BEYOND GUNS AND BUTTER: Finnish Central Government Spending Patterns the in Twentieth Century

Directory of Open Access Journals (Sweden)

Jari Eloranta

2008-01-01

Full Text Available This paper explains the long-run demand for central government spending in Finland by analyzing quantitative and qualitative changes in the spending behavior, examining possible links between variables in a VAR-framework, and performing multivariate analysis of the demand factors. The results was shoved that a explained  by a lack of military versus social spending tradeoff effect. Even though certain other variables were found to be relevant in explaining this demand, this lack of a tradeoff increased the Finnish spending levels substantially during the twentieth centurt welfare state expansion.

Working Mothers and the State: Under Which Conditions do governments spend much on maternal employment supporting policies?

NARCIS (Netherlands)

Koole, K.; Vis, B.

2012-01-01

Over the last years, the level of spending on maternal employment supporting policies has risen in most countries. Still, the variation across governments in this level is substantial. Under which conditions do governments spend relatively much? Drawing on the critical mass literature, we argue that

COMPARING THE TREND BETWEEN SOUTH AFRICAN GOVERNMENT SPENDING AND THE INCREASE IN TAX REVENUE FOR THE COUNTRY’S TAXPAYERS

OpenAIRE

Jacobs, Lerike; Moolman, Anneke Maré

2017-01-01

Adam Smith provides guidance through the four Canons of Taxation to assist government to design a good tax system based on a set of principles. These principles are being applied throughout the world, as well as in South Africa. However, the South African government has been challenged to reduce income inequality and promote growth. This has led to an increase in government spending. Although literature provides information about governmental spending, spending patterns have not been in...

Government Spending Shocks, the Current Account and the Real Exchange Rate in OECD Countries

Directory of Open Access Journals (Sweden)

Soyoung Kim

2008-06-01

Full Text Available This paper examines the effects of government spending shocks on the current account and the real exchange rate for 20 OECD countries using panel VAR model, in order to provide empirical stylized facts. The countries were grouped based on openness and size, and the influence of openness and size on the effects of government spending shocks. The main findings are as follows. First, in the analysis of all 20 countries, in response to government spending shocks, the worsening of the current account is significant, but real exchange rate appreciation is not significant. Second, real exchange rate appreciation is more significant and worsening of the current account is more temporary in the group of countries with higher openness than in those with low openness. Third, the worsening of the current account is more significant in the group of large countries than in the group of small countries. Although real exchange rate depreciation under fiscal expansion is not consistent with traditional theories, the results are broadly consistent with the existing theories that incorporate openness and the size of the country.

Changes in government spending on healthcare and population mortality in the European union, 1995-2010: a cross-sectional ecological study.

Science.gov (United States)

Budhdeo, Sanjay; Watkins, Johnathan; Atun, Rifat; Williams, Callum; Zeltner, Thomas; Maruthappu, Mahiben

2015-12-01

Economic measures such as unemployment and gross domestic product are correlated with changes in health outcomes. We aimed to examine the effects of changes in government healthcare spending, an increasingly important measure given constrained government budgets in several European Union countries. Multivariate regression analysis was used to assess the effect of changes in healthcare spending as a proportion of total government expenditure, government healthcare spending as a proportion of gross domestic product and government healthcare spending measured in purchasing power parity per capita, on five mortality indicators. Additional variables were controlled for to ensure robustness of data. One to five year lag analyses were conducted. European Union countries 1995-2010. Neonatal mortality, postneonatal mortality, one to five years of age mortality, under five years of age mortality, adult male mortality, adult female mortality. A 1% decrease in government healthcare spending was associated with significant increase in all mortality metrics: neonatal mortality (coefficient -0.1217, p = 0.0001), postneonatal mortality (coefficient -0.0499, p = 0.0018), one to five years of age mortality (coefficient -0.0185, p = 0.0002), under five years of age mortality (coefficient -0.1897, p = 0.0003), adult male mortality (coefficient -2.5398, p = 0.0000) and adult female mortality (coefficient -1.4492, p = 0.0000). One per cent decrease in healthcare spending, measured as a proportion of gross domestic product and in purchasing power parity, was both associated with significant increases (p < 0.05) in all metrics. Five years after the 1% decrease in healthcare spending, significant increases (p < 0.05) continued to be observed in all mortality metrics. Decreased government healthcare spending is associated with increased population mortality in the short and long term. Policy interventions implemented in response to the financial crisis may be associated with worsening

County Spending

Data.gov (United States)

Montgomery County of Maryland — This dataset includes County spending data for Montgomery County government. It does not include agency spending. Data considered sensitive or confidential and will...

Accountable and Responsible Disclosure of Financial Open Government Data: Open Spending Initiatives enhancing Civic Engagement

OpenAIRE

Mulder, A.W. (Bert); Hartog, M.W. (Martijn)

2017-01-01

This research focuses an optimal arrangement of open spending as added instrumental value to the accountability incommunicating financial information towards citizens within The Netherlands. Open Spending is more and more of relevance in the Netherlands and is addressed as one of the key action points in the Open Government Partnership Action plan of The Netherlands. In order to adequately communicate financial information towards citizens, 5 arrangement variables of accountability (transpare...

Linkage of Credit on BI Rate, Funds Rate, Inflation and Government Spending on Capital

Directory of Open Access Journals (Sweden)

Mangasa Augustinus Sipahutar

2017-03-01

Full Text Available Linkage of credit on BI rate, funds rate, inflation, and government spending on capital provides evidence from Indonesia.  This paper found advance explanation about banks credit as monetary transmission channel and its role on Indonesian economy.  We used credit depth as a ratio of banks credit to GDP nominal, to explain the role of credit in Indonesian economy.  We developed a VAR model to measure the response of credit to BI rate, funds rate and inflation rate, and OLS method to find out how banks credit response to government spending on capital. This paper revealed bi-direction causality between credit and BI rate, credit and funds rate, and credit and inflation.  There is trade-off between credit and BI rate, credit and funds rate, and credit and inflation, but government spending on capital promotes credit depth.  We found that Indonesian banking is bank view, allocated their credit based on their performance, not merely on the monetary policy determined by central bank.  For bank view perspectives, we analyzed the link between LDR as an indicator of credit channel mechanism to NPLs and CAR.  We found that there is no significant effect of CAR to LDR, but has a strong negatively relationship between NPLs to LDR.  This evidence indicates that commercial banks in Indonesia allocated their credit do not related to their capital but merely to the quality of their credit portfolio.

"Optimal Financing by Money and Taxes of Productive and Unproductive Government Spending: Effects on Economic Growth, Inflation, and Welfare"

OpenAIRE

David Alan Aschauer

1998-01-01

This paper contains an investigation of the effects of different means of financing government spending on economic growth, inflation, and welfare. In this setting, two different types of government spending are considered: productive expenditures which provide services to the private sector in its production activities; and unproductive expenditures which have no direct influence on the private economy. In turn, two different forms of finance are considered: proportional income taxation; and...

The adverse effects of government spending on private consumption in New Keynesian Models

NARCIS (Netherlands)

Kuehn, S.; Veen, van A.P. (Tom); Muysken, J.

2009-01-01

Empirical evidence shows that government spending crowds in private consumption, a Keynesian phenomenon. The current state of the art, New Keynesian models based on optimising households and firms, is not able to predict such a result. We show with a graphical framework as well as a formal model why

Unemployment, government healthcare spending, and cerebrovascular mortality, worldwide 1981-2009: an ecological study.

Science.gov (United States)

Maruthappu, Mahiben; Shalhoub, Joseph; Tariq, Zoon; Williams, Callum; Atun, Rifat; Davies, Alun H; Zeltner, Thomas

2015-04-01

The global economic downturn has been associated with unemployment rises, reduced health spending, and worsened population health. This has raised the question of how economic variations affect health outcomes. We sought to determine the effect of changes in unemployment and government healthcare expenditure on cerebrovascular mortality globally. Data were obtained from the World Bank and World Health Organization. Multivariate regression analysis was used to assess the effect of changes in unemployment and government healthcare expenditure on cerebrovascular mortality. Country-specific differences in infrastructure and demographics were controlled for. One- to five-year lag analyses and robustness checks were conducted. Across 99 countries worldwide, between 1981 and 2009, every 1% increase in unemployment was associated with a significant increase in cerebrovascular mortality (coefficient 187, CI: 86.6-288, P = 0.0003). Every 1% rise in government healthcare expenditure, across both genders, was associated with significant decreases in cerebrovascular deaths (coefficient 869, CI: 383-1354, P = 0.0005). The association between unemployment and cerebrovascular mortality remained statistically significant for at least five years subsequent to the 1% unemployment rise, while the association between government healthcare expenditure and cerebrovascular mortality remained significant for two years. These relationships were both shown to be independent of changes in gross domestic product per capita, inflation, interest rates, urbanization, nutrition, education, and out-of-pocket spending. Rises in unemployment and reductions in government healthcare expenditure are associated with significant increases in cerebrovascular mortality globally. Clinicians may also need to consider unemployment as a possible risk factor for cerebrovascular disease mortality. © 2015 World Stroke Organization.

Tax-and-Spend or Spend-and-Tax? Empirical Evidence from Malaysia

OpenAIRE

Tan Juat Hong

2009-01-01

The paper investigates the causal relationships between government spending and revenue for Malaysia. The study uses annual data, a Johansen cointegration test and an error-correction model. A preliminary test shows that government revenue and expenditure are cointegrated. Empirical results support the spend-and-tax hypothesis. Furthermore, they underscore the fact that fiscal policy may not be effective enough to curb the rising budget deficits over the long term and may even reduce private ...

Transmission of government spending shocks in the Euro area: time variation and driving forces

NARCIS (Netherlands)

Kirchner, M.; Cimadomo, J.; Hauptmeier, S.

This paper applies structural vector autoregressions with time-varying parameters in order to investigate changes in the effects of government spending shocks in the euro area, and the driving forces of those changes. Our contribution is two-fold. First, we present evidence that the short-run impact

Quality of governance, public spending on health and health status in Sub Saharan Africa: a panel data regression analysis.

Science.gov (United States)

Makuta, Innocent; O'Hare, Bernadette

2015-09-21

The population in Sub Saharan Africa (SSA) suffers poor health as manifested in high mortality rates and low life expectancy. Economic growth has consistently been shown to be a major determinant of health outcomes. However, even with good economic growth rates, it is not possible to achieve desired improvements in health outcomes. Public spending on health (PSH) has long been viewed as a potential complement to economic growth in improving health. However, the relationship between PSH and health outcomes is inconclusive and this inconclusiveness may, in part, be explained by governance-related factors which mediate the impact of the former on the latter. Little empirical work has been done in this regard on SSA. This paper investigates whether or not the quality of governance (QoG) has a modifying effect on the impact of public health spending on health outcomes, measured by under-five mortality (U5M) and life expectancy at birth (LE), in SSA. Using two staged least squares regression technique on panel data from 43 countries in SSA over the period 1996-2011, we estimated the effect of public spending on health and quality of governance U5M and LE, controlling for GDP per capita and other socio-economic factors. We also interacted PSH and QoG to find out if the latter has a modifying effect on the former's impact on U5M and LE. Public spending on health has a statistically significant impact in improving health outcomes. Its direct elasticity with respect to under-five mortality is between -0.09 and -0.11 while its semi-elasticity with respect to life expectancy is between 0.35 and 0.60. Allowing for indirect effect of PSH spending via interaction with quality of governance, we find that an improvement in QoG enhances the overall impact of PSH. In countries with higher quality of governance, the overall elasticity of PSH with respect to under-five mortality is between -0.17 and -0.19 while in countries with lower quality of governance, it is about -0.09. The

Government spending on Canada's oil and gas industry : undermining Canada's Kyoto commitment

International Nuclear Information System (INIS)

Taylor, A.; Bramley, M.; Winfield, M.

2005-01-01

This study investigates government spending in the Canadian oil and gas industry within the context of greenhouse gas emission trends and Kyoto commitments. Various forms of provincial and federal government support provided between 1996 and 2002 through grants, tax expenditures, and government program expenditures for conventional oil and gas and oil sands sectors are presented. The paper contextualizes government support for oil and gas production, discusses what constitutes a subsidy, presents the methodology and approach used to establish expenditure estimates, presents the study findings and discusses expenditure estimates and puts the results into the context of other public policy work. The conclusion recommends policy changes and describes important areas for future research related to public expenditure on oil and gas production. The study concludes that while it is understood that reform or removal of environmentally harmful subsidies will not solve environmental problems alone, such actions are important in order to achieve environmental improvements and objectives. 163 refs., 24 tabs, 5 figs

Private Debt Overhang and the Government Spending Multiplier: Evidence for the United States

OpenAIRE

Bernardini, Marco; Peersman, Gert

2015-01-01

Using state-dependent local projection methods and historical U.S. data, we find that government spending multipliers are considerably larger in periods of private debt overhang. In particular, we find significant crowding-out of personal consumption and investment in low-debt states, resulting in multipliers that are significantly below one. Conversely, in periods of private debt overhang, there is a strong crowding-in effect, while multipliers are much larger than one. In high-debt states, ...

The Role Of The Natural Resource Sector And Government Spending For Education Towards Poverty Reduction In East Kalimantan

Directory of Open Access Journals (Sweden)

Sudarlan

2017-10-01

Full Text Available East Kalimantan Province is one of the rich provinces in natural resources such as coal mining oil and gas. Utilization of the natural resources is expected to be used optimally to improve the welfare of the community. The purpose of this research is to find out how big the influence of natural resources sector which the consist of mining and quarrying sector and processing industry sector and government expenditure for education against poverty alleviation in East Kalimantan Province. This research uses explanatory method with time-series and cross-section data and applying multiple regression model with Ordinary Least Square OLS method. The results of this study show that a the natural resource sector and government spending on education have no effect on per capita income growth b economic growth as measured by per capita income growth positively affects on poverty and government spending on education is not significantly influential to poverty reduction and c the natural resource sector has no significant effect on the poverty headcount in East Kalimantan.

Which type of government revenue leads government expenditure?

OpenAIRE

Abdi, Zeinab; Masih, Mansur

2014-01-01

This Malaysia is a developing Islamic state that faced government budget deficit since 1998. It is undeniable that a budget deficit or inability to cover government spending is not positively seen by external parties. The optimum level of government budget is the state where government spending is totally offset by government revenue and that can be achieved through an increase in tax revenue or decrease in spending. The paper aims to discover the existence of a theoretical relationship betwe...

Monitoring what governments "give for" and "spend on" vaccine procurement: Vaccine Procurement Assistance and Vaccine Procurement Baseline.

Science.gov (United States)

Nelson, E A S; Bloom, David E; Mahoney, Richard T

2014-01-01

The Global Vaccine Action Plan will require, inter alia, the mobilization of financial resources from donors and national governments - both rich and poor. Vaccine Procurement Assistance (VPA) and Vaccine Procurement Baseline (VPB) are two metrics that could measure government performance and track resources in this arena. VPA is proposed as a new subcategory of Official Development Assistance (ODA) given for the procurement of vaccines and VPB is a previously suggested measure of the share of Gross Domestic Product (GDP) that governments spend on their own vaccine procurement. To determine realistic targets for VPA and VPB. Organization for Economic Co-Operation and Development (OECD) and World Bank data for 2009 were analyzed to determine the proportions of bilateral ODA from the 23 Development Assistance Committee (DAC) countries disbursed (as % of GDP in current US$) for infectious disease control. DAC country contributions to the GAVI Alliance for 2009 were assessed as a measure of multilateral donor support for vaccines and immunization programs. In 2009, total DAC bilateral ODA was 0.16% of global GDP and 0.25% of DAC GDP. As a percentage of GDP, Norway (0.013%) and United Kingdom (0.0085%) disbursed the greatest proportion of bilateral ODA for infectious disease control, and Norway (0.024%) and Canada (0.008%) made the greatest contributions to the GAVI Alliance. In 2009 0.02% of DAC GDP was US$7.61 billion and 0.02% of the GDP of the poorest 117 countries was US$2.88 billion. Adopting 0.02% GDP as minimum targets for both VPA and VPB is based on realistic estimates of what both developed and developing countries should spend, and can afford to spend, to jointly ensure procurement of vaccines recommended by national and global bodies. New OECD purpose codes are needed to specifically track ODA disbursed for a) vaccine procurement; and b) immunization programs.

Why do some countries spend more for health? An assessment of sociopolitical determinants and international aid for government health expenditures.

Science.gov (United States)

Liang, Li-Lin; Mirelman, Andrew J

2014-08-01

A consensus exists that rising income levels and technological development are among key drivers of total health spending. Determinants of public sector health expenditure, by contrast, are less well understood. This study examines a complex relationship across government health expenditure (GHE), sociopolitical risks, and international aid, while taking into account the impacts of national income, debt and tax financing and aging populations on health spending. We apply a fixed-effects two-stage least squares regression method to a panel dataset comprising 120 countries for the years 1995 through 2010. Our results show that democratic accountability has a diminishing positive correlation with GHE, and that levels of GHE are higher when government is more stable. Corruption is associated with less GHE in developing countries, but with higher GHE in developed countries. We also find that development assistance for health (DAH) is fungible with domestically financed government health expenditure (DGHE). For an average country, a 1% increase in DAH to government is associated with a 0.03-0.04% decrease in DGHE. Furthermore, the degree of fungibility of DAH to government is higher in countries where corruption or ethnic tensions are widespread. However, DAH to non-governmental organizations is not fungible with DGHE. Copyright © 2014 Elsevier Ltd. All rights reserved.

Benefit Incidence Analysis of Government Spending on Public-Private Partnership Schooling under Universal Secondary Education Policy in Uganda

Science.gov (United States)

Wokadala, J.; Barungi, M.

2015-01-01

The study establishes whether government spending on private universal secondary education (USE) schools is equitable across quintiles disaggregated by gender and by region in Uganda. The study employs benefit incidence analysis tool on the Uganda National Panel Survey (UNPS 2009/10) data to establish the welfare impact of public subsidy on…

Geography of conservation spending, biodiversity, and culture.

Science.gov (United States)

McClanahan, T R; Rankin, P S

2016-10-01

We used linear and multivariate models to examine the associations between geography, biodiversity, per capita economic output, national spending on conservation, governance, and cultural traits in 55 countries. Cultural traits and social metrics of modernization correlated positively with national spending on conservation. The global distribution of this spending culture was poorly aligned with the distribution of biodiversity. Specifically, biodiversity was greater in the tropics where cultures tended to spend relatively less on conservation and tended to have higher collectivism, formalized and hierarchical leadership, and weaker governance. Consequently, nations lacking social traits frequently associated with modernization, environmentalism, and conservation spending have the largest component of Earth's biodiversity. This has significant implications for setting policies and priorities for resource management given that biological diversity is rapidly disappearing and cultural traits change slowly. Therefore, we suggest natural resource management adapt to and use characteristics of existing social organization rather than wait for or promote social values associated with conservation spending. Supporting biocultural traditions, engaging leaders to increase conservation commitments, cross-national efforts that complement attributes of cultures, and avoiding interference with nature may work best to conserve nature in collective and hierarchical societies. Spending in modernized nations may be a symbolic response to a symptom of economic development and environmental degradation, and here conservation actions need to ensure that biodiversity is not being lost. © 2016 Society for Conservation Biology.

Monitoring what governments "give for" and "spend on" vaccine procurement: Vaccine Procurement Assistance and Vaccine Procurement Baseline.

Directory of Open Access Journals (Sweden)

E A S Nelson

Full Text Available BACKGROUND: The Global Vaccine Action Plan will require, inter alia, the mobilization of financial resources from donors and national governments - both rich and poor. Vaccine Procurement Assistance (VPA and Vaccine Procurement Baseline (VPB are two metrics that could measure government performance and track resources in this arena. VPA is proposed as a new subcategory of Official Development Assistance (ODA given for the procurement of vaccines and VPB is a previously suggested measure of the share of Gross Domestic Product (GDP that governments spend on their own vaccine procurement. OBJECTIVE: To determine realistic targets for VPA and VPB. METHODS: Organization for Economic Co-Operation and Development (OECD and World Bank data for 2009 were analyzed to determine the proportions of bilateral ODA from the 23 Development Assistance Committee (DAC countries disbursed (as % of GDP in current US$ for infectious disease control. DAC country contributions to the GAVI Alliance for 2009 were assessed as a measure of multilateral donor support for vaccines and immunization programs. FINDINGS: In 2009, total DAC bilateral ODA was 0.16% of global GDP and 0.25% of DAC GDP. As a percentage of GDP, Norway (0.013% and United Kingdom (0.0085% disbursed the greatest proportion of bilateral ODA for infectious disease control, and Norway (0.024% and Canada (0.008% made the greatest contributions to the GAVI Alliance. In 2009 0.02% of DAC GDP was US$7.61 billion and 0.02% of the GDP of the poorest 117 countries was US$2.88 billion. CONCLUSIONS: Adopting 0.02% GDP as minimum targets for both VPA and VPB is based on realistic estimates of what both developed and developing countries should spend, and can afford to spend, to jointly ensure procurement of vaccines recommended by national and global bodies. New OECD purpose codes are needed to specifically track ODA disbursed for a vaccine procurement; and b immunization programs.

Rethinking the Relation between Government Spending and Economic Growth: A Composition Approach to Fiscal Policy Instruction for Principles Students

Science.gov (United States)

Goldsmith, Arthur H.

2008-01-01

Standard introductory textbook authors assert that an increase in government spending expands aggregate demand in the short run but also raises the interest rate and, thus, crowds out private investment in the long run. Because the decrease in investment results in a smaller capital stock, potential output or production capacity decreases. The…

Italian refiners' environmental spending to soar in 1990s

International Nuclear Information System (INIS)

Anon.

1993-01-01

Industry estimates are that Italian refiners' capital outlays will total almost 12 trillion lire ($7.2 billion), in 1990 currencies, in the 1990's. Most spending will be earmarked to develop cleaner fuels and plant-specific environmental mitigation measures related to new European Community regulations. Italian refiners generally have lagged some of their counterparts in Europe and North America on environmental spending. That's because they have faced a continuing margin squeeze as a result of product prices remaining under tight government controls. Last year, the government began to implement price deregulation in line with EC directives. At the same time, the government is enforcing stiffer emissions rules to improve air quality in urban areas. The paper describes spending plans; demand for oxygenates; demand for low sulfur fuel oil for power plants; and price regulations

Assessment of the relationship of government spending on social assistance programs with Brazilian macroeconomic variables

Science.gov (United States)

de Senna, Viviane; Souza, Adriano Mendonça

2016-11-01

Since the 1988 Federal Constitution social assistance has become a duty of the State and a right to everyone, guaranteeing the population a dignified life. To ensure these rights federal government has created programs that can supply the main needs of people in extreme poverty. Among the programs that provide social assistance to the population, the best known are the ;Bolsa Família; Program - PBF and the Continuous Cash Benefit - Continuous Cash Benefit - BPC. This research's main purpose is to analyze the relationship between the main macroeconomic variables and the Federal government spending on social welfare policy in the period from January 2004 to August 2014. The used methodologies are the Vector auto regression model - VAR and Error Correction Vector - VEC. The conclusion, was that there is a meaningful relationship between macroeconomic variables and social assistance programs. This indicates that if the government takes a more abrupt resolution in changing the existing programs it will result in fluctuations in the main macroeconomic variables interfering with the stability of Brazilian domestic economy up to twelve months.

Essays in economics: 1. Pre-committed government spending and partisan politics. 2. Investment in energy efficiency: Do the characteristics of firms matter? 3. Information processing and organizational structure

Science.gov (United States)

Watkins, William Edward, Jr.

1. Spending commitments requiring future outlays are important for understanding partisan politics because they prevent a conservative government from scaling back spending programs. In a one-government-good model, a "stubborn liberal" policy maker can use precommitted spending to prevent a later conservative government from imposing spending cuts. In a model where parties differ about spending priorities, re-election uncertainty creates a bias towards higher government spending and higher taxes. 2. The literature on energy efficiency provides examples of profitable technologies that are not universally adopted. Theory indicates that firms should undertake all investments with a positive net present value, and that the discount rate for computing the present value of a project should be the return available on other projects in the same risk class, not on characteristics of the firm. This model is tested by examining whether firms' characteristics influence their decision to join the Environmental Protection Agency's Green Lights program. A discrete choice regression is estimated over a sample of participating and non-participating firms. Missing values in the data matrix are replaced with multiple imputations using the EM algorithm. The results show that: (1) substantial improvements in the power of hypothesis tests can be achieved through imputation of missing data, and (2) characteristics of firms do affect their decision to join Green Lights. 3. Standard theories of the firm stress profit maximization as the foundation for derivation of predictable behavior. Yet evidence continues to accumulate that firms do not act as required by the neoclassical framework. Instead of being represented by ever more elaborate maximization models, the firm can be modeled simply as a network of information-processing agents. The actions of the firm are then a function only of the network structure and the information-processing capabilities of the agents. This approach can be

Monitoring What Governments “Give for” and “Spend on” Vaccine Procurement: Vaccine Procurement Assistance and Vaccine Procurement Baseline

Science.gov (United States)

Nelson, E. A. S.; Bloom, David E.; Mahoney, Richard T.

2014-01-01

Background The Global Vaccine Action Plan will require, inter alia, the mobilization of financial resources from donors and national governments – both rich and poor. Vaccine Procurement Assistance (VPA) and Vaccine Procurement Baseline (VPB) are two metrics that could measure government performance and track resources in this arena. VPA is proposed as a new subcategory of Official Development Assistance (ODA) given for the procurement of vaccines and VPB is a previously suggested measure of the share of Gross Domestic Product (GDP) that governments spend on their own vaccine procurement. Objective To determine realistic targets for VPA and VPB. Methods Organization for Economic Co-Operation and Development (OECD) and World Bank data for 2009 were analyzed to determine the proportions of bilateral ODA from the 23 Development Assistance Committee (DAC) countries disbursed (as % of GDP in current US$) for infectious disease control. DAC country contributions to the GAVI Alliance for 2009 were assessed as a measure of multilateral donor support for vaccines and immunization programs. Findings In 2009, total DAC bilateral ODA was 0.16% of global GDP and 0.25% of DAC GDP. As a percentage of GDP, Norway (0.013%) and United Kingdom (0.0085%) disbursed the greatest proportion of bilateral ODA for infectious disease control, and Norway (0.024%) and Canada (0.008%) made the greatest contributions to the GAVI Alliance. In 2009 0.02% of DAC GDP was US$7.61 billion and 0.02% of the GDP of the poorest 117 countries was US$2.88 billion. Conclusions Adopting 0.02% GDP as minimum targets for both VPA and VPB is based on realistic estimates of what both developed and developing countries should spend, and can afford to spend, to jointly ensure procurement of vaccines recommended by national and global bodies. New OECD purpose codes are needed to specifically track ODA disbursed for a) vaccine procurement; and b) immunization programs. PMID:24586899

The quality of governance and education spending in Africa

African Journals Online (AJOL)

public budget allocation to education by using data for a panel of ... social sector spending categories, education accounts for the highest share of GDP. (5.3%), which ..... that politically stable countries will devote more resources to education.

The Relationship Between Federal Government Revenue and Spending: Empirical Evidence From Asean-5 Countries

OpenAIRE

Mohd.Yusoff, Zetty Zahureen; Antoni, Antoni; Abdullah, Azrina Al-Hadi; Asri, Norain Mod; Karim, Zulkefly Abdul

2006-01-01

The main objectives of this paper is to examine the long run relationship between total expenditure, revenue (tax and nontax) and economic growth in ASEAN-5 countries namely by Malaysia, Indonesia, Thailand, Singapore and Philippines. According to the prior studies, there are several hypotheses to explain the relationship between revenue and spend-ing such as (1) spend-revenue hypotheses, (2) revenue-spend hypotheses and (3)bi-directional causality hypotheses. To test the validity of these hy...

The Relationship Between Federal Government Revenue and Spending: Empirical Evidence from Asean-5 Countries

OpenAIRE

Karim, Zulkefly Abdul; Asri, Norain Mod; Abdullah, Azrina Al-Hadi; Antoni, Antoni; Mohd.Yusoff, Zetty Zahureen

2009-01-01

The main objectives of this paper is to examine the long run relationship between total expenditure, revenue (tax and nontax) and economic growth in ASEAN-5 countries namely by Malaysia, Indonesia, Thailand, Singapore and Philippines. According to the prior studies, there are several hypotheses to explain the relationship between revenue and spend-ing such as (1) spend-revenue hypotheses, (2) revenue-spend hypotheses and (3)bi-directional causality hypotheses. To test the validity of these hy...

Exposing government response action contractors to environmental tort liability

International Nuclear Information System (INIS)

Roy, M.J.

1991-01-01

Government contractors, particularly those involved with hazardous waste response action activities, are encountering increased risks for environmental tort liabilities. Contracts often include tasks and work assignments requiring the management of industrial, chemical, nuclear or mining wastes, spent fuels, munitions or other toxic substances. Contractors exposure to liability for damages results directly from the environmental laws and regulations pursuant to which the Government has contracted them to respond. Additionally, contractors may be exposed to common law liability under such dogmas as nuisance, trespass and strict liability in tort

Evolution and patterns of global health financing 1995-2014: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries.

Science.gov (United States)

2017-05-20

An adequate amount of prepaid resources for health is important to ensure access to health services and for the pursuit of universal health coverage. Previous studies on global health financing have described the relationship between economic development and health financing. In this study, we further explore global health financing trends and examine how the sources of funds used, types of services purchased, and development assistance for health disbursed change with economic development. We also identify countries that deviate from the trends. We estimated national health spending by type of care and by source, including development assistance for health, based on a diverse set of data including programme reports, budget data, national estimates, and 964 National Health Accounts. These data represent health spending for 184 countries from 1995 through 2014. We converted these data into a common inflation-adjusted and purchasing power-adjusted currency, and used non-linear regression methods to model the relationship between health financing, time, and economic development. Between 1995 and 2014, economic development was positively associated with total health spending and a shift away from a reliance on development assistance and out-of-pocket (OOP) towards government spending. The largest absolute increase in spending was in high-income countries, which increased to purchasing power-adjusted $5221 per capita based on an annual growth rate of 3·0%. The largest health spending growth rates were in upper-middle-income (5·9) and lower-middle-income groups (5·0), which both increased spending at more than 5% per year, and spent $914 and $267 per capita in 2014, respectively. Spending in low-income countries grew nearly as fast, at 4·6%, and health spending increased from $51 to $120 per capita. In 2014, 59·2% of all health spending was financed by the government, although in low-income and lower-middle-income countries, 29·1% and 58·0% of spending was OOP

A study on environment public spending

Directory of Open Access Journals (Sweden)

Wellington Bueno

2013-12-01

Full Text Available This text deals with the importance of studying environment public spending. Initially, we discuss the concept of environment public spending and how it became a public accounting function. Later, an analysis of several studies on the theme was carried out to promote a discussion on the environment public funds allocated by governments. Next, a discussion on the relevance of the theme and the need for further studies is presented, since investments on environment management still need to be better allocated and duly dimensioned. Currently, transparence in public spending has promoted the realization of more studies, leading to a more careful observation of environmental issues by the society, showing that these issues still need more attention from the goverment.

Government for the People; On the Determinants of the Size of U.S. Government

OpenAIRE

Tamim Bayoumi; Fernando M. Gonçalves

2007-01-01

Trends in the size of U.S. government are examined. In the postwar period, general government primary spending rose by ¼ percent of GDP a year through 1975, stabilizing thereafter. With higher social transfers offset by a lower burden of defense spending, expansion reflected a baby-boom driven rise in education spending. The parallel improvement in tax efficiency helped equate the benefits of higher spending with the costs from higher taxation, in accordance with a marginalist view of the siz...

GOVERNMENT SIZE VERSUS GOVERNMENT EFFICIENCY IN A MODEL OF ECONOMIC GROWTH

Directory of Open Access Journals (Sweden)

Francisca Guedes de Oliveira

2016-04-01

Full Text Available We develop a Solow type growth model where firms produce a single homogenous good using labor, private capital and a public good. The "amount" of public good depends on current government spending and government quality. Quality is the result of the accumulation of public capital. Governments charge distortionary taxes and provide the public good, investing also in "quality" by accumulating public capital. We analyze how the composition of government spending between current expenditures and quality affects the equilibrium levels. We aim to understand the difference in terms of steady state levels between leviathan, quality driven and benevolent governments.

Projecting long term medical spending growth.

Science.gov (United States)

Borger, Christine; Rutherford, Thomas F; Won, Gregory Y

2008-01-01

We present a dynamic general equilibrium model of the U.S. economy and the medical sector in which the adoption of new medical treatments is endogenous and the demand for medical services is conditional on the state of technology. We use this model to prepare 75-year medical spending forecasts and a projection of the Medicare actuarial balance, and we compare our results to those obtained from a method that has been used by government actuaries. Our baseline forecast predicts slower health spending growth in the long run and a lower Medicare actuarial deficit relative to the previous projection methodology.

Cross-country differences in government sector activities

Directory of Open Access Journals (Sweden)

Primož Pevcin

2005-06-01

Full Text Available The purpose of the analysis presented in the article is to identify various economic, social, political, demographic and cultural factors that could shape the differences in the size of government sector across countries and, with the use of econometric analysis empirically verify the effect of those factors. The analysis focuses only on ”budgetary” government, meaning that the size of government is measured with a certain government spending ratio. The results of the analysis revealed that economic factors are more important in explaining the variation in the size of government consumption spending, whereas political, social and cultural factors are more important in explaining the variation in the size of transfer spending. In addition, the results indicate that the relative size of government spending is inversely related to the extent of the regulation of the economy.

R&D figures 'distorted' by defence spending

CERN Multimedia

Coghlan, A

1990-01-01

A report published by the House of Lords Select Committee on Science and Technology, claims that government figures for R&D spending are misleading. They apparently include military projects that are more concerned with product development than original research.

Does Government Public Capital Expenditure Matter?: Evidence for Canada

OpenAIRE

Dadgostar, Bahram; Mirabelli, Frank

1998-01-01

Does the provision of Canadian government capital expenditures and government deficits displace private economic activity? In the U.S., Erenburg (1993) found that private sector investment spending is enhanced by expected increases in public spending on infrastructure, while also showing that deficit spending has no significant effect on private investment. There is no empirical study to date that addresses the relationship between government capital investment and government debt on private ...

THE OPTIMIZATION OF GOVERNMENT'S SPENDING ON RESEARCH AND DEVELOPMENT IN THE ENTREPRENEURIAL SECTOR OF SCIENCE

Directory of Open Access Journals (Sweden)

A. M. Khamatkanova

2015-01-01

Full Text Available The article suggests that it is critical to optimise the State's expenses on research and development (R&D. The authors suggest that one of the key instruments for increasing efficiency in spending of government's resources on R&D sector would be to introduce new models of financing projects from the entrepreneurial sector of science. This sector uses the largest gross expenditures on R&D (60% and more than half of State resources. According to international practice it is evident that the entrepreneurial sector of science is precisely the one that should take the lead in moving R&D towards new technological milestones. However, a relative analysis of State and entrepreneurial sectors of Russian science has shown that the industrial sector, having spent 60% of National resources on R&D and owing 47% of total scientific personnel, has yet not contributed to re-industrialisation of domestic industry.

Government spending: an economic boost?

OpenAIRE

Daniel J. Wilson

2012-01-01

The severe global economic downturn and the large stimulus programs that governments in many countries adopted in response have generated a resurgence in research on the effects of fiscal policy. One key lesson emerging from this research is that there is no single fiscal multiplier that sums up the economic impact of fiscal policy. Rather, the impact varies widely depending on the specific fiscal policies put into effect and the overall economic environment.

Accountable and Responsible Disclosure of Financial Open Government Data : Open Spending Initiatives enhancing Civic Engagement

NARCIS (Netherlands)

A.W. (Bert) Mulder; M.W. (Martijn) Hartog

2017-01-01

This research focuses an optimal arrangement of open spending as added instrumental value to the accountability incommunicating financial information towards citizens within The Netherlands. Open Spending is more and more of relevance in the Netherlands and is addressed as one of the key action

National spending on health by source for 184 countries between 2013 and 2040.

Science.gov (United States)

Dieleman, Joseph L; Templin, Tara; Sadat, Nafis; Reidy, Patrick; Chapin, Abigail; Foreman, Kyle; Haakenstad, Annie; Evans, Tim; Murray, Christopher J L; Kurowski, Christoph

2016-06-18

A general consensus exists that as a country develops economically, health spending per capita rises and the share of that spending that is prepaid through government or private mechanisms also rises. However, the speed and magnitude of these changes vary substantially across countries, even at similar levels of development. In this study, we use past trends and relationships to estimate future health spending, disaggregated by the source of those funds, to identify the financing trajectories that are likely to occur if current policies and trajectories evolve as expected. We extracted data from WHO's Health Spending Observatory and the Institute for Health Metrics and Evaluation's Financing Global Health 2015 report. We converted these data to a common purchasing power-adjusted and inflation-adjusted currency. We used a series of ensemble models and observed empirical norms to estimate future government out-of-pocket private prepaid health spending and development assistance for health. We aggregated each country's estimates to generate total health spending from 2013 to 2040 for 184 countries. We compared these estimates with each other and internationally recognised benchmarks. Global spending on health is expected to increase from US$7·83 trillion in 2013 to $18·28 (uncertainty interval 14·42-22·24) trillion in 2040 (in 2010 purchasing power parity-adjusted dollars). We expect per-capita health spending to increase annually by 2·7% (1·9-3·4) in high-income countries, 3·4% (2·4-4·2) in upper-middle-income countries, 3·0% (2·3-3·6) in lower-middle-income countries, and 2·4% (1·6-3·1) in low-income countries. Given the gaps in current health spending, these rates provide no evidence of increasing parity in health spending. In 1995 and 2015, low-income countries spent $0·03 for every dollar spent in high-income countries, even after adjusting for purchasing power, and the same is projected for 2040. Most importantly, health spending in many low

Shopping Association Of Government Education Development In East Java

OpenAIRE

Muhamamd Guzali Tafalas; Deddy T. Tikson; Baharuddin; Hj. Hasniati

2017-01-01

The purpose of this study is to explain and analyze in detail The positive association Government spending in education PP with a Gross Enrolment Ratio GER and net enrollment ratio NER in East Java Province. Government spending on education is less associated significantly to the gross enrollment ratio at primary education. gross enrollment GER especially at the level of elementary education. As for the middle and high school level of education government spending on education was significant...

[Central purchasing bodies and spending review in health sector].

Science.gov (United States)

Spampinato, Luigi

2017-01-01

The aim of this paper is to analyze the new model of centralization of purchases in Italy after the approval of the 2016 Stability Law, with particular reference to the health sector. In fact, the spending review process in Italy in the health sector has had a strong evolution with the 2016 Stability Law, which has introduced the obligation for the institutions of the National Health Service to obtain supplies, exclusively, from aggregators subjects, for certain product categories of the health sector. The legislature, over the years, was mainly characterized by measures to reduce the spending limits for purchases of goods and services or by resetting the fees, including the provision of an obligation for the renegotiation of health goods and services contracts, in order to ensure the effective implementation of the expenditure rationalization by aggregation of goods and services. From 2016, the legislature has provided an innovative model of centralization of purchases based on a new network governance model on several levels, national and regional, which should ensure an efficiency of procurement processes. The proper functioning of the governance model adopted can be an important driver of economic policy in order to understand that it is important not only to spend less, but to spend better. This can be realized in the public administration with a strong innovation process in this administration and also with a strong investment in skills, in order to ensure the same service quality throughout the national territory to the health sector.

Trends in Health Care Spending by the Private Sector

Science.gov (United States)

1997-04-01

private - sector spending for health insurance increases each year has raised many questions about the meaning of the trend and its implications for the future. According to the federal government’s national health accounts (NHA), the annual growth rate of private health insurance expenditures tumbled from around 14 percent in 1990 to less than 3 percent in 1994 and 1995. Understanding the factors that contribute to that reduction is of particular concern to policymakers who are seeking ways to slow the growth of Medicare spending. At the same time that fundamental

Health spending, illicit financial flows and tax incentives in Malawi.

Science.gov (United States)

O'Hare, B; Curtis, M

2014-12-01

This analysis examines the gaps in health care financing in Malawi and how foregone taxes could fill these gaps. It begins with an assessment of the disease burden and government health expenditure. Then it analyses the tax revenues foregone by the government of Malawi by two main routes: Illicit financial flows (IFF) from the country, Tax incentives. We find that there are significant financing gaps in the health sector; for example, government expenditure is United States Dollars (USD) 177 million for 2013/2014 while projected donor contribution in 2013/2014 is USD 207 million and the total cost for the minimal health package is USD 535 million. Thus the funding gap between the government budget for health and the required spending to provide the minimal package for 2013/2014 is USD 358 million. On the other hand we estimate that almost USD 400 million is lost through IFF and corporate utilization of tax incentives each year. The revenues foregone plus the current government health spending would be sufficient to cover the minimal public health package for all Malawians and would help tackle Malawi's disease burden. Every effort must be made, including improving transparency and revising laws, to curtail IFF and moderate tax incentives.

WHY DOES GOVERNMENT GROW?THE SOURCESOF GOVERNMENT GROWTHFROM PUBLIC CHOICEPERSPECTIVE

OpenAIRE

Coskun Can Aktan, PhD

2017-01-01

Many empirical studies that examined the government spending concludes that the sizeand scope of government has grown considerably since the beginning of the twentiethcentury in most developed countries. If this is the fact, then we must ask and explore thefollowing questions: Why does government grow? What are the main sources ofgovernment growth? What are the main reasons of the expansion of government? Thisintroductory paper aims to answerthose and other questions regardin...

Pocket Spending Guide

OpenAIRE

Poff, Karen

2015-01-01

Provides an example for how to set up a pocket spending guide. By filling out the guide and keeping it with you, you can easily see at any time how much money you have available to spend in each category. A pocket spending guide will help you adjust your spending plan to make your money go where you really want it to go.

Retail Spending Potential

Data.gov (United States)

City and County of Durham, North Carolina — This map shows the average household spending potential for retail goods in the United States in 2012. Spending potential data measures household consumer spending...

Recession contributes to slowest annual rate of increase in health spending in five decades.

Science.gov (United States)

Martin, Anne; Lassman, David; Whittle, Lekha; Catlin, Aaron

2011-01-01

In 2009, US health care spending grew 4.0 percent--a historically low rate of annual increase--to $2.5 trillion, or $8,086 per person. Despite the slower growth, the share of the gross domestic product devoted to health spending increased to 17.6 percent in 2009 from 16.6 percent in 2008. The growth rate of health spending continued to outpace the growth of the overall economy, which experienced its largest drop since 1938. The recession contributed to slower growth in private health insurance spending and out-of-pocket spending by consumers, as well as a reduction in capital investments by health care providers. The recession also placed increased burdens on households, businesses, and governments, which meant that fewer financial resources were available to pay for health care. Declining federal revenues and strong growth in federal health spending increased the health spending share of total federal revenue from 37.6 percent in 2008 to 54.2 percent in 2009.

France, Germany, Greece and the United Kingdom an analysis and comparison of budget deficits and defense spending

OpenAIRE

Schoettelndreyer, Friedrich.

2011-01-01

Approved for public release; distribution is unlimited. This thesis documents findings on the relationship of government budget deficits and defense spending for France, Germany, Greece, and the United Kingdom in detail and for NATO and OECD country collectives. The thesis topic is relevant, as many European countries are justifying their recent cuts in defense spending with high government budget deficits. The author looked at different data sources and metrics to graphically analyze the ...

WHY DOES GOVERNMENT GROW?THE SOURCESOF GOVERNMENT GROWTHFROM PUBLIC CHOICEPERSPECTIVE

Directory of Open Access Journals (Sweden)

Coskun Can Aktan, PhD

2017-01-01

Full Text Available Many empirical studies that examined the government spending concludes that the sizeand scope of government has grown considerably since the beginning of the twentiethcentury in most developed countries. If this is the fact, then we must ask and explore thefollowing questions: Why does government grow? What are the main sources ofgovernment growth? What are the main reasons of the expansion of government? Thisintroductory paper aims to answerthose and other questions regarding governmentgrowth. The paperismostlydependon public choice literature of government growth.

