif productivity variationvariation inputinput misallocationmisallocation evidenceevidence hospitalscertificate needlabor marketmarket impactemployers reactreact paypay playplay mandatemandate earlyearly evidencemedicare beneficiariesregulated stateslikely receivelow valuevalue imagingvalue carereturn impliesmoney spentallocative efficiencyproductivity changeemployment effectwage level1990 2010health care systemhealth insurancehealth care reformhospitals technologytechnology regulationregulation reconsideredreconsidered effectseffects certificateneed policiespolicies quantityquantity qualityquality diagnosticdiagnostic imagingimaging productivityhospitals hospitalhospital competitioncompetition qualityquality expendituresexpenditures medicaremedicare populationpopulation laborimpact sanfrancisco employeremployer benefitbenefit mandatemandate laborimpact employeremployer healthhealth benefitbenefit mandatesmandates evidencefrancisco healthcare securitysecurity ordinance
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