Interregional Transfers for Pandemic Surges

Background Hospital inpatient and intensive care unit (ICU) bed shortfalls may arise due to regional surges in volume. We sought to determine how interregional transfers could alleviate bed shortfalls during a pandemic. Methods We used estimates of past and projected inpatient and ICU cases of coronavirus disease 2019 (COVID-19) from 4 February 2020 to 1 October 2020. For regions with bed shortfalls (where the number of patients exceeded bed capacity), transfers to the nearest region with unused beds were simulated using an algorithm that minimized total interregional transfer distances across the United States. Model scenarios used a range of predicted COVID-19 volumes (lower, mean, and upper bounds) and non–COVID-19 volumes (20%, 50%, or 80% of baseline hospital volumes). Scenarios were created for each day of data, and worst-case scenarios were created treating all regions’ peak volumes as simultaneous. Mean per-patient transfer distances were calculated by scenario. Results For the worst-case scenarios, national bed shortfalls ranged from 669 to 58 562 inpatient beds and 3208 to 31 190 ICU beds, depending on model volume parameters. Mean transfer distances to alleviate daily bed shortfalls ranged from 23 to 352 miles for inpatient and 28 to 423 miles for ICU patients, depending on volume. Under all worst-case scenarios except the highest-volume ICU scenario, interregional transfers could fully resolve bed shortfalls. To do so, mean transfer distances would be 24 to 405 miles for inpatients and 73 to 476 miles for ICU patients. Conclusions Interregional transfers could mitigate regional bed shortfalls during pandemic hospital surges.

Delegation of Taxation Authority and Multipolicy Commitment in a Decentralized Leadership Model

This article examines to what extent taxation authority should be delegated to local or lower-level government. Delegation of taxation authority can be regarded as a commitment to the local tax rate ex ante in a decentralized leadership model, in which local governments set policies ex ante and the central government decides transfer policies ex post. Previous papers point out that ex post interregional transfers of the central government distort ex ante regional policies of local governments. However, Silva clarify the case where efficient expenditure by local governments is achieved. This article examines the delegation of taxation authority by extending Silva’s model to include commitment to taxation and generally derives the conditions when efficient public expenditure by local governments can be achieved in relation to the delegation of taxation authority. The model adopted in this article allows various levels of spillovers of local public goods and various types of multipolicy commitments of taxation and/or expenditure.

Water and Greenhouse Gas Tradeoffs Associated With a Transition to a Low Carbon Transportation System

Transportation fuels are heavily dominated by the use of petroleum, but concerns over oil depletion (e.g., peak oil), energy security, and greenhouse gas emissions from petroleum combustion are driving the search for alternatives. As we look to shift away from petroleum-based transportation fuels, most options consume and withdraw more water during their life cycle. Thus, shifting to alternative fuel and energy supplies for transportation will likely increase water use for the transportation sector. Previous work suggests that water consumption for transportation could reach 10% of total U.S. water consumption when meeting the Federal Renewable Fuels Standard mandate at modest irrigation levels for feedstock crops (corn, cellulosic grasses) in combination with other alternative fuels and vehicle technologies (electric vehicles, natural gas vehicles, etc.), but more refined analysis is needed. It is important to understand when and where these new water demands for transportation are anticipated to occur. This paper presents results from simulations of the U.S. 9-region (EPAUS9r) MARKAL (MARKet ALlocation) integrated energy systems model for mapping the changes in water withdrawal and consumption during a transition to a low carbon-emitting U.S. transportation fleet. The advantage of using a bottom-up, multi-sector model like MARKAL is the ability to look at consistent scenarios for the full energy system, and endogenously capture interactions between different sectors (e.g. electric power production, biorefineries, and the LDV fleet). MARKAL can simulate a baseline scenario driven by assumptions for biomass feedstock and fossil resource costs and availability, as well as the costs of converting those resources to liquid fuels and electricity. We investigate alternative scenarios both with and without carbon constraints, while varying the pace of vehicle electrification. We compare these scenarios to assess regional differences in water needs as well as aggregate water demand for transportation energy, and how those trade off against greenhouse gas emissions reductions. Our results indicate that the regional water demands and interregional transfers of embodied water could be significant as the light-duty vehicle fleet moves away from petroleum-based fuels, with exports of embodied water on the order of hundreds of billion gallons of water per year for ethanol coming from the Midwest. Interregional transfers of water embodied in electricity may also reach tens of billion gallons of water per year. However, these water requirements will vary substantially based on the light-duty vehicle mix, carbon policy, electric power generation mix, biofuel production levels, and feedstock characteristics.