Government observations on the 7. report from the Committee (Session 1989-90) on the Department of Energy's spending plans, 1990-91

International Nuclear Information System (INIS)

1990-01-01

The House of Commons Energy Committee recently reported in the Department of Energy's spending plans for 1990-91. This Memorandum represents the Government's response to their recommendations. A review of the structure and size of research and development expenditure is anticipated. Research should focus on pollution reduced coal-based electricity generation and wave energy provided prospects prove sufficiently promising. The reasons for the closure of the Winfrith Reactor are outlined. Fusion power is seen as expensive, too long term and unlikely to be economically viable, but the Joint European Torus (JET) programme will be supported until 1996. Cost of decommissioning JET are a cause for concern. Nuclear Electric is deemed to be acting too slowly in setting proper financial targets. No change is envisaged in the Government's arrangements to fund overseas atomic energy programmes in collaboration with the International Atomic Energy Authority. The costs of publicity promoting civilian nuclear programmes is seen as too high. (author)

National Health Care Spending In 2016: Spending And Enrollment Growth Slow After Initial Coverage Expansions.

Science.gov (United States)

Hartman, Micah; Martin, Anne B; Espinosa, Nathan; Catlin, Aaron; The National Health Expenditure Accounts Team

2018-01-01

Total nominal US health care spending increased 4.3 percent and reached $3.3 trillion in 2016. Per capita spending on health care increased by $354, reaching $10,348. The share of gross domestic product devoted to health care spending was 17.9 percent in 2016, up from 17.7 percent in 2015. Health spending growth decelerated in 2016 following faster growth in 2014 and 2015 associated with coverage expansions under the Affordable Care Act (ACA) and strong retail prescription drug spending growth. In 2016 the slowdown was broadly based, as spending for the largest categories by payer and by service decelerated. Enrollment trends drove the slowdown in Medicaid and private health insurance spending growth in 2016, while slower per enrollee spending growth influenced Medicare spending. Furthermore, spending for retail prescription drugs slowed, partly as a result of lower spending for drugs used to treat hepatitis C, while slower use and intensity of services drove the slowdown in hospital care and physician and clinical services.

Medicare hospital spending per patient (Medicare Spending per Beneficiary) – Additional Decimal Places

Data.gov (United States)

U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

The governance of federal debt in the United States of America

Directory of Open Access Journals (Sweden)

Gisele Mah

2017-02-01

Full Text Available The United State of America has been experiencing high debt to GDP ratio of more than 100% and these Public debts are detrimental. The main purpose of this study was to examine the shocks of the variables on others in the USA economy by using quarterly data. The variance decomposition and the Generalised Impulse Response Function techniques were employed to analyse the data. The result revealed that high variation of shocks in real federal debt is explained by their own innovations in the short run, by CPI followed by real federal debt its self. In the long run, this leads to CPI and real government spending. The GIRF reveals that in the short run, real federal debt responds negatively to shocks from CPI, real federal interest payment and real federal government tax receipts and positively to real federal debt and real government spending. In medium term, only real federal government tax receipts are negative while the others are positive. In the long run, the response are all positive to shock from the independent variables. The results lead to the recommendation that the US government should focus on real federal debt in the short run. In the medium term, US government should focus on increasing real government spending and reducing only real federal government tax receipts. In the long run the target should real be federal debt, CPI, real federal interest payment, real government spending and real federal government tax receipts

Health spending, illicit financial flows and tax incentives in Malawi ...

African Journals Online (AJOL)

Health spending, illicit financial flows and tax incentives in Malawi. B O'Hare, M Curtis. Abstract. This analysis examines the gaps in health care financing in Malawi and how foregone taxes could fill these gaps. It begins with an assessment of the disease burden and government health expenditure. Then it analyses the tax ...

The great recession and health spending among uninsured U.S. immigrants: implications for the Affordable Care Act implementation.

Science.gov (United States)

Vargas Bustamante, Arturo; Chen, Jie

2014-12-01

We study the association between the timing of the Great Recession (GR) and health spending among uninsured adults distinguishing by citizenship/nativity status and time of U.S. residence. Uninsured U.S. citizens and noncitizens from the 2005-2006 and 2008-2009 Medical Expenditure Panel Survey. The probability of reporting any health spending and the natural logarithm of health spending are our main dependent variables. We compare health spending across population categories before/during the GR. Subsequently, we implement two-part regression analyses of total and specific health-spending measures. We predict average health spending before/during the GR with a smearing estimation. The probability of reporting any spending diminished for recent immigrants compared to citizens during the GR. For those with any spending, recent immigrants reported higher spending during the GR (27 percent). Average reductions in total spending were driven by the decline in the share of the population reporting any spending among citizens and noncitizens. Our study findings suggest that recent immigrants could be forgoing essential care, which later translates into higher spending. It portrays the vulnerability of a population that would remain exposed to income shocks, even after the Affordable Care Act (ACA) implementation. © Health Research and Educational Trust.

Spending on health and HIV/AIDS: domestic health spending and development assistance in 188 countries, 1995-2015.

Science.gov (United States)

2018-05-05

2015, $562·6 billion (531·1 billion to 621·9 billion) was spent on HIV/AIDS worldwide. Governments financed 57·6% (52·0 to 60·8) of that total. Global HIV/AIDS spending peaked at 49·7 billion (46·2-54·7) in 2013, decreasing to $48·9 billion (45·2 billion to 54·2 billion) in 2015. That year, low-income and lower-middle-income countries represented 74·6% of all HIV/AIDS disability-adjusted life-years, but just 36·6% (34·4 to 38·7) of total HIV/AIDS spending. In 2015, $9·3 billion (8·5 billion to 10·4 billion) or 19·0% (17·6 to 20·6) of HIV/AIDS financing was spent on prevention, and $27·3 billion (24·5 billion to 31·1 billion) or 55·8% (53·3 to 57·9) was dedicated to care and treatment. From 1995 to 2015, total health spending increased worldwide, with the fastest per capita growth in middle-income countries. While these national disparities are relatively well known, low-income countries spent less per person on health and HIV/AIDS than did high-income and middle-income countries. Furthermore, declines in development assistance for health continue, including for HIV/AIDS. Additional cuts to development assistance could hasten this decline, and risk slowing progress towards global and national goals. The Bill & Melinda Gates Foundation. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

CMS Drug Spending

Data.gov (United States)

U.S. Department of Health & Human Services — CMS has released several information products that provide spending information for prescription drugs in the Medicare and Medicaid programs. The CMS Drug Spending...

Worldwide Military Spending, 1990-1995

OpenAIRE

Jerald A Schiff; Benedict J. Clements; Sanjeev Gupta

1996-01-01

The decline in military spending that began in the mid-1980s continued through 1995, and this decline was widespread both geographically and by level of development. Cuts in military spending appear to have potentially important implications for nonmilitary spending and fiscal adjustment. In contrast to findings for previous periods, military spending has declined more than proportionately in those countries that have reduced total spending. Countries with Fund programs have reduced military ...

HOW DOES ECONOMIC FREEDOM INFLUENCE THE RELATIONSHIP BETWEEN GOVERNMENT SIZE AND CONVERGENCE?

Directory of Open Access Journals (Sweden)

Nadasi Levente

2015-07-01

Full Text Available In this paper we present some empirical results about absolute and conditional convergence of real GDP within 121 countries using cross-country data. We assume that there is an inverted U-shaped curve, which describes the relationship between economic growth and government spending. It is mainly because the institutional conditions of productivity do not exist at lower levels of government spending. At higher levels, the government needs to levy higher taxes to finance its expenditures, which hinders growth. So there can be somewhere an optimal government redistribution level that maximizes growth. This optimal level depends on institutional factors that can be grabbed by certain Economic Freedom and Worldwide Governance Indicators. It was not our aim necessarily to determine exactly the level of optimal government redistribution, it would be difficult because of the heterogeneity of the countries, only to make a comparison between free and less free countries, and draw some conclusions about how this level depends on these institutional variables. Summing up we can say that our aim was to compare free and less free, legally “good” and “bad”, as well as corrupt and less corrupt countries from the aspect of government redistribution level. If we divide countries into free and less free countries and assume that both groups have an inverted U-shaped curve, the optimal level of government spending share is larger in the richer countries because of their better institutional system. These results do not contradict those findings that declare positive or negative relationship between government spending and economic growth. One part of the literature presumes that there is only one optimal level of government spending, we point out that there can be at least two optimal levels, and they depend on the institutional quality.

Public procurement, governance and economic growth: some policy ...

African Journals Online (AJOL)

Public procurement, governance and economic growth: some policy ... Employing the Keynesian income-expenditure approach to measuring the Gross Domestic ... reduce wastage, enhance the effectiveness of government spending, ensure ...

Design of governmental policies for oil production rates and oil income spending. A long-term perspective. [Norway

Energy Technology Data Exchange (ETDEWEB)

Moxnes, E

1982-09-01

In 1980, oil production in Norway amounted to 1 million barrels per day. Taxes and royalties to the government from this production provides 9 per cent of the GNP. With current estimates of recoverable reserves, the 1980 production rate would last for 100 years. Decisions about oil production rates and oil income spending have tremendous impact on society. Attemps to design an appropriate oil policy are complicated by uncertainty about total reserves, future oil prices and complex economic responses to production and income. This report provides and integrating framework to aid government officials in their evaluation of policy options. A system dynamics model of the Norwegian national economy is developed for the analysis. The model determines endogenously the spending of oil income, GNP, consumption and investments, imports and exports, unemployment and labor migration from exporting industries to service industries; all variables result from exogenous decisions about oil production. Though the model is based on behavioral theory of economic decision making at the microeconomic level, it reproduces well major behavior modes of macroeconomic indicators from the 1970s. The most attractive oil policy has been found to be a dynamic and firm ceiling on spending. Dynamic means that growth in spending should be limited, spending should not increase unless the economy is appropriately buffered against oil price drops by foreign savings and spending should never exceed a maximum ceiling set to ensure a desirabel distribution of benefits and problems over time. Firm means that the ceiling cannot be changed by Parliament within an election period. If a firm ceiling on spending is politically infeasible, oil production should be kept lower than otherwise.

New Mexican taxes to transform Pemex capital spending strategy

International Nuclear Information System (INIS)

Anon.

1994-01-01

Mexico's government this year will introduce petroleum tax reforms that will transform how its state owned petroleum company approaches capital spending. Effective Jan. 1, 1994, the Mexican government began to implement a revamped tax regime designed to accompany the breakup of Petroleos Mexicanos into four new operating subsidiaries. Each of the four new companies -- Pemex Exploration and Production, Pemex Refining, Pemex Natural Gas and Basic Petrochemicals, and Pemex Secondary Petrochemicals -- will be responsible for paying a new income tax. Levies on E and P will be tied to a ring-fence mechanism tailored after the scheme employed by the U.K. and Norwegian governments in the North Sea. The paper discusses the affected investment rationale, the North Sea ring-fence model, other tax changes, and shifting the burden

Market-based Lobbying: Evidence from Advertising Spending in Italy

OpenAIRE

Stefano DellaVigna; Ruben Durante; Brian Knight; Eliana La Ferrara

2013-01-01

An extensive literature has studied lobbying by special interest groups. We analyze a novel lobbying channel: lobbying businessmen-politicians through business proxies. When a politician controls a business, firms attempting to curry favors shift their spending towards the politician's business. The politician benefits from increased revenues, and the firms hope for favorable regulation in return. We investigate this channel in Italy where government members, including the prime minister, are...

The Problem With Estimating Public Health Spending.

Science.gov (United States)

Leider, Jonathon P

2016-01-01

Accurate information on how much the United States spends on public health is critical. These estimates affect planning efforts; reflect the value society places on the public health enterprise; and allows for the demonstration of cost-effectiveness of programs, policies, and services aimed at increasing population health. Yet, at present, there are a limited number of sources of systematic public health finance data. Each of these sources is collected in different ways, for different reasons, and so yields strikingly different results. This article aims to compare and contrast all 4 current national public health finance data sets, including data compiled by Trust for America's Health, the Association of State and Territorial Health Officials (ASTHO), the National Association of County and City Health Officials (NACCHO), and the Census, which underlie the oft-cited National Health Expenditure Account estimates of public health activity. In FY2008, ASTHO estimates that state health agencies spent $24 billion ($94 per capita on average, median $79), while the Census estimated all state governmental agencies including state health agencies spent $60 billion on public health ($200 per capita on average, median $166). Census public health data suggest that local governments spent an average of $87 per capita (median $57), whereas NACCHO estimates that reporting LHDs spent $64 per capita on average (median $36) in FY2008. We conclude that these estimates differ because the various organizations collect data using different means, data definitions, and inclusion/exclusion criteria--most notably around whether to include spending by all agencies versus a state/local health department, and whether behavioral health, disability, and some clinical care spending are included in estimates. Alongside deeper analysis of presently underutilized Census administrative data, we see harmonization efforts and the creation of a standardized expenditure reporting system as a way to

Does spending on refugees make a difference? A cross-sectional study of the association between refugee program spending and health outcomes in 70 sites in 17 countries.

Science.gov (United States)

Tan, Timothy M; Spiegel, Paul; Haskew, Christopher; Greenough, P Gregg

2016-01-01

Numerous simultaneous complex humanitarian emergencies strain the ability of local governments and the international community to respond, underscoring the importance of cost-effective use of limited resources. At the end of 2011, 42.5 million people were forcibly displaced, including 10.4 million refugees under the mandate of the United Nations High Commissioner for Refugees (UNHCR). UNHCR spent US$1.65 billion on refugee programs in 2011. We analyze the impact of aggregate-level UNHCR spending on mortality of refugee populations. Using 2011 budget data, we calculated purchasing power parity adjusted spending, disaggregated by population planning groups (PPGs) and UNHCR Results Framework objectives. Monthly mortality reported to UNHCR's Health Information System from 2011 to 2012 was used to calculate crude (CMR) and under-5 (U5MR) mortality rates, and expressed as ratios to country of asylum mortality. Log-linear regressions were performed to assess correlation between spending and mortality. Mortality data for 70 refugee sites representing 1.6 million refugees in 17 countries were matched to 20 PPGs. Median 2011 spending was $623.27 per person (constant 2011 US$). Median CMR was 2.4 deaths per 1,000 persons per year; median U5MR was 18.1 under-5 deaths per 1,000 live births per year. CMR was negatively correlated with total spending ( p =  0.027), and spending for fair protection processes and documentation ( p =  0.005), external relations ( p =  0.034), logistics and operations support ( p =  0.007), and for healthcare ( p =  0.046). U5MR ratio was negatively correlated with total spending ( p =  0.015), and spending for favorable protection environment ( p =  0.024), fair protection processes and documentation ( p =  0.003), basic needs and essential services ( p =  0.027), and within basic needs, for healthcare services ( p =  0.007). Increased UNHCR spending on refugee populations is correlated with lower mortality

The Reaction of Private Spending and Market Interest Rates to the Changes in Public Spending

Directory of Open Access Journals (Sweden)

Przekota Grzegorz

2016-01-01

Full Text Available Expansionary fiscal policy is mired in controversy. Its proponents suggest that during recession, it stimulates investors’ activity and has a stabilizing effect on economic growth. However, its opponents point to the costs associated with the budget deficit and public debt handling. Increased public spending may result in an increase in the interest rates, which may, in turn, hinder private investment and weaken the multiplier effect of public spending. The following study examines how private spending and market interest rates reacted to changes in public spending in Poland. The study has shown that public spending stimulates private spending, which is consistent with the Keynesian model, but it also leads to an increase in market interest rates, which is consistent with the neoclassical model.

Income Elasticity of Vaccines Spending versus General Healthcare Spending.

Science.gov (United States)

Alfonso, Y Natalia; Ding, Guiru; Bishai, David

2016-07-01

Using cross-country data on gross domestic product and national expenditure on vaccines, we estimate and compare the income elasticity of vaccine expenditure and general curative healthcare expenditure. This study provides the first evidence on the national income elasticity of vaccination spending. Both fixed and random effects models are applied to data from 84 countries from 2010 to 2011. The income elasticities for healthcare expenditure and vaccine expenditure are 0.844 and 0.336, respectively. Despite vaccines' high cost-effectiveness, the national propensity to spend income on vaccines as income increases lags behind general health care. The low income elasticity of vaccine spending means that relying on economic growth alone will provide an unacceptably slow trajectory to achieving high vaccine coverage levels. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Evaluating the Effectiveness of Possible Introduction of Fiscal Spending Regulation in Ukraine in Retrospective

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Laktionova Olexandra A.

2016-02-01

Full Text Available A possible impact of introducing fiscal regulation of spending into the budgetary mechanism, if used before the financial crisis of 2008—2009 or afterwards, has been studied. Accumulation of public finance imbalances in the form of government deficit and debt was taken as an introduction effect. Two approaches are considered as a variant of the spending regulation — limitation of spending depending on the state revenue growth and depending on the nominal GDP growth as well. According to the dynamics, the model defined by the GDP dynamics has more tight restrictions but it is more correlated with the business activity dynamics and is more procyclical. Provided the application of the spending regulation at the beginning of the financial crisis, its level in the GDP would have amounted to 9—21%, the reserve of fiscal space according to this indicator would have amounted to 1—16 percentage points.

Health Spending By State 1991-2014: Measuring Per Capita Spending By Payers And Programs.

Science.gov (United States)

Lassman, David; Sisko, Andrea M; Catlin, Aaron; Barron, Mary Carol; Benson, Joseph; Cuckler, Gigi A; Hartman, Micah; Martin, Anne B; Whittle, Lekha

2017-07-01

As the US health sector evolves and changes, it is informative to estimate and analyze health spending trends at the state level. These estimates, which provide information about consumption of health care by residents of a state, serve as a baseline for state and national-level policy discussions. This study examines per capita health spending by state of residence and per enrollee spending for the three largest payers (Medicare, Medicaid, and private health insurance) through 2014. Moreover, it discusses in detail the impacts of the Affordable Care Act implementation and the most recent economic recession and recovery on health spending at the state level. According to this analysis, these factors affected overall annual growth in state health spending and the payers and programs that paid for that care. They did not, however, substantially change state rankings based on per capita spending levels over the period. Project HOPE—The People-to-People Health Foundation, Inc.

Tax Expert Offers Ideas for Monitoring Big Spending on College Sports

Science.gov (United States)

Sander, Libby

2009-01-01

The federal government could take a cue from its regulation of charitable organizations in monitoring the freewheeling fiscal habits of big-time college athletics, a leading tax lawyer says. The author reports on the ideas offered by John D. Colombo, a professor at the University of Illinois College of Law, for monitoring big spending on college…

Government technology push in agribusiness: a model of endogenous growth

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Francisco Venegas Martínez

2008-10-01

Full Text Available This paper develops a model of endogenous growth where the government acts as a promoting agent to boost technology in agribusiness. In the framework of a monetary economy, the optimal level of government spending to enhance technology in the agricultural industry is characterized. Moreover the impact of such a spending on economic welfare is assessed. Finally, a number of agro-oriented policies to increase growth in the sector are established.

Globalisation and social spending

OpenAIRE

De Grauwe, Paul; Polan, Magdalena

2003-01-01

We provide evidence indicating that countries with well-developed social security systems do not necessarily face a trade-off between social spending and competitiveness. On average, countries that spend a lot on social needs score well in the competitiveness league. We investigate the importance of a reverse causality from competitiveness to social spending, and find that this is weak. We also present some possible explanations for our empirical finding. Finally, we interpret our findings in...

Federal Grants to State and Local Governments

Science.gov (United States)

Congressional Budget Office, 2013

2013-01-01

In fiscal year 2011, the federal government provided $607 billion in grants to state and local governments. Those funds accounted for 17 percent of federal outlays, 4 percent of gross domestic product (GDP), and a quarter of spending by state and local governments that year. Over the past 30 years, those "intergovernmental" grants--financial…

Retiree out-of-pocket healthcare spending: a study of consumer expectations and policy implications.

Science.gov (United States)

Hoffman, Allison K; Jackson, Howell E

2013-01-01

Even though most American retirees benefit from Medicare coverage, a mounting body of research predicts that many will face large and increasing out-of-pocket expenditures for healthcare costs in retirement and that many already struggle to finance these costs. It is unclear, however, whether the general population understands the likely magnitude of these out-of-pocket expenditures well enough to plan for them effectively. This study is the first comprehensive examination of Americans' expectations regarding their out-of-pocket spending on healthcare in retirement. We surveyed over 1700 near retirees and retirees to assess their expectations regarding their own spending and then compared their responses to experts' estimates. Our main findings are twofold. First, overall expectations of out-of-pocket spending are mixed. While a significant proportion of respondents estimated out-of-pocket costs in retirement at or above expert estimates of what the typical retiree will spend, a disproportionate number estimated their future spending substantially below what experts view as likely. Estimates by members of some demographic subgroups, including women and younger respondents, deviated relatively further from the experts' estimates. Second, respondents consistently misjudged spending uncertainty. In particular, respondents significantly underestimated how much individual health experience and changes in government policy can affect individual out-of-pocket spending. We discuss possible policy responses, including efforts to improve financial planning and ways to reduce unanticipated financial risk through reform of health insurance regulation.

A Primer on the Government of Alberta’s Budget

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Ronald D. Kneebone

2013-01-01

Full Text Available Provincial budgets may normally make for dry reading, but in Alberta’s case, there is plenty of suspense lurking inside the pages — and that’s not necessarily a good thing. Your average family may know certain things about balancing a budget: keeping spending roughly in line with income; not relying on volatile, unpredictable income streams to cover expenses; and not leaving the kids with an inheritance of significant debt. But look at how Alberta has been managing its budget in the last decade, and it is obvious that the provincial government is breaking a lot of the financial management rules that most Albertans are disciplined enough to live by at home. A clear way to get a sense of how the Alberta government has managed its finances is by analyzing how much provincial program spending relies on depleting provincial savings, either in the form of savings funds or non-renewable resource deposits, such as oil and gas. By 2011, Alberta’s “Budget Gap” had grown to almost the same level it was in 1993, when the province was forced to adopt wrenching budget cuts in order to close what had become a yawning gap between revenue and costs amounting to $4,000 in spending for every man, woman and child in the province. This paper suggests there are three key questions that should be posed to our government and to any political party seeking to represent our interests as our government: 1. How tolerant are they of annual deficits? Do they advocate a strategy of relatively lower levels of government spending and/or higher tax rates, so as to avoid deficits no matter the state of the economy? Or will they tolerate deficits during economic slowdowns to enable higher levels of spending and/or lower tax rates? 2. To what extent are they willing to trust the payment of health-care costs and the costs of education and social assistance to oil and gas royalties as opposed to taxation? 3. How, exactly, does one define investments in social

Financial protection from health spending in the Philippines: policies and progress.

Science.gov (United States)

Bredenkamp, Caryn; Buisman, Leander R

2016-09-01

The objective of this article is to assess the progress of the Philippines health sector in providing financial protection to the population, as measured by estimates of health insurance coverage, out-of-pocket spending, catastrophic payments and impoverishing health expenditures. Data are drawn from eight household surveys between 2000 and 2013, including two Demographic and Health Surveys, one Family Health Survey and five Family Income and Expenditure Surveys. We find that out-of-pocket spending increased by 150% (real) from 2000 to 2012, with the sharpest increases occurring in recent years. The main driver of health spending is medicines, accounting for almost two-thirds of total health spending, and as much as three-quarters among the poor. The incidence of catastrophic payments has tripled since 2000, from 2.5% to 7.7%. The percentage of people impoverished by health spending has also increased and, in 2012, out-of-pocket spending on health added 1.5 percentage points to the poverty rate, pushing more than 1.5 million people into poverty. In light of these findings, recent policies to enhance financial risk protection-such as the expansion of government-subsidized health insurance from the poor to the near-poor, a policy of zero copayments for the poor, a deepening of the benefit package and provider payment reform aimed at cost-containment-are to be commended. Indeed, between 2008 and 2013, self-reported health insurance coverage increased across all quintiles and its distribution became more pro-poor. To speed progress toward financial protection goals, quick wins could include issuing health insurance cards to the poor to increase awareness of coverage and limiting out-of-pocket spending by clearly defining a clear copayment structure for non-poor members. An in-depth analysis of the pharmaceutical sector would help to shed light on why medicines impose such a large financial burden on households. © The Author 2016. Published by Oxford University Press

Federal Funding Insulated State Budgets From Increased Spending Related To Medicaid Expansion.

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Sommers, Benjamin D; Gruber, Jonathan

2017-05-01

As states weigh whether to expand Medicaid under the Affordable Care Act (ACA) and Medicaid reform remains a priority for some federal lawmakers, fiscal considerations loom large. As part of the ACA's expansion of eligibility for Medicaid, the federal government paid for 100 percent of the costs for newly eligible Medicaid enrollees for the period 2014-16. In 2017 states will pay some of the costs for new enrollees, with each participating state's share rising to 10 percent by 2020. States continue to pay their traditional Medicaid share (roughly 25-50 percent, depending on the state) for previously eligible enrollees. We used data for fiscal years 2010-15 from the National Association of State Budget Officers and a difference-in-differences framework to assess the effects of the expansion's first two fiscal years. We found that the expansion led to an 11.7 percent increase in overall spending on Medicaid, which was accompanied by a 12.2 percent increase in spending from federal funds. There were no significant increases in spending from state funds as a result of the expansion, nor any significant reductions in spending on education or other programs. States' advance budget projections were also reasonably accurate in the aggregate, with no significant differences between the projected levels of federal, state, and Medicaid spending and the actual expenses as measured at the end of the fiscal year. Project HOPE—The People-to-People Health Foundation, Inc.

Budget spending and economic growth in Croatia - Dynamics and relathionships over the past two decades

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Helena Blažić

2011-12-01

Full Text Available The objective of this research is to analyze the relationship between government budget spending and the effect on the growth and structure of the GDP of Croatia during the past two decades. The starting working assumption (hypothesis is that the volume of total budget expenditure (including the foreign borrowing has not been realizing appropriate effect on GDP growth. In the analysis of these relationships we primarily use the method of vector autoregressions (VAR. The main result of the analysis showed that, in accordance with theoretical assumptions, the structure of expenditures is essential for the effects of budgetary spending on economic growth. We determine the positive effects of investment spending and purchases of goods and services and the negative effects of other categories of current spending. The reduction of capital expenditures during the recession presents a particularly adverse trend, which reduces the rate of growth of the economy in the long and short term. A fundamental conclusion of the research is that the budget expenditures have not adequately affected the GDP growth. Therefore, it is possible to affect the economic growth by changing the structure of budgetary spending, as well as directing public borrowing to investment financing.

Medicare Hospital Spending Per Patient - National

Data.gov (United States)

U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

Medicare Hospital Spending Per Patient - Hospital

Data.gov (United States)

U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

Medicare Hospital Spending Per Patient - State

Data.gov (United States)

U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

Inequalities in Parental Spending on Young Children

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Sabino Kornrich

2016-04-01

Full Text Available This article investigates inequality in parental spending on young children over the period from 1972 to 2010. I find increased spending among parents at the top of the income distribution but little change among parents at the bottom of the income distribution. The gap in spending is equally attributable to increased spending on center-based care for preschool-age children and spending on enrichment goods and activities. The article examines potential causes of increased spending, including income, parental education, and wife’s work status, using decomposition analysis. Results indicate that higher incomes are the largest cause of the increased gap in spending but that increases in wife’s earnings, college completion, and wife’s work hours are also important for growth in spending.

INTERCONNECTIONS BETWEEN THE ECONOMIC STRUCTURE OF LOCAL SPENDING AND ECONOMIC GROWTH IN ROMANIA

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Bilan Irina

2015-07-01

Full Text Available The issue of the effects of government interventions, explicitly of the taxes and expenditures of local public authorities, has generated substantial debate over time, and still gives rise to numerous controversies in theory and practice. Following the Keynesian path of reasoning, it is, at least theoretically, admitted that it is possible to influence the socio-economic activities and support for economic growth by means of government spending, but different other factors act towards enhancing or, on the contrary, impeding the achievement of the desired effects. From this point of view, the delimitation of competences and public expenditure responsibilities between different levels of government raises the issue of some possible different effects of the central and local governments’ interventions. As the macroeconomic stabilization function is usually associated with central governments, and the contribution of local governments often is of lesser importance, less attention is paid to the effectiveness of local administrative actions. In such a context, the paper aims to empirically evaluate the effects of the economic structure of local public expenditures on the local (territorial economic growth in Romania, over the period 2007 to 2012. The analysis has been conducted at the level of the 42 Romanian counties and on annual data collected from both international and national sources (World Bank, INSSE, The Romanian Ministry of Regional Development and Public Administration.The general method of estimation is the fixed effects estimation technique for panel data models. Our empirical approach is of absolute novelty, especially for Romania, where previous empirical studies have been focusing on the assessment of the overall effects of general government spending. The main findings of our study are that local public expenditures have a negative impact on territorial economic growth, confirmed both for overall expenditures and for various

Health spending, macroeconomics and fiscal space in countries of the World Health Organization South-East Asia Region.

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Gupta, Indrani; Mondal, Swadhin

2014-01-01

The paper examines the issues around mobilization of resources for the 11 countries of the South-East Asia Region of the World Health Organization (WHO), by analysing their macroeconomic situation, health spending, fiscal space and other determinants of health. With the exception of a few, most of these countries have made fair progress on their own Millennium Development Goal (MDG) targets of maternal mortality ratio and mortality rate in children aged under 5 years. However, the achieved targets have been very modest - with the exception of Thailand and Sri Lanka - indicating the continued need for additional efforts to improve these indicators. The paper discusses the need for investment, by looking at evidence on economic growth, the availability of fiscal space, and improvements in "macroeconomic-plus" factors like poverty, female literacy, governance and efficiency of the health sector. The analysis indicates that, overall, the countries of the WHO South-East Asia Region are collectively in a position to make the transition from low public spending to moderate or even high health spending, which is required, in turn, for transition from lowcoverage-high out-of-pocket spending (OOPS) to highcoverage-low OOPS. However, explicit prioritization for health within the overall government budget for low spenders would require political will and champions who can argue the case of the health sector. Additional innovative avenues of raising resources, such as earmarked taxes or a health levy can be considered in countries with good macroeconomic fundamentals. With the exception of Thailand, this is applicable for all the countries of the region. However, countries with adverse macroeconomic-plus factors, as well as inefficient health systems, need to be alert to the possibility of overinvesting - and thereby wasting - resources for modest health gains, making the challenge of increasing health sector spending alongside competing demands for spending on other areas of

Understanding Trends in Medicare Spending, 2007-2014.

Science.gov (United States)

Keohane, Laura M; Gambrel, Robert J; Freed, Salama S; Stevenson, David; Buntin, Melinda B

2018-03-06

To analyze the sources of per-beneficiary Medicare spending growth between 2007 and 2014, including the role of demographic characteristics, attributes of Medicare coverage, and chronic conditions. Individual-level Medicare spending and enrollment data. Using an Oaxaca-Blinder decomposition model, we analyzed whether changes in price-standardized, per-beneficiary Medicare Part A and B spending reflected changes in the composition of the Medicare population or changes in relative spending levels per person. We identified a 5 percent sample of fee-for-service Medicare beneficiaries age 65 and above from years 2007 to 2014. Mean payment-adjusted Medicare per-beneficiary spending decreased by $180 between the 2007-2010 and 2011-2014 time periods. This decline was almost entirely attributable to lower spending levels for beneficiaries. Notably, declines in marginal spending levels for beneficiaries with chronic conditions were associated with a $175 reduction in per-beneficiary spending. The decline was partially offset by the increasing prevalence of certain chronic diseases. Still, we are unable to attribute a large share of the decline in spending levels to observable beneficiary characteristics or chronic conditions. Declines in spending levels for Medicare beneficiaries with chronic conditions suggest that changing patterns of care use may be moderating spending growth. © Health Research and Educational Trust.

Spending to save? State health expenditure and infant mortality in India.

Science.gov (United States)

Bhalotra, Sonia

2007-09-01

There are severe inequalities in health in the world, poor health being concentrated amongst poor people in poor countries. Poor countries spend a much smaller share of national income on health expenditure than do richer countries. What potential lies in political or growth processes that raise this share? This depends upon how effective government health spending in developing countries is. Existing research presents little evidence of an impact on childhood mortality. Using specifications similar to those in the existing literature, this paper finds a similar result for India, which is that state health spending saves no lives. However, upon allowing lagged effects, controlling in a flexible way for trended unobservables and restricting the sample to rural households, a significant effect of health expenditure on infant mortality emerges, the long run elasticity being about -0.24. There are striking differences in the impact by social group. Slicing the data by gender, birth order, religion, maternal and paternal education and maternal age at birth, I find the weakest effects in the most vulnerable groups (with the exception of a large effect for scheduled tribes). Copyright (c) 2007 John Wiley & Sons, Ltd.

Government revenue-expenditure nexus: Evidence from several transitional economies

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Konukcu-Önal Debi

2008-01-01

Full Text Available Budget deficits and the debate on the sources of deficit finance have been on the agenda of public economics ever since the 1980s. However recently in the post-communist countries fiscal imbalances appear to be an important problem due to prolonged periods of growing poverty resulting from the transition process. Poverty alleviation policies considerably affect the revenue and expenditure decisions of governments, which are subject to hard budget constraints in an open transitional economy and do not have room for departing from sound fiscal policies. The public finance literature provides a vast number of studies analyzing the relationship between public revenues and expenditures. These studies are mostly characterized by efforts to reveal the attitude of the fiscal authority towards maintaining the budget balance. In this respect, budgetary dynamics in which past government revenues have predictive power on the current level of government expenditures are accepted as evidence of the so-called tax-and-spend hypothesis. On the other hand, the revenue-expenditure nexus running from expenditures to revenues is known in the literature as the spend-and-tax hypothesis. The objective of this study is to analyze empirically the relationship between government revenues and expenditures in four of the transitional economies, i.e. Belarus, Kazakhstan, the Kyrgyz Republic and the Russian Federation. The empirical findings of this study, which are based on Granger causality tests, indicate evidence supporting the tax-and-spend hypothesis in Belarus and the Russian Federation and fiscal synchronization in Kazakhstan and the Kyrgyz Republic. The empirical support for the tax-and-spend hypothesis in these economies implies that increasing government revenues may not end up with lower budget deficits due to their stimulating effect on the demand for public goods and services.

Trade Costs, Conflicts, and Defense Spending

OpenAIRE

Seitz, Michael; Tarasov, Alexander; Zakharenko, Roman

2013-01-01

This paper develops a quantitative model of trade, military conflicts, and defense spending. Trade liberalization between two countries reduces probability of an armed conflict between them, causing both to cut defense spending. This in turn causes a domino effect on defense spending by other countries. As a result, both countries and the rest of the world are better off. We estimate the model using data on trade, conflicts, and military spending. We find that, after reduction of costs of tra...

Spending more money, saving more lives? The relationship between avoidable mortality and healthcare spending in 14 countries.

Science.gov (United States)

Heijink, Richard; Koolman, Xander; Westert, Gert P

2013-06-01

Healthcare expenditures rise as a share of GDP in most countries, raising questions regarding the value of further spending increases. Against this backdrop, we assessed the value of healthcare spending growth in 14 western countries between 1996 and 2006. We estimated macro-level health production functions using avoidable mortality as outcome measure. Avoidable mortality comprises deaths from certain conditions "that should not occur in the presence of timely and effective healthcare". We investigated the relationship between total avoidable mortality and healthcare spending using descriptive analyses and multiple regression models, focussing on within-country variation and growth rates. We aimed to take into account the role of potential confounders and dynamic effects such as time lags. Additionally, we explored a method to estimate macro-level cost-effectiveness. We found an average yearly avoidable mortality decline of 2.6-5.3% across countries. Simultaneously, healthcare spending rose between 1.9 and 5.9% per year. Most countries with above-average spending growth demonstrated above-average reductions in avoidable mortality. The regression models showed a significant association between contemporaneous and lagged healthcare spending and avoidable mortality. The time-trend, representing an exogenous shift of the health production function, reduced the impact of healthcare spending. After controlling for this time-trend and other confounders, i.e. demographic and socioeconomic variables, a statistically significant relationship between healthcare spending and avoidable mortality remained. We tentatively conclude that macro-level healthcare spending increases provided value for money, at least for the disease groups, countries and years included in this study.

Labour Costs and the Size of Government

OpenAIRE

Facchini, François; Melki, Mickael; Pickering, Andrew Christopher

2016-01-01

Given inelastic demand for labour-intensive public services, the size of government depends positively on labour costs. OECD data exhibit a strong statistical association between government size and the business-sector labour share of income. When the labour share is instrumented with measures of technological change, institutional variation and predetermined data it continues to positively impact government size. In contrast, transfer spending is unaffected by the labour share. The evidence ...

Towards a lean-government using new IT-architectures for compliance monitoring

NARCIS (Netherlands)

Bharosa, N; Hulstijn, J; Janssen, MFWHA; Tan, Y; van Wijk, R; de Winne, N; Estevez E. and Janssen, M.

2011-01-01

Recent turmoil in financial markets has invoked governments to monitor activities and transactions in the private sector more strictly. At the same time, policy makers strive to cut back on government spending by reducing the size of government agencies. These contradicting developments require

Adjusting health expenditure for military spending and interest payment: Israel and the OECD countries.

Science.gov (United States)

Shmueli, Amir; Israeli, Avi

2013-02-20

Compared to OECD countries, Israel has a remarkably low percentage of GDP and of government expenditure spent on health, which are not reflected in worse national outcomes. Israel is also characterized by a relatively high share of GDP spent on security expenses and payment of public debt. To determine to what extent differences between Israel and the OECD countries in security expenses and payment of the public debt might account for the gaps in the percentage of GDP and of government expenditures spent on health. We compare the percentages of GDP and of government expenditures spent on health in the OECD countries with the respective percentages when using primary civilian GDP and government expenditures (i.e., when security expenses and interest payment are deducted). We compared Israel with the OECD average and examined the ranking of the OECD countries under the two measures over time. While as a percentage of GDP, the national expenditure on health in Israel was well below the average of the OECD countries, as a percentage of primary civilian GDP it was above the average until 2003 and below the average thereafter. When the OECD countries were ranked according to decreasing percent of GDP and of government expenditure spent on health, adjusting for security and debt payment expenditures changed the Israeli rank from 23rd to 17th and from 27th to 25th, respectively. Adjusting for security expenditures and interest payment, Israel's low spending on health as a percentage of GDP and as a percentage of government's spending increases and is closer to the OECD average. Further analysis should explore the effect of additional population and macroeconomic differences on the remaining gaps.

Saving Money or Spending Tomorrow's Money

Institute of Scientific and Technical Information of China (English)

罗芳梅

2017-01-01

Chinese are normally believed to be thrifty.However,economic development has had a tremendous impact upon Chinese society,uprooting the long-engraved ideas.With the emergence of the credit cards,spending tomorrow's money becomes a reality.In this way,people are in dilemma:saving money or spending tomorrow's money.Firstly,this paper focuses on the benefits of spending tomorrow's money.Secondly,it shows that spending tomorrow's money is confronted with many challenges.Finally,the paper comes up with some suggestions to solve these problems.

Health spending by state of residence, 1991-2009.

Science.gov (United States)

Cuckler, Gigi; Martin, Anne; Whittle, Lekha; Heffler, Stephen; Sisko, Andrea; Lassman, Dave; Benson, Joseph

2011-12-06

Provide a detailed discussion of baseline health spending by state of residence (per capita personal health care spending, per enrollee Medicare spending, and per enrollee Medicaid spending) in 2009, over the last decade (1998-2009), as well as the differential regional and state impacts of the recent recession. State Health Expenditures by State of Residence for 1991-2009, produced by the Centers for Medicare & Medicaid Services' Office of the Actuary. In 2009, the 10 states where per capita spending was highest ranged from 13 to 36 percent higher than the national average, and the 10 states where per capita spending was lowest ranged from 8 to 26 percent below the national average. States with the highest per capita spending tended to have older populations and the highest per capita incomes; states with the lowest per capita spending tended to have younger populations, lower per capita incomes, and higher rates of uninsured. Over the last decade, the New England and Mideast regions exhibited the highest per capita personal health care spending, while states in the Southwest and Rocky Mountain regions had the lowest per capita spending. Variation in per enrollee Medicaid spending, however, has consistently been greater than that of total per capita personal health care spending or per enrollee Medicare spending from 1998-2009. The Great Lakes, New England, and Far West regions experienced the largest slowdown in per person health spending growth during the recent recession, largely as a result of higher unemployment rates. Public Domain.

Machine-Learning Algorithms to Code Public Health Spending Accounts.

Science.gov (United States)

Brady, Eoghan S; Leider, Jonathon P; Resnick, Beth A; Alfonso, Y Natalia; Bishai, David

Government public health expenditure data sets require time- and labor-intensive manipulation to summarize results that public health policy makers can use. Our objective was to compare the performances of machine-learning algorithms with manual classification of public health expenditures to determine if machines could provide a faster, cheaper alternative to manual classification. We used machine-learning algorithms to replicate the process of manually classifying state public health expenditures, using the standardized public health spending categories from the Foundational Public Health Services model and a large data set from the US Census Bureau. We obtained a data set of 1.9 million individual expenditure items from 2000 to 2013. We collapsed these data into 147 280 summary expenditure records, and we followed a standardized method of manually classifying each expenditure record as public health, maybe public health, or not public health. We then trained 9 machine-learning algorithms to replicate the manual process. We calculated recall, precision, and coverage rates to measure the performance of individual and ensembled algorithms. Compared with manual classification, the machine-learning random forests algorithm produced 84% recall and 91% precision. With algorithm ensembling, we achieved our target criterion of 90% recall by using a consensus ensemble of ≥6 algorithms while still retaining 93% coverage, leaving only 7% of the summary expenditure records unclassified. Machine learning can be a time- and cost-saving tool for estimating public health spending in the United States. It can be used with standardized public health spending categories based on the Foundational Public Health Services model to help parse public health expenditure information from other types of health-related spending, provide data that are more comparable across public health organizations, and evaluate the impact of evidence-based public health resource allocation.

'Government Patent Use': A Legal Approach To Reducing Drug Spending.

Science.gov (United States)

Kapczynski, Amy; Kesselheim, Aaron S

2016-05-01

The high cost of patent-protected brand-name drugs can strain budgets and curb the widespread use of new medicines. An example is the case of direct-acting antiviral drugs for the treatment of hepatitis C. While prices for these drugs have come down in recent months, they still create barriers to treatment. Additionally, prescribing restrictions imposed by insurers put patients at increased risk of medical complications and contribute to transmission of the hepatitis C virus. We propose that the federal government invoke its power under an existing "government patent use" law to reduce excessive prices for important patent-protected medicines. Using this law would permit the government to procure generic versions of patented drugs and in exchange pay the patent-holding companies reasonable royalties to compensate them for research and development. This would allow patients in federal programs, and perhaps beyond, to be treated with inexpensive generic medicines according to clinical need-meaning that many more patients could be reached for no more, and perhaps far less, money than is currently spent. Another benefit would be a reduction in the opportunity for companies to extract monopoly profits that far exceed their risk-adjusted costs of research and development. Project HOPE—The People-to-People Health Foundation, Inc.

Increasing personal exemption of fixed income earners: A cost-benefit analysis on government revenues

Directory of Open Access Journals (Sweden)

Rebecca Maquiling

2016-12-01

Full Text Available Personal exemption (PE was one of the remedies of the government to offset the burden of taxation imposed to its sovereignty. In the Philippines, a motion to increase the PE has already been made by lawmakers, and this prompted the researchers to conduct a study on the effect of this disposable income of fixed income earners on their spending pattern on identified goods and services to VAT and other taxes collected by the government. The study made use of descriptive-survey method given to 100 random respondents earning fixed income in the City of Davao, Philippines. The study determined that the respondents’ age, civil status, sex, and number of qualified dependents affects her/his spending pattern. Married people spend more on basic commodities than single people, male spends more alcohol and tobacco than the female, zero dependents spends more on recreation than more dependents and there is a decrease of spending in recreation as people aged. Moreover, the survey revealed that implementing additional PE will decrease direct income tax of the government. However, forty percent of this will return in the form of indirect taxes since respondents have lower marginal propensity to save than their marginal propensity to consume, it results in a positive impact in the economy as a whole. This is done through the use of the concept of the Tax Cut Multiplier (m[tax]= -MPC/MPS effect. Given the prospective increase in PE, consumers spend their additional disposable income on basic commodities, additional clothing, recreation and excises taxed products, among others.

Adjusting health expenditure for military spending and interest payment: Israel and the OECD countries

Directory of Open Access Journals (Sweden)

Shmueli Amir

2013-02-01

Full Text Available Abstract Background Compared to OECD countries, Israel has a remarkably low percentage of GDP and of government expenditure spent on health, which are not reflected in worse national outcomes. Israel is also characterized by a relatively high share of GDP spent on security expenses and payment of public debt. Objectives To determine to what extent differences between Israel and the OECD countries in security expenses and payment of the public debt might account for the gaps in the percentage of GDP and of government expenditures spent on health. Methods We compare the percentages of GDP and of government expenditures spent on health in the OECD countries with the respective percentages when using primary civilian GDP and government expenditures (i.e., when security expenses and interest payment are deducted. We compared Israel with the OECD average and examined the ranking of the OECD countries under the two measures over time. Results While as a percentage of GDP, the national expenditure on health in Israel was well below the average of the OECD countries, as a percentage of primary civilian GDP it was above the average until 2003 and below the average thereafter. When the OECD countries were ranked according to decreasing percent of GDP and of government expenditure spent on health, adjusting for security and debt payment expenditures changed the Israeli rank from 23rd to 17th and from 27th to 25th, respectively. Conclusions Adjusting for security expenditures and interest payment, Israel's low spending on health as a percentage of GDP and as a percentage of government's spending increases and is closer to the OECD average. Further analysis should explore the effect of additional population and macroeconomic differences on the remaining gaps.

The Effect of Government Expenditures, Private Investment and Labor on Economic Growth in Pidie District

Directory of Open Access Journals (Sweden)

Munzir AG

2018-02-01

Full Text Available This study aims to determine the effect of government spending, private investment, and labor on economic growth in Pidie District, Data analyzed from 2000-2016, using multiple linear regression model. The results of research on government spending, private investment and labor both simultaneously and partially have a positive and significant impact on economic growth in Pidie District. Variations of government expenditure variables, private investment and labor are able to explain the variation of economic growth in Pidie District by 48,7 percent and the rest of 51,3 percent influenced by other variables. Labor is the most dominant variable of influence on economic growth in Pidie District. Private investment is the least influence variable to economic growth in Pidie District. The need for a policy that could make private government investment spending, and labor increases simultaneously so it is likely to have a positive impact on improving economic growth in Pidie District.

Three essays on the causes and consequences of government spending and regulatory programs

Science.gov (United States)

Bee, C. Adam

Chapter 1 assesses the impact of household car ownership on individual labor supply. Various economic theories suggest one reason for low rates of employment among low-skill, inner-city residents is that their residences are spatially separated from suburban jobs. To measure this, I exploit changes in state insurance rate regulation which has been shown to suppress auto insurance prices, thereby decreasing the cost of owning a car. I find that rate regulation increases multi-car ownership among married couples with children. I find that the additional car in the household consequently encourages married mothers to decrease their labor supply while their husbands increase their labor supply. One possible explanation of this result is that second cars are stronger complements to time spent in home production (and especially childrearing) than they are to time spent in the labor market. Chapter 2 (with Shawn Moulton) tests for political budget cycles among US municipalities. According to the political budget cycle hypothesis, in election years government officials engage in opportunistic fiscal policy manipulation for electoral gains. This chapter tests that hypothesis using data on taxes and spending for a panel of 268 US cities over the period 1970-2004. While our estimates provide no evidence of altered total expenditures or taxes in election years, we do find a 0.7 percent increase in total municipal employment, including increases in police, education, and sanitation employment. Chapter 3 (with Andrew Deines, David Lodge, and Richard Jensen) assesses trade-offs between fisheries and hydropower production in a tropical floodplain fishery. We compile catch per unit effort, total harvest, and monthly-mean hydrographs from the Kafue River in Zambia for the years 1955-1996 and develop population growth models to test for effects of density, total fisheries harvest, and water regime. We find that alteration of the flood regime has reduced fish density but enhanced

Determinants of government HIV/AIDS financing: a 10-year trend analysis from 125 low- and middle-income countries.

Science.gov (United States)

Ávila, Carlos; Loncar, Dejan; Amico, Peter; De Lay, Paul

2013-07-19

Trends and predictors of domestic spending from public sources provide national authorities and international donors with a better understanding of the HIV financing architecture, the fulfillment of governments' commitments and potential for long-term sustainability. We analyzed government financing of HIV using evidence from country reports on domestic spending. Panel data from 2000 to 2010 included information from 647 country-years amongst 125 countries. A random-effects model was used to analyze ten year trends and identify independent predictors of public HIV spending. Low- and middle-income countries spent US$ 2.1 billion from government sources in 2000, growing to US$ 6.6 billion in 2010, a three-fold increase. Per capita spending in 2010 ranged from 5 cents in low-level HIV epidemics in the Middle East to US$ 32 in upper-middle income countries with generalized HIV epidemics in Southern Africa. The average domestic public spending per capita was US$ 2.55. The analysis found that GDP per capita and HIV prevalence are positively associated with increasing levels of HIV-spending from public sources; a 10 percent increase in HIV prevalence is associated with a 2.5 percent increase in domestic funding for HIV. Additionally, a 10 percent increase in GDP per capita is associated with an 11.49 percent increase in public spending for HIV and these associations were highly significant. Domestic resources in low- and middle-income countries showed a threefold increase between 2000 and 2010 and currently support 50 percent of the global response with 41 percent coming from sub-Saharan Africa. Domestic spending in LMICs was associated with increased economic growth and an increased burden of HIV. Sustained increases in funding for HIV from public sources were observed in all regions and emphasize the increasing importance of government financing.

Where does the money go? A peregrination of government spending in South Africa

Directory of Open Access Journals (Sweden)

Raphael T Mpofu

2013-12-01

Full Text Available The study looked at the relationship between GDP per capita and health expenditure per capita as well as that of GDP per capita and education expenditure per capita in South Africa between 1994 and 2012. Adolph Wagner’s “Law” proposes that a state will increase its government expenditure relatively to the national income (Henrekson, 1993. Any change in the amount of health expenditure will influence the per capita health expenditure in a country. In this study, using the Human Development Index (HDI as the yardstick for Quality of Life (QoL, the concepts of Standard of Living (SoL and per capita income were examined closely in relation to the role of government in its public expenditure programmes and how these programmes in turn influenced QoL. In particular, the role of government expenditure on health and education seems to signify the commitment of a government in improving the HDI or QoL. Using data on government expenditure in South, the relationships amongst these variables were examined. Since Quality of Life is related to health expenditure per capita, then QoL too should change as government health expenditure increases. The same is expected of an increase in education expenditure. From the study results, it is clear that total tax revenue has increased sharply since 2000 and at a much faster rate than its contribution to GDP but the government deficit has also burgeoned in tandem with government revenue collection as if in tango. The reality is that government expenditure has increased sharply since 1993 but has this been directed at QoL? Public service protests tell a different story. The departments of Cooperative Governance and Traditional Affairs and the Police seem to be receiving the largest revenue votes, raising the question of whether there is real value added and whether this expenditure is warrantied in terms of SoL.

TRENDS IN SLOVAK REPUBLIC’S MILITARY SPENDING

Directory of Open Access Journals (Sweden)

Milota KUSTROVÁ

2012-01-01

Full Text Available The article focuses on the amount of military spending in the Slovak Republic. In the first part, the terms of defense expenditure and military spending are defined. The second part focuses on the evolution of military spending in the Slovak Republic so far and the future prospects, as well as on the structure of military spending. The final part covers the amount of defense expenditure in relation to the objectives and tasks of the Armed Forces of the Slovak Republic.

An Analysis of Fiscal Years 2014 to 2016 Navy Fourth Quarter Spending: Trends and Characteristics of Q4 O and M Contractual Awards

Science.gov (United States)

2017-09-01

Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188...spending in the Navy Operations and Maintenance accounts between fiscal years 2014 and 2016 to help ensure the government is getting the best value for the...Competition. 14. SUBJECT TERMS Department of the Navy, appropriations, spending, contracts, operations and maintenance , fiscal, Anti-Deficiency Act

CAUSALITY BETWEEN TAX REVENUE AND GOVERNMENT SPENDING IN MALAYSIA

OpenAIRE

Roshaiza Taha; Nanthakumar Loganathan

2008-01-01

The trend of tax collection in Malaysia is inconsistent, changing upward and downward depending upon economic conditions. However, over a 30 year period, most years show an increasing increment in total collection. The exceptions are when there is an abnormal economic condition such as financial crisis, war or increase in world oil prices. Total tax revenue has always been a major contribution to Malaysia’s federal government revenue. Income tax is one of the surest ways to fund the governm...

Health Spending by State of Residence, 1991–2009

Science.gov (United States)

Cuckler, Gigi; Martin, Anne; Whittle, Lekha; Heffler, Stephen; Sisko, Andrea; Lassman, Dave; Benson, Joseph

2011-01-01

Objective Provide a detailed discussion of baseline health spending by state of residence (per capita personal health care spending, per enrollee Medicare spending, and per enrollee Medicaid spending) in 2009, over the last decade (1998–2009), as well as the differential regional and state impacts of the recent recession. Data Source State Health Expenditures by State of Residence for 1991–2009, produced by the Centers for Medicare & Medicaid Services' Office of the Actuary. Principal Findings In 2009, the 10 states where per capita spending was highest ranged from 13 to 36 percent higher than the national average, and the 10 states where per capita spending was lowest ranged from 8 to 26 percent below the national average. States with the highest per capita spending tended to have older populations and the highest per capita incomes; states with the lowest per capita spending tended to have younger populations, lower per capita incomes, and higher rates of uninsured. Over the last decade, the New England and Mideast regions exhibited the highest per capita personal health care spending, while states in the Southwest and Rocky Mountain regions had the lowest per capita spending. Variation in per enrollee Medicaid spending, however, has consistently been greater than that of total per capita personal health care spending or per enrollee Medicare spending from 1998–2009. The Great Lakes, New England, and Far West regions experienced the largest slowdown in per person health spending growth during the recent recession, largely as a result of higher unemployment rates. PMID:22340779

Natural resources: A curse on education spending?

International Nuclear Information System (INIS)

Cockx, Lara; Francken, Nathalie

2016-01-01

In line with the rising interest in harnessing natural resource revenues for economic and human development through productive government investments, this paper aims to address an important blind spot in our understanding of the “resource curse” by contributing innovative insights on how natural resource wealth impacts government priorities and expenditure practices. Using a large panel dataset of 140 countries covering the period from 1995 to 2009, we find an adverse effect of resource dependence on public education expenditures relative to GDP that is robust to controlling for a range of additional covariates. Furthermore, our findings indicate that this resource curse effect on the government prioritization of education mainly stems from point-source natural resources. These results are of particular importance for the sustainable management of natural resource wealth in developing countries, as they could achieve especially high returns by investing resource revenues in public goods such as education. While this paper underlines the importance of institutions and government accountability, our findings also raise questions on the role of the private sector as a partner in development, as the extractives industry could consider increasing funding for education through Corporate Social Responsibility (CSR) initiatives. - Highlights: •We use a panel dataset of 140 countries covering the period from 1995 to 2009. •We find an inverse relationship between resource dependence and education spending. •The effect of resource dependence is robust to controlling for several covariates. •Indirect effects through a decline in accountability and the service industry. •This curse mainly stems from point-source resource dependence.

National Health Expenditure Projections, 2015-25: Economy, Prices, And Aging Expected To Shape Spending And Enrollment.

Science.gov (United States)

Keehan, Sean P; Poisal, John A; Cuckler, Gigi A; Sisko, Andrea M; Smith, Sheila D; Madison, Andrew J; Stone, Devin A; Wolfe, Christian J; Lizonitz, Joseph M

2016-08-01

Health spending growth in the United States for 2015-25 is projected to average 5.8 percent-1.3 percentage points faster than growth in the gross domestic product-and to represent 20.1 percent of the total economy by 2025. As the initial impacts associated with the Affordable Care Act's coverage expansions fade, growth in health spending is expected to be influenced by changes in economic growth, faster growth in medical prices, and population aging. Projected national health spending growth, though faster than observed in the recent history, is slower than in the two decades before the recent Great Recession, in part because of trends such as increasing cost sharing in private health insurance plans and various Medicare payment update provisions. In addition, the share of total health expenditures paid for by federal, state, and local governments is projected to increase to 47 percent by 2025. Project HOPE—The People-to-People Health Foundation, Inc.

Understanding the recent growth in Medicaid spending, 2000-2003.

Science.gov (United States)

Holahan, John; Ghosh, Arunabh

2005-01-01

Growth in Medicaid spending averaged 10.2 percent per year between 2000 and 2003, resulting in a one-third increase in program spending. Spending growth was lower from 2002 to 2003 because of slower growth in enrollment and in spending per enrollee, particularly for acute care services, and declines in disproportionate-share hospital (DSH) payments and upper payment limit (UPL) programs. For the entire 2000-2003 period, Medicaid spending increases were largely driven by enrollment growth, much of which was attributable to the economic downturn. Increases in spending per enrollee over the period were faster than inflation but slower than increases in private insurance spending.

Dynamic relationships between oil revenue, government spending and economic growth in Oman

Directory of Open Access Journals (Sweden)

Ahmad Hassan Ahmad

2015-07-01

Full Text Available This paper investigates the short-run and long-run relationships between three main macroeconomic variables in Oman using the Johansen multivariate co-integration techniques as well as the stationary VAR for the period between 1971 and 2013. The results indicate that there is a long-run relationship between these three macroeconomic variables; the real GDP, the real government expenditure and the real oil revenues. The estimated coefficients for the real oil revenues and the real government expenditure are correctly signed and statistically significant at 5% level. Both variables depict positive relationship with GDP which are 0.672 and 0.872 respectively. The impulse response functions and the variance decomposition from the stationary VAR show that these variables are very important to the short-run dynamics of the Omani economy. Overall, government expenditure appears to be the main source for economic growth in long-run, and in short run variations in government expenditure are generally derived by oil revenue shocks. Therefore, the volatility in oil revenue requires public expenditure management reforms and the need to diversify income sources in order to enhance economic stability and growth.

High Spending on Maternity Care in India: What Are the Factors Explaining It?

Science.gov (United States)

Goli, Srinivas; Moradhvaj; Rammohan, Anu; Shruti; Pradhan, Jalandhar

2016-01-01

High maternity-related health care spending is often cited as an important barrier in utilizing quality health care during pregnancy and childbirth. This study has two objectives: (i) to measure the levels of expenditure on total maternity care in disaggregated components such as ANCs, PNCs, and Natal care expenditure; (ii) to quantify the extent of catastrophic maternity expenditure (CME) incurred by households and identify the factors responsible for it. Data from the 71st round of the National Sample Survey (2014) was used to estimate maternity expenditure and its predictors. CME was measured as a share of consumption expenditure by different cut-offs. The two-part model was used to identify the factors associated with maternity spending and CME. The findings show that household spending on maternity care (US$ 149 in constant price) is much higher than previous estimates (US$ 50 in constant price). A significant proportion of households in India (51%) are incurring CME. Along with economic and educational status, type of health care and place of residence emerged as significant factors in explaining CME. Findings from this study assume importance in the context of an emerging demand for higher maternity entitlements and government spending on public health care in India. To reduce CME, India needs to improve the availability and accessibility of better-quality public health services and increase maternity entitlements in line with maternity expenditure identified in this study.

Consumption patterns and levels among households with HIV positive members and economic impoverishment due to medical spending in Pune city, India.

Science.gov (United States)

Sharma, Varun; Krishnaswamy, Divya; Mulay, Sanjeevanee

2015-01-01

HIV infection poses a serious threat to the economy of a household. Out of pocket (OOP) health spending can be prohibitive and can drag households below poverty level. Based on the data collected from a cross-sectional survey of 401 households with HIV+ members in Pune city, India, this paper examines the consumption levels and patterns among households, and comments on the economic impoverishment resulting from OOP medical spending. Analysis reveals that households with HIV members spend a major portion of their monthly consumption expenditure on food items. Medical expenditure constitutes a large portion of their total consumption spending. Expenditure on children's education constitutes a minor proportion of total monthly spending. A high proportion of medical expenditure has a bearing on the economic condition of households with HIV members. Poverty increases by 20% among the studied HIV households when OOP health spending is adjusted. It increases 18% among male-headed households and 26% among female-headed households. The results reiterate the need of greater support from the government in terms of accessibility and affordability of health care to save households with HIV members from economic catastrophe.

Hong Kong's domestic health spending--financial years 1989/90 through 2004/05.

Science.gov (United States)

Leung, G M; Tin, K Y K; Yeung, G M K; Leung, E S K; Tsui, E L H; Lam, D W S; Tsang, C S H; Fung, A Y K; Lo, S V

2008-04-01

observed a system-wide trend towards service consolidation at institutions (as opposed to free-standing ambulatory clinics, most of which are staffed by solo practitioner). In 2004/05, public expenditure on health amounted to $35,247 million (53.9% of total current expenditure), which was mostly incurred at hospitals (76.5%), whilst private expenditure ($30,182 million) was mostly incurred at providers of ambulatory health care (54.6%). This reflects the mixed health care economy of Hong Kong where public hospitals generally account for about 90% of total bed-days and private doctors (including Western and Chinese medicine practitioners) provide 75% to 80% of out-patient care. While both public and private spending were mostly expended on personal health care services and goods (92.9%), the distributional patterns among functional categories differed. Public expenditure was targeted at in-patient care (54.2%) and substantially less on out-patient care (24.5%), especially low-intensity first-contact care. In comparison, private spending was mostly concentrated on out-patient care (49.6%), whereas medical goods outside the patient care setting (22.6%) and in-patient care (18.8%) comprised the majority of the remaining share. Compared to OECD countries, Hong Kong has devoted a relatively low percentage of gross domestic product to health in the last decade. As a share of total spending, public funding (either general government revenue or social security funds) was also lower than in most comparably developed economies, although commensurate with its public revenue collection base.

Medical Spending in Denmark

DEFF Research Database (Denmark)

Christensen, Bent Jesper; Gørtz, Mette; Kallestrup-Lamb, Malene

2016-01-01

is responsible for more than twice as much spending on health as the richest, and this reverse social gradient is even stronger for long-term care and is stronger among men than among women, especially in hospital expenses. Expenditures in the year (over the three years) before death are nearly 12 times...... (respectively nine times) higher than average, but nevertheless are only 11 per cent (respectively a quarter) of lifetime spending. Out-of-pocket expenses on prescription drugs only amount to 3 per cent of total health expenditures and are less concentrated than these....

Measuring transparency in public spending: Case of Czech public e-procurement information system

OpenAIRE

Chvalkovská, Jana; Skuhrovec, Jiří

2010-01-01

The objective of this paper is to analyze the potential of e-Government tools to enable the general public to oversee spending of public institutions. The paper illustrates the “watchdog” potential of reducing corruption by means of providing information to the public on the example of the Czech Public e-Procurement Information System (further called System). The System is an Internet portal, where public authorities announce their intention to purchase goods and services. Such announcements ...

Spending more money, saving more lives? The relationship between avoidable mortality and healthcare spending in 14 countries

NARCIS (Netherlands)

Heijink, R.; Koolman, X.; Westert, G.P.

2013-01-01

Healthcare expenditures rise as a share of GDP in most countries, raising questions regarding the value of further spending increases. Against this backdrop, we assessed the value of healthcare spending growth in 14 western countries between 1996 and 2006. We estimated macro-level health production

Income distribution determinants and public spending efficiency

OpenAIRE

Afonso, António; Schuknecht, Ludger; Tanzi, Vito

2008-01-01

In this paper we examine the impact of public spending, education, and institutions on income distribution in advanced economies. We also assess the efficiency of public spending in redistributing income by using a DEA (Data Envelopment Analysis) nonparametric approach. We find that public policies significantly affect income distribution, notably via social spending, and indirectly via high quality education/human capital and via sound economic institutions. Moreover, for our set of OECD cou...

Positional spending and status seeking in rural China

NARCIS (Netherlands)

Brown, P.; Bulte, E.H.; Zhang, X.

2011-01-01

Focusing on a remote area in rural China, we use a panel census of households in 26 villages to show that socially observable spending has risen sharply in recent years. We demonstrate that such spending by households is highly sensitive to social spending by other villagers. This suggests that

Health needs, budget cuts & military spending.

Science.gov (United States)

1991-01-01

A healthy, well-fed, educated populace is synonymous with a prospering economy. Yet, when planning their budgets, governments tend to emphasize infrastructural/industrial projects and defence rather than investing in health, education and other social programmes to eliminate the widespread poverty and high mortality of its population, which would assure a more promising future in the long-term. As citizens, nurses are responsible for initiating and supporting action to meet the health and social needs of the public. And in keeping with ICN's 1989 resolution on nuclear war, INR presents some facts on social and defence spending to show how health needs are often being deprived by emphasis on others sectors, particularly defence. The aim is "to encourage nurses to critically appraise expenditure on health and welfare at a national and global level in relation to that spent on conventional and nuclear arms and to assist nurses to develop strategies of action to contribute to international peace."

Local Government Responses to Education Grants.

Science.gov (United States)

Fisher, Ronald C.; Papke, Leslie E.

2000-01-01

Provides a primer for policymakers about the economics of education grants and draws implications for school finance reform. Includes an overview of the types of education grants that states and the federal government have used to aid local spending and summarizes findings from states' experiences with different forms of education finance.…

New government to make social security cutbacks

NARCIS (Netherlands)

Grünell, M.

2003-01-01

In May 2003, a new coalition government of the Christian Democrats and two liberal parties, VVD and D66, took office in the Netherlands. The parties' coalition agreement provides for major cutbacks in public spending, largely targeted on social security expenditure. The trade unions are fiercely

Measuring Economic Freedom: Better Without Size of Government.

Science.gov (United States)

Ott, Jan

2018-01-01

The Heritage Foundation and the Fraser Institute measure economic freedom in nations using indices with ten and five indicators respectively. Eight of the Heritage indicators and four of the Fraser-indicators are about specific types of institutional quality, like rule of law, the protection of property, and the provision of sound money. More of these is considered to denote more economic freedom. Both indices also involve indicators of 'big government', or levels of government activities. More of that is seen to denote less economic freedom. Yet, levels of government spending, consumption, and transfers and subsidies appear to correlate positively with the other indicators related to institutional quality, while this correlation is close to zero for the level of taxation as a percentage of GDP. Using government spending, consumption transfers and subsidies as positive indicators is no alternative, because these levels stand for very different government activities, liberal or less liberal. This means that levels of government activities can better be left out as negative or positive indicators. Thus shortened variants of the indices create a better convergent validity in the measurement of economic freedom, and create higher correlations between economic freedom and alternative types of freedom, and between economic freedom and happiness. The higher correlations indicate a better predictive validity, since they are predictable in view of the findings of previous research and theoretical considerations about the relations between types of freedom, and between freedom and happiness.

Does fiscal discipline towards subnational governments affect citizens' well-being? Evidence on health.

Science.gov (United States)

Piacenza, Massimiliano; Turati, Gilberto

2014-02-01

This paper aims to assess the impact on citizens' well-being of fiscal discipline imposed by the central government on subnational governments. Because healthcare policies involve strategic interactions between different layers of governments in many different countries, we focus on a particular dimension of well-being, namely citizens' health. We model fiscal discipline by considering government expectations of future deficit bailouts from the central government. We then study how these bailout expectations affect the expenditure for healthcare policies carried out by decentralized governments. To investigate this issue, we separate efficient health spending from inefficiencies by estimating an input requirement frontier. This allows us to assess the effects of bailout expectations on both the structural component of health expenditure and its deviations from the 'best practice'. The evidence from the 15 Italian ordinary statute regions (observed from 1993 to 2006) points out that bailout expectations do not significantly influence the position of the frontier, thus not affecting citizens' health. However, they do appear to exert a remarkable impact on excess spending. Copyright © 2013 John Wiley & Sons, Ltd.

Alcohol industry and government revenue derived from underage drinking by Australian adolescents 2005.

Science.gov (United States)

Doran, Christopher M; Shakeshaft, Anthony P; Hall, Wayne; Petrie, Dennis

2009-01-01

The purpose of this study was to estimate the revenue gained from consumption of alcohol by adolescents for each beverage type for the year 2005. Secondary analysis of self-reported alcohol use in the 2005 Australian Secondary School Surveys Alcohol and Drug Use. Australia. Over 506,000 adolescents aged between 12 and 17 years (29% of all Australian adolescents) consumed approximately 175.69 million standard drinks in 2005. The total revenue generated by the consumption of these beverages was estimated to be $218 million, of which the government received approximately $107 million or 49% in taxation revenue. Total revenue per underage drinker is estimated at $430.84 with revenue increasing with age. Males tend to spend more on spirits and beer while females spend more on pre-mixed spirits. Females aged 12-15 years spend around $121 per year (or 50% of total expenditure) on pre-mixed spirits compared to females aged 16-17 years old that spend around $257 per year (or 62% of total expenditure) on pre-mixed spirits. The Australian government and the alcohol industry receive substantial financial benefit from the sale of alcoholic beverages to under age drinkers.

Is spending money on others good for your heart?

Science.gov (United States)

Whillans, Ashley V; Dunn, Elizabeth W; Sandstrom, Gillian M; Dickerson, Sally S; Madden, Kenneth M

2016-06-01

Does spending money on others (prosocial spending) improve the cardiovascular health of community-dwelling older adults diagnosed with high blood pressure? In Study 1, 186 older adults diagnosed with high blood pressure participating in the Midlife in the U.S. Study (MIDUS) were examined. In Study 2, 73 older adults diagnosed with high blood pressure were assigned to spend money on others or to spend money on themselves. In Study 1, the more money people spent on others, the lower their blood pressure was 2 years later. In Study 2, participants who were assigned to spend money on others for 3 consecutive weeks subsequently exhibited lower systolic and diastolic blood pressure compared to participants assigned to spend money on themselves. The magnitude of these effects was comparable to the effects of interventions such as antihypertensive medication or exercise. Together, these findings suggest that spending money on others shapes cardiovascular health, thereby providing a pathway by which prosocial behavior improves physical health among at-risk older adults. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Canadian capital spending to slip 4.7% in 1993

International Nuclear Information System (INIS)

Anon.

1993-01-01

Total capital and exploration spending by the Canadian petroleum industry is estimated at $6.579 billion in 1993, a drop of 4.7% from estimated 1992 outlays. Last year Canadian capital spending of $6.9 billion represented a drop of 8.9% from 1991 outlays, according to an Oil and Gas Journal survey. All survey related spending estimates in this paper are in U.S. dollars. All individual company spending estimates are in Canadian dollars

Loyalty for Sale? Military Spending and Coups d'Etat

OpenAIRE

Leon, G.

2012-01-01

Coups d'etat continue to be common around the world, often leading to changes in leaders and institutions. We examine the relationship between military spending and coups and find that (i) successful coups increase military spending by more than failed attempts, and (ii) coups are more likely when military spending as a share of GDP is relatively low. Our identification strategy exploits the conditional independence between a coup's outcome and the change in military spending that follows it....

A Closer look on Ineffectiveness in Riau Mainland Expenditure: Local Government Budget Case

Science.gov (United States)

Yandra, Alexsander; Roserdevi Nasution, Sri; Harsini; Wardi, Jeni

2018-05-01

this study discussed about the issues on ineffectiveness of expenditure by one Indonesia local Government in Riau. This Provence were amounted Rp. 10.7 trillion through Local Government Budget (APBD) in 2015. According to data from Financial Management Board and Regions Assets (BPKAD) APBD Riau in 2015 stood at approximately 37.58% until October 2015,another data taken from the Ministry of Home Affairs, Riau regional budget, from January to December 2015, it shows the lowest in Indonesia which amounted to 59.6%. The percentage described the lacking implementation of the budget, this can be interpreted that Riau government is less optimal and irrelevant in spending the budget in 2015. Through a theoretical approach to government spending, the implementation of public policies showed the ineffectiveness of the budget that have implicated towards regional development. As regional budget is only the draft in achieving the targets. Budget management in 2015 by the provincial administration through the Local Government Unit (SKPD) shows unsynchronized between the Medium Term Development Plan with the work program from SKPD.

Multidimensional poverty and catastrophic health spending in the mountainous regions of Myanmar, Nepal and India.

Science.gov (United States)

Mohanty, Sanjay K; Agrawal, Nand Kishor; Mahapatra, Bidhubhusan; Choudhury, Dhrupad; Tuladhar, Sabarnee; Holmgren, E Valdemar

2017-01-18

not significant. The multidimensionally poor in the poorer regions are more likely to face health shocks and are less likely to afford professional health services. Increasing government spending on health and increasing households' access to health insurance can reduce catastrophic health spending and multidimensional poverty.

Money Buys Happiness When Spending Fits Our Personality.

Science.gov (United States)

Matz, Sandra C; Gladstone, Joe J; Stillwell, David

2016-05-01

In contrast to decades of research reporting surprisingly weak relationships between consumption and happiness, recent findings suggest that money can indeed increase happiness if it is spent the "right way" (e.g., on experiences or on other people). Drawing on the concept of psychological fit, we extend this research by arguing that individual differences play a central role in determining the "right" type of spending to increase well-being. In a field study using more than 76,000 bank-transaction records, we found that individuals spend more on products that match their personality, and that people whose purchases better match their personality report higher levels of life satisfaction. This effect of psychological fit on happiness was stronger than the effect of individuals' total income or the effect of their total spending. A follow-up study showed a causal effect: Personality-matched spending increased positive affect. In summary, when spending matches the buyer's personality, it appears that money can indeed buy happiness. © The Author(s) 2016.

The effect of altruism on the spending behavior of elderly caregivers of family members with HIV/AIDS in South African townships.

Science.gov (United States)

Klemz, Bruce R; Boshoff, Christo; Mazibuko, Noxolo-Eileen; Asquith, Jo Ann

2015-01-01

HIV/AIDS has led to an enormous demand for health care in the developing world and many governments have opted to capitalize on altruistic home-based caregivers. These caregivers are mainly poor older women and their financial survival is critically important to themselves and their families. We found that as the patient's illness progressed: (a) the altruistic cultural norm "ubuntu" led the caregiver to increase spending and (b) the social pressure (sanction) of stigma led to a very dramatic drop in direct interpersonal assistance. The impact on their spending, health care, and the related public policies are discussed.

Nongovernment Philanthropic Spending on Public Health in the United States.

Science.gov (United States)

Shaw-Taylor, Yoku

2016-01-01

The objective of this study was to estimate the dollar amount of nongovernment philanthropic spending on public health activities in the United States. Health expenditure data were derived from the US National Health Expenditures Accounts and the US Census Bureau. Results reveal that spending on public health is not disaggregated from health spending in general. The level of philanthropic spending is estimated as, on average, 7% of overall health spending, or about $150 billion annually according to National Health Expenditures Accounts data tables. When a point estimate of charity care provided by hospitals and office-based physicians is added, the value of nongovernment philanthropic expenditures reaches approximately $203 billion, or about 10% of all health spending annually.

Business Development in Emerging Markets: The Impact on spending behaviour of elderly caregivers of family members with HIV/AIDS in SA

Directory of Open Access Journals (Sweden)

Christo Boshoff

2010-12-01

Full Text Available Business development in emerging markets, known as the “base of the pyramid”, is not without financial risk and a key concern in South African communities are the costs associated with HIV/AIDS. Due to the enormous demand for healthcare, many governments have opted for home-based care systems. Caregivers are mainly older women and their financial survival is critically important. We found that as the patient’s illness progressed: 1 the cultural norm ubuntu led the caregiver to increase spending on the patient and a decreased spending on themselves and 2 the social pressure of stigma led to a very dramatic drop in direct interpersonal assistance to the patient and an increase in spending on themselves. Their resulting coping strategies and implications for economic development are discussed. Keywords - Emerging Markets, Cultural, Health Services

When the terrain does not fit the map: Local government taxation in Africa

OpenAIRE

Fjeldstad, Odd-Helge

2015-01-01

Fiscal decentralisation – the devolution of revenue mobilisation and spending powers to lower levels of government – has become a main theme of governance over the past two decades. A sound revenue system for local governments is an essential pre-condition for the success of fiscal decentralisation. In addition to raising revenues, local revenue mobilisation has the potential to foster political and administrative accountability by empowering communities. However, local government financing i...

Health care spending growth: can we avoid fiscal Armageddon?

Science.gov (United States)

Chernew, Michael

Both private and public payers have experienced a persistent rise in health care spending that has exceeded income growth. The issue now transcends the health care system because health care spending growth threatens the fiscal health of the nation. This paper examines the causes and consequences of health care spending growth. It notes that the determinants of spending growth may differ from the determinants of high spending at a point in time. Specifically, the evidence overwhelmingly suggests that the primary driver ofinflation-adjusted, per capita spending growth over the past decades (and thus premium growth) has been the diffusion of new medical technology. The paper argues that while new technology has provided significant clinical benefit, we can no longer afford the persistent gap between health spending and income growth. In simple terms, if the economy is growing 2%, we cannot afford persistent health care spending growth of 4%. Growth in public spending is particularly important. If not abated, high public spending will require either substantially higher taxes or debt, both of which could lead to fiscal Armageddon. Growth in private spending also threatens economic well-being by forcing more resources toward health care and away from other sectors. For example, since the cost of employer-based coverage is always borne by employees (directly or indirectly), salary increases and health care cost increases cannot continue on together. To avoid economic disaster, payers will be forced to have a greater resolve in the future. Specifically, because neither public nor private payers will be able to finance growing health care spending, the coming decade will likely experience significant changes in health care financing. Consumers may be asked to pay more out of pocket when they seek care and both public and private payers will put increasing pressure on payment rates. Furthermore, payment rates to providers are likely to rise more slowly than in the past

Charter School Spending and Saving in California

Science.gov (United States)

Reed, Sherrie; Rose, Heather

2015-01-01

Examining resource allocation practices, including savings, of charter schools is critical to understanding their financial viability and sustainability. Using 9 years of finance data from California, we find charter schools spend less on instruction and pupil support services than traditional public schools. The lower spending on instruction and…

The Arts and State Governments: At Arm's Length or Arm in Arm?

Science.gov (United States)

Lowell, Julia F.; Ondaatje, Elizabeth Heneghan

2006-01-01

Even though a majority of Americans claim to support public funding of the arts, state government spending on the arts is minimal--and may be losing ground relative to other types of state expenditures. Moreover, most state arts agencies, or SAAs, have not succeeded in convincing state government leaders that the arts should be integral to their…

Retail prescription drug spending in the National Health Accounts.

Science.gov (United States)

Smith, Cynthia

2004-01-01

Recent rapid spending growth for retail drugs has largely arisen from increased use of new drugs, rather than from increasing prices of existing drugs. A sizable shift in the payment from consumers to third parties has also contributed to faster growth. Strategies such as negotiating for rebates and using tiered copayments have sought to slow spending growth but simultaneously have complicated the estimation of spending in the National Health Accounts (NHA). NHA estimates show that retail pharmaceuticals' share of health spending is not much different than it was in 1960, although its share of gross domestic product (GDP) has tripled.

Primary Healthcare Spending: Striving for Equity under Fiscal ...

International Development Research Centre (IDRC) Digital Library (Canada)

2010-04-01

Apr 1, 2010 ... Book cover Primary Healthcare Spending: Striving for Equity under Fiscal Federalism ... Primary Healthcare Spending is an important reference for ... field of health policy and health economics, agencies involved in providing ...

U.S. industry to hold 1994 spending at the 1993 level

International Nuclear Information System (INIS)

Beck, R.J.

1994-01-01

A sharp cut in spending on pipelines will hold US petroleum industry budgets at about 1993 levels for domestic projects this year. Excluding pipeline outlays, industry spending for capital and exploration items will advance. Oil and Gas Journal's annual budget survey shows US companies plan to spend $31.3 billion on US projects in 1994, down only 0.7% from 1993. Spending last year was down by the same percentage from 1992's $31.7 billion. Total outlays, excluding pipelines, well be $28.9 billion, up 5.8% from 1993. In 1993 spending excluding pipelines was $27.3 billion, down 1.2% from 1992. Industry's total spending hit a high of $83 billion in 1981. It then fell to the recent low of $25.2 billion in 1987. Adjusted for inflation, spending in 1994 will be the lowest since 1987. A sharp drop in drilling lowered upstream outlays during the past several years. At the same time, spending for upgrades, renovation, environmental compliance, marketing, and transportation bolstered downstream budgets. E and P spending in 1994 will increase 6.2% from the 1993 level, moving up to $14.8 billion. Refining capital spending will inch up 0.9% to $5.4 billion for 1994

State Spending on Higher Education Capital Outlays

Science.gov (United States)

Delaney, Jennifer A.; Doyle, William R.

2014-01-01

This paper explores the role that state spending on higher education capital outlays plays in state budgets by considering the functional form of the relationship between state spending on higher education capital outlays and four types of state expenditures. Three possible functional forms are tested: a linear model, a quadratic model, and the…

Hedging Medical Spending Growth: An Adaptive Expectations Approach.

Science.gov (United States)

Lieberthal, Robert D

2016-08-01

Long-term health insurance provides consumers with protection against persistent, negative health shocks. While the stochastic rise in medical spending growth may make some health risks harder to insure, financial assets could act as a hedge for medical spending growth risk. The purpose of this research was to determine whether such hedges exist. The results of this study were two-fold. First, the asset classes with the strongest statistical evidence as hedges were bonds, not stocks. Second, any strategy to hedge medical spending growth involved shorting assets i.e. betting against the bond or stock market. Health insurers writing long-term contracts should combine the use of hedges in the bond market with of portfolio diversification, and may benefit from health policies to moderate the uncertainty of medical spending growth.

Hong Kong domestic health spending: financial years 1989/90 to 2011/12.

Science.gov (United States)

Tin, K Y K; Tsoi, P K O; Lee, Y H; Chong, D S Y; Lam, D W S; Yeung, A Y T; Ma, E S K; Maw, C K C

2015-06-01

This report presents the latest estimates of Hong Kong domestic health spending for financial years 1989/90 to 2011/12, cross-stratified and categorized by financing source, provider, and function. Total expenditure on health (TEH) was HK$101 985 million in financial year 2011/12, which represents an increase of HK$8580 million or 9.2% over the preceding year. TEH grew faster relative to gross domestic product (GDP) leading to a rise in TEH as a percentage of GDP from 5.1% in 2010/11 to 5.2% in 2011/12. During the period 1989/90 to 2011/12, total health spending per capita (at constant 2012 prices) grew at an average annual rate of 4.8%, which was faster than the average annual growth rate of per capita GDP by 1.8 percentage points. In 2011/12, public and private expenditure on health increased by 8.3% and 10.0% when compared with 2010/11, reaching HK$49,262 million and HK$52,723 million respectively. Consequently, public share of total health expenditure dropped slightly from 48.7% to 48.3% over the year. Of private spending, the most important source of health financing was out-of-pocket payments by households (34.9% of TEH), followed by employer-provided group medical benefits (7.5%) and private insurance (7.4%). It is worth noting that private insurance will likely take over employers as the second largest private payer if the insurance market continues to expand at the current rate. Of the HK$101,985 million total health expenditure in 2011/12, current expenditure comprised HK$96,572 million (94.7%), whereas HK$5413 million (5.3%) was for capital expenses (ie investment in medical facilities). Analysed by health care function, services of curative care accounted for the largest share of total health spending (65.2%), which was made up of ambulatory services (33.6%), in-patient curative care (26.9%), day patient hospital services (4.1%), and home care (0.5%). Notwithstanding its small share, the total spending for day patient hospital services shows an

Hong Kong domestic health spending: financial years 1989/90 to 2009/10.

Science.gov (United States)

Tin, K Y K; Tsoi, P K O; Lee, Y H; Tsui, E L H; Lam, D W S; Chui, A W M; Lo, S V

2013-04-01

devoted a relatively low percentage of GDP to health care in the last decade. As a share of total spending, public funding (either general government revenue or social security funds) was also lower than in most economies with comparable economic development and public revenue collection base.

In-house or outsourced public services? A social and economic analysis of the impact of spending policy on the private wage share in OECD countries.

Science.gov (United States)

Pensiero, Nicola

2017-08-01

This article analyses the relationship between government spending and the distribution of private income between capital and labour. While most previous research assumes that government spending redistributes in favour of the less wealthy, I distinguish between types of expenditures that enhance the bargaining position of labour - that is, unemployment benefits, public sector employment and investment in new capital - and labour-saving and pro-business types of expenditures - that is, outsourcing to private firms. The results are derived from various panel regression techniques on a panel of 19 Organisation for Economic Co-operation and Development (OECD) countries in the period 1985-2010 and show that expenditures on public sector employment and, to a lesser extent, on new capital prevented the private wage share from declining further, even after controlling for labour market institutions, globalisation and technological change. Conversely, expenditures on outsourcing substantially contributed to reducing the private wage share. Unemployment benefits had a non-significant and negative effect on the private wage share because their increase was the consequence of higher levels of unemployment rather than policy. Implications for theory and policy are drawn, including the support for a public employment-led spending policy.

In-house or outsourced public services? A social and economic analysis of the impact of spending policy on the private wage share in OECD countries

Science.gov (United States)

Pensiero, Nicola

2017-01-01

This article analyses the relationship between government spending and the distribution of private income between capital and labour. While most previous research assumes that government spending redistributes in favour of the less wealthy, I distinguish between types of expenditures that enhance the bargaining position of labour – that is, unemployment benefits, public sector employment and investment in new capital – and labour-saving and pro-business types of expenditures – that is, outsourcing to private firms. The results are derived from various panel regression techniques on a panel of 19 Organisation for Economic Co-operation and Development (OECD) countries in the period 1985–2010 and show that expenditures on public sector employment and, to a lesser extent, on new capital prevented the private wage share from declining further, even after controlling for labour market institutions, globalisation and technological change. Conversely, expenditures on outsourcing substantially contributed to reducing the private wage share. Unemployment benefits had a non-significant and negative effect on the private wage share because their increase was the consequence of higher levels of unemployment rather than policy. Implications for theory and policy are drawn, including the support for a public employment-led spending policy. PMID:28919641

THE RELATIONSHIP BETWEEN DEFENSE SPENDING AND MACROECONOMIC VARIABLES

Directory of Open Access Journals (Sweden)

Onur OZSOY

2010-01-01

Full Text Available In this study, the rate of Defense Spendings in the GDP, and the growth rate of GDP, and the portion of current accounts in GDP and Annual Inflation Rate are examined with getting the annual data between the 1980-2006 years, and using VAR model for Egypt, Israel, Jordan, and Turkey. In course of this examination, the results of Granger Casuality and Impulse-Response Functions and Variance Decomposition were used. The focus point of our study is for the reason of defense spendings are effective on macroeconomic variables that while Egypt and Israel has uni-directional Granger causality from the defense spendings to inflation, for other countries there couldn`t be found any Granger causality. On the other hand when we look at the impulse response functions, in case of a shock of defense spending as a percentage of GNP, while the rate of Israel`s inflation and Current account as a percentage of GNP are affected by the pozitive direction , Turkey`s growth rate is affected negatively. For Egypt and Jordan, the significiant effects on defense spendings according to macroeconomic variables couldn`t be found any significiant effects.

Social protection spending and inequalities in depressive symptoms across Europe.

Science.gov (United States)

Niedzwiedz, Claire L; Mitchell, Richard J; Shortt, Niamh K; Pearce, Jamie R

2016-07-01

Common mental disorders are an increasing global public health concern. The least advantaged in society experience a greater burden of mental illness, but inequalities in mental health vary by social, political, and economic contexts. This study investigates whether spending on different types of social protection alters the extent of social inequality in depressive symptoms. Data were obtained from the 2006 and 2012 cross-sectional waves of the European Social Survey, which included 48,397 individuals from 18 European countries. Depressive symptoms were measured using the Centre for Epidemiologic Studies-Depression Scale (CES-D 8). Statistical interactions between country-level social protection spending and individuals' education level, employment and family status were explored using multilevel regression models. Higher spending on active labour market programmes was related to narrower inequality in depressive symptoms by education level. Compared to men with high education, the marginal effect of having low education was 1.67 (95 % CI, 1.46-1.87) among men in countries with lower spending and 0.85 (95 % CI, 0.66-1.03) in higher spending countries. Single parents exhibited fewer depressive symptoms, as spending on family policies increased. Little evidence was found for an overall association between spending on unemployment benefits and employment-related inequalities in depressive symptoms, but in 2012, unemployment spending appeared beneficial to mental health among the unemployed. Greater investment in social protection may act to reduce inequalities in depressive symptoms. Reductions in spending levels or increased conditionality may adversely affect the mental health of disadvantaged social groups.

VALUE CREATION THROUGH CORPORATE GOVERNANCE

Directory of Open Access Journals (Sweden)

Elena Chitimus

2013-12-01

Full Text Available Companies spend time and money in order to improve their corporate governance (CG system and also do not forget to inform third parties about their efforts in this field. CG studies the separation of power at an entity level and the segregation of responsibilities between shareholders, management, and board of directors. As a mechanism CG helps to align management’s goals with those of the stakeholders in order to avoid conflict and to sustain and develop a healthy company. The objective of this article is to show how corporate governance is defined, what does it stands for and why it is important or maybe better said why companies give it so much importance.

[The application of National AIDS spending assessment in a county of Dehong prefecture, Yunnan province, China].

Science.gov (United States)

Shan, Duo; Sun, Jiang-ping; Yakusik, Anna; Chen, Zhong-dan; Yuan, Jian-hua; Li, Tao; Duan, Song; Yang, Xing; Wei, Mei; Michael, Sante; Ye, Run-hua; Xiang, Li-fen; Yang, Yue-cheng; Ren, Da

2012-11-01

To calculate the actual expenditures in a county of Dehong prefecture, Yunnan province, China by using the method of National AIDS Spending Assessment (NASA) in 2010. Data were collected through NASA data collection form based on adapted NASA classification in the county of Dehong prefecture from October to December, 2011, and complemented by semi-structured interview with 16 well trained programmatic and financial representatives in 8 spending units. Data were entered in Resource Tracking Software (RTS) V 2009.3.0, and SPSS 13.0 was used for data processing and analysis. The NASA estimations showed that the county spent a total of ¥16 235 954 on HIV/AIDS in 2010. Public funds constituted 96.3% of the total expenditure (¥15 630 937), followed by Global Fund which accounted for 3.0% (¥484 585) and private sources which accounted for 0.7% (¥120 432). Findings based on NASA categories showed that AIDS spendings were mainly on 4 areas, and expenditure on Care & Treatment was ¥12 401 382 (76.4% of total expenditure), followed by Prevention which accounted for 14.3% (¥2 325 707), Program Management & Administration which accounted for 7.8% (¥1 268 523) and human resources which accounted for 1.5% (¥240 342). The most beneficial population group was People Living with HIV (PLHIV), accounting for 84.7% of total expenditure. (¥13 753 428), followed by 4.8% for high risk population, including female sex workers and their partners (¥297 333), injection drug users and their partners (¥293 143), men having sex with men and their partners (¥185 136) and 1.5% (¥241 429) for the general population. The local funds for HIV/AIDS in this county was insufficient. The local government should increase corresponding funds based on central government funding. Care and treatment was the first spending priority in the county and the investment of prevention services needs to be increased. Prevention and treatment and care should be combined to ensure the effectiveness of

Does Advertising Spending Improve Sales Performance?

DEFF Research Database (Denmark)

Assaf, A. George; Josiassen, Alexander; Mattila, Anna S.

2015-01-01

Hotel managers and investors commonly analyze the impact of advertising spending on firm performance. This paper investigates such an impact using a comprehensive framework incorporating the moderating effects of hotel size and star ratings. We estimated sales performance via dynamic, stochastic...... frontier modelling. Using longitudinal data from a sample of Slovenian and Croatian hotels, we demonstrate that advertising spending has a positive impact on hotel sales performance, and that the relationship strengthens for larger hotels and hotels with higher star ratings. Theoretical and managerial...

Primary Healthcare Spending : Striving for Equity under Fiscal ...

International Development Research Centre (IDRC) Digital Library (Canada)

Primary Healthcare Spending : Striving for Equity under Fiscal Federalism. Couverture du livre Primary Healthcare Spending: Striving for Equity under Fiscal Federalism. Auteur(s) : Okore Apia Okorafor. Maison(s) d'édition : UCT Press, CRDI. 1 avril 2010. ISBN : 9781919895215. 200 pages. e-ISBN : 9781552504895.

Equalising spending needs of sub national governments in a developing country : the case of Tanzania

NARCIS (Netherlands)

Allers, Maarten A.; Ishemoi, Lewis J.

Decentralisation of government creates fiscal disparities: some subnational governments can provide their citizens with more public services than others. Many countries try to equalise fiscal disparities by targeting grants at disadvantaged jurisdictions. This is especially difficult for developing

Pro Bono Publico? Demand for Military Spending Between the World Wars

Directory of Open Access Journals (Sweden)

Jari Eloranta

2017-06-01

Full Text Available This article analyzes the demand for military spending in the 1920s and 1930s, based on variables arising from the international system and the selected countries. The main premise is that the military spending was an impure public good, implying that both public and private benefits drove the demand for this type of expenditure. Threats arising from the autocratic states in the 1930s increased these expenditures, and democracies overall tended to spend less. Moreover, the absence of clear international leadership by the USA or UK destabilized the international system and increased military spending, with alliances failing to produce a public good effect. Military spending resulted in joint products at the level of state and within state, and the level of economic development seemed to exert a downward pressure on the military spending of these states. There were some contradictory spillover effects felt by these states. On the whole, this article suggests that scholars should expand their explanatory models to include impure public good influences in military spending analysis.

Economic, energy and greenhouse emissions impacts of some consumer choice, technology and government outlay options

International Nuclear Information System (INIS)

Lenzen, Manfred; Dey, Christopher J.

2002-01-01

The impacts of selected spending options in the Australian economy are determined in terms of energy consumption, greenhouse gas emissions and a range of economic parameters. Six case studies of one current-practice and one alternative, environmentally motivated spending option are carried out, describing consumer choices, technologies and government outlays. The assessment method is based on input-output theory and, as such, enables both the direct and indirect effects of spending to be quantified. In general, the results indicate that pro-environmental objectives, such as reductions in energy consumption and greenhouse gas emissions, are compatible with broad socio-economic benefits, such as increases in employment and income, and reductions in imports

Consumer Spending and Customer Satisfaction: Untying the Knot

OpenAIRE

Sephton, Peter

2012-01-01

The recession of 2007–2009 has led to renewed interest in forecasting discretionary consumer spending and whether marketing variables contain predictive content. Using the ACSI customer satisfaction index and both linear and nonlinear methods, this note suggests the index fails to enhance our understanding of the temporal evolution of discretionary spending.

The demand for military spending in Egypt

OpenAIRE

Abu-Qarn, A. S.; Dunne, J. P.; Abdelfattah, Y.; Zaher, S.

2013-01-01

Egypt plays a pivotal role in the security of the Middle East as the doorway to Europe and its military expenditure reflects its involvement in the machinations of such an unstable region, showing considerable variation over the last forty years. These characteristics make it a particularly interesting case study of the determinants of military spending. This paper specifies and estimates an econometric model of the Egyptian demand for military spending, taking into account important strategi...

Spending Disclosure - Fiscal Year 2012

Data.gov (United States)

Montgomery County of Maryland — The purpose of this Spending Disclosure Fiscal Year 12 dataset is to allow the public to search and view summary information on payments made to recipients (referred...

[Colombian Health spending 1993-2003: its composition and trends].

Science.gov (United States)

Barón-Leguizamón, Gilberto

2007-01-01

Analysing the magnitude, composition, evolution and trends in Colombian national spending on health, forming a proposal and making an important contribution towards knowledge re the reality of social health security. The results obtained respond to an ongoing effort to systematise and standardise the adopted methodology and update calculations and estimates for the eleven-year period during which Law 100/1993 was being reformed. Analysing the above led to identifying changes in the flow of resources and establishing objective comparisons according to current/available international standards. The project began in the Colombian Planning Department (lasting 5 years) and was then passed to the Ministry of Social Protection's Health Reform Support Programme where new institutional scope has been applied during the last four years. Perhaps the work's most important contribution consists of producing annual estimates of total public and private spending on health as a time-series, for a relatively significant period. The results confirm fulfilment of the reform's suppositions in terms of the significant amount of resources channelled to the sector, the important substitution of financing private spending for spending on health insurance, greater dynamism and the importance of public funds in financing total spending and the managing of an important segment of such resources by some of the new agents created by the reform. This contrasts with the little importance paid to spending on promotion and prevention and on public health and basic attention programmes.

The economic impact of NASA R and D spending

Science.gov (United States)

Evans, M. K.

1976-01-01

The economic impact of R and D spending, particularly NASA R and D spending, on the U. S. economy was evaluated. The crux of the methodology and hence the results revolve around the fact that it was necessary to consider both the demand effects of increased spending and the supply effects of a higher rate of technological growth and a larger total productive capacity. The demand effects are primarily short-run in nature, while the supply effects do not begin to have a significant effect on aggregate economic activity until the fifth year after increased expenditures have taken place. The short-term economic impact of alternative levels of NASA expenditures for 1975 was first examined. The long-term economic impact of increased levels of NASA R and D spending over a sustained period was then evaluated.

THE EFFECT OF GOVERNMENT EXPENDITURE ON INFRASTRUCTURE ON THE GROWTH OF THE NIGERIAN ECONOMY, 1977-2009

Directory of Open Access Journals (Sweden)

Mary Modupe Fasoranti

2012-01-01

Full Text Available The paper examined the effects of government expenditures on infrastructure on the growth of the Nigerian economy. The data sourced majorly from the various issues of Central Bank statistical bulletin was analyzed with the aid of econometric methods. Data collected included government expenditures on education, environment and housing, health services, transport and communication, agriculture, security, inflation rate and gross domestic product. Data treatment methods used was the unit root test, co-integration and vector error correction estimation. Simple multiple regression model was used to obtain the results used for the analysis. Results showed a long run relationship between the growth of the economy and government expenditures in education, environment and housing, health services, water resources, inflation rate, agriculture, security, transport and communication. The paper observed that government expenditures on health services, transport and communication imparted negatively on growth while expenditures in agriculture and security were not significant in the growth of the economy. To increase the growth rate of the economy, the government must adopt stringent controls on its expenditures on infrastructure so as to reduce fraud, fund diversion and mismanagement. Moreover, monitoring and evaluation of government spending must be given top priority. This will help to ensure that the targets of government spending are reached.

How and why do countries differ in their governance and financing-related administrative expenditure in health care? An analysis of OECD countries by health care system typology.

Science.gov (United States)

Hagenaars, Luc L; Klazinga, Niek S; Mueller, Michael; Morgan, David J; Jeurissen, Patrick P T

2018-01-01

Administration is vital for health care. Its importance may increase as health care systems become more complex, but academic attention has remained minimal. We investigated trends in administrative expenditure across OECD countries, cross-country spending differences, spending differences between health care system typologies, and differences in the scale and scope of administrative functions across typologies. We used OECD data, which include health system governance and financing-related administrative activities by regulators, governance bodies, and insurers (macrolevel), but exclude administrative expenditure by health care providers (mesolevel and microlevel). We find that governance and financing-related administrative spending at the macrolevel has remained stable over the last decade at slightly over 3% of total health spending. Cross-country differences range from 1.3% of health spending in Iceland to 8.3% in the United States. Voluntary private health insurance bears much higher administrative costs than compulsory schemes in all countries. Among compulsory schemes, multiple payers exhibit significantly higher administrative spending than single payers. Among single-payer schemes, those where entitlements are based on residency have significantly lower administrative spending than those with single social health insurance, albeit with a small difference. These differences can partially be explained because multi-payer and voluntary private health insurance schemes require additional administrative functions and enjoy less economies of scale. Studies in hospitals and primary care indicate similar differences in administrative costs across health system typologies at the mesolevel and microlevel of health care delivery, which warrants more research on total administrative costs at all the levels of health systems. Copyright © 2017 John Wiley & Sons, Ltd.

Small and Exposed: Debt Accumulation in Canada’s Small Provinces

Directory of Open Access Journals (Sweden)

Ronald D. Kneebone

2015-05-01

the last three years of our period of analysis, policy-induced deficits have the province sliding in the wrong direction, adding 2.6 percentage points of GDP to its accumulated operating account deficit. Notably, there appears to be little difference between NDP and PC governments when it comes to policy-induced debt accumulation. The one distinction appears to be that the PCs have tended to begin governing by adding debt, and reducing it later, while the NDP has followed the opposite pattern. The record of P.E.I.’s policy decisions, meanwhile, has been the reverse of Manitoba’s: After managing to keep its debt in check for 20 years, the government since 1999 has added 11 percentage points of GDP to its accumulated operating account deficit almost entirely as the result of policy choices. Particularly worrisome is the recent rapid accumulation of debt between 2009 and 2014. In the meantime, Nova Scotia continues working to undo the risky policies of the “lost decade” from 1984 to 1994, where PC governments increased the debt ratio by nearly a third. In all four provinces the ability to keep debt ratios under control will depend heavily on constraining the growth in health-care spending. Health spending has soared in all provinces since 1999–2000, the most extreme case being in New Brunswick where the share of revenue spent on health has leaped from 25.4 to 35.9 per cent. Even if these provinces cannot change the fact that they are small and exposed, and are stuck with the specific economic risks that entails, they do have the ability to make policy choices that mitigate the length and severity of the effects of exogenous shocks. With three of the provinces (save P.E.I. expected to enjoy faster growth in 2015, the work in better preparing their economies for shocks should begin right away.

Spending and cutting are two different worlds

DEFF Research Database (Denmark)

Houlberg, Kurt; Olsen, Asmus Leth; Pedersen, Lene Holm

2016-01-01

This article investigates politicians’ preferences for cutting and spending. The research questions are where do politicians prefer to cut, where do they prefer to spend and how is this influenced by political ideology? These questions are investigated in a large-scale survey experiment fielded...... to Danish local councillors, who are randomly assigned to a decision-making situation, where the block grant provided to their municipality is either increased or reduced. The results show that the politicians’ preferences for cutting and spending are asymmetric, in the sense that the policy areas, which...... are assigned the least cuts when the grant is reduced, are rarely the ones which are assigned extra money when the grant is increased. Areas with well-organised interests and a target group which is perceived as deserving are granted more money, whereas policy areas where the target group is perceived as less...

Hong Kong domestic health spending: financial years 1989/90 to 2008/09.

Science.gov (United States)

Tin, K Y K; Tsoi, P K O; Lee, Y H; Tsui, E L H; Lam, D W S; Chui, A W M; Lo, S V

2012-08-01

hospital services, there was an increasing trend over the period 1989/90 to 2008/09, likely as a result of policy directives to shift the emphasis from inpatient to day patient care. 1989/90 to 46.8% in 2002/03 and then dropped slightly to 43.1% in 2007/08, which was primarily driven by reduced expenditure of Hospital Authority. Compared with the preceding year, expenditure on hospitals increased by HK$2935 million in 2008/09, whereas the corresponding increase for providers of ambulatory health care was only HK$919 million. As a result, the hospital share rebounded a little to 44.0% of total health spending, whereas that of providers of ambulatory health care dropped to 29.1%. Without taking into account capital expenses (ie investment in medical facilities), public current expenditure on health amounted to HK$39 301 million (48.4% of total current expenditure) in 2008/09 with the remaining HK$41 885 million made up from private sources. Public current expenditure was mostly incurred at hospitals (76.1%), whereas private current expenditure was mostly incurred at providers of ambulatory health care (48.9%). Although both public and private spending were mostly expended on personal health care services and goods (91.8% of total current spending), the patterns of distribution among functional categories differed. Public expenditure was targeted at in-patient care (51.8%) and substantially less on out-patient care (25.1%). In comparison, private spending was mostly concentrated on out-patient care (42.6%), whereas in-patient care (23.4%) and medical goods outside the patient care setting (22.5%) accounted for the majority of the remaining share. Compared to the Organisation for Economic Cooperation and Development countries, Hong Kong has devoted a relatively low percentage of GDP to health care in the last decade. As a share of total spending, public funding (either general government revenue or social security funds) in Hong Kong was also lower than that in most economies

Smart Shopping Carts: How Real-Time Feedback Influences Spending

NARCIS (Netherlands)

Ittersum, van K.; Wansink, B.; Pennings, J.M.E.; Sheehan, D.

2013-01-01

Although interest in smart shopping carts is increasing, both retailers and consumer groups have concerns about how real-time spending feedback will influence shopping behavior. Building on budgeting and spending theories, the authors conduct three lab and grocery store experiments that robustly

Smart shopping carts : How real-time feedback influences spending

NARCIS (Netherlands)

van Ittersum, Koert; Wansink, B.; Pennings, J.M.E.; Sheehan, D.

Although interest in smart shopping carts is increasing, both retailers and consumer groups have concerns about how real-time spending feedback will influence shopping behavior. Building on budgeting and spending theories, the authors conduct three lab and grocery store experiments that robustly

Smart shopping carts : How real-time feedback influences spending

NARCIS (Netherlands)

van Ittersum, Koert; Wansink, B.; Pennings, J.M.E.; Sheehan, D.

2013-01-01

Although interest in smart shopping carts is increasing, both retailers and consumer groups have concerns about how real-time spending feedback will influence shopping behavior. Building on budgeting and spending theories, the authors conduct three lab and grocery store experiments that robustly

The Multi-Billion Dollar Drug-Sensitive Spending Opportunity.

Science.gov (United States)

Easter, Jon C; Thorpe, Kenneth

2018-01-01

Chronic diseases increase utilization and avoidable drug-sensitive spending, but little is done to optimize medication use and drive value. Value-based approaches to health care financing should shift focus to drug-sensitive spending to balance patient access and quality improvement with cost containment. ©2018 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

Effects of macroeconomic trends on social security spending due to sickness and disability.

Science.gov (United States)

Khan, Jahangir; Gerdtham, Ulf-G; Jansson, Bjarne

2004-11-01

We analyzed the relationship between macroeconomic conditions, measured as unemployment rate and social security spending, from 4 social security schemes and total spending due to sickness and disability. We obtained aggregated panel data from 13 Organization for Economic Cooperation and Development member countries for 1980-1996. We used regression analysis and fixed effect models to examine spending on sickness benefits, disability pensions, occupational-injury benefits, survivor's pensions, and total spending. A decline in unemployment increased sickness benefits spending and reduced disability pension spending. These effects reversed direction after 4 years of unemployment. Inclusion of mortality rate as an additional variable in the analysis did not affect the findings. Macroeconomic conditions influence some reimbursements from social security schemes but not total spending.

The impact of IMF conditionality on government health expenditure: A cross-national analysis of 16 West African nations.

Science.gov (United States)

Stubbs, Thomas; Kentikelenis, Alexander; Stuckler, David; McKee, Martin; King, Lawrence

2017-02-01

How do International Monetary Fund (IMF) policy reforms-so-called 'conditionalities'-affect government health expenditures? We collected archival documents on IMF programmes from 1995 to 2014 to identify the pathways and impact of conditionality on government health spending in 16 West African countries. Based on a qualitative analysis of the data, we find that IMF policy reforms reduce fiscal space for investment in health, limit staff expansion of doctors and nurses, and lead to budget execution challenges in health systems. Further, we use cross-national fixed effects models to evaluate the relationship between IMF-mandated policy reforms and government health spending, adjusting for confounding economic and demographic factors and for selection bias. Each additional binding IMF policy reform reduces government health expenditure per capita by 0.248 percent (95% CI -0.435 to -0.060). Overall, our findings suggest that IMF conditionality impedes progress toward the attainment of universal health coverage. Copyright © 2016 Elsevier Ltd. All rights reserved.

Refining estimates of public health spending as measured in national health expenditure accounts: the Canadian experience.

Science.gov (United States)

Ballinger, Geoff

2007-01-01

The recent focus on public health stemming from, among other things, severe acute respiratory syndrome and avian flu has created an imperative to refine health-spending estimates in the Canadian Health Accounts. This article presents the Canadian experience in attempting to address the challenges associated with developing the needed taxonomies for systematically capturing, measuring, and analyzing the national investment in the Canadian public health system. The first phase of this process was completed in 2005, which was a 2-year project to estimate public health spending based on a more classic definition by removing the administration component of the previously combined public health and administration category. Comparing the refined public health estimate with recent data from the Organization for Economic Cooperation and Development still positions Canada with the highest share of total health expenditure devoted to public health than any other country reporting. The article also provides an analysis of the comparability of public health estimates across jurisdictions within Canada as well as a discussion of the recommendations for ongoing improvement of public health spending estimates. The Canadian Institute for Health Information is an independent, not-for-profit organization that provides Canadians with essential statistics and analysis on the performance of the Canadian health system, the delivery of healthcare, and the health status of Canadians. The Canadian Institute for Health Information administers more than 20 databases and registries, including Canada's Health Accounts, which tracks historically 40 categories of health spending by 5 sources of finance for 13 provincial and territorial jurisdictions. Until 2005, expenditure on public health services in the Canadian Health Accounts included measures to prevent the spread of communicable disease, food and drug safety, health inspections, health promotion, community mental health programs, public

Drivers of Greek and Turkish Defense Spending

Directory of Open Access Journals (Sweden)

Waszkiewicz Grzegorz

2016-09-01

Full Text Available This paper evaluates the factors responsible for maintaining substantial military expenditures in Greece and Turkey. The presented research encompasses theoretical and empirical aspects. First, defense spending by both countries was analyzed based on statistical data from international sources. Next, the theoretical determinants of budgetary spending are reviewed, which consider political, economic and military factors behind high expenditures on the army in Greece and in Turkey. Finally, Granger causality tests is applied to determine whether a causal relation between variables exists in the case of these two countries.

Public hospital spending in England: Evidence from National Health Service administrative records

OpenAIRE

Kelly, Elaine; Stoye, George; Vera-Hernández, Marcos

2015-01-01

Health spending per capita in England has more than doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending in England. We describe how costs vary across the lifecycle, and the concentration of spending among people and over time. We find that costs per person start to increase after age 50 and escalate after...

Trends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016-40.

Science.gov (United States)

2018-05-05

Achieving universal health coverage (UHC) requires health financing systems that provide prepaid pooled resources for key health services without placing undue financial stress on households. Understanding current and future trajectories of health financing is vital for progress towards UHC. We used historical health financing data for 188 countries from 1995 to 2015 to estimate future scenarios of health spending and pooled health spending through to 2040. We extracted historical data on gross domestic product (GDP) and health spending for 188 countries from 1995 to 2015, and projected annual GDP, development assistance for health, and government, out-of-pocket, and prepaid private health spending from 2015 through to 2040 as a reference scenario. These estimates were generated using an ensemble of models that varied key demographic and socioeconomic determinants. We generated better and worse alternative future scenarios based on the global distribution of historic health spending growth rates. Last, we used stochastic frontier analysis to investigate the association between pooled health resources and UHC index, a measure of a country's UHC service coverage. Finally, we estimated future UHC performance and the number of people covered under the three future scenarios. In the reference scenario, global health spending was projected to increase from US$10 trillion (95% uncertainty interval 10 trillion to 10 trillion) in 2015 to $20 trillion (18 trillion to 22 trillion) in 2040. Per capita health spending was projected to increase fastest in upper-middle-income countries, at 4·2% (3·4-5·1) per year, followed by lower-middle-income countries (4·0%, 3·6-4·5) and low-income countries (2·2%, 1·7-2·8). Despite global growth, per capita health spending was projected to range from only $40 (24-65) to $413 (263-668) in 2040 in low-income countries, and from $140 (90-200) to $1699 (711-3423) in lower-middle-income countries. Globally, the share of health spending

Brazilian healthcare in the context of austerity: private sector dominant, government sector failing.

Science.gov (United States)

Costa, Nilson do Rosário

2017-04-01

This paper presents the arguments in favor of government intervention in financing and regulation of health in Brazil. It describes the organizational arrangement of the Brazilian health system, for the purpose of reflection on the austerity agenda proposed for the country. Based on the literature in health economics, it discusses the hypothesis that the health sector in Brazil functions under the dominance of the private sector. The categories employed for analysis are those of the national health spending figures. An international comparison of indicators of health expenses shows that Brazilian public spending is a low proportion of total spending on Brazilian health. Expenditure on individuals' health by out-of-pocket payments is high, and this works against equitability. The private health services sector plays a crucial role in provision, and financing. Contrary to the belief put forward by the austerity agenda, public expenditure cannot be constrained because the government has failed in adequate provision of services to the poor. This paper argues that, since the Constitution did not veto activity by the private sector segment of the market, those interests that have the greatest capacity to vocalize have been successful in imposing their preferences in the configuration of the sector.

The impact of healthcare spending on health outcomes: A meta-regression analysis.

Science.gov (United States)

Gallet, Craig A; Doucouliagos, Hristos

2017-04-01

While numerous studies assess the impact of healthcare spending on health outcomes, typically reporting multiple estimates of the elasticity of health outcomes (most often measured by a mortality rate or life expectancy) with respect to healthcare spending, the extent to which study attributes influence these elasticity estimates is unclear. Accordingly, we utilize a meta-data set (consisting of 65 studies completed over the 1969-2014 period) to examine these elasticity estimates using meta-regression analysis (MRA). Correcting for a number of issues, including publication selection bias, healthcare spending is found to have the greatest impact on the mortality rate compared to life expectancy. Indeed, conditional on several features of the literature, the spending elasticity for mortality is near -0.13, whereas it is near to +0.04 for life expectancy. MRA results reveal that the spending elasticity for the mortality rate is particularly sensitive to data aggregation, the specification of the health production function, and the nature of healthcare spending. The spending elasticity for life expectancy is particularly sensitive to the age at which life expectancy is measured, as well as the decision to control for the endogeneity of spending in the health production function. With such results in hand, we have a better understanding of how modeling choices influence results reported in this literature. Copyright © 2017 Elsevier Ltd. All rights reserved.

The economic impact of NASA R and D spending: Executive summary

Science.gov (United States)

Evans, M. K.

1976-01-01

An evaluation of the economic impact of NASA research and development programs is made. The methodology and the results revolve around the interrelationships existing between the demand and supply effects of increased research and development spending, in particular, NASA research and development spending. The INFORUM Inter-Industry Forecasing Model is used to measure the short-run economic impact of alternative levels of NASA expenditures for 1975. An aggregate production function approach is used to develop the data series necessary to measure the impact of NASA research and development spending, and other determinants of technological progress, on the rate of growth in productivity of the U. S. economy. The measured relationship between NASA research and development spending and technological progress is simulated in the Chase Macroeconometric Model to measure the immediate, intermediate, and long-run economic impact of increased NASA research and development spending over a sustained period.

AN EMPIRICAL ANALYSIS OF EFFECTS OF MILITARY SPENDING ON ECONOMIC GROWTH IN NIGERIA: A BOUND TESTING APPROACH TO COINTEGRATION 1989 - 2013

Directory of Open Access Journals (Sweden)

Olumuyiwa Tolulope APANISILE

2014-12-01

Full Text Available The study examines the effect of military expenditure on output in Nigeria both in the short-run and in the long-run period. In addition, it verified whether military expenditure is an economically non-contributive activity using ARDL bounds testing approach to co-integration. Results showed that military spending has negative and significant effect on output in the short-run but positive and significant effect in the long-run. Labour and capital have positive and significant effects both in the long-run and short-run. In addition, labour has the highest coefficient (3.0709 in the long-run.The study concludes that government should reduce its expenditure on defense and concentrate more on human capital development, since military spending contributes nothing to output in the short-run.

Child poverty: what can social spending explain in Europe?

NARCIS (Netherlands)

Diris, R.; Vandenbroucke, F.; Verbist, G.

2014-01-01

This study assesses the role of social spending in relation to child poverty in European welfare states. Using macro-level panel data from EU SILC 2005-2012, we analyze the effect of the size of social spending and the effect of how those benefits are targeted. We separately estimate the effect of

Progress on impoverishing health spending in 122 countries: a retrospective observational study.

Science.gov (United States)

Wagstaff, Adam; Flores, Gabriela; Smitz, Marc-François; Hsu, Justine; Chepynoga, Kateryna; Eozenou, Patrick

2018-02-01

The goal of universal health coverage (UHC) requires that families who get needed health care do not suffer financial hardship as a result. This can be measured by instances of impoverishment, when a household's consumption including out-of-pocket spending on health is more than the poverty line but its consumption, excluding out-of-pocket spending, is less than the poverty line. This links UHC directly to the policy goal of reducing poverty. We measure the incidence and depth of impoverishment as the difference in the poverty head count and poverty gap with and without out-of-pocket spending included in household total consumption. We use three poverty lines: the US$1·90 per day and $3·10 per day international poverty lines and a relative poverty line of 50% of median consumption per capita. We estimate impoverishment in 122 countries using 516 surveys between 1984 and 2015. We estimate the global incidence of impoverishment due to out-of-pocket payments by aggregating up from each country, using a survey for the year in question when available, and interpolation and model-based estimates otherwise. We do not derive global estimates to measure the depth of impoverishment but focus on the median depth for the 122 countries in our sample, accounting for 90% of the world's population. We find impoverishment due to out-of-pocket spending even in countries where the entire population is officially covered by a health insurance scheme or by national or subnational health services. Incidence is negatively correlated with the share of total health spending channelled through social security funds and other government agencies. Across countries, the population-weighted median annual rate of change of impoverishment is negative at the $1·90 per day poverty line but positive at the $3·10 per day and relative poverty lines. We estimate that at the $1·90 per day poverty line, the worldwide incidence of impoverishment decreased between 2000 and 2010, from 131 million

State Variation in Medical Imaging: Despite Great Variation, the Medicare Spending Decline Continues.

Science.gov (United States)

Rosenkrantz, Andrew B; Hughes, Danny R; Duszak, Richard

2015-10-01

The purpose of this study was to assess state-level trends in per beneficiary Medicare spending on medical imaging. Medicare part B 5% research identifiable files from 2004 through 2012 were used to compute national and state-by-state annual average per beneficiary spending on imaging. State-to-state geographic variation and temporal trends were analyzed. National average per beneficiary Medicare part B spending on imaging increased 7.8% annually between 2004 ($350.54) and its peak in 2006 ($405.41) then decreased 4.4% annually between 2006 and 2012 ($298.63). In 2012, annual per beneficiary spending was highest in Florida ($367.25) and New York ($355.67) and lowest in Ohio ($67.08) and Vermont ($72.78). Maximum state-to-state geographic variation increased over time, with the ratio of highest-spending state to lowest-spending state increasing from 4.0 in 2004 to 5.5 in 2012. Spending in nearly all states decreased since peaks in 2005 (six states) or 2006 (43 states). The average annual decrease among states was 5.1% ± 1.8% (range, 1.2-12.2%) The largest decrease was in Ohio. In only two states did per beneficiary spending increase (Maryland, 12.5% average annual increase since 2005; Oregon, 4.8% average annual increase since 2008). Medicare part B average per beneficiary spending on medical imaging declined in nearly every state since 2005 and 2006 peaks, abruptly reversing previously reported trends. Spending continued to increase, however, in Maryland and Oregon. Identification of state-level variation may facilitate future investigation of the potential effect of specific and regional changes in spending on patient access and outcomes.

Budget transparency on maternal health spending: a case study in five Latin American countries.

Science.gov (United States)

Malajovich, Laura; Alcalde, Maria Antonieta; Castagnaro, Kelly; Barroso, Carmen

2012-06-01

Progress in reducing maternal mortality has been slow and uneven, including in Latin America, where 23,000 women die each year from preventable causes. This article is about the challenges civil society organizations in Latin America faced in assessing budget transparency on government spending on specific aspects of maternity care, in order to hold them accountable for reducing maternal deaths. The study was carried out by the International Planned Parenthood, Western Hemisphere Region and the International Budget Partnership in five Latin American countries--Costa Rica, El Salvador, Guatemala, Panama and Peru. It found that only in Peru was most of the information they sought available publicly (from a government website). In the other four countries, none of the information was available publicly, and although it was possible to obtain at least some data from ministry and health system sources, the search process often took a complex course. The data collected in each country were very different, depending not only on the level of budget transparency, but also on the existence and form of government data collection systems. The obstacles that these civil society organizations faced in monitoring national and local budget allocations for maternal health must be addressed through better budgeting modalities on the part of governments. Concrete guidelines are also needed for how governments can better capture data and track local and national progress. Copyright © 2012 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Institutions and government growth: a comparison of the 1890s and the 1930s

OpenAIRE

Thomas A. Garrett; Russell M. Rhine

2008-01-01

Statistics on the size and growth of the U.S. federal government, along with the rhetoric of President Franklin Roosevelt, seem to indicate that the Great Depression was the event that started the dramatic growth in government spending and intervention in the private sector that has continued to the present day. Through a comparison of the economic conditions of the 1890s and the 1930s, we argue that post-1930 government growth in the United States is not the direct result of the Great Depres...

Advertising Spending, Firm Performance, and the Moderating Impact of CSR

DEFF Research Database (Denmark)

Assaf, A. George; Josiassen, Alexander; Ahn, Jin Sun

2017-01-01

This article investigates the potential of corporate social responsibility (CSR) to influence the link between advertising spending and firm performance. Drawing upon the literature of CSR, we hypothesize that CSR positively moderates the relationship between advertising spending and firm perform...

Social Spending and Aggregate Welfare in Developing and Transition Economies

DEFF Research Database (Denmark)

Gebregziabher, Fiseha Haile; Niño-Zarazúa, Miguel

Notwithstanding the unprecedented attention devoted to reducing poverty and fostering human development via scaling up social sector spending, there is surprisingly little rigorous empirical work on the question of whether social spending is effective in achieving these goals. This paper examines...

Brazil - Governance in Brazil's Unified Health System : Raising the Quality of Public Spending and Resource Management

OpenAIRE

World Bank

2007-01-01

This report on governance in Brazil's unified health system assesses resource allocation and management, planning and budgeting functions, and budget execution at different levels of government for public expenditures on health services. The emphasis is on understanding the incentives generated for service providers, and the overall soundness of the accountabilities established in the publ...

Crowd-out of defence and health spending: is Israel different from other industrialised nations?

Science.gov (United States)

Reeves, Aaron; Stuckler, David

2013-04-22

Does high defence spending limit the growth of public health investment? Using comparative data from 31 OECD countries between 1980 and 2010, we find little evidence that defence crowds out public health spending. Whether measured in terms of long-term levels or short-term changes, per capita defence and health spending positively and significantly correlate. To investigate the possibility that countries with high security needs such as Israel exhibit differing patterns, we also compare crowd-out among countries experiencing violent conflicts as well as current high military-spending countries. We observed a greater positive correlation between changes in health and defence spending among conflict-countries (r = 0.65, p military spending countries, Israel's politicians reduced defence spending while increasing health expenditure during its recent recession. These analyses reveal that while Israel's politicians have chronically underinvested in public health, there are modest steps being taken to rectify the country's unique and avoidable crowding out of public health from its high military spending.

How do candidates spend their money? Objects of campaign spending and the effectiveness of diversification

NARCIS (Netherlands)

Sudulich, M.L.; Wall, M.

2011-01-01

We present a novel approach to the study of campaign effectiveness using disaggregated spending returns from the 2007 Irish general election. While previous studies have focused on overall levels of expenditure as a predictor of electoral success, we consider the types of activities on which

Military spending and economic growth in China: a regime-switching analysis

OpenAIRE

Menla Ali, F; Dimitraki, O

2014-01-01

This article has been made available through the Brunel Open Access Publishing Fund. This article investigates the impact of military spending changes on economic growth in China over the period 1953 to 2010. Using two-state Markov-switching specifications, the results suggest that the relationship between military spending changes and economic growth is state dependent. Specifically, the results show that military spending changes affect the economic growth negatively during a slower grow...

Linking Quality and Spending to Measure Value for People with Serious Illness

Science.gov (United States)

Rodgers, Phillip E.

2018-01-01

Abstract Background: Healthcare payment is rapidly evolving to reward value by measuring and paying for quality and spending performance. Rewarding value for the care of seriously ill patients presents unique challenges. Objective: To evaluate the state of current efforts to measure and reward value for the care of seriously ill patients. Design: We performed a PubMed search of articles related to (1) measures of spending for people with serious illness and (2) linking spending and quality measures and rewarding performance for the care of people with serious illness. We limited our search to U.S.-based studies published in English between January 1, 1960, and March 31, 2017. We supplemented this search by identifying public programs and other known initiatives that linked quality and spending for the seriously ill and extracted key program elements. Results: Our search related to linking spending and quality measures and rewarding performance for the care of people with serious illness yielded 277 articles. We identified three current public programs that currently link measures of quality and spending—or are likely to within the next few years—the Oncology Care Model; the Comprehensive End-Stage Renal Disease Model; and Home Health Value-Based Purchasing. Models that link quality and spending consist of four core components: (1) measuring quality, (2) measuring spending, (3) the payment adjustment model, and (4) the linking/incentive model. We found that current efforts to reward value for seriously ill patients are targeted for specific patient populations, do not broadly encourage the use of palliative care, and have not closely aligned quality and spending measures related to palliative care. Conclusions: We develop recommendations for policymakers and stakeholders about how measures of spending and quality can be balanced in value-based payment programs. PMID:29091529

Geographic Variation in Medicare Spending Dashboard

Data.gov (United States)

U.S. Department of Health & Human Services — The Geographic Variation Dashboards present Medicare fee-for-service per-capita spending at the state and county level in an interactive format. We calculated the...

The Impact of Public Spending on Regional Economic Dynamics

Directory of Open Access Journals (Sweden)

Henry Antonio Mendoza Tolosa

2014-01-01

Full Text Available The impact that public spending and investment have upon economic growth in the departments of Colombia is examined using the results of national accounts for the years 2000-2011. Figures for departmental production by activity, along with change over the period and information for the gross public capital are brought together to create a statistical model to assess effects. A data panel model is chosen to relate the existing differences between departments and compare the impact of spending and investment between departments using the available information. Results indicate that public spending and investment play an important role in departmental economic dynamic and that its effect is greater in larger and wealthier departments.

It's the recipient that counts: spending money on strong social ties leads to greater happiness than spending on weak social ties.

Science.gov (United States)

Aknin, Lara B; Sandstrom, Gillian M; Dunn, Elizabeth W; Norton, Michael I

2011-02-10

Previous research has shown that spending money on others (prosocial spending) increases happiness. But, do the happiness gains depend on who the money is spent on? Sociologists have distinguished between strong ties with close friends and family and weak ties--relationships characterized by less frequent contact, lower emotional intensity, and limited intimacy. We randomly assigned participants to reflect on a time when they spent money on either a strong social tie or a weak social tie. Participants reported higher levels of positive affect after recalling a time they spent on a strong tie versus a weak tie. The level of intimacy in the relationship was more important than the type of relationship; there was no significant difference in positive affect after recalling spending money on a family member instead of a friend. These results add to the growing literature examining the factors that moderate the link between prosocial behaviour and happiness.

FRANKLIN ROOSEVELT, FEDERAL SPENDING, AND THE POSTWAR SOUTHERN ECONOMIC REBOUND

Directory of Open Access Journals (Sweden)

Fred Bateman

2002-01-01

Full Text Available Franklin Roosevelt publicly stated his devotion to the American South and pledged to help reform the region’s laggard economy. However, Southern states received significantly fewer federal expenditures per capita, both during the New Deal of the 1930s and the military emergency of the 1940s. This article investigates economic, political, and strategic reasons for this result. Additionally, we apply a public goods perspective to New Deal and World War II spending and propose that lower levels of per capita spending in the South do not necessarily translate into a smaller impact of that spending.

Economic Recovery vs. Defense Spending.

Science.gov (United States)

De Grasse, Robert; Murphy, Paul

1981-01-01

Evaluates President Reagan's proposed military buildup in light of the cuts such expenditures would necessitate in approximately 300 domestic programs. Suggests that the dramatic proposed increase in military spending risks higher inflation and slower economic growth. Concludes with a plea for rethinking of Reagan's dramatic shift in national…

Applying Financial Portfolio Analysis to Government Program Portfolios

Science.gov (United States)

2007-06-01

himself points out, “The Rational Man, like the unicorn , does not exist” (Markowitz, 1959). The various investor assumptions presented above break down...originally envisioned benefits quickly grow (Levine, 2005). As a recent Government Accountability Office report notes, the sheer size of IT spending in the...shows no change in EAC for the first three quarters and a decrease in the fourth quarter- although the SV and CV shrink and grow during the same period

The income elasticity of health care spending in developing and developed countries.

Science.gov (United States)

Farag, Marwa; NandaKumar, A K; Wallack, Stanley; Hodgkin, Dominic; Gaumer, Gary; Erbil, Can

2012-06-01

To date, international analyses on the strength of the relationship between country-level per capita income and per capita health expenditures have predominantly used developed countries' data. This study expands this work using a panel data set for 173 countries for the 1995-2006 period. We found that health care has an income elasticity that qualifies it as a necessity good, which is consistent with results of the most recent studies. Furthermore, we found that health care spending is least responsive to changes in income in low-income countries and most responsive to in middle-income countries with high-income countries falling in the middle. Finally, we found that 'Voice and Accountability' as an indicator of good governance seems to play a role in mobilizing more funds for health.

Poverty in Mexico : An Assessment of Conditions, Trends and Government Strategy

OpenAIRE

Michael Walton; Gladys Lopez-Acevedo

2005-01-01

In 2002, half of Mexico's population lived in poverty and one fifth in extreme poverty, slightly lower than before the 1994-1995 crisis. Mexico has made major progress in some poverty dimensions -health, nutrition and education outcomes, access to basic health and education services, electricity, water and (to a lesser extent) sanitation. Large increases in government spending enabled key ...

Healthcare Utilization and Spending for Constipation in Children With Versus Without Complex Chronic Conditions.

Science.gov (United States)

Stephens, John R; Steiner, Michael J; DeJong, Neal; Rodean, Jonathan; Hall, Matt; Richardson, Troy; Berry, Jay G

2017-01-01

The aim of the study was to examine the prevalence of diagnosis and treatment for constipation among children receiving Medicaid and to compare healthcare utilization and spending for constipation among children based on number of complex chronic conditions (CCCs). Retrospective cohort study of 4.9 million children ages 1 to 17 years enrolled in Medicaid from 2009 to 2011 in 10 states in the Truven Marketscan Database. Constipation was identified using International Classification of Disease, 9th revision codes for constipation (564.0x), intestinal impaction (560.3x), or encopresis (307.7). Outpatient and inpatient utilization and spending for constipation were assessed. CCC status was identified using validated methodology. A total of 267,188 children (5.4%) were diagnosed with constipation. Total constipation spending was $79.5 million. Outpatient constipation spending was $66.8 million (84.1%) during 406,814 visits, mean spending $120/visit. Among children with constipation, 1363 (0.5%) received inpatient treatment, accounting for $12.2 million (15.4%) of constipation spending, mean spending $7815/hospitalization. Of children hospitalized for constipation, 552 (40.5%) did not have an outpatient visit for constipation before admission. Approximately 6.8% of children in the study had ≥1 CCC; these children accounted for 33.5% of total constipation spending, 70.3% of inpatient constipation spending, and 19.8% of emergency department constipation spending. Constipation prevalence was 11.0% for children with 1 CCC, 16.6% with 2 CCCs, and 27.1% with ≥3 CCCs. Although the majority of pediatric constipation treatment occurs in the outpatient setting, inpatient care accounts for a sizable percentage of spending. Children with CCCs have a higher prevalence of constipation and account for a disproportionate amount of constipation healthcare utilization and spending.

Interdependence between US and European Military Spending: A Panel Cointegration Analysis (1988-2013)

OpenAIRE

Caruso, Raul; Di Domizio, Marco

2015-01-01

The aim of this paper is to study the interdependence of military spending between US and a panel of European countries in the period 1988-2013. The empirical estimation is based on a: (i) a unit root tests and a cointegration analysis; (ii) FMOLS and DOLS estimations. General results highlight that military spending of European countries is: (1) positively associated with US military spending and (2) negatively associated with average military spending of other European countries.

The Foundational Public Health Services as a Framework for Estimating Spending.

Science.gov (United States)

Resnick, Beth A; Fisher, Jessica S; Colrick, Ian P; Leider, Jonathon P

2017-11-01

In support of the nation's effort to address rising healthcare costs and improve healthcare outcomes, the National Academy of Medicine called for a minimum package of public health services available in every community to protect and improve population health and identification of the resources needed to make these services universally available. In response, the Foundational Public Health Services (FPHS) framework was developed to outline a basic set of public health programs and capabilities. Although the FPHS is considered a useful public health practice tool, cost estimation for providing the FPHS is in its infancy. This is in part due to inability to estimate total costs of individual public health services and programs. This research begins to address this knowledge gap. FPHS formed the basis of a coding framework used in 2013-2016 to code 1.9 million U.S. Census Bureau State Finance non-hospital expenditure records from 49 states from 2000 to 2013. Results were used to develop estimates of state governmental FPHS spending. FPHS spending constituted 36% of total state governmental non-hospital health spending from 2008 to 2013. The largest proportion of FPHS spending was on maternal/child health and the smallest proportion of spending was on access and linkage to clinical care. This research is an important step in response to the National Academy of Medicine's call for estimating the resources needed to provide the FPHS. Such estimates allow for spending comparisons across states and may inform future research to assess and evaluate FPHS spending impacts. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Monitoring and Evaluating Government Performance in Botswana

Directory of Open Access Journals (Sweden)

E. K. Botlhale

2015-03-01

Full Text Available In an era characterised by fiscal stress in the post-global recession era, clichés such as ‘bang for the buck’ are commonplace. Governments are under increasing pressure to spend limited public resources in efficient and  effective ways. Efficient and  effective governments are a necessary, though not sufficient, condition for economic development. Hence, governments have adopted performance-improving interventions such as New Public Management. Botswana jumped into the bandwagon of public sector reforms in the 1990s through interventions such as Performance-based Management Systems. The focus was almost entirely on performance enhancement to the neglect of performance measurement through a result-based Monitoring and Evaluation (M&E framework. However, in 2009, the government decided to mainstream M&E into the development planning regime. Since the M&E tool is still in draft form, Botswana is very favourably circumstanced to learn from others. Meanwhile essentials to do are: attitudinal change, shared vision on M&E, stakeholder management and demand and use of M&E information by policy-makers such as Members of Parliament.

It's the recipient that counts: spending money on strong social ties leads to greater happiness than spending on weak social ties.

Directory of Open Access Journals (Sweden)

Lara B Aknin

Full Text Available Previous research has shown that spending money on others (prosocial spending increases happiness. But, do the happiness gains depend on who the money is spent on? Sociologists have distinguished between strong ties with close friends and family and weak ties--relationships characterized by less frequent contact, lower emotional intensity, and limited intimacy. We randomly assigned participants to reflect on a time when they spent money on either a strong social tie or a weak social tie. Participants reported higher levels of positive affect after recalling a time they spent on a strong tie versus a weak tie. The level of intimacy in the relationship was more important than the type of relationship; there was no significant difference in positive affect after recalling spending money on a family member instead of a friend. These results add to the growing literature examining the factors that moderate the link between prosocial behaviour and happiness.

Perceived Need Versus Current Spending: Gaps in Providing Foundational Public Health Services in Communities.

Science.gov (United States)

Bekemeier, Betty; Marlowe, Justin; Squires, Linda Sharee; Tebaldi, Jennifer; Park, Seungeun

Our objective was to estimate the gap between the costs for local health jurisdictions (LHJs) to provide foundational public health services (FPHS) and actual spending on FPHS and to examine factors associated with that gap. We employed resource-based cost estimation methods for this observational study and conducted multivariate analyses with measures derived from secondary administrative data. We used primary data collected from LHJ leaders that depicted 2014 spending and perceived need. We also included secondary administrative data depicting annual 2000-2013 expenditures organized into categories containing key elements of FPHS areas. We included primary data from a representative sample of 10 LHJs in Washington State and secondary data for all 35 LHJs in Washington. Participants were public health practice leaders from each sample LHJ. Our main outcome of interest was the gap identified between current spending and the perceived spending needed to provide FPHS in a jurisdiction. Actual FPHS spending was approximately 65% of spending needed to provide overall FPHS for our sample LHJs, but the size of the gap varied substantially by program. Some gaps also varied widely by LHJ, with spending gaps widest among rural and high poverty communities. Percent poverty and the metropolitan nature of a jurisdiction were factors significantly related to FPHS spending in our multivariate analyses. Actual spending lags far behind local officials' estimates of spending needed to provide FPHS and is likely influenced by local conditions. Major apparent gaps between spending and need, particularly in areas such as costly Business Competencies, underscore the need for cross-cutting capabilities to support public health system responsiveness and for attention to be paid to local conditions.

School Library Journal's Spending Survey

Science.gov (United States)

Farmer, Lesley; Shontz, Marilyn

2009-01-01

This year's "School Library Journal's" spending survey showed that, despite the recession, the vast majority of media centers around the country have retained their credentialed media specialists. For example, almost 85% of elementary schools and more than 95% of middle and high schools have a full-time certified librarian. In addition, salaries…

Resource flows and levels of spending for the response to HIV and AIDS in Belarus

Directory of Open Access Journals (Sweden)

Amico Peter

2011-07-01

Full Text Available Abstract Background Belarus has a focused HIV epidemic concentrated among injecting drug users, female sex workers and men who have sex with men. However, until 2008, Belarus had no way of evaluating HIV spending priorities. In 2008, Belarus committed to undertaking a comprehensive National AIDS Spending Assessment (NASA in order to analyze HIV spending priorities. NASA was used to 'follow the money' from the funding sources to agents and providers, and eventually to beneficiary populations. Findings Belarus spent the majority of its funding on prevention, diagnosis and treatment of sexually transmitted infections and on securing the blood supply. International donors and NGOs working within Belarus spent the majority of their funding on preventative activities for high risk groups while Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM solely funded antiretroviral treatment. Conclusions The data and experience obtained through conducting NASA will help build capacity for future resource tracking activities for HIV and other health priorities. This experience established the foundation for enhanced and future consistent quality-reporting of National Health Accounts. Monitoring the flow of resources for Belarus' HIV response provides valuable strategic information that can improve operations and planning as well as mobilize greater resources. NASA offers Belarusian policy makers an overview of HIV activities that merit their priority attention. In addition, the findings from Belarus are particularly relevant for the rest of the Commonwealth of Independent States due to their similar epidemiological profiles and centrally planned systems. The Belarusian government faces future challenges, especially in increasing public investments in HIV prevention for female sex workers and their clients, men who have sex with men, and among intravenous drug users.

Budgeting and spending habits of university students in South Africa ...

African Journals Online (AJOL)

The aim of this study was to investigate the budgeting and spending habits of university students at a South African university. In addition, the study examined if there is a significant gender difference in the budgeting and spending habits of university students. The study adopted a quantitative research approach with a ...

Public Health's Falling Share of US Health Spending.

Science.gov (United States)

Himmelstein, David U; Woolhandler, Steffie

2016-01-01

We examined trends in US public health expenditures by analyzing historical and projected National Health Expenditure Accounts data. Per-capita public health spending (inflation-adjusted) rose from $39 in 1960 to $281 in 2008, and has fallen by 9.3% since then. Public health's share of total health expenditures rose from 1.36% in 1960 to 3.18% in 2002, then fell to 2.65% in 2014; it is projected to fall to 2.40% in 2023. Public health spending has declined, potentially undermining prevention and weakening responses to health inequalities and new health threats.

Senate panel boosts DOE spending, save Yucca account

CERN Multimedia

Behrens, L

2002-01-01

The Senate Appropriations Committee last week approved an energy and water spending bill with $21 billion for the Energy Department, $426 million more than the Bush administration requested, and $1.1 billion more than the agency received in the financial year 2000. The bill would provide increases above the Bush request and current spending across-the-board in DOE's renewable energy, nuclear energy, science, weapons complex cleanup, defense and nonproliferation programs. The only major program that would be funded below the president's request is nuclear waste disposal (1 page).

Using Analysis of Governance to Unpack Community-Based Conservation: A Case Study from Tanzania.

Science.gov (United States)

Robinson, Lance W; Makupa, Enock

2015-11-01

Community-based conservation policies and programs are often hollow with little real devolution. But to pass a judgment of community-based or not community-based on such initiatives and programs obscures what is actually a suite of attributes. In this paper, we analyze governance around a specific case of what is nominally community-based conservation-Ikona Wildlife Management Area (WMA) in Tanzania-using two complementary sets of criteria. The first relates to governance "powers": planning powers, regulatory powers, spending powers, revenue-generating powers, and the power to enter into agreements. The second set of criteria derive from the understanding of governance as a set of social functions: social coordination, shaping power, setting direction, and building community. The analysis helps to detail ways in which the Tanzanian state through policy and regulations has constrained the potential for Ikona WMA to empower communities and community actors. Although it has some features of community-based conservation, community input into how the governance social functions would be carried out in the WMA was constrained from the start and is now largely out of community hands. The two governance powers that have any significant community-based flavor-spending powers and revenue-generating powers-relate to the WMA's tourism activities, but even here the picture is equivocal at best. The unpacking of governance that we have done, however, reveals that community empowerment through the processes associated with creating and recognizing indigenous and community-conserved areas is something that can be pursued through multiple channels, some of which might be more strategic than others.

The U.S. employment effects of military and domestic spending priorities.

Science.gov (United States)

Pollin, Robert; Garrett-Peltier, Heidi

2009-01-01

This study focuses on the employment effects of military spending versus alternative domestic spending priorities. The authors begin by introducing the basic input-output modeling technique for considering issues such as these in a systematic way. They then present some simple alternative spending scenarios-namely, devoting $1 billion to the military versus the same amount of money spent for five alternatives: tax cuts that produce increased levels of personal consumption; health care; education; mass transit; and construction targeted at home weatherization and infrastructure repair. The first conclusion in assessing such relative employment effects is straightforward: $1 billion spent on personal consumption, health care, education, mass transit, and construction for home weatherization/infrastructure will all create more jobs in the U.S. economy than would the same $1 billion spent on the military. The authors then examine the pay level of jobs created through these alternative spending priorities and assess the overall welfare effects of the alternative employment outcomes. Combining these alternative domestic spending categories in an effective way can also generate a higher level of compensation for working people in the United States and a better average quality ofjobs.

Radicals and reactionaries : the polarisation of community and government in the name of public safety and security

OpenAIRE

Weeks, Douglas M.

2013-01-01

The contemporary threat of terrorism has changed the ways in which government and the public view the world. Unlike the existential threat from nation states in previous centuries, today, government and the public spend much of their effort looking for the inward threat. Brought about by high profile events such as 9/11, 7/7, and 3/11, and exacerbated by globalisation, hyper-connected social spheres, and the media, the threats from within are reinforced daily. In the UK, government has taken ...

Hong Kong's health spending projections through 2033.

Science.gov (United States)

Leung, Gabriel M; Tin, Keith Y K; Chan, Wai-Sum

2007-04-01

To derive actuarial projection estimates of Hong Kong's total domestic health expenditure to the year 2033. Disaggregating health expenditure by age, sex, unit cost and utilisation level, we estimated future health spending by projecting utilisation (by public/private, inpatient/outpatient care) to reflect demographic changes and associated increase in demand (from higher expectations and greater intensity of care), and then multiplying such by the projected unit costs (incorporating the impact of key cost drivers such as public expectations, technological changes and potential productivity gains) to obtain total expenditure estimates. The model was most sensitive to the excess health care price inflation rate, i.e. the annual price/cost growth of medical goods and services over and above per capita GDP growth. Population ageing and growth per se, without taking into account related technologic innovation for chronic conditions that particularly afflict older adults, contribute relatively little to overall spending growth. Given the model assumptions, it is possible to limit total health spending to below 10% of GDP by 2033, where the public share would gradually decline from the current 57% to between 46% and 49%. Expenditure control through global budgeting, technology assessment and demand-side constraints should be considered although their effectiveness remains inconclusive.

Variation In Accountable Care Organization Spending And Sensitivity To Risk Adjustment: Implications For Benchmarking.

Science.gov (United States)

Rose, Sherri; Zaslavsky, Alan M; McWilliams, J Michael

2016-03-01

Spending targets (or benchmarks) for accountable care organizations (ACOs) participating in the Medicare Shared Savings Program must be set carefully to encourage program participation while achieving fiscal goals and minimizing unintended consequences, such as penalizing ACOs for serving sicker patients. Recently proposed regulatory changes include measures to make benchmarks more similar for ACOs in the same area with different historical spending levels. We found that ACOs vary widely in how their spending levels compare with those of other local providers after standard case-mix adjustments. Additionally adjusting for survey measures of patient health meaningfully reduced the variation in differences between ACO spending and local average fee-for-service spending, but substantial variation remained, which suggests that differences in care efficiency between ACOs and local non-ACO providers vary widely. Accordingly, measures to equilibrate benchmarks between high- and low-spending ACOs--such as setting benchmarks to risk-adjusted average fee-for-service spending in an area--should be implemented gradually to maintain participation by ACOs with high spending. Use of survey information also could help mitigate perverse incentives for risk selection and upcoding and limit unintended consequences of new benchmarking methodologies for ACOs serving sicker patients. Project HOPE—The People-to-People Health Foundation, Inc.

Trends in Spending by the Department of Defense for Operation and Maintenance

Science.gov (United States)

2017-01-01

funding across DoD has occurred at the ime that the number of military personnel er stayed relatively flat or fallen. As a result, spending for each... military personnel and their families, see Congressional Budget Office, Approaches to Reducing Federal Spending on Military Health Care (January...MAINTENANCE BETWEEN 1980 AND 2015 TRENDS IN SPENDING BY ibit 1. D’s Base Budget by Type of Appropriation, 1980 to 2015 ions of 2015 Dollars Military Personnela

Prosocial Spending and Well-Being: Cross-Cultural Evidence for a Psychological Universal

OpenAIRE

Lara B. Aknin; Christopher P. Barrington-Leigh; Elizabeth W. Dunn; John F. Helliwell; Robert Biswas-Diener; Imelda Kemeza; Paul Nyende; Claire E. Ashton-James; Michael I. Norton

2010-01-01

This research provides the first support for a possible psychological universal: human beings around the world derive emotional benefits from using their financial resources to help others (prosocial spending). Analyzing survey data from 136 countries, we show that prosocial spending is consistently associated with greater happiness. To test for causality, we conduct experiments within two very different countries (Canada and Uganda) and show that spending money on others has a consistent, ca...

Tax-Exempt Hospitals' Investments in Community Health and Local Public Health Spending: Patterns and Relationships.

Science.gov (United States)

Singh, Simone R; Young, Gary J

2017-12-01

To investigate whether tax-exempt hospitals' investments in community health are associated with patterns of governmental public health spending focusing specifically on the relationship between hospitals' community benefit expenditures and the spending patterns of local health departments (LHDs). We combined data on tax-exempt hospitals' community benefit spending with data on spending by the corresponding LHD that served the county in which a hospital was located. Data were available for 2 years, 2009 and 2013. Generalized linear regressions were estimated with indicators of hospital community benefit spending as the dependent variable and LHD spending as the key independent variable. Hospital community benefit spending was unrelated to how much local public health agencies spent, per capita, on public health in their communities. Patterns of local public health spending do not appear to impact the investments of tax-exempt hospitals in community health activities. Opportunities may, however, exist for a more active engagement between the public and private sector to ensure that the expenditures of all stakeholders involved in community health improvement efforts complement one another. © Health Research and Educational Trust.

The Long-Term Impact of Educational and Health Spending on Unemployment Rates

Directory of Open Access Journals (Sweden)

ZAFER PIRIM

2017-12-01

Full Text Available This study used panel data regression analysis to evaluate the long-term effects of several measures of U.S. education expenditure on unemployment rates in 50 states and Washington D.C. over 25 years. The data included state-level statistics for fiscal effort, graduation rates, education spending per pupil, gross state product per capita, welfare spending, health spending, political party affiliation, union versus nonunion states, and unemployment rates. Results find that the best way to effectively reduce unemployment is investment in improving the quality of human capital through funding education. Findings specifically conclude that over the long term, investment in human capital through education as defined by per-pupil spending and health services could play a significant role in reducing unemployment rates.

The Research Frontier in Corporate Governance

DEFF Research Database (Denmark)

Ahrens, Thomas; Filatotchev, Igor; Thomsen, Steen

2011-01-01

in our knowledge of corporate governance and is likely to lead of a rethink of central concepts like shareholder value, debt governance, and management incentives (2) what do we know and what do we need to how about the impact of national institutions on corporate governance? (3) What research questions......In this paper we attempt to identify the research frontier in corporate governance using three different approaches: (1) what challenges does the financial crisis 2007–2009 pose for corporate governance research? We show that the financial crisis is a huge natural experiment which has exposed gaps...

Public Hospital Spending in England: Evidence from National Health Service Administrative Records

OpenAIRE

Kelly, E.; Stoye, G.; Vera-Hernández, M.

2016-01-01

© 2016 The Authors. Fiscal Studies published by John Wiley & Sons Ltd. on behalf of Institute for Fiscal StudiesHealth spending per capita in England has almost doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending in England. We describe how costs vary across the life cycle, and the concentration of spendi...

User fee exemptions and excessive household spending for normal delivery in Burkina Faso: the need for careful implementation

Directory of Open Access Journals (Sweden)

Ameur Amal

2012-11-01

Full Text Available Abstract Background In 2006, the Parliament of Burkina Faso passed a policy to reduce the direct costs of obstetric services and neonatal care in the country’s health centres, aiming to lower the country’s high national maternal mortality and morbidity rates. Implementation was via a “partial exemption” covering 80% of the costs. In 2008 the German NGO HELP launched a pilot project in two health districts to eliminate the remaining 20% of user fees. Regardless of any exemptions, women giving birth in Burkina Faso’s health centres face additional expenses that often represent an additional barrier to accessing health services. We compared the total cost of giving birth in health centres offering partial exemption versus those with full exemption to assess the impact on additional out-of-pocket fees. Methods A case–control study was performed to compare medical expenses. Case subjects were women who gave birth in 12 health centres located in the Dori and Sebba districts, where HELP provided full fee exemption for obstetric services and neonatal care. Controls were from six health centres in the neighbouring Djibo district where a partial fee exemption was in place. A random sample of approximately 50 women per health centre was selected for a total of 870 women. Results There was an implementation gap regarding the full exemption for obstetric services and neonatal care. Only 1.1% of the sample from Sebba but 17.5% of the group from Dori had excessive spending on birth related costs, indicating that women who delivered in Sebba were much less exposed to excessive medical expenses than women from Dori. Additional out-of-pocket fees in the full exemption health districts took into account household ability to pay, with poorer women generally paying less. Conclusions We found that the elimination of fees for facility-based births benefits especially the poorest households. The existence of excessive spending related to direct costs of

Pharmaceutical company spending on research and development and promotion in Canada, 2013-2016: a cohort analysis.

Science.gov (United States)

Lexchin, Joel

2018-01-01

Competing claims are made about the amount of money that pharmaceutical companies spend on research and development (R&D) versus promotion. This study investigates this question in the Canadian context. Two methods for determining industry-wide figures for spending on promotion were employed. First, total industry spending on detailing and journal advertising for 2013-2016 was abstracted from reports from QuintilesIMS. Second, the mean total promotion spending for the years 2002-2005 was used to estimate total spending for 2013-2016. Total industry spending on R&D came from the Patented Medicine Prices Review Board (PMPRB). R&D to promotion spending using each method of determining the amount spent on promotion was compared for 2013-2016 inclusive. Data on the 50 top promoted drugs, the amounts spent, the companies marketing these products and their overall sales were abstracted from the QuintilesIMS reports. Spending on R&D and promotion as a percent of sales was compared for these companies. Industry wide, the ratio of R&D to promotion spending went from 1.43 to 2.18 when promotion was defined as the amount spent on detailing and journal advertising for the 50 most promoted drugs. Calculating total promotion spending from the mean of the 2002-2005 figures the ratio was 0.88 to 1.32 for the 50 most promoted drugs. For individual companies marketing one or more of the 50 most promoted drugs, mean R&D spending ranged from 3.7% of sales to 4.1% compared to mean promotion spending that went from 1.7 to 1.9%. The ratio of spending on R&D to promotion varied from 2.11 to 2.32. Eight to 10 companies per year spent more on promotion than on R&D. Depending on the method used to determine promotion spending, industry-wide the ratio of R&D spending to promotion ranges from 1.45 to 2.18 (sales representatives and journal advertising only) or from 0.88 to 1.32 (total promotion spending estimated based 2003-2005 data.) For the individual companies promoting one or more of the

Income growth, government spending, and wasting assets: Alberta's oil and gas

International Nuclear Information System (INIS)

Smith, R.S.

1992-01-01

Physical and monetary accounts for the oil and gas sectors in Alberta from 1963 through 1988 are used to adjust Alberta's Gross Domestic Product and Gross Domestic Investment for changes in oil and gas reserves. Other resources, non-renewable and renewable, are important to Alberta, but the change in oil and gas reserves over the past quarter century deserves attention in itself. Growth rates of income and investment during the 1970s and 1980s differ significantly when the adjustments are made to conventional income accounts. Since policies are often based on conventional statistics, alternative measures yielding very different results warrant attention. The oil and gas accounts also permit comparison of past expenditures of resource revenues with what would be spent under a rule of thumb such as Robert Solow's (1986) suggestion that allowable consumption be interest on an initial patrimony of resource endowment. Such a comparison indicates the provincial government may, at times, have overspent resource revenues during the past quarter century; at other times its policies appear to have been quite conservative. The estimates presented require various assumptions, and therefore are but one possible set of adjustments deserving consideration. 26 refs., 4 figs., 13 tabs

Report on Spending Trends Highlights Inequities in Model for Financing Colleges

Science.gov (United States)

Blumenstyk, Goldie

2009-01-01

An analysis of spending trends that is designed to discourage policy makers' focus on finding new revenue rather than reining in spending suggests that the model for financing colleges has reinforced educational inequities and failed to increase the rate at which students graduate. According to the analysis, "serious fault lines" in the current…

How Medicaid Expansion Affected Out-of-Pocket Health Care Spending for Low-Income Families.

Science.gov (United States)

Glied, Sherry; Chakraborty, Ougni; Russo, Therese

2017-08-01

ISSUE. Prior research shows that low-income residents of states that expanded Medicaid under the Affordable Care Act are less likely to experience financial barriers to health care access, but the impact on out-of-pocket spending has not yet been measured. GOAL. Assess how the Medicaid expansion affected out-of-pocket health care spending for low-income families compared to those in states that did not expand and consider whether effects differed in states that expanded under conventional Medicaid rules vs. waiver programs. METHODS. Analysis of the Consumer Expenditure Survey 2010–2015. KEY FINDINGS AND CONCLUSIONS. Compared to families in nonexpansion states, low-income families in states that did expand Medicaid saved an average of $382 in annual spending on health care. In these states, low-income families were less like to report any out-of-pocket spending on insurance premiums or medical care than were similar families in nonexpansion states. For families that did have some out-of-pocket spending, spending levels were lower in states that expanded Medicaid. Low-income families in Medicaid expansion states were also much less likely to have catastrophically high spending levels. The form of coverage expansion — conventional Medicaid or waiver rules — did not have a statistically significant effect on these outcomes.

Allocating Spending Between Advertising and Information Technology in Electronic Retailing

OpenAIRE

Yong Tan; Vijay S. Mookerjee

2005-01-01

This study examines coordination issues that occur in allocating spending between advertising and information technology (IT) in electronic retailing. Electronic retailers run the risk of overspending on advertising to attract customers but underspending on IT, thus resulting in inadequate processing capacity at the firm's website. In this paper, we present a centralized, joint marketing-IT model to optimally allocate spending between advertising and IT, and we discuss an uncoordinated case w...

Re-spending rebound: A macro-level assessment for OECD countries and emerging economies

International Nuclear Information System (INIS)

Antal, Miklós; Bergh, Jeroen C.J.M. van den

2014-01-01

It is well-known that energy conservation can lead to rebound effects that partly offset the original energy savings. One particular rebound mechanism is re-spending of money savings associated with energy savings on energy intensive goods or services. We calculate the average magnitude of this “re-spending rebound” for different fuels and countries, and for both energy and carbon (CO 2 ) emissions. We find that emerging economies, neglected in past studies, typically have larger rebounds than OECD countries. Since such economies play an increasingly important role in the global economy the re-spending rebound is a growing concern. The re-spending effect is generally larger for gasoline than for natural gas and electricity. Paradoxically, stronger financial incentives to conserve energy tend to increase the rebound. This suggests that with climate regulation and peak oil the re-spending rebound may become more important. We discuss the policy implications of our findings. - highlights: • Energy and carbon rebound due to re-spending of money savings is analyzed. • The average magnitude of this rebound is calculated for several countries. • Emerging economies typically have substantially larger rebounds than OECD countries. • The effect is generally stronger for gasoline than for natural gas and electricity. • Policy conclusions are drawn

Images of illness: how causal claims and racial associations influence public preferences toward diabetes research spending.

Science.gov (United States)

Gollust, Sarah E; Lantz, Paula M; Ubel, Peter A

2010-12-01

Despite the salience of health disparities in media and policy discourse, little previous research has investigated if imagery associating an illness with a certain racial group influences public perceptions. This study evaluated the influence of the media's presentation of the causes of type 2 diabetes and its implicit racial associations on attitudes toward people with diabetes and preferences toward research spending. Survey participants who viewed an article on genetic causation or social determinants of diabetes were more likely to support increased government spending on research than those viewing an article with no causal language, while participants viewing an article on behavioral choices were more likely to attribute negative stereotypes to people with diabetes. Participants who viewed a photo of a black woman accompanying the article were less likely to endorse negative stereotypes than those viewing a photo of a white woman, but those who viewed a photo of a glucose-testing device expressed the lowest negative stereotypes. The effect of social determinants language was significantly different for blacks and whites, lowering stereotypes only among blacks. Emphasizing the behavioral causes of diabetes, as is common in media coverage, may perpetuate negative stereotypes. While drawing attention to the social determinants that shape these behaviors could mitigate stereotypes, this strategy is unlikely to influence the public uniformly.

40 CFR 35.4070 - How can my group spend TAG money?

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false How can my group spend TAG money? 35.4070 Section 35.4070 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL... my group spend TAG money? (a) Your group must use all or most of your funds to procure a technical...

Public Health Spending and Medicare Resource Use: A Longitudinal Analysis of U.S. Communities.

Science.gov (United States)

Mays, Glen P; Mamaril, Cezar B

2017-12-01

To examine whether local expenditures for public health activities influence area-level medical spending for Medicare beneficiaries. Six census surveys of the nation's 2,900 local public health agencies were conducted between 1993 and 2013, linked with contemporaneous information on population demographics, socioeconomic characteristics, and area-level Medicare spending estimates from the Dartmouth Atlas of Health Care. Measures derive from agency survey data and aggregated Medicare claims. A longitudinal cohort design follows the geographic areas served by local public health agencies. Multivariate, fixed-effects, and instrumental-variables regression models estimate how area-level Medicare spending changes in response to shifts in local public health spending, controlling for observed and unmeasured confounders. A 10 percent increase in local public health spending per capita was associated with 0.8 percent reduction in adjusted Medicare expenditures per person after 1 year (p health insurance coverage, and health professional shortages. Expanded financing for public health activities may provide an effective way of constraining Medicare spending, particularly in low-resource communities. © Health Research and Educational Trust.

Tracking development assistance and government health expenditures for 35 malaria-eliminating countries: 1990-2017.

Science.gov (United States)

Shretta, Rima; Zelman, Brittany; Birger, Maxwell L; Haakenstad, Annie; Singh, Lavanya; Liu, Yingying; Dieleman, Joseph

2017-07-14

Donor financing for malaria has declined since 2010 and this trend is projected to continue for the foreseeable future. These reductions have a significant impact on lower burden countries actively pursuing elimination, which are usually a lesser priority for donors. While domestic spending on malaria has been growing, it varies substantially in speed and magnitude across countries. A clear understanding of spending patterns and trends in donor and domestic financing is needed to uncover critical investment gaps and opportunities. Building on the Institute for Health Metrics and Evaluation's annual Financing Global Health research, data were collected from organizations that channel development assistance for health to the 35 countries actively pursuing malaria elimination. Where possible, development assistance for health (DAH) was categorized by spend on malaria intervention. A diverse set of data points were used to estimate government health budgets expenditure on malaria, including World Malaria Reports and government reports when available. Projections were done using regression analyses taking recipient country averages and earmarked funding into account. Since 2010, DAH for malaria has been declining for the 35 countries actively pursuing malaria elimination (from $176 million in 2010 to $62 million in 2013). The Global Fund is the largest external financier for malaria, providing 96% of the total external funding for malaria in 2013, with vector control interventions being the highest cost driver in all regions. Government expenditure on malaria, while increasing, has not kept pace with diminishing DAH or rising national GDP rates, leading to a potential gap in service delivery needed to attain elimination. Despite past gains, total financing available for malaria in elimination settings is declining. Health financing trends suggest that substantive policy interventions will be needed to ensure that malaria elimination is adequately financed and that

Business Subsidies in Canada Comprehensive Estimates for the Government of Canada and the Four Largest Provinces

Directory of Open Access Journals (Sweden)

John Lester

2018-01-01

Full Text Available Business subsidies in Canada: the “winner” is Alberta; the loser is the taxpayer The federal government and the four largest provinces in Canada spend about $29 billion a year on business subsidies, delivered through program spending, the tax system, government business enterprises and direct investments by government. These subsidies represent almost half of the corporate income tax revenue collected by the five jurisdictions. Surprisingly, given its reputation as a bastion of free enterprise, Alberta is the most prolific subsidizer. In the 2014-15 fiscal year, per person subsidies were $640 in Alberta, about $100 ahead of the next most generous jurisdiction, Québec. Alberta has probably added to its “lead” through measures introduced in the October 2015 Fiscal Update and the 2016 budget. Alberta also stands out by having the least transparent public reporting of business subsidies. What motivates governments to subsidize business? Abstracting from cynical efforts to win votes, business subsidies have two broad objectives: to improve economic performance and to achieve a social objective by supporting specific firms, industries or regions. On average in the five jurisdictions, the split between the two categories is about 70-30 in favour of economic development measures. Assessing value for money from programs with a social objective is subjective, but measures intended to improve economic performance should be assessed on their ability to raise real income. Business subsidies can only raise real income if markets fail to allocate labour and capital to their best uses. The classic case is R&D. When a firm undertakes R&D, some of the knowledge created inevitably spills over to the benefit other firms. Firms are focused on their own benefits and costs when deciding how much to spend on R&D, not the benefits received by other firms, so society has an interest in encouraging additional R&D. While markets generally do a good job allocating

The US healthcare workforce and the labor market effect on healthcare spending and health outcomes.

Science.gov (United States)

Pellegrini, Lawrence C; Rodriguez-Monguio, Rosa; Qian, Jing

2014-06-01

The healthcare sector was one of the few sectors of the US economy that created new positions in spite of the recent economic downturn. Economic contractions are associated with worsening morbidity and mortality, declining private health insurance coverage, and budgetary pressure on public health programs. This study examines the causes of healthcare employment growth and workforce composition in the US and evaluates the labor market's impact on healthcare spending and health outcomes. Data are collected for 50 states and the District of Columbia from 1999-2009. Labor market and healthcare workforce data are obtained from the Bureau of Labor Statistics. Mortality and health status data are collected from the Centers for Disease Control and Prevention's Vital Statistics program and Behavioral Risk Factor Surveillance System. Healthcare spending data are derived from the Centers for Medicare and Medicaid Services. Dynamic panel data regression models, with instrumental variables, are used to examine the effect of the labor market on healthcare spending, morbidity, and mortality. Regression analysis is also performed to model the effects of healthcare spending on the healthcare workforce composition. All statistical tests are based on a two-sided [Formula: see text] significance of [Formula: see text] .05. Analyses are performed with STATA and SAS. The labor force participation rate shows a more robust effect on healthcare spending, morbidity, and mortality than the unemployment rate. Study results also show that declining labor force participation negatively impacts overall health status ([Formula: see text] .01), and mortality for males ([Formula: see text] .05) and females ([Formula: see text] .001), aged 16-64. Further, the Medicaid and Medicare spending share increases as labor force participation declines ([Formula: see text] .001); whereas, the private healthcare spending share decreases ([Formula: see text] .001). Public and private healthcare spending also

Russia's defense spending and the economic decline

Directory of Open Access Journals (Sweden)

Susanne Oxenstierna

2016-01-01

Full Text Available The purpose of this article is to explore the development of Russian military spending in light of weak and negative growth of the Russian economy and to look at the reasons for the economic decline that has developed after the economic crisis in 2009 and is due to long-term internal structural factors that have existed since the mid-2000s. The confidence crisis resulting from Russia's aggression against Ukraine 2014, Western sanctions and falling oil prices has further aggravated these tendencies and the economy is now contracting. The main conclusions are that the share of the defense budget in GDP has risen substantially, but there is still a trade-off between defense and other public spending in the budget. Political reform would be necessary to implement market institutions and revive the economy.

Reducing the Deficit: Spending and Revenue Options

Science.gov (United States)

1994-03-01

357 B SPENDING OPTIONS BY BUDGET FUNCION ...... 363 TABLES 1. Baseline Deficit Projections, Fiscal Years 1993-2004...direct control of the Congress. abled beneficiaries and beneficiaries with end-stage renal disease. Nonhealth changes enacted in The total that is

Natural resources and government revenue : recent trends in Saskatchewan

International Nuclear Information System (INIS)

Warnock, J.W.

2005-01-01

This document discusses recent trends in Saskatchewan regarding natural resources and government revenue. It discusses the history of politics in terms of government expenditure and investment in natural resources; the polarization between urban and rural areas; natural resources and capital accumulation and economic rent and royalties from resource extraction. The document also discusses several industries in Saskatchewan including petroleum, natural gas discovery and extraction. Uranium and coal mining activities were also documented along with other minerals such as gold, diamonds, and sodium sulphate. The article focused on the share of economic rent going to the general public compared to the amount going to private corporations. The author argued that with rising prices for natural resources, the provincial government has been transferring billions of dollars of resources rent to private investors by reducing royalties, fees and taxes. This has resulted in less revenue for the provincial government to spend on programs such as health, education and public services. The author suggested that concerted efforts must be put forward to put the issue of the public role in resource development back on the government agenda. 99 refs., 7 tabs

International Monetary Fund and aid displacement.

Science.gov (United States)

Stuckler, David; Basu, Sanjay; McKee, Martin

2011-01-01

Several recent papers find evidence that global health aid is being diverted to reserves, education, military, or other sectors, and is displacing government spending. This is suggested to occur because ministers of finance have competing, possibly corrupt, priorities and deprive the health sector of resources. Studies have found that development assistance for health routed to governments has a negative impact on health spending and that similar assistance routed to private nongovernmental organizations has a positive impact. An alternative hypothesis is that World Bank and IMF macro-economic policies, which specifically advise governments to divert aid to reserves to cope with aid volatility and keep government spending low, could be causing the displacement of health aid. This article evaluates whether aid displacement was greater when countries undertook a new borrowing program from the IMF between 1996 and 2006. As found in existing studies, for each $1 of development assistance for health, about $0.37 is added to the health system. However, evaluating IMF-borrowing versus non-IMF-borrowing countries reveals that non-borrowers add about $0.45 whereas borrowers add less than $0.01 to the health system. On average, health system spending grew at about half the speed when countries were exposed to the IMF than when they were not. It is important to take account of the political economy of global health finance when interpreting data on financial flows.

Hong Kong domestic health spending: financial years 1989/90 to 2010/11.

Science.gov (United States)

Tin, K Y K; Tsoi, P K O; Lee, Y H; Tsui, E L H; Lam, D W S; Yeung, A Y T; Chui, A W M; Tay, M S M

2013-12-01

/90 to 2010/11, which is likely due to shift of policy directives from in-patient to day patient care, and the increasing demand for dialysis and cataract surgery in an ageing population.Hospitals accounted for an increasing share of TEH, from 28.2% in 1989/90 to 46.8% in 2002/03 and then dropped slightly to 43% to 44%during the period 2005/06 to 2010/11, which was primarily driven by reduced expenditure by the Hospital Authority. As a result of several epidemics (e g avian flu, SARS, swine flu) and expansion of the private health insurance market in the last two decades, spending on the provision and administration of public health programmes, and general health administration and insurance accounted for increasing, though less significant, shares of TEH over that period.Without taking into account capital expenses (ie investment in medical facilities), public current expenditure on health amounted to HK$42 264 million(47.5% of total current expenditure) in 2010/11. The remaining HK$46 723 million was from private sources. Public current expenditure was mostly incurred at hospitals (74.7%), whereas private current expenditure was mostly incurred at providers of ambulatory health care (51.0%). Although both public and private spending were mostly expended on personal health care services and goods (91.4%of total current spending), the distributional patterns among functional categories differed. Public expenditure was targeted at in-patient care (47.6%) and substantially less on out-patient care (27.5%). In comparison, private spending was mostly concentrated on out-patient care (43.2%),whereas in-patient care (24.5%) and medical goods outside the patient care setting (19.9%) accounted for most of the remaining share. Compared to the Organisation for Economic Cooperation and Development countries, Hong Kong has devoted a relatively low percentage of GDP to healthcare in the last decade. As a share of TEH, public funding(either general government revenue or social

Adjusting health spending for the presence of comorbidities: an application to United States national inpatient data.

Science.gov (United States)

Dieleman, Joseph L; Baral, Ranju; Johnson, Elizabeth; Bulchis, Anne; Birger, Maxwell; Bui, Anthony L; Campbell, Madeline; Chapin, Abigail; Gabert, Rose; Hamavid, Hannah; Horst, Cody; Joseph, Jonathan; Lomsadze, Liya; Squires, Ellen; Tobias, Martin

2017-08-29

One of the major challenges in estimating health care spending spent on each cause of illness is allocating spending for a health care event to a single cause of illness in the presence of comorbidities. Comorbidities, the secondary diagnoses, are common across many causes of illness and often correlate with worse health outcomes and more expensive health care. In this study, we propose a method for measuring the average spending for each cause of illness with and without comorbidities. Our strategy for measuring cause of illness-specific spending and adjusting for the presence of comorbidities uses a regression-based framework to estimate excess spending due to comorbidities. We consider multiple causes simultaneously, allowing causes of illness to appear as either a primary diagnosis or a comorbidity. Our adjustment method distributes excess spending away from primary diagnoses (outflows), exaggerated due to the presence of comorbidities, and allocates that spending towards causes of illness that appear as comorbidities (inflows). We apply this framework for spending adjustment to the National Inpatient Survey data in the United States for years 1996-2012 to generate comorbidity-adjusted health care spending estimates for 154 causes of illness by age and sex. The primary diagnoses with the greatest number of comorbidities in the NIS dataset were acute renal failure, septicemia, and endocarditis. Hypertension, diabetes, and ischemic heart disease were the most common comorbidities across all age groups. After adjusting for comorbidities, chronic kidney diseases, atrial fibrillation and flutter, and chronic obstructive pulmonary disease increased by 74.1%, 40.9%, and 21.0%, respectively, while pancreatitis, lower respiratory infections, and septicemia decreased by 21.3%, 17.2%, and 16.0%. For many diseases, comorbidity adjustments had varying effects on spending for different age groups. Our methodology takes a unified approach to account for excess spending caused

Systems GMM estimates of the health care spending and GDP relationship: a note.

Science.gov (United States)

Kumar, Saten

2013-06-01

This paper utilizes the systems generalized method of moments (GMM) [Arellano and Bover (1995) J Econometrics 68:29-51; Blundell and Bond (1998) J Econometrics 87:115-143], and panel Granger causality [Hurlin and Venet (2001) Granger Causality tests in panel data models with fixed coefficients. Mime'o, University Paris IX], to investigate the health care spending and gross domestic product (GDP) relationship for organisation for economic co-operation and development countries over the period 1960-2007. The system GMM estimates confirm that the contribution of real GDP to health spending is significant and positive. The panel Granger causality tests imply that a bi-directional causality exists between health spending and GDP. To this end, policies aimed at raising health spending will eventually improve the well-being of the population in the long run.

Spending Behavior of the Teaching Personnel in an Asian University

Directory of Open Access Journals (Sweden)

Niño Philip L. Perculeza

2016-02-01

Full Text Available Money, through the years, has been a commodity for everyone. As it is termed in international trade parlance, it is considered to be “sine qua non” or without which, nothing could be done. This study aimed to determine the current status of the spending practices of the teaching personnel in Lyceum of the Philippines University – Batangas; specifically, their profile, spending behavior and their encountered problems related to the forgoing matter. This study is descriptive in nature. It was participated by 161 teaching personnel of LPU-Batangas computed and selected through the G* power series with an effective size of 40 percent and power size of 95 percent. It made use of an adopted and modified questionnaire as its primary data gathering instrument which has three parts. The needed data were encoded, tallied and interpreted using different statistical tools such as frequency distribution, ranking, weighted mean and F-Test; and were further analyzed and interpreted through PASW version 19 using 0.05 alpha levels. From the results, it was concluded that the respondents had an often type of spending on the Basic Necessity. Moreover, overspending is the problem that was most encountered by the respondents. Various recommendations were posted by the researchers including a proposed plan of action that could help improve the spending behavior of the faculty members of LPU Batangas.

[Financial and economic sustainability of public spending on health care by local governments: an analysis of data from municipalities in Mato Grosso State, Brazil].

Science.gov (United States)

Scatena, João Henrique Gurtler; Viana, Ana Luiza d'Avila; Tanaka, Oswaldo Yoshimi

2009-11-01

Brazil's Unified National Health System is financed according to a model known as fiscal federalism, the fund-sharing rules of the Social Security Budget, Ministry of Health norms, and Constitutional Amendment 29 (EC-29), which links Federal, State, and municipal resources to health. This article discusses the sustainability of public spending on health at the municipal level. Twenty-one municipalities were studied, using municipal budget data. From 1996 to 2006, total current per capita revenues increased by 280% above the accumulated inflation and Gross Domestic Product, varying by size of municipality, which also defined the composition of the municipal budgets. Meanwhile, the budget comprising the basis for EC-29 increased less (178%), thus placing limits on the municipal share of health spending. The results observed in these municipalities are believed to reflect the reality in thousands of other Brazilian municipalities, thus jeopardizing the capacity for municipal investment in health, especially beginning in 2008. The situation may become even worse, considering the repeal of the so-called Bank Transaction Tax (CPMF), Bills of Law 306/08 and 233/08 (currently under review in the National Congress), and the world recession stemming from the U.S. financial crisis.

U.S., non-U.S. outlays to rise in '98, but oil price plunge clouds spending outlook

International Nuclear Information System (INIS)

Beck, R.J.

1998-01-01

Capital spending by oil and gas companies in and outside the US will rise in 1998, but that forecast may be jeopardized by the continuing plunge in oil prices. For operations in the US, oil and gas company capital spending is expected to move up in 1998 for the fourth year in a row. If the money is spent, it will be the highest industry investment level since 1985. Strong oil and gas prices and increased volumes have boosted company cash flow and profits the last few years, fueling increased spending. However, the near-term outlook has now been clouded by economic turmoil in a number of Asian countries and the recent collapse of oil prices. The paper discusses oil and gas prices, US upstream spending, US non-exploration and production spending, capital spending in Canada, and spending outside US and Canada

Trends in prescription drug utilization and spending for the Department of Defense, 2002-2007.

Science.gov (United States)

Devine, Joshua W; Trice, Shana; Spridgen, Stacia L; Bacon, Thomas A

2009-09-01

Examine trends in U.S. Department of Defense (DoD) outpatient drug spending and utilization between 2002 and 2007. We analyzed pharmacy claims data from the U.S. Military Health System (MHS), using a cross-sectional analysis at the prescription and patient-year level and measuring utilization in 30-day equivalent prescriptions and expenditures in dollars. Pharmaceutical spending more than doubled in DoD, from $3 billion in FY02 to $6.5 billion in FY07. The largest increase occurred in the DoD community pharmacy network, where utilization grew from 6 million 30-day equivalent prescriptions in the first quarter of FY02 to more than 16 million in the last quarter of FY07. The smallest increase in annual spending occurred in FY07 (5.5%), down from a high of 27.5% in FY03. The MHS has experienced rapid growth in pharmaceutical spending since FY02. However, there are signs that growth in pharmaceutical spending may be slowing.

Cities through the Prism of People's Spending Behavior.

Science.gov (United States)

Sobolevsky, Stanislav; Sitko, Izabela; Tachet des Combes, Remi; Hawelka, Bartosz; Murillo Arias, Juan; Ratti, Carlo

2016-01-01

Scientific studies of society increasingly rely on digital traces produced by various aspects of human activity. In this paper, we exploit a relatively unexplored source of data-anonymized records of bank card transactions collected in Spain by a big European bank, and propose a new classification scheme of cities based on the economic behavior of their residents. First, we study how individual spending behavior is qualitatively and quantitatively affected by various factors such as customer's age, gender, and size of his/her home city. We show that, similar to other socioeconomic urban quantities, individual spending activity exhibits a statistically significant superlinear scaling with city size. With respect to the general trends, we quantify the distinctive signature of each city in terms of residents' spending behavior, independently from the effects of scale and demographic heterogeneity. Based on the comparison of city signatures, we build a novel classification of cities across Spain in three categories. That classification exhibits a substantial stability over different city definitions and connects with a meaningful socioeconomic interpretation. Furthermore, it corresponds with the ability of cities to attract foreign visitors, which is a particularly remarkable finding given that the classification was based exclusively on the behavioral patterns of city residents. This highlights the far-reaching applicability of the presented classification approach and its ability to discover patterns that go beyond the quantities directly involved in it.

Cities through the Prism of People's Spending Behavior.

Directory of Open Access Journals (Sweden)

Stanislav Sobolevsky

Full Text Available Scientific studies of society increasingly rely on digital traces produced by various aspects of human activity. In this paper, we exploit a relatively unexplored source of data-anonymized records of bank card transactions collected in Spain by a big European bank, and propose a new classification scheme of cities based on the economic behavior of their residents. First, we study how individual spending behavior is qualitatively and quantitatively affected by various factors such as customer's age, gender, and size of his/her home city. We show that, similar to other socioeconomic urban quantities, individual spending activity exhibits a statistically significant superlinear scaling with city size. With respect to the general trends, we quantify the distinctive signature of each city in terms of residents' spending behavior, independently from the effects of scale and demographic heterogeneity. Based on the comparison of city signatures, we build a novel classification of cities across Spain in three categories. That classification exhibits a substantial stability over different city definitions and connects with a meaningful socioeconomic interpretation. Furthermore, it corresponds with the ability of cities to attract foreign visitors, which is a particularly remarkable finding given that the classification was based exclusively on the behavioral patterns of city residents. This highlights the far-reaching applicability of the presented classification approach and its ability to discover patterns that go beyond the quantities directly involved in it.

Funding AIDS programmes in the era of shared responsibility: an analysis of domestic spending in 12 low-income and middle-income countries.

Science.gov (United States)

Resch, Stephen; Ryckman, Theresa; Hecht, Robert

2015-01-01

As the incomes of many AIDS-burdened countries grow and donors' budgets for helping to fight the disease tighten, national governments and external funding partners increasingly face the following question: what is the capacity of countries that are highly affected by AIDS to finance their responses from domestic sources, and how might this affect the level of donor support? In this study, we attempt to answer this question. We propose metrics to estimate domestic AIDS financing, using methods related to national prioritisation of health spending, disease burden, and economic growth. We apply these metrics to 12 countries in sub-Saharan Africa with a high prevalence of HIV/AIDS, generating scenarios of possible future domestic expenditure. We compare the results with total AIDS financing requirements to calculate the size of the resulting funding gaps and implications for donors. Nearly all 12 countries studied fall short of the proposed expenditure benchmarks. If they met these benchmarks fully, domestic spending on AIDS would increase by 2·5 times, from US$2·1 billion to $5·1 billion annually, covering 64% of estimated future funding requirements and leaving a gap of around a third of the total $7·9 billion needed. Although upper-middle-income countries, such as Botswana, Namibia, and South Africa, would become financially self-reliant, lower-income countries, such as Mozambique and Ethiopia, would remain heavily dependent on donor funds. The proposed metrics could be useful to stimulate further analysis and discussion around domestic spending on AIDS and corresponding donor contributions, and to structure financial agreements between recipient country governments and donors. Coupled with improved resource tracking, such metrics could enhance transparency and accountability for efficient use of money and maximise the effect of available funding to prevent HIV infections and save lives. US Centers for Disease Control and Prevention. Copyright © 2015 Hecht et

Association between quality domains and health care spending across physician networks

Science.gov (United States)

Rahman, Farah; Guan, Jun; Glazier, Richard H.; Brown, Adalsteinn; Bierman, Arlene S.; Croxford, Ruth; Stukel, Therese A.

2018-01-01

One of the more fundamental health policy questions is the relationship between health care quality and spending. A better understanding of these relationships is needed to inform health systems interventions aimed at increasing quality and efficiency of care. We measured 65 validated quality indicators (QI) across Ontario physician networks. QIs were aggregated into domains representing six dimensions of care: screening and prevention, evidence-based medications, hospital-community transitions (7-day post-discharge visit with a primary care physician; 30-day post-discharge visit with a primary care physician and specialist), potentially avoidable hospitalizations and emergency department (ED) visits, potentially avoidable readmissions and unplanned returns to the ED, and poor cancer end of life care. Each domain rate was computed as a weighted average of QI rates, weighting by network population at risk. We also measured overall and sector-specific per capita healthcare network spending. We evaluated the associations between domain rates, and between domain rates and spending using weighted correlations, weighting by network population at risk, using an ecological design. All indicators were measured using Ontario health administrative databases. Large variations were seen in timely hospital-community transitions and potentially avoidable hospitalizations. Networks with timely hospital-community transitions had lower rates of avoidable admissions and readmissions (r = -0.89, -0.58, respectively). Higher physician spending, especially outpatient primary care spending, was associated with lower rates of avoidable hospitalizations (r = -0.83) and higher rates of timely hospital-community transitions (r = 0.81) and moderately associated with lower readmission rates (r = -0.46). Investment in effective primary care services may help reduce burden on the acute care sector and associated expenditures. PMID:29614131

Regulatory activities of government: analysis of determinants

Directory of Open Access Journals (Sweden)

Primož Pevcin

2006-12-01

Full Text Available International comparisons show that large cross-country differences exist in the overall macro extent of regulation of the economy. In this context, the main purpose of the article is to investigate, why such differences exist by identifying and empirically verifying the effect of various factors that could potentially shape those differences. Empirical analysis based on the sample of 32 developed and democratic countries revealed that almost 70 % of variation in the macro extent of regulation could be explained with 7 statistically significant explanatory variables. The econometric analysis revealed that the macro extent of regulation decreases with income inequality in society, with the level of economic development, with the sizeof economy, with the share of transfer spending in GDP and with the share of government employment in labour force. On the other hand, the extent of regulation is positively related to government ownership of enterprises and to presidential political regime

One sector models, indeterminacy, and productive public spending

Czech Academy of Sciences Publication Activity Database

Slobodyan, Sergey

-, č. 293 (2006), s. 1-24 ISSN 1211-3298 Institutional research plan: CEZ:MSM0021620846 Keywords : indeterminacy * absolute instability * productive public spending Subject RIV: AH - Economics http://www.cerge-ei.cz/pdf/wp/Wp293.pdf

Health care expenditure in the Islamic Republic of Iran versus other high spending countries.

Science.gov (United States)

Khosravi, Bahman; Soltani, Shahin; Javan-Noughabi, Javad; Faramarzi, Ahmad

2017-01-01

Background: In all countries, health expenditures are a main part of government expenditure, and governments try to find policies and strategies to reduce this expenditure. Overall expenditure index has been raised 30 times during the past 20 years in Iran, while in the health sector, the growth in health expenditures index has been 71 times. The present study aimed at examining health care expenditure in the Islamic Republic of Iran versus other high spending countries. Methods: A comparative panel study was conducted in selected countries with the high mean of health expenditure per capita. Data were collected from the WORLD BANK. Out- of- pocket (OOP), health expenditure per capita, public and private health expenditure, and total health expenditure were compared among the selected counties. Results: Iran has the lowest health expenditure per capita compared to other countries and the USA has the highest health expenditures per capita. In Iran, out- of- pocket expenditure, with more than 50%, was the most cost, while in Luxembourg it was the least cost during 2004 to 2014, with less than 12%. Conclusion: Our findings revealed that politicians and health care executives should find a stable source to finance the health system. Stable sources of financing lead to having a steady trend in health expenditure.

A Bayesian sequential design using alpha spending function to control type I error.

Science.gov (United States)

Zhu, Han; Yu, Qingzhao

2017-10-01

We propose in this article a Bayesian sequential design using alpha spending functions to control the overall type I error in phase III clinical trials. We provide algorithms to calculate critical values, power, and sample sizes for the proposed design. Sensitivity analysis is implemented to check the effects from different prior distributions, and conservative priors are recommended. We compare the power and actual sample sizes of the proposed Bayesian sequential design with different alpha spending functions through simulations. We also compare the power of the proposed method with frequentist sequential design using the same alpha spending function. Simulations show that, at the same sample size, the proposed method provides larger power than the corresponding frequentist sequential design. It also has larger power than traditional Bayesian sequential design which sets equal critical values for all interim analyses. When compared with other alpha spending functions, O'Brien-Fleming alpha spending function has the largest power and is the most conservative in terms that at the same sample size, the null hypothesis is the least likely to be rejected at early stage of clinical trials. And finally, we show that adding a step of stop for futility in the Bayesian sequential design can reduce the overall type I error and reduce the actual sample sizes.

Tax reform in the Lula government: continuity and fiscal injustice

Directory of Open Access Journals (Sweden)

Alexandrine Brami-Celentano

2007-04-01

Full Text Available The tax reform proposed by the Lula government in 2003, quickly approved by Congress, remained at the limits of the proposals of the previous government of President Fernando Henrique Cardoso and his Social Democratic party (PSDB, inspired by neoliberal ideology. The small advances in reducing regressivity, such as exemptions for basic consumer products, have not altered the role of the tax structure in the concentration of wealth, with a predominance of indirect taxes and their regressive effects. Taxation has deserved little attention in the broad debate about social policies in Brazil, which concentrates on the allocation of public expenses and the efficiency of spending, without proper attention to the role of the tax structure in the concentration of income and wealth in the country. The article presents the regressive profile of the Brazilian tax structure, preserved by the reform of 2003 and discusses the neoliberal agenda that guides the initiatives of the Lula government in this field.

Evaluating the Effects of Pioneer Accountable Care Organizations on Medicare Part D Drug Spending and Utilization.

Science.gov (United States)

Zhang, Yuting; Caines, Kadin J; Powers, Christopher A

2017-05-01

The improvement of medication use is a critical mechanism that accountable care organization (ACO) could use to save overall costs. Currently pharmaceutical spending is not part of the calculation for ACO-shared savings and risks. Thus, ACO providers may have strong incentives to prescribe more medications hoping to avoid expensive downstream medical costs. We designed a quasinatural experiment study to evaluate the effects of Pioneer ACOs on Medicare Part D spending and utilization. Medicare fee-for-service beneficiaries with Part D drug coverage who were aligned to a Pioneer ACO were compared with a random 5% sample of non-ACO beneficiaries. Outcomes included changes in Part D spending, number of prescription fills, percent of brand medications, and total Part A and B medical spending. We utilized a generalized linear model with a difference-in-differences approach to estimate 2011-2012 changes in these outcomes among beneficiaries aligned with Pioneer ACOs, adjusting for all beneficiary-level demographics, income and insurance status, clinical characteristics, and regional fixed effects. Being in an ACO did not significantly affect Part D spending (-$23.52; P=0.19), total prescriptions filled (-0.12; P=0.27), and the percent of claims for brand-name drugs (0.06%; P=0.23). The ACO group was associated with savings in Parts A and B spending of $345 (PPioneer ACOs were not associated with changes in pharmaceutical spending and use, but were associated with savings in Parts A and B spending in 2012.

Microeconomics. Harnessing naturally occurring data to measure the response of spending to income.

Science.gov (United States)

Gelman, Michael; Kariv, Shachar; Shapiro, Matthew D; Silverman, Dan; Tadelis, Steven

2014-07-11

This paper presents a new data infrastructure for measuring economic activity. The infrastructure records transactions and account balances, yielding measurements with scope and accuracy that have little precedent in economics. The data are drawn from a diverse population that overrepresents males and younger adults but contains large numbers of underrepresented groups. The data infrastructure permits evaluation of a benchmark theory in economics that predicts that individuals should use a combination of cash management, saving, and borrowing to make the timing of income irrelevant for the timing of spending. As in previous studies and in contrast to the predictions of the theory, there is a response of spending to the arrival of anticipated income. The data also show, however, that this apparent excess sensitivity of spending results largely from the coincident timing of regular income and regular spending. The remaining excess sensitivity is concentrated among individuals with less liquidity. Copyright © 2014, American Association for the Advancement of Science.

Information Technology in a Developing Country: An Exploration of the Factors Associated with Attitudes of Decision Makers in Jordanian Government Institutions toward the Utilization of Computer-Based Technology

Science.gov (United States)

Khasawneh, Saleh

2010-01-01

In this era of rapidly advancing technologies, many governments around the globe are spending a great amount of money on these technologies, in order to increase their work performance. Therefore, the Jordanian government decided to implement IT in its public organizations. However, the picture is unclear about users' attitudes toward this…

SpEnD: Linked Data SPARQL Endpoints Discovery Using Search Engines

OpenAIRE

Yumusak, Semih; Dogdu, Erdogan; Kodaz, Halife; Kamilaris, Andreas

2016-01-01

In this study, a novel metacrawling method is proposed for discovering and monitoring linked data sources on the Web. We implemented the method in a prototype system, named SPARQL Endpoints Discovery (SpEnD). SpEnD starts with a "search keyword" discovery process for finding relevant keywords for the linked data domain and specifically SPARQL endpoints. Then, these search keywords are utilized to find linked data sources via popular search engines (Google, Bing, Yahoo, Yandex). By using this ...

2014 National Park visitor spending effects: economic contributions to local communities, states, and the nation

Science.gov (United States)

Cullinane Thomas, Catherine; Huber, Christopher; Koontz, Lynne

2015-01-01

The National Park System covers more than 84 million acres and is comprised of more than 401 sites across the Nation. These lands managed by the National Park Service (NPS) serve as recreational destinations for visitors from across the Nation and around the world. On vacations or on day trips, NPS visitors spend time and money in the gateway communities surrounding NPS sites. Spending by NPS visitors generates and supports a considerable amount of economic activity within park gateway economies. The NPS has been measuring and reporting visitor spending and economic effects for the past 25 years. The 2012 analysis marked a major revision to the NPS visitor spending effects analyses, with the development of the Visitor Spending Effects model (VSE model) which replaced the previous Money Generation Model (see Cullinane Thomas et al. (2014) for a description of how the VSE model differs from the previous model). This report provides updated VSE estimates associated with 2014 NPS visitation.

How College Students Spend Their Time Communicating

Science.gov (United States)

Emanuel, Richard; Adams, Jim; Baker, Kim; Daufin, E. K.; Ellington, Coke; Fitts, Elizabeth; Himsel, Jonathan; Holladay, Linda; Okeowo, David

2008-01-01

This study sought to assess how college students spend their time communicating and what impact, if any, communications devices may be having on how that time is spent. Undergraduates (N = 696) at four southeastern colleges were surveyed. Results revealed that listening comprises 55.4% of the total average communication day followed by reading…

Future and potential spending on health 2015-40

NARCIS (Netherlands)

Dieleman, Joseph L.; Campbell, Madeline; Chapin, Abigail; Eldrenkamp, Erika; Fan, Victoria Y.; Haakenstad, Annie; Kates, Jennifer; Li, Zhiyin; Matyasz, Taylor; Micah, Angela; Reynolds, Alex; Sadat, Nafis; Schneider, Matthew T.; Sorensen, Reed; Abbas, Kaja M.; Abera, Semaw Ferede; Ahmad Kiadaliri, Aliasghar; Ahmed, Muktar Beshir; Alam, Khurshid; Alizadeh-Navaei, Reza; Alkerwi, A.; Amini, Erfan; Ammar, Walid; Antonio, Carl Abelardo T.; Atey, Tesfay Mehari; Avila-Burgos, Leticia; Awasthi, Ashish; Barac, Aleksandra; Berheto, Tezera Moshago; Beyene, Addisu Shunu; Beyene, Tariku Jibat; Birungi, Charles; Bizuayehu, Habtamu Mellie; Breitborde, Nicholas J.K.; Cahuana-Hurtado, Lucero; Castro, Ruben Estanislao; Catalá-López, Ferran; Dalal, Koustuv; Dandona, Lalit; Dharmaratne, Rakhi Dandona Samath D.; Dubey, Manisha; Faro, Andé; Feigl, Andrea B.; Fischer, Florian; Anderson Fitchett, Joseph R.; Foigt, Nataliya; Giref, Ababi Zergaw; Gupta, Rahul; Hamidi, Samer; Harb, Hilda L.; Hay, Simon I.; Hendrie, Delia; Horino, Masako; Jürisson, Mikk; Jakovljevic, Mihajlo B.; Javanbakht, Mehdi; John, Denny; Jonas, Jost B.; Karimi, Seyed M.; Khang, Young Ho; Khubchandani, Jagdish; Kim, Yun Jin; Kinge, Jonas M.; Krohn, Kristopher J.; Kumar, G.A.; Leung, Ricky; Magdy Abd El Razek, Hassan; Magdy Abd El Razek, Mohammed; Majeed, Azeem; Malekzadeh, Reza; Malta, Deborah Carvalho; Meretoja, Atte; Miller, Ted R.; Mirrakhimov, Erkin M.; Mohammed, Shafiu; Molla, Gedefaw; Nangia, Vinay; Olgiati, Stefano; Owolabi, Mayowa O.; Patel, Tejas; Paternina Caicedo, Angel J.; Pereira, David M.; Perelman, Julian; Polinder, Suzanne; Rafay, Anwar; Rahimi-Movaghar, Vafa; Rai, Rajesh Kumar; Ram, Usha; Ranabhat, Chhabi Lal; Roba, Hirbo Shore; Savic, Miloje; Sepanlou, Sadaf G.; Ao, Te Braden J.; Tesema, Azeb Gebresilassie; Thomson, Alan J.; Tobe-Gai, Ruoyan; Topor-Madry, Roman; Undurraga, Eduardo A.; Vargas, Veronica; Vasankari, Tommi; Violante, Francesco S.; Wijeratne, Tissa; Xu, Gelin; Yonemoto, Naohiro; Younis, Mustafa Z.; Yu, Chuanhua; Zaidi, Zoubida; Sayed Zaki, El Maysaa; Murray, Christopher J.L.

2017-01-01

Background: The amount of resources, particularly prepaid resources, available for health can affect access to health care and health outcomes. Although health spending tends to increase with economic development, tremendous variation exists among health financing systems. Estimates of future

Business spending markets and buying behavior

Directory of Open Access Journals (Sweden)

Stanković Čedomir

2004-01-01

Full Text Available Most buyers on the business spending markets use one or more of the following buying methods: description, inspection, sampling and negotiating. Products are usually standardized according to their characteristics (size, shape, weight or color. The buyer is able to buy only depending in the description or quantity or other characteristic. In some cases buyer may specify business brand or its equivalent when describing desired product.

Defense Spending, Growth And Inequality, 1970-2008: An Econometric Analysis

Directory of Open Access Journals (Sweden)

Seyhan TAŞ

2013-12-01

Full Text Available This paper examines the relationship between defense expentures, income inequality and growth in Turkey for the period of 1970-2008. In the study, the problem of lack of time series data has been overcome by using manufacturing pay inequality index constructed by Theil T Statistic. Although there are numerous studies that examine the different aspects of military spending in Turkey, there are few studies that analyse the impact of military spending on income distribution in Turkey. Considering this lack in the literature, the study, utilizing basic cointegration and VAR model, aims to contribute to the literaure

Inventory information approval system certification and flexible spending account purchases.

Science.gov (United States)

Shuey, Brandon; Williams, La Vonn A

2010-01-01

There is no question that 2009 was a year of change within the pharmacy industry. Several new requirements were implemented, including the need for an Inventory Information Approval System for accepting flexible spending or health reimbursement account cords. Some pharmacies relied on the 90% exemption rule, which is discussed within this article, or an alternative method to avoid the expense of a point of sale. However, with flexible spending or health reimbursement account card participation expected to reach 85% in 2010, now bay be the time for compounding pharmacists to weigh the pros and cons of Inventory Information Approval System certification.

Spending Reviews – a Tool to Support the Effcient Management of Public Funds

Directory of Open Access Journals (Sweden)

Marta Postuła

2017-06-01

Full Text Available Purpose: Respective European Union member states’ interest in using spending reviews varies as there are no international mandatory regulations. The EU legislation contains general indications as to maintaining a rational fscal policy, from the provisions of the TFUE, expanded in the Pact for Stability and Growth, and elaborated in 2011. Methodology: Adopting an interpretative research approach, this article elaborates a multiple explanatory case study design to discover how existing theories about public spending reviews are conceptualized by practitioners in their natural contexts. Findings: The deteriorated state of many countries’ public fnances, as a result of the global fnancial crisis, has increased the interest in advanced innovative consolidation and fscal stabilization methods. Spending reviews are among the most developed and advanced methods. Such reviews were conducted both by countries that had applied this instrument before (Netherlands, Denmark, Finland, United Kingdom, Australia, and by those that introduced them for the frst time (Ireland, Canada, France. However, reviews are applied in countries characterized by signifcant economic advancement and mature public management systems. Originality: This article analyses and draws conclusions from several selected countries’ experience to date in using spending reviews. The budget functions are compared using information from the implementation of the spending reviews. This article contributes to flling two main gaps identifed in the literature review.

Corporate Governance in Banks and its Impact on Risk and Performance: Review of Literature on the Selected Governance Mechanisms

Directory of Open Access Journals (Sweden)

Himaj Shkendije

2014-09-01

Full Text Available Corporate governance is viewed as an important, essential, and most significant factor for well-functioning of firms. Recent academic work and policy analyses have given insight into the governance problems in banks exposed to the financial crisis and suggest possible solutions. This paper begins by explaining the importance of corporate governance and its impact on risk taking and bank performance based on the theoretical background relevant to the corporate governance of banks. I combine the literature that looks at three areas of governance: ownership structure; board structure; and risk management, with the literature on risk-taking and performance effects in order to better assess the weight of the impact that these governance mechanisms have on both performance and risk. The paper concludes by highlighting the areas where further research is needed.

Variation In Health Outcomes: The Role Of Spending On Social Services, Public Health, And Health Care, 2000-09.

Science.gov (United States)

Bradley, Elizabeth H; Canavan, Maureen; Rogan, Erika; Talbert-Slagle, Kristina; Ndumele, Chima; Taylor, Lauren; Curry, Leslie A

2016-05-01

Although spending rates on health care and social services vary substantially across the states, little is known about the possible association between variation in state-level health outcomes and the allocation of state spending between health care and social services. To estimate that association, we used state-level repeated measures multivariable modeling for the period 2000-09, with region and time fixed effects adjusted for total spending and state demographic and economic characteristics and with one- and two-year lags. We found that states with a higher ratio of social to health spending (calculated as the sum of social service spending and public health spending divided by the sum of Medicare spending and Medicaid spending) had significantly better subsequent health outcomes for the following seven measures: adult obesity; asthma; mentally unhealthy days; days with activity limitations; and mortality rates for lung cancer, acute myocardial infarction, and type 2 diabetes. Our study suggests that broadening the debate beyond what should be spent on health care to include what should be invested in health-not only in health care but also in social services and public health-is warranted. Project HOPE—The People-to-People Health Foundation, Inc.

Revealed preference for taxation and spending

OpenAIRE

McDowell, Moore

1993-01-01

This paper analyses some of the results of a survey of public opinion carried out in Ireland in the early Autumn of 1989. The survey itself was an innovation in the political economy of taxation and public spending in Ireland in that it was the first time a fully articulated exercise was mounted to establish the actual preferences of the population over specified areas of the economics of the public sector.[extract

Regional Employment Growth and Defense Spending.

Science.gov (United States)

1987-12-01

important part of regional growth. UI ACCA 9o1n For ’NDis i - Dljt s i-: . TABLE OF CONTENTS I. INTRODUCTION .. .. .. .... ..... .... .... .... ..... .. 7...Mideast and Great Lakes, all show spending to taxation ratios of less than one on a per capita basis, yet the Southwest and Rocky Mountain states have...because businesses look beyond the obvious nominal rate and locate according to effective rates of taxation , ie. actual tax liability. In addition, tax

End-of-Life Medical Spending In Last Twelve Months of Life is Lower than Previously Reported

DEFF Research Database (Denmark)

French, Eric; Aragon, Maria; Mccauley, Jeremy

2017-01-01

Although end-of-life medical spending is often viewed as a major component of aggregate medical expenditure, accurate measures of this type of medical spending are scarce. We used detailed health care data for the period 2009–11 from Denmark, England, France, Germany, Japan, the Netherlands, Taiw...... but to spending on people with chronic conditions, which are associated with shorter life expectancies....

50 CFR 86.73 - What if I do not spend all the money?

Science.gov (United States)

2010-10-01

... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false What if I do not spend all the money? 86.73 Section 86.73 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE... GRANT (BIG) PROGRAM How States Manage Grants § 86.73 What if I do not spend all the money? Funds not...

Cities through the Prism of People’s Spending Behavior

Science.gov (United States)

Hawelka, Bartosz; Murillo Arias, Juan; Ratti, Carlo

2016-01-01

Scientific studies of society increasingly rely on digital traces produced by various aspects of human activity. In this paper, we exploit a relatively unexplored source of data–anonymized records of bank card transactions collected in Spain by a big European bank, and propose a new classification scheme of cities based on the economic behavior of their residents. First, we study how individual spending behavior is qualitatively and quantitatively affected by various factors such as customer’s age, gender, and size of his/her home city. We show that, similar to other socioeconomic urban quantities, individual spending activity exhibits a statistically significant superlinear scaling with city size. With respect to the general trends, we quantify the distinctive signature of each city in terms of residents’ spending behavior, independently from the effects of scale and demographic heterogeneity. Based on the comparison of city signatures, we build a novel classification of cities across Spain in three categories. That classification exhibits a substantial stability over different city definitions and connects with a meaningful socioeconomic interpretation. Furthermore, it corresponds with the ability of cities to attract foreign visitors, which is a particularly remarkable finding given that the classification was based exclusively on the behavioral patterns of city residents. This highlights the far-reaching applicability of the presented classification approach and its ability to discover patterns that go beyond the quantities directly involved in it. PMID:26849218

Effects of a consumer driven health plan on pharmaceutical spending and utilization.

Science.gov (United States)

Parente, Stephen T; Feldman, Roger; Chen, Song

2008-10-01

To compare pharmaceutical spending and utilization in a consumer driven health plan (CDHP) with a three-tier pharmacy benefit design, and to examine whether the CDHP creates incentives to reduce pharmaceutical spending and utilization for chronically ill patients, generic or brand name drugs, and mail-order drugs. Retrospective insurance claims analysis from a large employer that introduced a CDHP in 2001 in addition to a point of service (POS) plan and a preferred provider organization (PPO), both of which used a three-tier pharmacy benefit. Difference-in-differences regression models were estimated for drug spending and utilization. Control variables included the employee's income, age, and gender, number of covered lives per contract, election of flexible spending account, health status, concurrent health shock, cohort, and time trend. Results. CDHP pharmaceutical expenditures were lower than those in the POS cohort in 1 year without differences in the use of brand name drugs. We find limited evidence of less drug consumption by CDHP enrollees with chronic illnesses, and some evidence of less generic drug use and more mail-order drug use among CDHP members. The CDHP is cost-neutral or cost-saving to both the employer and the employee compared with three-tier benefits with no differences in brand name drug use. © Health Research and Educational Trust.

Identification with the retail organization and customer-perceived employee similarity: effects on customer spending.

Science.gov (United States)

Netemeyer, Richard G; Heilman, Carrie M; Maxham, James G

2012-09-01

Two constructs important to academicians and managers are the degree to which employees and customers identify with an organization, employee organizational identification (employee OI) and customer-company identification (customer identification), respectively. This research examines the effects of these identification constructs and the related construct of customer perceived similarity to employees on customer spending. Via a 1-year multilevel study of 12,047 customers and 1,464 store employees (sales associates) covering 212 stores of a specialty apparel retailer, our study contributes to the literature in 2 critical ways. First, we expand the theoretical network of employee OI and customer identification by examining the related construct of a customer's perceived similarity to store employees. We examine the incremental (not fully mediated) main and interaction effects of customer-perceived similarity to employees and employee OI on customer spending. Second, we examine the effect of customer identification on customer spending relative to the effect of customer satisfaction on customer spending. Thus, our study also contributes by demonstrating a potential complementary route to achieve customer spending (customer identification), a route that may be more readily affected by management than the efforts required for a sustained increase in customer satisfaction. Implications for academics and managers are offered.

Bending The Spending Curve By Altering Care Delivery Patterns: The Role Of Care Management Within A Pioneer ACO.

Science.gov (United States)

Hsu, John; Price, Mary; Vogeli, Christine; Brand, Richard; Chernew, Michael E; Chaguturu, Sreekanth K; Weil, Eric; Ferris, Timothy G

2017-05-01

Accountable care organizations (ACOs) appear to lower medical spending, but there is little information on how they do so. We examined the impact of patient participation in a Pioneer ACO and its care management program on rates of emergency department (ED) visits and hospitalizations and on Medicare spending. We used data for the period 2009-14, exploiting naturally staggered program entry to create concurrent controls to help isolate the program effects. The care management program (the ACO's primary intervention) targeted beneficiaries with elevated but modifiable risks for future spending. ACO participation had a modest effect on spending, in line with previous estimates. Participation in the care management program was associated with substantial reductions in rates for hospitalizations and both all and nonemergency ED visits, as well as Medicare spending, when compared to preparticipation levels and to rates and spending for a concurrent sample of beneficiaries who were eligible for but had not yet started the program. Rates of ED visits and hospitalizations were reduced by 6 percent and 8 percent, respectively, and Medicare spending was reduced by 6 percent. Targeting beneficiaries with modifiable high risks and shifting care away from the ED represent viable mechanisms for altering spending within ACOs. Project HOPE—The People-to-People Health Foundation, Inc.

Targets for Marine Corps Purchasing and Supply Management Initiatives: Spend Analysis Findings

Science.gov (United States)

2011-01-01

Corps Purchasing and Supply Management Initiatives: Spend Analysis Findings source contracts with providers in them. We also examine contract “ churn ...repair, and rebuilding of equipment; general purpose ADP equipment; ADP and telecommunication ser- vices—are also shown in the previous chart for top...to $469 million in FY 2004. The spend for other ADP and telecommunication services, $264 million in FY 2004, was not even in the top ten in FY 2003

Trends in Health Care Spending by the Private Sector

National Research Council Canada - National Science Library

1997-01-01

A recent dramatic slowdown in the rate at which private-sector spending for health insurance increases each year has raised many questions about the meaning of the trend and its implications for the future...

Globalisation, corporate governance and the construction industry

CSIR Research Space (South Africa)

Van Wyk, Llewellyn V

2004-11-01

Full Text Available , corporate governance, ethics, globalisation Introduction One of the characteristics of globalisation is the ease of engaging in business transactions in global financial markets. The exploration of these markets has, however, exposed a high degree.... The search for core values is manifest in the inclusion of social issues like poverty alleviation, job creation, human rights, corporate governance, and ethics and spirituality onto the global agenda. The second struggle – determining a management model...

Spending on Hospital Care and Pediatric Psychology Service Use Among Adolescents and Young Adults With Cancer.

Science.gov (United States)

McGrady, Meghan E; Peugh, James L; Brown, Gabriella A; Pai, Ahna L H

2017-10-01

To examine the relationship between need-based pediatric psychology service use and spending on hospital care among adolescents and young adults (AYAs) with cancer. Billing data were obtained from 48 AYAs with cancer receiving need-based pediatric psychology services and a comparison cohort of 48 AYAs with cancer not receiving services. A factorial analysis of covariance examined group differences in spending for hospital care. Pending significant findings, a multivariate analysis of covariance was planned to examine the relationship between need-based pediatric psychology service use and spending for inpatient admissions, emergency department (ED) visits, and outpatient visits. Spending for hospital care was higher among AYAs receiving need-based pediatric psychology services than in the comparison cohort (p psychology services. The behavioral and psychosocial difficulties warranting need-based pediatric psychology services may predict higher health care spending. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Pattern and levels of spending allocated to HIV prevention programs in low- and middle-income countries

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Amico Peter

2012-03-01

Full Text Available Abstract Background AIDS continues to spread at an estimated 2.6 new million infections per year, making the prevention of HIV transmission a critical public health issue. The dramatic growth in global resources for AIDS has produced a steady scale-up in treatment and care that has not been equally matched by preventive services. This paper is a detailed analysis of how countries are choosing to spend these more limited prevention funds. Methods We analyzed prevention spending in 69 low- and middle-income countries with a variety of epidemic types, using data from national domestic spending reports. Spending information was from public and international sources and was analyzed based on the National AIDS Spending Assessment (NASA methods and classifications. Results Overall, prevention received 21% of HIV resources compared to 53% of funding allocated to treatment and care. Prevention relies primarily on international donors, who accounted for 65% of all prevention resources and 93% of funding in low-income countries. For the subset of 53 countries that provided detailed spending information, we found that 60% of prevention resources were spent in five areas: communication for social and behavioral change (16%, voluntary counselling and testing (14%, prevention of mother-to-child transmission (13%, blood safety (10% and condom programs (7%. Only 7% of funding was spent on most-at-risk populations and less than 1% on male circumcision. Spending patterns did not consistently reflect current evidence and the HIV specific transmission context of each country. Conclusions Despite recognition of its importance, countries are not allocating resources in ways that are likely to achieve the greatest impact on prevention across all epidemic types. Within prevention spending itself, a greater share of resources need to be matched with interventions that approximate the specific needs and drivers of each country's epidemic.

Monitoring What Governments “Give for” and “Spend on” Vaccine Procurement: Vaccine Procurement Assistance and Vaccine Procurement Baseline

OpenAIRE

Nelson, E. A. S.; Bloom, David E.; Mahoney, Richard T.

2014-01-01

BACKGROUND: The Global Vaccine Action Plan will require, inter alia, the mobilization of financial resources from donors and national governments - both rich and poor. Vaccine Procurement Assistance (VPA) and Vaccine Procurement Baseline (VPB) are two metrics that could measure government performance and track resources in this arena. VPA is proposed as a new subcategory of Official Development Assistance (ODA) given for the procurement of vaccines and VPB is a previously suggested measure of...

The economic downturn and its lingering effects reduced medicare spending growth by $4 billion in 2009-12.

Science.gov (United States)

Dranove, David; Garthwaite, Craig; Ody, Christopher

2015-08-01

Previous work has found a strong connection between the most recent economic recession and reductions in private health spending. However, the effect of economic downturns on Medicare spending is less clear. In contrast to studies involving earlier time periods, our study found that when the macroeconomy slowed during the Great Recession of 2007-09, so did Medicare spending growth. A small (14 percent) but significant share of the decline in Medicare spending growth from 2009 to 2012 relative to growth from 2004 to 2009 can be attributed to lingering effects of the recession. Absent the economic downturn, Medicare spending would have been $4 billion higher in 2009-12. A major reason for the relatively small impact of the macroeconomy is the relative lack of labor-force participation among people ages sixty-five and older. We estimate that if they had been working at the same rate as the nonelderly before the recession, the effect of the downturn on Medicare spending growth would have been twice as large. Project HOPE—The People-to-People Health Foundation, Inc.

High Out-of-Pocket Health Spending in Countries With a Mediterranean Connection

Directory of Open Access Journals (Sweden)

Simon Grima

2018-05-01

Full Text Available In this study, we analyzed healthcare provision and health expenditure across six Mediterranean countries that adopt the National Health System (Beveridge model and that form part of the European Union (EU with the main aim being that of analyzing and comparing out-of-pocket health spending in countries with a European Mediterranean connection. To this end, we considered various economic indicators and statistics to derive commonalities and differences across these countries and also compared trends in these indicators to those observed across the rest of the EU. We then analyzed these findings in light of other data related to the quality of healthcare delivery and the infrastructure of the health system and discussed recent developments in healthcare within each country and the main challenges faced by the respective health systems. The results show that on average, Mediterranean countries spend less on total healthcare expenditure (THE than the EU average, both as a proportion of GDP, as well as in per capita terms. This is primarily driven by lower-than-EU-average public funding of healthcare. The 2008/2009 macro-economic and financial crisis had a significant impact on the countries under review, and explains the persistent reductions in public health spending as part of the austerity measures put in force across sectors. On the flipside, Mediterranean countries have a higher presence of private health providers in total funding, thereby explaining the higher Out-of-Pocket (OOPs health expenditures in these countries relative to the EU-average. With regard to the overall health infrastructure in these countries, we observed that although the supply of physicians is largely in line with the rest of the EU, there is under-supply when it comes to hospital beds. This may be symptomatic of lower government funding. Nonetheless, all countries score highly in the evaluation of the quality of health services, as recorded by international rankings

Elderly Bias, New Social Risks, and Social Spending

DEFF Research Database (Denmark)

Tepe, Markus; Vanhuysse, Pieter

2010-01-01

of the large-scale arrival of such risks 'on the ground' does play a key role. Countries that entered the postindustrial society comparatively late record lower NSRS values, as they spend less on programs such as education and family allowances. Institutional differences as captured by welfare regime type...

Is happiness choosing to give or to take money? : An experimental study of prosocial spending, active and passive choices and nudging

OpenAIRE

Moche, Hajdi

2016-01-01

Research within positive psychology has shown that spending money on other people (prosocial spending) makes you happier than spending it on yourself (proself spending). The present study tested and extended this idea. Also, how an active or a passive choice in spending affect happiness has been tested. Lastly, this study is the first one to test the effect of nudging on happiness by examining the role of choice, defaults in spending. Three measures of subjective well-being (SWB) was used bef...

Poor markets, lack of incentives cause drastic drop in capital spending. [1977

Energy Technology Data Exchange (ETDEWEB)

Fish, R

1977-10-01

Canadian Mining Journal's 1977 Capital Expenditure Survey shows a drop of 52% in announced spending intentions compared with the 1976 survey total. Coal is particularly hard hit with announced spending for 1977 at 1,250,000 dollars as compared to 700,770,000 in 1976. This total 1977 amount is reported by Kaiser Resources for installing a Honeywell Model 66/05 large scale computer system to be used for accounting, inventory control, engineering and material procurement applications at Sparwood.

Single European currency and Monetary Union. Macroeconomic implications for pharmaceutical spending.

Science.gov (United States)

Kanavos, P

1998-01-01

This article examines the potential implications of introducing a single currency among the Member States of the European Union for national pharmaceutical prices and spending. In doing so, it provides a brief account of the direct effects of introducing a single currency on pharmaceutical business. These are static in nature and include the elimination of exchange rate volatility and transaction costs, increased price transparency and limited potential for parallel trade. It subsequently analyses the potential medium and long term macroeconomic policy choices facing the Member States and their impact on pharmaceutical spending following the introduction of a single currency. These include policy directions in order to meet the Maastricht convergence criteria in the run-up to forming an Economic and Monetary Union (EMU) and the implications of EMU on national macroeconomic policy thereafter. This article argues that the necessity for tight fiscal policies across the EU and, in particular, in those Member States facing high budget deficits and overall debt levels, will continue to exert considerable downward pressure on pharmaceutical spending.

Two-year impact of the alternative quality contract on pediatric health care quality and spending.

Science.gov (United States)

Chien, Alyna T; Song, Zirui; Chernew, Michael E; Landon, Bruce E; McNeil, Barbara J; Safran, Dana G; Schuster, Mark A

2014-01-01

To examine the 2-year effect of Blue Cross Blue Shield of Massachusetts' global budget arrangement, the Alternative Quality Contract (AQC), on pediatric quality and spending for children with special health care needs (CSHCN) and non-CSHCN. Using a difference-in-differences approach, we compared quality and spending trends for 126,975 unique 0- to 21-year-olds receiving care from AQC groups with 415,331 propensity-matched patients receiving care from non-AQC groups; 23% of enrollees were CSHCN. We compared quality and spending pre (2006-2008) and post (2009-2010) AQC implementation, adjusting analyses for age, gender, health risk score, and secular trends. Pediatric outcome measures included 4 preventive and 2 acute care measures tied to pay-for-performance (P4P), 3 asthma and 2 attention-deficit/hyperactivity disorder quality measures not tied to P4P, and average total annual medical spending. During the first 2 years of the AQC, pediatric care quality tied to P4P increased by +1.8% for CSHCN (P < .001) and +1.2% for non-CSHCN (P < .001) for AQC versus non-AQC groups; quality measures not tied to P4P showed no significant changes. Average total annual medical spending was ~5 times greater for CSHCN than non-CSHCN; there was no significant impact of the AQC on spending trends for children. During the first 2 years of the contract, the AQC had a small but significant positive effect on pediatric preventive care quality tied to P4P; this effect was greater for CSHCN than non-CSHCN. However, it did not significantly influence (positively or negatively) CSHCN measures not tied to P4P or affect per capita spending for either group.

Size of government and entrepreneurship. Analysis of three groups of countries with different economic development

Directory of Open Access Journals (Sweden)

Juan Carlos Díaz Casero

2015-07-01

Full Text Available This study analyzes the impact of the "size of government" in entrepreneurial activity for countries with different levels of economical development. It has been used the variables "size of government" of the economic freedom indices released by the Economic Freedom Network (2000-2009 and by The Heritage Foundation (2000-2011, and the variables of "entrepreneurship" released by the Global Entrepreneurship Monitor. Furthermore, the same analysis has been carried out grouping the countries by development level, following the classification elaborated by the World Economic Forum. Statistical analyses of correlations have shown that the “size of government” is related to entrepreneurship. The variables "Size of Government: Expenditures, Taxes and Enterprises" and " Government Size” have revealed a positive correlation with the total, opportunity and necessity entrepreneurial activity indices for the economies based on efficiency and innovation, thus less taxes on income and lower government spending, increase the entrepreneurship of the country. In “factor driven economies”, there is no relationship between the size of government and entrepreneurship

Changes in Healthcare Spending After Diagnosis of Comorbidities Among Endometriosis Patients: A Difference-in-Differences Analysis.

Science.gov (United States)

Epstein, Andrew J; Soliman, Ahmed M; Davis, Matthew; Johnson, Scott J; Snabes, Michael C; Surrey, Eric S

2017-11-01

We sought to characterize changes in healthcare spending associated with the onset of 22 endometriosis-related comorbidities. Women aged 18-49 years with endometriosis (N = 180,278) were extracted from 2006-2015 de-identified Clinformatics ® DataMart claims data. For 22 comorbidities, comorbidity patients were identified on the basis of having a first comorbidity diagnosis after their initial endometriosis diagnosis. Controls were identified on the basis of having no comorbidity diagnosis and were matched 1:1 to comorbidity patients on demographics and baseline spending. Total medical and pharmacy spending was measured during 12 months before and after each patient's index date (first comorbidity diagnosis for comorbidity patients, and equal number of days after earliest endometriosis claim for controls). Pre-post spending differences were compared using difference-in-differences linear regression. Total and comorbidity-related cumulative spending per patient for all endometriosis patients were calculated annually for the 5 years following endometriosis diagnosis. The number of endometriosis patients with each comorbidity varied between 121 for endometrial cancer and 16,177 for fatigue. Healthcare spending increased significantly with the onset of eight comorbidities: breast cancer, ovarian cancer, pregnancy complications, systemic lupus erythematosus/rheumatoid arthritis/Sjogren's/multiple sclerosis, infertility, uterine fibroids, ovarian cyst, and headache [p endometriosis patient, of which between 11% and 23% was attributable to comorbidity-related medical claims. For all but one of the 22 comorbidities associated with endometriosis, comorbidity onset was associated with a relative increase in total healthcare spending. AbbVie Inc.

Out-of-pocket health spending by poor and near-poor elderly Medicare beneficiaries.

Science.gov (United States)

Gross, D J; Alecxih, L; Gibson, M J; Corea, J; Caplan, C; Brangan, N

1999-04-01

To estimate out-of-pocket health care spending by lower-income Medicare beneficiaries, and to examine spending variations between those who receive Medicaid assistance and those who do not receive such aid. DATA SOURCES AND COLLECTION: 1993 Medicare Current Beneficiary Survey (MCBS) Cost and Use files, supplemented with data from the Bureau of the Census (Current Population Survey); the Congressional Budget Office; the Health Care Financing Administration, Office of the Actuary (National Health Accounts); and the Social Security Administration. We analyzed out-of-pocket spending through a Medicare Benefits Simulation model, which projects out-of-pocket health care spending from the 1993 MCBS to 1997. Out-of-pocket health care spending is defined to include Medicare deductibles and coinsurance; premiums for private insurance, Medicare Part B, and Medicare HMOs; payments for non-covered goods and services; and balance billing by physicians. It excludes the costs of home care and nursing facility services, as well as indirect tax payments toward health care financing. Almost 60 percent of beneficiaries with incomes below the poverty level did not receive Medicaid assistance in 1997. We estimate that these beneficiaries spent, on average, about half their income out-of-pocket for health care, whether they were enrolled in a Medicare HMO or in the traditional fee-for-service program. The 75 percent of beneficiaries with incomes between 100 and 125 percent of the poverty level who were not enrolled in Medicaid spent an estimated 30 percent of their income out-of-pocket on health care if they were in the traditional program and about 23 percent of their income if they were enrolled in a Medicare HMO. Average out-of-pocket spending among fee-for-service beneficiaries varied depending on whether beneficiaries had Medigap policies, employer-provided supplemental insurance, or no supplemental coverage. Those without supplemental coverage spent more on health care goods and

Pipeline, utilities to spend $127 million on scada systems

International Nuclear Information System (INIS)

Anon.

1993-01-01

Spending for new or upgraded supervisory control and data acquisition (scada) systems and for additional remote-terminal units (RTUs) by North American pipelines and utilities will exceed $165 million through February 1996. New and updated scada systems will total 122 at a cost of more than $127 million; 143 RTU add-on projects will cost more than $38 million. Pipelines and combined utilities/pipelines will spend $89.5 million for 58 scada-system projects and $30.2 million for RTU add-on projects. Scada systems are computerized hardware and software systems that perform monitoring and control functions. In gas utilities, these systems perform functions normally associated with gas transmission and distribution as well as production-plant process control. In gas and oil pipelines, the systems perform these functions as well as such specialized functions as batch tracking, leak detection, and gas load flow

GROWTH, LIQUIDITY CONSTRAINTS, CREDIBILITY AND THE EFFECTS OF SHOCKS UNDER A NON-CREDIBLE GOVERNMENT

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DURMUŞ ÖZDEMİR

2013-06-01

Full Text Available This paper presents an overlapping generations model for a small open economy. The model is calibrated to fit data for Turkey. Simulations suggest that for a fairly open economy such as Turkey, credibility and liquidity constraints matter and the choice of income taxation rate, the mix of government spending and the long-run government debt/GDP ratio can all significantly affect the economic growth. The paper also examines the effectiveness of fiscal policy under different levels of liquidity constraint in an open economy within a dynamic framework. It shows that liquidity constraints can affect the outcome of any fiscal policy. Hence fiscal policy is even more important for the less developed economies of the world.

[Public spending on health and population health in Algeria: an econometric analysis].

Science.gov (United States)

Messaili, Moussa; Kaïd Tlilane, Nouara

2017-07-10

Objective: The objective of this study was to estimate the impact of public spending on health, among other determinants of health, on the health of the population in Algeria, using life expectancy (men and women) and infant mortality rates as indicators of health status. Methods: We conducted a longitudinal study over the period from 1974 to 2010 using the ARDL (Autoregressive Distributed Lags) approach to co-integration to estimate the short-term and long-term relationship. Results: Public spending on health has a positive, but not statistically significant impact, in the long and short term, on life expectancy (men and women). However, public spending significantly reduces the infant mortality rate. The long-term impact of the number of hospital beds is significant for the life expectancy of men, but not for women and infant mortality, but is significant for all indicators in the short-term relationship. The most important variables in improving the health of the population are real GDP per capita and fertility rate.

Communicating Spending Cuts: Lessons for Australian University Leaders

Science.gov (United States)

Sharrock, Geoff

2014-01-01

In 2011 and 2012, two Australian university vice chancellors flagged spending cuts at their institutions to overcome financial problems. In both cases, union and staff opposition led to public protests, intense media scrutiny, delays and retreats. This article compares the two cases to see what lessons may be drawn for university leaders faced…

An Empirical Approach to Determining Advertising Spending Level.

Science.gov (United States)

Sunoo, D. H.; Lin, Lynn Y. S.

To assess the relationship between advertising and consumer promotion and to determine the optimal short-term advertising spending level for a product, a research project was undertaken by a major food manufacturer. One thousand homes subscribing to a dual-system cable television service received either no advertising exposure to the product or…

Ageing, government budgets, retirement, and growth

DEFF Research Database (Denmark)

Gonzalez Eiras, Martin; Niepelt, Dirk

2012-01-01

changes of taxes, government spending components and the retirement age in politico-economic equilibrium. Growth is driven by capital accumulation and productivity increases fueled by public investment. The closed-form solutions of the model predict taxation and the retirement age in OECD economies...... to increase in response to demographic ageing and per-capita growth to accelerate. If the retirement age were held constant, the growth rate in politico-economic equilibrium would essentially remain unchanged, due to a surge of social security transfers and crowding out of public investment.......We analyze the short and long run effects of demographic ageing - increased longevity and reduced fertility - on per-capita growth. The OLG model captures direct effects, working through adjustments in the savings rate, labor supply, and capital deepening, and indirect effects, working through...

To what extent does recurrent government health expenditure in Uganda reflect its policy priorities?

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Nabyonga-Orem Juliet

2010-10-01

Full Text Available Abstract Background The National Health Policy 2000 - 2009 and Health sector strategic plans I & II emphasized that Primary Health Care (PHC would be the main strategy for national development and would be operationalized through provision of the minimum health care package. Commitment was to spend an increasing proportion of the health budget for the provision of the basic minimum package of health services which was interpreted to mean increasing spending at health centre level. This analysis was undertaken to gain a better understanding of changes in the way recurrent funding is allocated in the health sector in Uganda and to what extent it has been in line with agreed policy priorities. Methods Government recurrent wage and non-wage expenditures - based on annual releases by the Uganda Ministry of Finance, Planning and Economic Development were compiled for the period 1997/1998 to financial year 2007/2008. Additional data was obtained from a series of Ministry of Health annual health sector reports as well as other reports. Data was verified by key government officials in Ministry of Finance, Planning and Economic Development and Ministry of Health. Analysis of expenditures was done at sector level, by the different levels in the health care system and the different levels of care. Results There was a pronounced increase in the amount of funds released for recurrent expenditure over the review period fueled mainly by increases in the wage component. PHC services showed the greatest increase, increasing more than 70 times in ten years. At hospital level, expenditures remained fairly constant for the last 10 years with a slight reduction in the wage component. Conclusion The policy aspiration of increasing spending on PHC was attained but key aspects that would facilitate its realization were not addressed. At any given level of funding for the health sector, there is need to work out an optimal balance in investment in the different inputs to

MILITARY COMPETITION BETWEEN FRIENDS? HEGEMONIC DEVELOPMENT AND MILITARY SPENDING AMONG EIGHT WESTERN DEMOCRACIES, 1920-1938

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Jari Eloranta

2001-01-01

Full Text Available This article explores the complicated phenomenon of military spending among a sample of eight Western democracies in the interwar period by analyzing especially the possibility of economic and/or military competition between the Western Great Powers and the ensuing impacts on the smaller states included here. The hegemonic paradigm suggested by e.g. Paul Kennedy predicts that the economic leader in a system will increasingly invest on maintaining security; thus eventually bringing economic growth to a halt. The military spending patterns respective of economic growth at first seem to suggest that not only the totalitarian states, as is the traditional view, but also the UK and France stepped in to fill the void created by the lack of American leadership. However, the military expenditures of these nations were too low to warrant the conclusion that they had any impact on their respective economic performance. This result is also verified here by employing Granger non-causality tests between the military spending and economic growth variables. Moreover, regression analysis on the military spending variables for the UK and France points towards competition on the level. The smaller states, respectively, seemed to follow the UK and France fairly closely in their military spending decisions.

The 'Alternative Quality Contract,' based on a global budget, lowered medical spending and improved quality.

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Song, Zirui; Safran, Dana Gelb; Landon, Bruce E; Landrum, Mary Beth; He, Yulei; Mechanic, Robert E; Day, Matthew P; Chernew, Michael E

2012-08-01

Seven provider organizations in Massachusetts entered the Blue Cross Blue Shield Alternative Quality Contract in 2009, followed by four more organizations in 2010. This contract, based on a global budget and pay-for-performance for achieving certain quality benchmarks, places providers at risk for excessive spending and rewards them for quality, similar to the new Pioneer Accountable Care Organizations in Medicare. We analyzed changes in spending and quality associated with the Alternative Quality Contract and found that the rate of increase in spending slowed compared to control groups, more so in the second year than in the first. Overall, participation in the contract over two years led to savings of 2.8 percent (1.9 percent in year 1 and 3.3 percent in year 2) compared to spending in nonparticipating groups. Savings were accounted for by lower prices achieved through shifting procedures, imaging, and tests to facilities with lower fees, as well as reduced utilization among some groups. Quality of care also improved compared to control organizations, with chronic care management, adult preventive care, and pediatric care within the contracting groups improving more in year 2 than in year 1. These results suggest that global budgets with pay-for-performance can begin to slow underlying growth in medical spending while improving quality of care.

Florida's Opinion on K-12 Public Education Spending

Science.gov (United States)

Forster, Greg

2006-01-01

This scientifically representative poll of 1,200 Floridians finds that public opinion about K-12 public education spending is seriously misinformed. Floridians think public schools need more money, but the main reason is that they are badly mistaken about how much money the public schools actually get. Key findings of the study include: (1) Half…

National healthcare spending in the U.S. and Japan: national economic policy and implications for neurosurgery.

Science.gov (United States)

Bean, James R

2005-01-01

Growth of national healthcare spending is a problem confronting national governments of all industrially advanced countries. Healthcare spending in the U.S. reached 13.9% of the Gross Domestic Product (GDP) in 2003, compared to only 8% in Japan. In the U.S., health insurance is voluntary, with 15% of the population uninsured. In Japan, health insurance is mandatory and virtually universal, with growth in national health costs about half the rate of growth in the U.S. U.S. healthcare costs are projected to reach 18.4% of GDP 2013. The predicted growth in health care costs is expected to cause strain on the federal budget and a growing inability of employers and employees to pay for private insurance. Different national policies are the reason for different national health care costs in the U.S. and Japan. The U.S. has higher healthcare prices for salaries, equipment, supplies, and pharmaceuticals as compared to Japan. Higher prices, higher service intensity and volume during hospitalization create higher total cost in the U.S. Price controls in Japan kept medical inflation low at 0.46%/yr from 1980-2000. Market-pricing mechanisms in the U.S. have proven ineffective in controlling national healthcare costs, while Japan's national fee and price control policies have kept national costs among the lowest within the Organization for Economic Cooperation and Development. To guide insurance coverage policy, neurosurgery and other highly technical specialties should better define the comparative health benefit of high price technical services by prospective outcome studies.

Stability of regularly prescribed oral liquids formulated with SyrSpend® SF.

Science.gov (United States)

Uriel, M; Gómez-Rincón, C; Marro, D

2018-04-02

The purpose of this research was to evaluate the stability of 12 oral liquid formulations frequently compounded in hospital and community settings formulated in a specific vehicle: SyrSpend® SF. The stability of melatonin, glycopyrrolate, ciclosporin, chloral hydrate, flecainide acetate, tiagabine HCl, labetalol HCl, ciprofloxacin HCl, spironolactone/hydrochlorothiazide, hydrocortisone, itraconazole and celecoxib in SyrSpend SF PH4 (liquid) was investigated at 0, 30, 60 and 90 days and stored at both controlled room temperature and refrigerated. Itraconazole samples were also investigated at 15 and 45 days. No change in odor, color or appearance was observed in the formulations during the test period. Based on the results, a beyond-use date of 30 days can be assigned to tiagabine HCl 1.0 mg/ml in SyrSpend SF when stored at controlled room temperature, and 90 days under refrigeration, improving stability data previously published using other vehicles. A beyond-use date of 60 days can be assigned to chloral hydrate 100.0 mg/ml. In this case, stability is not enhanced by refrigeration. With the rest of the formulations, less than 10% API loss occurred over 90 days at either controlled room temperature or under refrigeration. Including for example itraconazole 20.0 mg/ml, thus providing extended stability compared to simple syrup and other oral liquid vehicles. The findings of this study show that SyrSpend SF is an appropriate suspending vehicle to be used for personalized formulations of the APIs studied here.

Specialty Drug Spending Trends Among Medicare And Medicare Advantage Enrollees, 2007–11

OpenAIRE

Trish, Erin; Joyce, Geoffrey; Goldman, Dana P.

2014-01-01

Specialty pharmaceuticals include most injectable and biologic agents used to treat complex conditions such as rheumatoid arthritis, multiple sclerosis, and cancer. We analyzed trends in specialty drug spending among Medicare beneficiaries ages sixty-five and older using 2007–11 pharmacy claims data from a 20 percent sample of Medicare beneficiaries. Annual specialty drug spending per beneficiary who used specialty drugs increased considerably during the study period, from $2,641 to $8,976. H...

Online ATM Helps Youth Smarten Up about Spending

Science.gov (United States)

Hibbert, Kathy; Coulson, Elizabeth

2009-01-01

While many high school students confess a desire to develop personal money management skills, statistics tracking the average Canadian's personal debt underscore the need to ensure the youth have the tools they need for financial success. What would it take to motivate teens to learn more about how they spend and manage their money? The authors…

Military Spending and Economic Well-Being in the American States: The Post-Vietnam War Era

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Borch, Casey; Wallace, Michael

2010-01-01

Using growth curve modeling techniques, this research investigates whether military spending improved or worsened the economic well-being of citizens within the American states during the post-Vietnam War period. We empirically test the military Keynesianism claim that military spending improves the economic conditions of citizens through its use…

Government regulation and public opposition create high additional costs for field trials with GM crops in Switzerland.

Science.gov (United States)

Bernauer, Thomas; Tribaldos, Theresa; Luginbühl, Carolin; Winzeler, Michael

2011-12-01

Field trials with GM crops are not only plant science experiments. They are also social experiments concerning the implications of government imposed regulatory constraints and public opposition for scientific activity. We assess these implications by estimating additional costs due to government regulation and public opposition in a recent set of field trials in Switzerland. We find that for every Euro spent on research, an additional 78 cents were spent on security, an additional 31 cents on biosafety, and an additional 17 cents on government regulatory supervision. Hence the total additional spending due to government regulation and public opposition was around 1.26 Euros for every Euro spent on the research per se. These estimates are conservative; they do not include additional costs that are hard to monetize (e.g. stakeholder information and dialogue activities, involvement of various government agencies). We conclude that further field experiments with GM crops in Switzerland are unlikely unless protected sites are set up to reduce these additional costs.

Impact of out-of-pocket spending caps on financial burden of those with group health insurance.

Science.gov (United States)

Riggs, Kevin R; Buttorff, Christine; Alexander, G Caleb

2015-05-01

The Affordable Care Act (ACA) mandates that all private health insurance include out-of-pocket spending caps. Insurance purchased through the ACA's Health Insurance Marketplace may qualify for income-based caps, whereas group insurance will not have income-based caps. Little is known about how out-of-pocket caps impact individuals' health care financial burden. We aimed to estimate what proportion of non-elderly individuals with group insurance will benefit from out-of-pocket caps, and the effect that various cap levels would have on their financial burden. We applied the expected uniform spending caps, hypothetical reduced uniform spending caps (reduced by one-third), and hypothetical income-based spending caps (similar to the caps on Health Insurance Marketplace plans) to nationally representative data from the Medical Expenditure Panel Survey (MEPS). Participants were non-elderly individuals (aged health insurance in the 2011 and 2012 MEPS surveys (n =26,666). (1) The percentage of individuals with reduced family out-of-pocket spending as a result of the various caps; and (2) the percentage of individuals experiencing health care services financial burden (family out-of-pocket spending on health care, not including premiums, greater than 10% of total family income) under each scenario. With the uniform caps, 1.2% of individuals had lower out-of-pocket spending, compared with 3.8% with reduced uniform caps and 2.1% with income-based caps. Uniform caps led to a small reduction in percentage of individuals experiencing financial burden (from 3.3% to 3.1%), with a modestly larger reduction as a result of reduced uniform caps (2.9%) and income-based caps (2.8%). Mandated uniform out-of-pocket caps for those with group insurance will benefit very few individuals, and will not result in substantial reductions in financial burden.

Comparison of historical medical spending patterns among the BRICS and G7.

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Jakovljevic, Mihajlo Michael

2016-01-01

The past few decades have been marked by a bold increase in national health spending across the globe. Rather successful health reforms in leading emerging markets such as BRICS reveal a reshaping of their medical care-related expenditures. There is a scarcity of evidence explaining differences in long-term medical spending patterns between top ranked G7 traditional welfare economies and the BRICS nations. A retrospective observational study was conducted on a longitudinal WHO Global Health Expenditure data-set based on the National Health Accounts (NHA) system. Data were presented in a simple descriptive manner, pointing out health expenditure dynamics and differences between the two country groups (BRICS and G7) and individual nations in a 1995-2013 time horizon. Average total per capita health spending still remains substantially higher among G7 (4747 Purchase Power Parity (PPP) $PPP in 2013) compared to the BRICS (1004 $PPP in 2013) nations. The percentage point share of G7 in global health expenditure (million current PPP international $US) has been falling constantly since 1995 (from 65% in 1995 to 53.2% in 2013), while in BRICS nations it grew (from 10.7% in 1995 to 20.2% in 2013). Chinese national level medical spending exceeded significantly that of all G7 members except the US in terms of current $PPP in 2013. Within a limited time horizon of only 19 years it appears that the share of global medical spending by the leading emerging markets has been growing steadily. Simultaneously, the world's richest countries' global share has been falling constantly, although it continues to dominate the landscape. If the contemporary global economic mainstream continues, the BRICS per capita will most likely reach or exceed the OECD average in future decades. Rising out-of-pocket expenses threatening affordability of medical care to poor citizens among the BRICS nations and a too low percentage of GDP in India remain the most notable setbacks of these developments.

[Municipal public health spending in the state of Pernambuco, Brazil, from 2000 to 2007].

Science.gov (United States)

Espírito Santo, Antônio Carlos Gomes do; Fernando, Virgínia Conceição Nascimento; Bezerra, Adriana Falangola Benjamin

2012-04-01

In order to assess the impact of macro-political measures implemented in the latter half of the 1990s on the increase in public spending on health and the possible reduction in allocation inequity, a descriptive, quantitative, cross-sectional study was carried out involving 184 municipalities in the state of Pernambuco, Brazil. Data from the Public Health Budget Information System was used, with the selected indicator being spending on health per inhabitant under the responsibility of the municipality. The correlations of this variable with the municipal Human Development Index, population size and value of the municipal budget per capita were analyzed. It was seen that, although the mean increase in municipal spending on health is 190.76%, the value per capita has remained relatively low - at around R$183.79 - which is below the national and macro-regional averages. Both spending on health per capita and growth percentages are distributed irregularly among health regions as well as among municipalities within a single region. In conclusion, there is marked allocation inequity among municipalities with regard to the distribution of public resources for health, despite the macro-political measures adopted to reduce this inequity.

Health care spending accounts: a flexible solution for Canadian employers.

Science.gov (United States)

Smithies, R; Steeves, L

1996-01-01

Flexible benefits plans have grown more slowly in Canada than in the United States, largely because of certain legal and regulatory considerations. Health care spending accounts (HCSAs) provide a cost-effective way for Canadian employers to address the health care benefit needs of a diverse workforce. A flexible health care spending account is a versatile and cost-effective instrument that can be used by Canadian employers that wish to provide a full range of health care benefits to employees. The health care alternatives available through an HCSA can provide employees with an opportunity to customize and optimize their benefits program. Regulatory requirements that an HCSA must meet in order to qualify for available tax advantages are discussed, as are the range of health care services that may be covered.

DEMAND FOR TURKEY MEAT: PRICE EFFECT OR SPENDING EFFECT

Directory of Open Access Journals (Sweden)

Miguel Angel Martinez Damian

2016-08-01

Full Text Available Turkey meat is a white meat demand in Mexico, however, its consumption is still low. In order to explore the convenience of expanding the market and foresee if the industry should compete in price or expenditure, the aim of this work is to study the demand for turkey meat as part of a protein basket; that consists of beef, chicken, pork and egg. Methodologically an almost ideal demand model was used, in an economic sense, this model allows an optimal assignment representation through budget share equations as a function of prices and real expenditure within the bundle. With statistical information from secondary sources, the results showed that the demand for turkey meat responds inelastically to price, and that the response on spending is almost one. With the estimates of price and expenditure growth rates, in terms of an expansion policy in the turkey market, results conclude that spending is the most relevant factor in demand, followed to a lesser extent by price.

Time Students Spend Working at Home for School

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Wagner, Petra; Schober, Barbara; Spiel, Christiane

2008-01-01

The paper presents three studies which deal with the time students spend working at home for school. In addition, the paper focuses on the distribution of time investment over the course of a week and on the relationship between academic achievement and time spent working at home for school. In sum, 824 students with an average age of 15 years…

HEALTH CARE SPENDING GROWTH AND THE FUTURE OF U.S. TAX RATES

Science.gov (United States)

Baicker, Katherine; Skinner, Jonathan S.

2011-01-01

The fraction of GDP devoted to health care in the United States is the highest in the world and rising rapidly. Recent economic studies have highlighted the growing value of health improvements, but less attention has been paid to the efficiency costs of tax-financed spending to pay for such improvements. This paper uses a life cycle model of labor supply, saving, and longevity improvement to measure the balanced-budget impact of continued growth in the Medicare and Medicaid programs. The model predicts that top marginal tax rates could rise to 70 percent by 2060, depending on the progressivity of future tax changes. The deadweight loss of the tax system is greater when the financing is more progressive. If the share of taxes paid by high-income taxpayers remains the same, the efficiency cost of raising the revenue needed to finance the additional health spending is $1.48 per dollar of revenue collected, and GDP declines (relative to trend) by 11 percent. A proportional payroll tax has a lower efficiency cost (41 cents per dollar of revenue averaged over all tax hikes, a 5 percent drop in GDP) but more than doubles the share of the tax burden borne by lower income taxpayers. Empirical support for the model comes from analysis of OECD country data showing that countries facing higher tax burdens in 1979 experienced slower health care spending growth in subsequent decades. The rising burden imposed by the public financing of health care expenditures may therefore serve as a brake on health care spending growth. PMID:21608156

Comparative analysis of Medicare spending for medical imaging: sustained dramatic slowdown compared with other services.

Science.gov (United States)

Lee, David W; Duszak, Richard; Hughes, Danny R

2013-12-01

The purpose of this study was to assess trends in Medicare spending growth for medical imaging relative to other services and the Deficit Reduction Act (DRA). We calculated per-beneficiary Part B Medicare medical imaging expenditures for three-digit Berenson-Eggers Type of Service (BETOS) categories using Physician Supplier Procedure Summary Master Files for 32 million beneficiaries from 2000 to 2011. We adjusted BETOS categories to address changes in coding and payment policy and excluded categories with 2011 aggregate spending less than $500 million. We computed and ranked compound annual growth rates over three periods: pre-DRA (2000-2005), DRA transition period (2005-2007), and post-DRA (2007-2011). Forty-four modified BETOS categories fulfilled the inclusion criteria. Between 2000 and 2006, Medicare outlays for nonimaging services grew by 6.8% versus 12.0% for imaging services. In the ensuing 5 years, annual growth in spending for nonimaging continued at 3.6% versus a decline of 3.5% for imaging. Spending growth for all services during the pre-DRA, DRA, and post-DRA periods were 7.8%, 3.8%, and 2.9 compared with 15.0%, -3.4%, and -2.2% for advanced imaging services. Advanced imaging was among the fastest growing categories of Medicare services in the early 2000s but was in the bottom 2% of spending categories in 2011. Between 2007 and 2011, the fastest growing service categories were evaluation and management services with other specialists (29.1%), nursing home visits (11.2%), anesthesia (9.1%), and other ambulatory procedures (9.0%). Slowing volume growth and massive Medicare payment cuts have left medical imaging near the bottom of all service categories contributing to growth in Medicare spending.

Medicare Spending for Breast, Prostate, Lung, and Colorectal Cancer Patients in the Year of Diagnosis and Year of Death.

Science.gov (United States)

Chen, Christopher T; Li, Ling; Brooks, Gabriel; Hassett, Michael; Schrag, Deborah

2017-07-26

To characterize spending patterns for Medicare patients with incident breast, prostate, lung, and colorectal cancer. 2007-2012 data from the Surveillance, Epidemiology, and End Results Program linked with Medicare fee-for-service claims. We calculate per-patient monthly and yearly mean and median expenditures, by cancer type, stage at diagnosis, and spending category, over the years of diagnosis and death. Over the year of diagnosis, mean spending was $35,849, $26,295, $55,597, and $63,063 for breast, prostate, lung, and colorectal cancer, respectively. Over the year of death, spending was similar across different cancer types and stage at diagnosis. Characterization of Medicare spending according to clinically meaningful categories may assist development of oncology alternative payment models and cost-effectiveness models. © Health Research and Educational Trust.

Sources of Cross-national Heterogeneity in E-retail Spending: Evidence from Country-Level Data

OpenAIRE

Nir Kshetri; Ralf Bebenroth; Nicholas C. Williamson

2010-01-01

The global e-retail industry is growing rapidly. Economies worldwide, however, differ greatly in the development of the e-retail industry. Using data from forty-seven economies, this paper empirically examines how technological, economic, and institutional factors explain international heterogeneity in e-retail spending. The results indicated that broadband penetration was the strongest predictor of e-retail spending. We found that externalities mechanisms generated by the development of the ...

Non-profit organisations and government’s pro-poor spending: the case of health and development in Gauteng

Directory of Open Access Journals (Sweden)

L B Mzini

2011-12-01

Full Text Available Globally, there is growing recognition of participatory public expenditure management (PPEM. PPEM is seen as the process whereby citizens and civil society organisations participate in the management of public expenditures. The adoption of PPEM is aimed at ensuring greater transparency, better targeting and tracking of resources, and increased overall responsiveness. The Gauteng Department of Health and Social Development (GDHSD is committed to co-operative governance; this includes working with different spheres of government and civil society or non-profit organisations (NPOs. NPOs are required to have a governing committee to manage funds allocated by GDHSD. The committee has the capacity to hold the NPO management accountable for the resources (financial and material entrusted to it by the GDHSD. The effectiveness of NPOs is challenged by poor attendance of board members at meetings, poor understanding of the board’s mandate and responsibilities and lack of experience amongst members. The paradigm of PPEM is still faced with challenges to ensure that significant flows of revenue are accounted for and used effectively for growth and poverty reduction. This study is divided into three components. The first section focuses on the background, the introduction and the conceptual framework. The second part focuses on the empirical study for deriving a benchmark for the South African NPO sector. The third section highlights good practices as well as governance-related challenges. Finally, for further consideration by the GDHSD, a series of recommendations is provided, focusing on how key domestic stakeholders can better contribute to successful participatory budgeting programmes. Keywords: Participatory public expenditure management, non-profit organisations, pro-poor spending, public finance, public financial management, early childhood development.  Disciplines: Public Management and Administration, Public Financial Management

2017 National Park visitor spending effects : Economic contributions to local communities, states, and the Nation

Science.gov (United States)

Cullinane Thomas, Catherine M.; Koontz, Lynne; Cornachione, Egan

2018-01-01

The National Park Service (NPS) manages the Nation’s most iconic destinations that attract millions of visitors from across the Nation and around the world. Trip-related spending by NPS visitors generates and supports a considerable amount of economic activity within park gateway communities. This economic effects analysis measures how NPS visitor spending cycles through local economies, generating business sales and supporting jobs and income. In 2017, the National Park System received an estimated 331 million recreation visits. Visitors to National Parks spent an estimated \\$18.2 billion in local gateway regions (defined as communities within 60 miles of a park). The contribution of this spending to the national economy was 306 thousand jobs, \\$11.9 billion in labor income, \\$20.3 billion in value added, and \\$35.8 billion in economic output. The lodging sector saw the highest direct contributions with \\$5.5 billion in economic output directly contributed to local gateway economies nationally. The sector with the next greatest direct contributions was the restaurants and bars sector, with \\$3.7 billion in economic output directly contributed to local gateway economies nationally. Results from the Visitor Spending Effects report series are available online via an interactive tool. Users can view year-by-year trend data and explore current year visitor spending, jobs, labor income, value added, and economic output effects by sector for national, state, and local economies. This interactive tool is available at https://www.nps.gov/subjects/socialscience/vse.htm.

2016 National Park visitor spending effects: Economic contributions to local communities, states, and the Nation

Science.gov (United States)

Cullinane Thomas, Catherine; Koontz, Lynne

2017-01-01

The National Park Service (NPS) manages the Nation’s most iconic destinations that attract millions of visitors from across the Nation and around the world. Trip-related spending by NPS visitors generates and supports a considerable amount of economic activity within park gateway communities. This economic effects analysis measures how NPS visitor spending cycles through local economies, generating business sales and supporting jobs and income. In 2016, the National Park System received an estimated 330,971,689 recreation visits. Visitors to National Parks spent an estimated $18.4 billion in local gateway regions (defined as communities within 60 miles of a park). The contribution of this spending to the national economy was 318 thousand jobs, $12.0 billion in labor income, $19.9 billion in value added, and $34.9 billion in economic output. The lodging sector saw the highest direct contributions with $5.7 billion in economic output directly contributed to local gateway economies nationally. The sector with the next greatest direct contributions was the restaurants and bars sector, with $3.7 billion in economic output directly contributed to local gateway economies nationally. Results from the Visitor Spending Effects report series are available online via an interactive tool. Users can view year-by-year trend data and explore current year visitor spending, jobs, labor income, value added, and economic output effects by sector for national, state, and local economies. This interactive tool is available at https://www.nps.gov/subjects/socialscience/vse.htm.

2015 National Park visitor spending effects: Economic contributions to local communities, states, and the nation

Science.gov (United States)

Cullinane Thomas, Catherine M.; Koontz, Lynne

2016-01-01

The National Park Service (NPS) manages the Nation’s most iconic destinations that attract millions of visitors from across the Nation and around the world. Trip-related spending by NPS visitors generates and supports a considerable amount of economic activity within park gateway communities. This economic effects analysis measures how NPS visitor spending cycles through local economies, generating business sales and supporting jobs and income.In 2015, the National Park System received over 307.2 million recreation visits. NPS visitors spent \\$16.9 billion in local gateway regions (defined as communities within 60 miles of a park). The contribution of this spending to the national economy was 295 thousand jobs, \\$11.1 billion in labor income, \\$18.4 billion in value added, and \\$32.0 billion in economic output. The lodging sector saw the highest direct contributions with \\$5.2 billion in economic output directly contributed to local gateway economies nationally. The sector with the next greatest direct contributions was the restaurants and bar sector, with \\$3.4 billion in economic output directly contributed to local gateway economies nationally.Results from the Visitor Spending Effects report series are available online via an interactive tool. Users can view year-by-year trend data and explore current year visitor spending, jobs, labor income, value added, and economic output effects by sector for national, state, and local economies. This interactive tool is available at http://go.nps.gov/vse.

Vertical integration: hospital ownership of physician practices is associated with higher prices and spending.

Science.gov (United States)

Baker, Laurence C; Bundorf, M Kate; Kessler, Daniel P

2014-05-01

We examined the consequences of contractual or ownership relationships between hospitals and physician practices, often described as vertical integration. Such integration can reduce health spending and increase the quality of care by improving communication across care settings, but it can also increase providers' market power and facilitate the payment of what are effectively kickbacks for inappropriate referrals. We investigated the impact of vertical integration on hospital prices, volumes (admissions), and spending for privately insured patients. Using hospital claims from Truven Analytics MarketScan for the nonelderly privately insured in the period 2001-07, we constructed county-level indices of prices, volumes, and spending and adjusted them for enrollees' age and sex. We measured hospital-physician integration using information from the American Hospital Association on the types of relationships hospitals have with physicians. We found that an increase in the market share of hospitals with the tightest vertically integrated relationship with physicians--ownership of physician practices--was associated with higher hospital prices and spending. We found that an increase in contractual integration reduced the frequency of hospital admissions, but this effect was relatively small. Taken together, our results provide a mixed, although somewhat negative, picture of vertical integration from the perspective of the privately insured.

Changes in health care spending and quality for Medicare beneficiaries associated with a commercial ACO contract.

Science.gov (United States)

McWilliams, J Michael; Landon, Bruce E; Chernew, Michael E

2013-08-28

In a multipayer system, new payment incentives implemented by one insurer for an accountable care organization (ACO) may also affect spending and quality of care for another insurer's enrollees served by the ACO. Such spillover effects reflect the extent of organizational efforts to reform care delivery and can contribute to the net impact of ACOs. We examined whether the Blue Cross Blue Shield (BCBS) of Massachusetts' Alternative Quality Contract (AQC), an early commercial ACO initiative associated with reduced spending and improved quality for BCBS enrollees, was also associated with changes in spending and quality for Medicare beneficiaries, who were not covered by the AQC. Quasi-experimental comparisons from 2007-2010 of elderly fee-for-service Medicare beneficiaries in Massachusetts (1,761,325 person-years) served by 11 provider organizations entering the AQC in 2009 or 2010 (intervention group) vs beneficiaries served by other providers (control group). Using a difference-in-differences approach, we estimated changes in spending and quality for the intervention group in the first and second years of exposure to the AQC relative to concurrent changes for the control group. Regression and propensity score methods were used to adjust for differences in sociodemographic and clinical characteristics. The primary outcome was total quarterly medical spending per beneficiary. Secondary outcomes included spending by setting and type of service, 5 process measures of quality, potentially avoidable hospitalizations, and 30-day readmissions. Before entering the AQC, total quarterly spending per beneficiary for the intervention group was $150 (95% CI, $25-$274) higher than for the control group and increased at a similar rate. In year 2 of the intervention group's exposure to the AQC, this difference was reduced to $51 (95% CI, -$109 to $210; P = .53), constituting a significant differential change of -$99 (95% CI, -$183 to -$16; P = .02) or a 3.4% savings

The Alternative Quality Contract: Impact on Service Use and Spending for Children With ADHD.

Science.gov (United States)

Joyce, Nina R; Huskamp, Haiden A; Hadland, Scott E; Donohue, Julie M; Greenfield, Shelly F; Stuart, Elizabeth A; Barry, Colleen L

2017-12-01

In 2009, Blue Cross-Blue Shield of Massachusetts (BCBSMA) implemented the alternative quality contract (AQC), which pays provider organizations a global payment for all services used by enrollees. BCBSMA claims for 2006-2011 were used to compare youths enrolled in provider organizations participating in the AQC (7,407 person-years [PYs]) with those not participating (45,398 PYs). Difference-in-differences models estimated changes in mental health and substance abuse treatment service utilization and spending attributable to the AQC. The AQC was associated with small increases in the probability of any outpatient visits and in the probability and number of medication management visits among children with attention-deficit hyperactivity disorder (ADHD). Spending did not change, and there was no evidence of reductions in service utilization or spending for children with ADHD in the first three years of AQC implementation.

The effects of mental health parity on spending and utilization for bipolar, major depression, and adjustment disorders.

Science.gov (United States)

Busch, Alisa B; Yoon, Frank; Barry, Colleen L; Azzone, Vanessa; Normand, Sharon-Lise T; Goldman, Howard H; Huskamp, Haiden A

2013-02-01

The Mental Health Parity and Addiction Equity Act requires insurance parity for mental health/substance use disorder and general medical services. Previous research found that parity did not increase mental health/substance use disorder spending and lowered out-of-pocket spending. Whether parity's effects differ by diagnosis is unknown. The authors examined this question in the context of parity implementation in the Federal Employees Health Benefits (FEHB) Program. The authors compared mental health/substance use disorder treatment use and spending before and after parity (2000 and 2002, respectively) for two groups: FEHB enrollees diagnosed in 1999 with bipolar disorder, major depression, or adjustment disorder (N=19,094) and privately insured enrollees unaffected by the policy in a comparison national sample (N=10,521). Separate models were fitted for each diagnostic group. A difference-in-difference design was used to control for secular time trends and to better reflect the specific impact of parity on spending and utilization. Total spending was unchanged among enrollees with bipolar disorder and major depression but decreased for those with adjustment disorder (-$62, 99.2% CI=-$133, -$11). Out-of-pocket spending decreased for all three groups (bipolar disorder: -$148, 99.2% CI=-$217, -$85; major depression: -$100, 99.2% CI=-$123, -$77; adjustment disorder: -$68, 99.2% CI=-$84, -$54). Total annual utilization (e.g., medication management visits, psychotropic prescriptions, and mental health/substance use disorder hospitalization bed days) remained unchanged across all diagnoses. Annual psychotherapy visits decreased significantly only for individuals with adjustment disorders (-12%, 99.2% CI=-19%, -4%). Parity implemented under managed care improved financial protection and differentially affected spending and psychotherapy utilization across groups. There was some evidence that resources were preferentially preserved for diagnoses that are typically more

Fiscal Policy and Welfare under Different Exchange Rate Regimes

DEFF Research Database (Denmark)

Østrup, Finn

a representativeindividual's utility, it is demonstrated that there are differences betweenexchange rate regimes with respect to the level of government spending. Thesedifferences arise first because a rise in government spending affects macroeconomicvariables differently under different exchange rate regimes......, and secondbecause the government's inclination to expand government spending is affectedby inflation which depends on the exchange rate regime. At low rates of inflation,the government is inclined to set a higher level of government spending under afixed exchange rate regime than under a floating exchange rate...... regime in whichthe monetary authority optimises preferences which include an employment targetand an inflation target. As government spending affects the representativeindividual's utility, the choice of exchange rate regime has an impact on welfare.Keywords: exchange rate regimes; fiscal policy...

End-of-life medical spending in last twelve months of life is lower than previously reported

NARCIS (Netherlands)

French, E.; Klein, Tobias; a., e.

Although end-of-life medical spending is often viewed as a major component of aggregate medical expenditure, accurate measures of this type of medical spending are scarce. We used detailed health care data for the period 2009–11 from Denmark, England, France, Germany, Japan, the Netherlands, Taiwan,

Mental health and substance use disorder spending in the Department of Veterans Affairs, fiscal years 2000-2007.

Science.gov (United States)

Wagner, Todd H; Sinnott, Patricia; Siroka, Andrew M

2011-04-01

This study analyzed spending for treatment of mental health and substance use disorders in the Department of Veterans Affairs (VA) in fiscal years (FYs) 2000 through 2007. VA spending as reported in the VA Decision Support System was linked to patient utilization data as reported in the Patient Treatment Files, the National Patient Care Database, and the VA Fee Basis files. All care and costs from FY 2000 to FY 2007 were analyzed. Over the study period the number of veterans treated at the VA increased from 3.7 million to over 5.1 million (an average increase of 4.9% per year), and costs increased .7% per person per year. For mental health and substance use disorder treatment, the volume of inpatient care decreased markedly, residential care increased, and spending decreased on average 2% per year (from $668 in FY 2000 to $578 per person in FY 2007). FY 2007 saw large increases in mental health spending, bucking the trend from FY 2000 through FY 2006. VA's continued emphasis on outpatient and residential care was evident through 2007. This trend in spending might be unimpressive if VA were enrolling healthier Veterans, but the opposite seems to be true: over this time period the prevalence of most chronic conditions, including depression and posttraumatic stress disorder, increased. VA spending on mental health care grew rapidly in 2007, and given current military activities, this trend is likely to increase.

Domestic Price, (Expected) Foreign Price, and Travel Spending by Canadians in the United States

OpenAIRE

Jan Vilasuso; Fredric C. Menz

1998-01-01

In this paper, the authors develop and test a model to explain travel expenditures in the United States by Canadians. The model examines a consumer's choice problem where income is allocated between domestic and foreign consumption. Consumers do not know the foreign price level and base their spending in part on expected foreign price. In addition to expected foreign price, domestic price, exchange rates, income, and foreign price uncertainty influence travel spending. Empirically, each deter...

SpEnD: Linked Data SPARQL Endpoints Discovery Using Search Engines

Science.gov (United States)

Yumusak, Semih; Dogdu, Erdogan; Kodaz, Halife; Kamilaris, Andreas; Vandenbussche, Pierre-Yves

In this study, a novel metacrawling method is proposed for discovering and monitoring linked data sources on the Web. We implemented the method in a prototype system, named SPARQL Endpoints Discovery (SpEnD). SpEnD starts with a "search keyword" discovery process for finding relevant keywords for the linked data domain and specifically SPARQL endpoints. Then, these search keywords are utilized to find linked data sources via popular search engines (Google, Bing, Yahoo, Yandex). By using this method, most of the currently listed SPARQL endpoints in existing endpoint repositories, as well as a significant number of new SPARQL endpoints, have been discovered. Finally, we have developed a new SPARQL endpoint crawler (SpEC) for crawling and link analysis.

TINGKAT EFISIENSI PENGELUARAN PEMERINTAH DAERAH DI PULAU JAWA

Directory of Open Access Journals (Sweden)

Zuhairan Y Yunan

2015-10-01

Full Text Available The objective of this research is to analyze the local government spending for education and health sector for all provices in the Java Island. The data used in this research is local government spending for education and health sector. The data are Life Expectancy Rate, Literacy Rate, and Average of School Duration. A method of analysis used to measure performance through health and education spending with DEAP software version 2.1. The result showed that local government spending for education and health sector has not been efficient. Only Yogyakarta Province showing that local government spending is already efficient, also in the term of output (Literacy Rate and Average of School Duration. Local government spending for health sector has not been efficient. Only Yogyakarta Province showing that local government spending is already efficient, also in the term of output (Life Expectancy RateDOI: 10.15408/sjie.v3i1.2053

Inequalities in Parental Spending on Young Children: 1980-2010

Science.gov (United States)

Kornrich, Sabino

2016-01-01

Using 1972-2000 data from the Consumer Expenditure Survey (CES), a nationally representative survey of spending conducted by the Bureau of Labor Statistics, this paper investigates changes in the income-based gap in monetary investments in children under the age of six, when most children typically have entered school in the United States. The…

Geographic Variation in Household and Catastrophic Health Spending in India: Assessing the Relative Importance of Villages, Districts, and States, 2011-2012.

Science.gov (United States)

Mohanty, Sanjay K; Kim, Rockli; Khan, Pijush Kanti; Subramanian, S V

2018-03-01

Policy Points: Per-capita household health spending was higher in economically developed states and was associated with ability to pay, but catastrophic health spending (CHS) was equally high in both poorer and more developed states in India. Based on multilevel modeling, we found that the largest geographic variation in health spending and CHS was at the state and village levels, reflecting wide inequality in the accessibility to and cost of health care at these levels. Contextual factors at macro and micro political units are important to reduce health spending and CHS in India. In India, health care is a local good, and households are the major source of financing it. Earlier studies have examined diverse determinants of health care spending, but no attempt has been made to understand the geographical variation in household and catastrophic health spending. We used multilevel modeling to assess the relative importance of villages, districts, and states to health spending in India. We used data on the health expenditures of 101,576 households collected in the consumption expenditure schedule (68th round) carried out by the National Sample Survey in 2011-2012. We examined 4 dependent variables: per-capita health spending (PHS), per-capita institutional health spending (PIHS), per-capita noninstitutional health spending (PNHS), and catastrophic health spending (CHS). CHS was defined as household health spending exceeding 40% of its capacity to pay. We used multilevel linear regression and logistic models to decompose the variation in each outcome by state, region, district, village, and household levels. The average PHS was 1,331 Indian rupees (INR), which varied by state-level economic development. About one-fourth of Indian households incurred CHS, which was equally high in both the economically developed and poorer states. After controlling for household level factors, 77.1% of the total variation in PHS was attributable to households, 10.1% to states, 9.5% to

Family socio-economic profile and private spending on educational goods and services in Poland

Directory of Open Access Journals (Sweden)

Magdalena Rokicka

2014-01-01

Full Text Available According to theory, educational goods and services have an important impact on a child’s human capital. Although the majority of educational services in Poland are delivered within a public education system, various educational costs are borne by parents. This paper looks at the socio-economic determinants of private spending on education, including fees, private tutoring and courses, educational goods and materials, and the internet. The analysis was performed using the Polish Household Budget Survey for 2009 and 2010. Results from a logit regression suggest that disposable household income per capita and parental level of education, especially mother’s level of education have the greatest impact on spending on educational goods and services. This was true for all analysed categories of expenditure. Regional disparities and community size were an important factor especially with regards to spending on private tutoring and additional courses.

Financial Incentives, Workplace Wellness Program Participation, and Utilization of Health Care Services and Spending.

Science.gov (United States)

Fronstin, Paul; Roebuck, M Christopher

2015-08-01

This paper analyzes data from a large employer that enhanced financial incentives to encourage participation in its workplace wellness programs. It examines, first, the effect of financial incentives on wellness program participation, and second, it estimates the impact of wellness program participation on utilization of health care services and spending. The Patient Protection and Affordable Care Act of 2010 (PPACA) allows employers to provide financial incentives of as much as 30 percent of the total cost of coverage when tied to participation in a wellness program. Participation in health risk assessments (HRAs) increased by 50 percentage points among members of unions that bargained in the incentive, and increased 22 percentage points among non-union employees. Participation in the biometric screening program increased 55 percentage points when financial incentives were provided. Biometric screenings led to an average increase of 0.31 annual prescription drug fills, with related spending higher by $56 per member per year. Otherwise, no significant effects of participation in HRAs or biometric screenings on utilization of health care services and spending were found. The largest increase in medication utilization as a result of biometric screening was for statins, which are widely used to treat high cholesterol. This therapeutic class accounted for one-sixth of the overall increase in prescription drug utilization. Second were antidepressants, followed by ACE inhibitors (for hypertension), and thyroid hormones (for hypothyroidism). Biometric screening also led to significantly higher utilization of biologic response modifiers and immunosuppressants. These specialty medications are used to treat autoimmune diseases, such as rheumatoid arthritis and multiple sclerosis, and are relatively expensive compared with non-specialty medications. The added spending associated with the combined increase in fills of 0.02 was $27 per member per year--about one-half of the

2012 National Park visitor spending effects: economic contributions to local communities, states, and the nation

Science.gov (United States)

Cullinane Thomas, Catherine; Huber, Christopher C.; Koontz, Lynne

2014-01-01

The National Park Service (NPS) manages the nation's most iconic destinations that attract millions of visitors from across the nation and around the world. Trip-related spending by NPS visitors generates and supports a considerable amount of economic activity within park gateway communities. This economic effects analysis measures how NPS visitor spending cycles through local economies, generating business sales and supporting jobs and income.

Vergi-Harcama Tartışması : Türkiye Örneği = The Tax-Spend Debate : The Case of Turkey

Directory of Open Access Journals (Sweden)

İhsan GÜNAYDIN

2004-06-01

Full Text Available This paper examines the short and long-run relationship between goverment revenues, expenditures, GNP and interest rates for Turkey for the period 1987:1-2003:3, using error correction model (ECM and the augmented vector autoregressive (VAR model developed in Toda-Yamamoto (1995. The results indicate that there is one long-run equilibrium relationship among the four variables, and the causal relationship flows unidirectionally from government revenues to expentitures both in the short and long-run, providing support for the tax-spend theory.The results further reveal that the unidirectional causal impact of revenues on expentitures is significantly negative as hypothesized by Buchanan and Wagner. Thus, higher taxes seem an optimal resolution to the budget deficits in Turkey.

EPIC Studies: Governments Finance, On Average, More Than 50 Percent Of Immunization Expenses, 2010-11.

Science.gov (United States)

Brenzel, Logan; Schütte, Carl; Goguadze, Keti; Valdez, Werner; Le Gargasson, Jean-Bernard; Guthrie, Teresa

2016-02-01

Governments in resource-poor settings have traditionally relied on external donor support for immunization. Under the Global Vaccine Action Plan, adopted in 2014, countries have committed to mobilizing additional domestic resources for immunization. Data gaps make it difficult to map how well countries have done in spending government resources on immunization to demonstrate greater ownership of programs. This article presents findings of an innovative approach for financial mapping of routine immunization applied in Benin, Ghana, Honduras, Moldova, Uganda, and Zambia. This approach uses modified System of Health Accounts coding to evaluate data collected from national and subnational levels and from donor agencies. We found that government sources accounted for 27-95 percent of routine immunization financing in 2011, with countries that have higher gross national product per capita better able to finance requirements. Most financing is channeled through government agencies and used at the primary care level. Sustainable immunization programs will depend upon whether governments have the fiscal space to allocate additional resources. Ongoing robust analysis of routine immunization should be instituted within the context of total health expenditure tracking. Project HOPE—The People-to-People Health Foundation, Inc.

Impact of minimally invasive surgery on medical spending and employee absenteeism.

Science.gov (United States)

Epstein, Andrew J; Groeneveld, Peter W; Harhay, Michael O; Yang, Feifei; Polsky, Daniel

2013-07-01

As many surgical procedures have undergone a transition from a standard, open surgical approach to a minimally invasive one in the past 2 decades, the diffusion of minimally invasive surgery may have had sizeable but overlooked effects on medical expenditures and worker productivity. To examine the impact of standard vs minimally invasive surgery on health plan spending and workplace absenteeism for 6 types of surgery. Cross-sectional regression analysis. National health insurance claims data and matched workplace absenteeism data from January 1, 2000, to December 31, 2009. A convenience sample of adults with employer-sponsored health insurance who underwent either standard or minimally invasive surgery for coronary revascularization, uterine fibroid resection, prostatectomy, peripheral revascularization, carotid revascularization, or aortic aneurysm repair. Health plan spending and workplace absenteeism from 14 days before through 352 days after the index surgery. There were 321,956 patients who underwent surgery; 23,814 were employees with workplace absenteeism data. After multivariable adjustment, mean health plan spending was lower for minimally invasive surgery for coronary revascularization (-$30,850; 95% CI, -$31,629 to -$30,091), uterine fibroid resection (-$1509; 95% CI, -$1754 to -$1280), and peripheral revascularization (-$12,031; 95% CI, -$15,552 to -$8717) and higher for prostatectomy ($1350; 95% CI, $611 to $2212) and carotid revascularization ($4900; 95% CI, $1772 to $8370). Undergoing minimally invasive surgery was associated with missing significantly fewer days of work for coronary revascularization (mean difference, -37.7 days; 95% CI, -41.1 to -34.3), uterine fibroid resection (mean difference, -11.7 days; 95% CI, -14.0 to -9.4), prostatectomy (mean difference, -9.0 days; 95% CI, -14.2 to -3.7), and peripheral revascularization (mean difference, -16.6 days; 95% CI, -28.0 to -5.2). For 3 of 6 types of surgery studied, minimally invasive

The role of market orientation in advertising spending during economic collapse : The case of Turkey in 2001

NARCIS (Netherlands)

Ozturan, P.; Oszomer, A.; Pieters, R.

The authors investigate the role of market orientation in advertising spending during economic contraction. They use the 2001 economic collapse in Turkey as the empirical context in which to test hypotheses regarding why some firms increase their advertising spending in a contraction period while

The Role of Market Orientation in Advertising Spending during Economic Collapse: The Case of Turkey in 2001

NARCIS (Netherlands)

Ozturan, P.; Ozsomer, A.; Pieters, F.G.M.

2014-01-01

The authors investigate the role of market orientation in advertising spending during economic contraction. They use the 2001 economic collapse in Turkey as the empirical context in which to test hypotheses regarding why some firms increase their advertising spending in a contraction period while

Reconsiderations of the Development and Governance Model after the Financial and Economic Crisis

Directory of Open Access Journals (Sweden)

Petre Prisecaru

2011-01-01

Full Text Available Financial crisis brought to the fore the fierce confrontation between Keynes disciples and Friedman disciples, between demand siders and supply siders, between Obama’s policies focused on economic growrh and EU austerity policies focused on deficit and debts reduction. Monetary policy showed its limits and neoliberal approach favored the risky products(derivatives and speculative activities. Supply siders, like David Harper, centred on three pillars: tax incentives, competition policy, enhancement of productive credit. Lisbon Strategy and Europe 2020 represent a supply side agenda based on sectoral policies. Great economists like Joseph Stiglitz and Paul Krugman have supported state interventionism and higher government spending for demand recovery and resuming the economic growth. Besides state interventionism one needs the urgent reconsideration of capitalist development model and strongly improving the governance at all levels: global, European, national, corporate.

How the ACA's Health Insurance Expansions Have Affected Out-of-Pocket Cost-Sharing and Spending on Premiums.

Science.gov (United States)

Glied, Sherry; Solís-Román, Claudia; Parikh, Shivani

2016-09-01

One important benefit gained by the millions of Americans with health insurance through the Affordable Care Act (ACA) is protection from high out-of-pocket health spending. While Medicaid unambiguously reduces out-of-pocket premium and medical costs for low-income people, it is less certain that marketplace coverage and other types of insurance purchased to comply with the law's individual mandate also protect from high health spending. Goal: To compare out-of-pocket spending in 2014 to spending in 2013; assess how this spending changed in states where many people enrolled in the marketplaces relative to states where few people enrolled; and project the decline in the percentage of people paying high amounts out-of-pocket. Methods: Linear regression models were used to estimate whether people under age 65 spent above certain thresholds. Key findings and conclusions: The probability of incurring high out-of-pocket costs and premium expenses declined as marketplace enrollment increased. The percentage reductions were greatest among those with incomes between 250 percent and 399 percent of poverty, those who were eligible for premium subsidies, and those who previously were uninsured or had very limited nongroup coverage. These effects appear largely attributable to marketplace enrollment rather than to other ACA provisions or to economic trends.

Climate change governance in the South African mining sector

CSIR Research Space (South Africa)

Mzenda, Venantio M

2012-07-01

Full Text Available value-added in its exports: all these expose the South African mining sector to climate change-related business risks. This study explores corporate governance as a vehicle through which South Africa’s mining companies could improve their response...

Estimating DoD Transportation Spending: Analyses of Contract and Payment Transactions

National Research Council Canada - National Science Library

Moore, Nancy Y; Chenoweth, Mary E; Reardon, Elaine; Grammich, Clifford A; Bullock, Arthur M; Mele, Judith D; Kofner, Aaron; Unger, Eric J

2007-01-01

.... This analysis of combined individual contracting action report (DD350) and PowerTrack (PT) data indicates that DoD has additional opportunities to leverage transportation spending, particularly where it uses tenders to purchase transportation services...

Economic Growth and Government Spending Nexus: Empirical ...

African Journals Online (AJOL)

The results highlight the need for policy makers to shift public outlays towards investment in physical infrastructure which will stimulate growth and consequently improve fiscal sustainability as opposed to recurrent expenditure. Keywords: Economic Growth, Fiscal Policy, Cointegration, Causality, Wagner' Law ...

Fiscal Impact of Smoking Cessation in Thailand: A Government Perspective Cost-Benefit Analysis.

Science.gov (United States)

Connolly, Mark P; Kotsopoulos, Nikolaos; Suthipinijtham, Pichaya; Rungruanghiranya, Suthat

2018-04-01

We evaluate the broader public economic consequences of investments in smoking cessation that change lifetime productivity, which can influence future government tax revenue and social transfer costs and health care spending. The analysis applies a government perspective framework for assessing the intergenerational relationships between morbidity and mortality and lifetime tax revenue and social transfers received. Applying smoking prevalence in Thailand, a cohort model was developed for smoker and former smokers to estimate impact on lifetime direct taxes and tobacco taxes paid. Age-specific earnings for males and wage appropriate tax rates were applied to estimate net taxes for smokers and former smokers. Introducing smoking cessation leads to lifetime public economic benefits of THB13 998 to THB43 356 per person depending on the age of introducing smoking cessation. Factoring in the costs of smoking cessation therapy, an average return on investment of 1.35 was obtained indicating fiscal surplus generated for government from the combined effect of increased tax revenues and of averting smoking-attributable health care costs.

China, Global Governance and the Future of Cuba

Directory of Open Access Journals (Sweden)

Adrian H. Hearn

2012-01-01

Full Text Available China’s deepening engagement with Latin America has been accompanied by concerns about the Chinese government’s regard for international conventions of economic governance. Critics claim that across Latin America and the Caribbean, Chinese aid and trade are characterised by excessive state intervention. This article argues that, for two reasons, the rationale for these misgivings is dissipating. First, since the onset of the global financial crisis, China has gained influence in multilateral institutions, prompting them toward greater acceptance of public spending in developing countries. Second, recent developments in Cuba show that China is actively encouraging the Western hemisphere’s only communist country to liberalise its economy. China sits at the crossroads of these local and global developments, prompting Cuba toward rapprochement with international norms even as it works to reform them.

Evolution of relationship between government and companies

International Nuclear Information System (INIS)

Tchuruk, S.

1995-01-01

The president of the Total petroleum company , during a meeting of Petroleum institute at London, exposed the relations and their evolution in energy area, between national government and petroleum industry. The nationalization or the privatization, the taxation, the differences made between different kind of energy are so many factors which are used to regulate energy policy

Financial effects of pharmaceutical price regulation on R&D spending by EU versus US firms.

Science.gov (United States)

Golec, Joseph; Vernon, John A

2010-01-01

EU countries closely regulate pharmaceutical prices, whereas the US does not. This paper shows how price constraints affect the profitability, stock returns and R&D spending of EU and US firms. Compared with EU firms, US firms are more profitable, earn higher stock returns and spend more on R&D. We tested the relationship between price regulation and R&D spending, and estimated the costs of tight EU price regulation. Although results show that EU consumers enjoyed much lower pharmaceutical price inflation, we estimated that price controls cost EU firms 46 fewer new medicines and 1680 fewer research jobs during our 19-year sample period. Had the US used controls similar to those used in the EU, we estimate it would have led to 117 fewer new medicines and 4368 fewer research jobs in the US.

Senior governments asked to return half of gasoline taxes collected in GTA

International Nuclear Information System (INIS)

2001-01-01

The Greater Toronto Services Board addressed a submission to the Standing Committee on Finance of the House of Commons in Ottawa and to the Legislature of the Province of Ontario, requesting the federal and provincial governments to earmark half the money they collect in gasoline taxes from motorists in the Greater Toronto Area (GTA) for local transportation spending, and by so doing help to end traffic gridlock in the GTA. In its submission the GTSB claims that as a result of 'pervasive traffic congestion' the GTA is quickly losing competitive ground to US cities that are enjoying substantial financial support from their federal government. The GTSB calculates that motorists throughout the GTA paid more than $1.7 billion to the federal and provincial governments in gasoline taxes; if half that amount, $863 million, were returned to the GTA and earmarked for transportation improvements, that would cover the GTA's shortfall on capital spending on roads and public transit, currently estimated at $800 million. The GTSB points out that the GTA generates about 18 per cent of the country's and 45 per cent of the province's gross domestic product; it would be false economy to neglect the needs of a region that is such a major producer of the country's and the province's wealth. The submission also points out the recommendation of a federal panel recently reviewing the Canada Transportation Act, that federal gasoline tax revenues should be reinvested in roads and public transit rather than going into general revenue. The submission emphasizes as the one inescapable reality of the global economy that financial and human resources flow to places where they see advantage, and avoid places where they see problems. City-regions with efficient roads and public transit systems and a healthy environment are bound to be in a better position to attract global businesses and their employees to their region than city-regions which are constantly mired in gridlock

Government programs for climate change mitigation in Japan. An analysis based on public budget documents and Government Project Review Sheets

International Nuclear Information System (INIS)

Kimura, Osamu

2016-01-01

The Japanese government has been spending huge public budgets for various programs to mitigate climate change, such as subsidy programs for energy efficient and renewable technologies, and R and D programs to develop innovative low carbon technologies. This report makes a comprehensive review of government projects and expenditure related to climate change mitigation in order to grasp their total expenditure and to analyze portfolio of supported technology and activity types, outcome, and the cost-effectiveness. It is estimated that the total expenditure for climate change mitigation excluding nuclear energy and forest sink projects amounts to 4.8 trillion JPY (approximately 40 billion USD) in the period of 2008 to 2014. 40% of the total expenditure went to only three largest programs, namely the Eco Car Subsidy, the Eco Point Programs for Appliances and Houses, all of which have gone through virtually no or only poor evaluations by the implementing ministries. While some programs had decent cost-effectiveness of reducing carbon dioxide emission at below 10,000 JPY/t-CO 2 (approximately 90 USD), there are also programs with very low cost-effectiveness at more than 100,000 JPY/t-CO 2 . Moreover, all of the evaluation was based on 'gross' reduction, not on 'net' of freeriders, rebound and other factors, which may lead to overestimation of performances. The result shows the need for a much larger resource for evaluation activities by the government. (author)

Growth Convergence and Spending Efficiency among Filipino Households

OpenAIRE

Erniel B. Barrios

2007-01-01

A growth model is used in the context of Sala-i-Martin’s definition of conditional convergence to assess the household income dynamics in segmented groups at the provincial level in the Philippines. There is a direct relationship between spending efficiency and income growth convergence across income groups. The lower income convergence rate among low income households can be attributed to their relatively less efficient access to the factors of production. The study provides tools in identif...

The ‘Alternative Quality Contract’ in Massachusetts, Based on Global Budgets, Lowered Medical Spending and Improved Quality

Science.gov (United States)

Song, Zirui; Safran, Dana Gelb; Landon, Bruce E.; Landrum, Mary Beth; He, Yulei; Mechanic, Robert E.; Day, Matthew P.; Chernew, Michael E.

2012-01-01

Seven provider organizations in Massachusetts entered the Blue Cross Blue Shield Alternative Quality Contract in 2009, followed by four more organizations in 2010. This contract, based on a global budget and pay-for-performance for achieving certain quality benchmarks, places providers at risk for excessive spending and rewards them for quality, similar to the new Pioneer Accountable Care Organizations in Medicare. We analyzed changes in spending and quality associated with the Alternative Quality Contract and found that the rate of increase in spending slowed compared to control groups. Overall, participation in the contract over two years led to a savings of 3.3% (1.9% in year-1, 3.3% in year-2) compared to spending in groups not participating in the contract. The savings were even higher for groups whose previous experience had been only in fee-for-service contracting. Such groups’ quarterly savings over two years averaged 8.2% (6.3% in year-1, 9.9% in year-2). Quality of care also improved within organizations participating in the Alternative Quality Contract compared to control organizations in both years. Chronic care management, adult preventive care, and pediatric care improved from year 1 to year 2 within the contracting groups. These results suggest that global budgets coupled with pay-for-performance can begin to slow the underlying growth in medical spending while improving quality. PMID:22786651

Consumption of food away from home in Bangladesh: Do rich households spend more?

Science.gov (United States)

Mottaleb, Khondoker A; Rahut, Dil Bahadur; Mishra, Ashok K

2017-12-01

While consumption of food away from home (FAFH) is an established phenomenon among households in the developed countries, FAFH is a growing phenomenon in many middle-income and rapidly growing developing countries. Although, studies are available on the factors affecting consumption of FAFH in developed countries, there is a paucity of such studies in developing countries. This study examines households' choice of and expenditures on FAFH. We used information from Bangladeshi households and applied a double-hurdle regression model estimation procedure. Findings show that, in general, rich households are spending proportionately less on FAFH and, over time, the trend is continuing. Although households with female members who work in the non-farm sector are more likely to consume FAFH, educated household heads and spouses, and particularly urban households are less likely to consume and spend on FAFH. As the problem of food adulteration by dishonest sellers is rampant in Bangladesh, perhaps it discourages rich, urban and households headed by educated heads and spouses to consume and spend more on FAFH. Based on the findings, some points of interventions are also prescribed in this study. Copyright © 2017 Elsevier Ltd. All rights reserved.

Robust Machine Learning Variable Importance Analyses of Medical Conditions for Health Care Spending.

Science.gov (United States)

Rose, Sherri

2018-03-11

To propose nonparametric double robust machine learning in variable importance analyses of medical conditions for health spending. 2011-2012 Truven MarketScan database. I evaluate how much more, on average, commercially insured enrollees with each of 26 of the most prevalent medical conditions cost per year after controlling for demographics and other medical conditions. This is accomplished within the nonparametric targeted learning framework, which incorporates ensemble machine learning. Previous literature studying the impact of medical conditions on health care spending has almost exclusively focused on parametric risk adjustment; thus, I compare my approach to parametric regression. My results demonstrate that multiple sclerosis, congestive heart failure, severe cancers, major depression and bipolar disorders, and chronic hepatitis are the most costly medical conditions on average per individual. These findings differed from those obtained using parametric regression. The literature may be underestimating the spending contributions of several medical conditions, which is a potentially critical oversight. If current methods are not capturing the true incremental effect of medical conditions, undesirable incentives related to care may remain. Further work is needed to directly study these issues in the context of federal formulas. © Health Research and Educational Trust.

Shopper marketing nutrition interventions: Social norms on grocery carts increase produce spending without increasing shopper budgets☆

Science.gov (United States)

Payne, Collin R.; Niculescu, Mihai; Just, David R.; Kelly, Michael P.

2015-01-01

Objectives We assessed the efficacy of an easy-to-implement shopper marketing nutrition intervention in a pilot and two additional studies to increase produce demand without decreasing store profitability or increasing shopper budgets. Methods We created grocery cart placards that detailed the number of produce items purchased (i.e., descriptive norm) at particular stores (i.e., provincial norm). The effect of these placards on produce spending was assessed across 971,706 individual person grocery store transactions aggregated by day. The pilot study designated a baseline period (in both control and intervention store) followed by installation of grocery cart placards (in the intervention store) for two weeks. The pilot study was conducted in Texas in 2012. In two additional stores, we designated baseline periods followed by 28 days of the same grocery cart placard intervention as in the pilot. Additional interventions were conducted in New Mexico in 2013. Results The pilot study resulted in a significant difference between average produce spending per day per person across treatment periods (i.e., intervention versus same time period in control) (16%) and the difference between average produce spending per day per person across stores in the control periods (4%); Furthermore, the same intervention in two additional stores resulted in significant produce spending increases of 12.4% and 7.5% per day per person respectively. In all stores, total spending did not change. Conclusions Descriptive and provincial social norm messages (i.e., on grocery cart placards) may be an overlooked tool to increase produce demand without decreasing store profitability and increasing shopper budgets. PMID:26844084

National Health Expenditure Projections, 2017-26: Despite Uncertainty, Fundamentals Primarily Drive Spending Growth.

Science.gov (United States)

Cuckler, Gigi A; Sisko, Andrea M; Poisal, John A; Keehan, Sean P; Smith, Sheila D; Madison, Andrew J; Wolfe, Christian J; Hardesty, James C

2018-03-01

Under current law, national health spending is projected to grow 5.5 percent annually on average in 2017-26 and to represent 19.7 percent of the economy in 2026. Projected national health spending and enrollment growth over the next decade is largely driven by fundamental economic and demographic factors: changes in projected income growth, increases in prices for medical goods and services, and enrollment shifts from private health insurance to Medicare that are related to the aging of the population. The recent enactment of tax legislation that eliminated the individual mandate is expected to result in only a small reduction to insurance coverage trends.

An unhealthy public-private tension: pharmacy ownership, prescribing, and spending in the Philippines.

Science.gov (United States)

James, Chris D; Peabody, John; Solon, Orville; Quimbo, Stella; Hanson, Kara

2009-01-01

Physicians' links with pharmacies may create perverse financial incentives to overprescribe, prescribe products with higher profit margins, and direct patients to their pharmacy. Interviews with pharmacy customers in the Philippines show that those who use pharmacies linked to public-sector physicians had 5.4 greater odds of having a prescription from such physicians and spent 49.3 percent more than customers using other pharmacies. For customers purchasing brand-name medicines, switching to generics would reduce drug spending by 58 percent. Controlling out-of-pocket spending on drugs requires policies to control financial links between doctors and pharmacies, as well as tighter regulation of nongeneric prescribing.

Influence of larval period on responses of overwintering green frog (Rana clamitans) larvae exposed to contaminated sediments

Energy Technology Data Exchange (ETDEWEB)

Snodgrass, J.W.; Hopkins, W.A.; Jackson, B.P.; Baionno, J.A.; Broughton, J. [Towson State University, Towson, MD (US). Dept. of Biological Science

2005-06-01

Pond-breeding amphibians exhibit large intra- and interspecific differences in the duration of the aquatic larval phase. In contaminated aquatic environments, a prolonged larval phase means prolonged exposure to pollutants and, potentially, more severe toxic effects. In the laboratory, we tested this hypothesis by exposing green frog larvae (Rana clamitans) to commercial clean sand (control), sediment from an abandoned surface mine (mine), or sediment contaminated with coal combustion waste (CCW). By collecting eggs late in the breeding season, we obligated larvae to overwinter and spend a protracted amount of time exposed to contaminated sediments. The experiment was continued until all larvae either successfully completed metamorphosis or died (301 d). Larvae exposed to mine sediments accumulated significant levels of Pb and Zn, whereas larvae exposed to CCW-contaminated sediment accumulated significant levels of As, Se, Sr, and V. Larvae exposed to mine sediments suffered sublethal effects in the form of reduced growth and size at metamorphosis, but the proportion of larvae successfully completing metamorphosis (93%) was the same for both control and mine treatments. In contrast, larvae exposed to CCW-contaminated sediment suffered greatly reduced survival (13%) compared to both control and mine treatments. Moreover, among larvae in the CCW treatment, the majority of mortality occurred during the latter part the overwintering period (after day 205), corresponding to the onset of metamorphosis in the controls. Our results suggest that the length of the larval period may be one of many life-history or ecological characteristics that influence the sensitivity of aquatic breeding amphibians to environmental pollutants.

The effect of public health spending on under-five mortality rate in ...

African Journals Online (AJOL)

The effect of public health spending on under-five mortality rate in Uganda. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... rate, Neonatal mortality rate, Public health expenditure, Sustainable Development Goals and Health status ...

Proposed Social Spending Innovation Research (SSIR) Program: Harnessing American Entrepreneurial Talent to Solve Major U.S. Social Problems

Science.gov (United States)

Coalition for Evidence-Based Policy, 2015

2015-01-01

The Social Spending Innovation Research (SSIR) proposal seeks to replicate, in social spending, the great success of the Small Business Innovation Research (SBIR) program in technology development. The SBIR program funds technology development by entrepreneurial small companies. The program has spawned breakthrough technologies in diverse areas…

CONTRACT SYSTEM AS A WAY TO ENHANCE THE EFFICIENCY OF BUDGET SPENDING IN THE ULYANOVSK REGION

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Elmira Rustamovna Burnasheva

2014-11-01

Full Text Available The article investigates the mechanism of implementation of public procurement at the present stage, which is one of the main instruments of state policy of regulation of social and economic development of the country. Described the main stages of the implementation of the procurement of goods, works and services for state and municipal needs, and highlighted the main objectives of inculcation new approaches to the organization of the procurement process in the Russian Federation.The aim of the study was to examine what impact the implementation of the contract system on the effectiveness of budget spending using the health sector in the Ulyanovsk region as an example. In all, the study analyzed the changes in the legislation governing the contract system, identified improvements that should contribute to budget savings and also determined the amount of savings of the budget of the Ulyanovsk region in health care sector on the basis of the procedures performed on the procurement of goods, work and services for state and municipal needs.

Review of "Spend Smart: Fix Our Broken School Funding System"

Science.gov (United States)

Baker, Bruce

2011-01-01

ConnCAN's Spend Smart: "Fix Our Broken School Funding System" was released concurrently with a bill introduced in the Connecticut legislature, based on the principles outlined in the report. However, the report is of negligible value to the policy debate over Connecticut school finance because it provides little or no support for any of…

The associations between US state and local social spending, income inequality, and individual all-cause and cause-specific mortality: The National Longitudinal Mortality Study.

Science.gov (United States)

Kim, Daniel

2016-03-01

To investigate government state and local spending on public goods and income inequality as predictors of the risks of dying. Data on 431,637 adults aged 30-74 and 375,354 adults aged 20-44 in the 48 contiguous US states were used from the National Longitudinal Mortality Study to estimate the impacts of state and local spending and income inequality on individual risks of all-cause and cause-specific mortality for leading causes of death in younger and middle-aged adults and older adults. To reduce bias, models incorporated state fixed effects and instrumental variables. Each additional $250 per capita per year spent on welfare predicted a 3-percentage point (-0.031, 95% CI: -0.059, -0.0027) lower probability of dying from any cause. Each additional $250 per capita spent on welfare and education predicted 1.6-percentage point (-0.016, 95% CI: -0.031, -0.0011) and 0.8-percentage point (-0.008, 95% CI: -0.0156, -0.00024) lower probabilities of dying from coronary heart disease (CHD), respectively. No associations were found for colon cancer or chronic obstructive pulmonary disease; for diabetes, external injury, and suicide, estimates were inverse but modest in magnitude. A 0.1 higher Gini coefficient (higher income inequality) predicted 1-percentage point (0.010, 95% CI: 0.0026, 0.0180) and 0.2-percentage point (0.002, 95% CI: 0.001, 0.002) higher probabilities of dying from CHD and suicide, respectively. Empirical linkages were identified between state-level spending on welfare and education and lower individual risks of dying, particularly from CHD and all causes combined. State-level income inequality predicted higher risks of dying from CHD and suicide. Copyright © 2015 The Author. Published by Elsevier Inc. All rights reserved.

Federal Spending for Means Tested Programs, 2007 to 2027

Science.gov (United States)

2017-02-01

child tax credits (which are refundable), the Supplemental Nutrition Assistance Program (SNAP), and Supplemental Security Income. The largest non...child tax credits, and SNAP—have been or will be significantly affected by program changes that unfold over time: B Medicaid spending rose by 35...total outlays in the Part D program). Increases in the number of beneficiaries account for about one- third of that growth; the introduction of new

Judging Money: When Courts Decide How to Spend Taxpayer Dollars

Science.gov (United States)

Dunn, Josh; Derthick, Martha

2007-01-01

Since the 1970s, proponents of greater spending in disadvantaged school districts have pursued their goal through litigation in state courts. They have brought suits in 45 of the 50 states. These suits began with claims of equity, which sought to redistribute revenues from rich to poor districts. Disappointed with the results, within a decade the…

[Comparison of physical activity and favourite ways of spending free time in preschool girls and boys from the Mazowsze region].

Science.gov (United States)

Merkiel, Sylwia; Chalcarz, Wojciech; Deptuła, Monika

2011-01-01

The aim of this study was to compare physical activity of preschool girls and boys from the Mazowsze region and their favourite ways of spending free time. The studied population included 131 children aged 3 to 7 years. Parents filled in questionnaires about their children's physical activity and favourite ways of spending free time, as well as about general information on the children and their families. Gender had statistically significant influence on the children's birth weight, attending karate outside the preschool and on riding a bicycle, playing with a ball and playing with a dog as favourite ways of spending free time during sunny weather as well as playing on a computer and playing with dolls as favourite ways of spending free time during rainy weather. Gender had little influence on the studied preschoolers' physical activity. However favourite ways of spending free time turned out to be significantly different according to gender. Physical activity level in both girls and boys was low, similarly to their peers from the previous studies.

26 CFR 1.148-7 - Spending exceptions to the rebate requirement.

Science.gov (United States)

2010-04-01

... issue to be a refunding issue. (4) De minimis rule. Any failure to satisfy the final spending... to land, such as buildings or other inherently permanent structures, including interests in real.... Except as otherwise provided, construction expenditures means capital expenditures (as defined in § 1.150...

Impact of defense spending on unemployment in five countries from Asia

Directory of Open Access Journals (Sweden)

Abdul Qayyum Khan

2015-11-01

Full Text Available The objective of this study is to examine empirically the impact of defense spending on unemployment along with a number of control variables for a set of five selected countries from Asia which include Cambodia, China, Malaysia, Pakistan, and the Philippines. For empirical investigation annual data over the period of 1992 to 2013 are used. While, prior to regression analysis, the data were sensibly checked using sundry of relevant tests. The empirical results reveal that defense spending is not a better option to overcome unemployment problem in most of the sample countries. Thus, the findings suggest that lower defense budget allocation will provide more resources for other sectors which are relatively more productive and can help to improve economic and social welfare of these selected countries from Asia. Besides decreased military expenditures, encouraging domestic investment and discouraging population growth can help reduce unemployment. Remittance appears to have a positive relation with unemployment, the implications of which need to be addressed by policymakers

Follow the Money: School Spending from Title I to Adult Earnings

Directory of Open Access Journals (Sweden)

Rucker C. Johnson

2015-12-01

Full Text Available Title I funding has been the largest federal program of K–12 education for the past fifty years, the objective being to eliminate the educational disadvantage associated with poverty. I provide new evidence on the long-term effects of school spending from Title I on children's educational and adult economic outcomes. To study effects of Title I, I link school district spending and administrative data on Title I funding to nationally representative data on children born between 1950 and 1977 and followed through 2011. Models include controls for birth cohort and school district fixed effects, childhood family–neighborhood characteristics, and other policies. I find that increases in Title I funding are significantly related to increases in educational attainment, high school graduation rates, higher earnings and work hours, reductions in grade repetition, school suspension or expulsion, incarceration, and reductions in the annual incidence of poverty in adulthood; effects on educational outcomes are more pronounced for poor children.

The centralization of territorial governance of active labor market policies in Spain during the Great Recession (2011-2016

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Jorge José Hernández-Moreno

2017-11-01

Full Text Available Spain is among the West European countries that has achieved higher levels of decentralization in its Welfare State. The 1990s and 2000s witnessed an acceleration of this process, which has been accompanied by an expansion of social spending at the subnational level, especially by the Autonomous Communities (Autonomous Communities. This article aims to contribute to several debates regarding changes in the territorial dimension of governance in social policies and their explanatory factors. Specifically, it focuses on active labor market policies (ALMPs and addresses the question of whether the reforms introduced in the field of activation in the context of the economic crisis have affected the exercise of political, financial and administrative authority by the different levels of government.

An Explanation of Nakamoto's Analysis of Double-spend Attacks

OpenAIRE

Ozisik, A. Pinar; Levine, Brian Neil

2017-01-01

The fundamental attack against blockchain systems is the double-spend attack. In this tutorial, we provide a very detailed explanation of just one section of Satoshi Nakamoto's original paper where the attack's probability of success is stated. We show the derivation of the mathematics relied upon by Nakamoto to create a model of the attack. We also validate the model with a Monte Carlo simulation, and we determine which model component is not perfect.

Local Medicaid home- and community-based services spending and nursing home admissions of younger adults.

Science.gov (United States)

Thomas, Kali S; Keohane, Laura; Mor, Vincent

2014-11-01

We used fixed-effect models to examine the relationship between local spending on home- and community-based services (HCBSs) for cash-assisted Medicaid-only disabled (CAMOD) adults and younger adult admissions to nursing homes in the United States during 2001 through 2008, with control for facility and market characteristics and secular trends. We found that increased CAMOD Medicaid HCBS spending at the local level is associated with decreased admissions of younger adults to nursing homes. Our findings suggest that states' efforts to expand HCBS for this population should continue.

Mapping at-risk-of-poverty rates, household employment, and social spending

NARCIS (Netherlands)

Vandenbroucke, F.; Diris, R.; Cantillon, B.; Vandenbroucke, F.

2014-01-01

As a first step stylized facts are presented concerning at-risk-of-poverty rates for the non-elderly population, household employment (a concept introduced in this chapter) and social spending in European welfare states. The chapter provides a first exploration of a central theme of the book, which

Defensive spending on tap water substitutes: the value of reducing perceived health risks.

Science.gov (United States)

Dupont, Diane P; Jahan, Nowshin

2012-03-01

We examine factors that explain consumer spending on tap water substitutes using information from a national survey undertaken with a representative set of Canadian respondents. We develop a model to predict the percentage of households that undertake such spending for the purpose of reducing perceived health risks from tap water consumption. Using results from the model we estimate the magnitude of defensive expenditures to be over half a billion dollars (2010 US$) per year for Canada, as a whole. This is equivalent to approximately $48 per household per year or about $19 per person per year. Residents of Ontario, the province in which an Escherichia coli incident took place in 2000, have the highest willingness-to-pay of approximately $60 per household per year.

The Impact of Perceived Advertising Spending and Price Promotion on Brand Equity:A Case of ABC Brand

OpenAIRE

Nurcahya, Kevin Edward

2014-01-01

Intense competition in Indonesian beverage industry lead many corporations to spend trillion rupiah on marketing communication, such as advertising and price promotion with the hope of increasing brand equity. However, the question is whether promotional activities in this industry amplify or attenuate the brand equity of a product. Therefore, this paper aims to model the impact of perceived advertising spending and price promotion on brand equity, measured through consumer perceptions, spec...

An analysis of government immunization program expenditures in lower and lower middle income countries 2006-12.

Science.gov (United States)

Nader, Alice Abou; de Quadros, Ciro; Politi, Claudio; McQuestion, Michael

2015-04-01

Financing is becoming increasingly important as the cost of immunizing the world's children continues to rise. By 2015, that cost will likely exceed US$60 per infant as new vaccines are introduced into national immunization programs. In 2006, 51 lower and lower middle income countries reported spending a mean US$12 per surviving infant on routine immunization. By 2012, the figure had risen to $20, a 67% increase. This study tests the hypothesis that lower and lower middle income countries will spend more on their routine immunization programs as their economies grow. A panel data regression approach is used. Expenditures reported by governments annually (2006-12) through the World Health Organization/UNICEF Joint Reporting Form are regressed on lagged annual per capita gross national income (GNI), controlling for prevailing mortality levels, immunization program performance, corruption control efforts, geographical region and correct reporting. Results show the expenditures increased with GNI. Expressed as an elasticity, the countries spent approximately $6.32 on immunization for every $100 in GNI increase from 2006 to 2012. Projecting forward and assuming continued annual GNI growth rates of 10.65%, countries could be spending $60 per infant by 2020 if national investment functions increase 4-fold. Given the political will, this result implies countries could fully finance their routine immunization programs without cutting funding for other programs. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

How Newspaper Advertising Sales Managers Spend Their Time: A Pilot Study.

Science.gov (United States)

Hudson, Jerry C.; Saathoff, Roger C.

A pilot study examined how newspaper advertising sales managers in five southwestern states spend their time during a typical work day. Of the 360 questionnaires mailed, 176 responses were received. The largest number of responses (93) came from retail sales managers of newspapers in markets with less than 50,000 population. The questionnaire…

Approaches based on behavioral economics could help nudge patients and providers toward lower health spending growth.

Science.gov (United States)

King, Dominic; Greaves, Felix; Vlaev, Ivo; Darzi, Ara

2013-04-01

Policies that change the environment or context in which decisions are made and "nudge" people toward particular choices have been relatively ignored in health care. This article examines the role that approaches based on behavioral economics could play in "nudging" providers and patients in ways that could slow health care spending growth. The basic insight of behavioral economics is that behavior is guided by the very fallible human brain and greatly influenced by the environment or context in which choices are made. In policy arenas such as pensions and personal savings, approaches based on behavioral economics have provided notable results. In health care, such approaches have been used successfully but in limited ways, as in the use of surgical checklists that have increased patient safety and reduced costs. With health care spending climbing at unsustainable rates, we review the role that approaches based on behavioral economics could play in offering policy makers a potential set of new tools to slow spending growth.

Socio-demographic and behavioural determinants of visitor spending at the Kruger National Park in South Africa

Directory of Open Access Journals (Sweden)

Andrea Saayman

2011-04-01

Full Text Available The Kruger National Park is one of the most visited national parks in the world and one of South Africa’s prime tourism destinations.  It attracts more than 1 million visitors per year and, as such, plays an important role in the regional and national economy.   The article aims to assess the extent to which socio-demographic and behavioural indicators influence the spending of tourists to the Park.  From 2001-2007 surveys have been conducted amongst tourists to the Park including a number of socio-demographic, behavioural and motivational questions, totalling 2 904 questionnaires used in the analysis.  The methodology includes both cross-sectional regression analysis and pseudo-panel data analysis to identify and compare possible influences on spending.  Findings indicate that, even though a combination of socio-demographic, behavioural and motivational factors influence spending at National Parks, behavioural indicators seem to be the most important and consistent influencer.

Patient risk taking and spending habits correlate with willingness to pay for novel total joint arthroplasty implants

Directory of Open Access Journals (Sweden)

Ran Schwarzkopf, MD, MSc

2015-03-01

Full Text Available In this study, we compare patients' risk-taking and spending behaviors to their willingness to pay (WTP for novel implants in a joint arthroplasty. 210 patients were surveyed regarding risk-taking and spending behavior, and WTP for novel implants with either increased-longevity, increased-longevity with higher risk of complications, or decreased risk of complications compared to a standard implant. Patients with increased recreational risk-taking behavior were more WTP for increased-longevity. Patients who “rarely“ take health-risks were more WTP for decreased risk of complications. Patients with higher combined risk scores were more WTP for all novel implants. Patients who paid more than $50,000 for their current car were more WTP for decreased complications. This study shows that patients' risk taking and spending behavior influences their WTP for novel implants.

The Consequences of IMF Conditionality for Government Expenditure on Health

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Nisreen Moosa

2018-01-01

Full Text Available The International Monetary Fund (IMF was established in 1944 to supervise the international monetary system that collapsed in 1971. Since then, the Fund has reinvented itself as some sort of a “development agency,” providing loans with strings attached. Any country that wishes to obtain loans must follow the IMF-prescribed policies that reflect the neoliberal ideas of the Washington Consensus. As these policies are typically contractionary and involve austerity, the IMF has been accused of pursuing policies that exhibit a negative impact on health expenditure, with dire consequences for the population. Although the empirical evidence on this issue is mixed, it is well known that the IMF operations are more likely to exert a negative effect than a positive effect on government spending on health.

The Use of Ict 'S and the Contribution of Digital Cities as Ways to Estimulate Governance

Directory of Open Access Journals (Sweden)

Claudia Cecilia Camacho Rojas

2015-12-01

governance concepts by comparing them with each other. Then, briefly reflecting on the theme, it will be exposed some contributions of the internet, as an ICT, for the development of governance, to finally investigate if the creation of digital cities can potentially contribute to the exercise of governance. The chosen methodology is the inductive method, conducted through the collection of bibliographic data and of data from other academic research.

Associations Between County Wealth, Health and Social Services Spending, and Health Outcomes.

Science.gov (United States)

McCullough, J Mac; Leider, Jonathon P

2017-11-01

Each year, the County Health Rankings rate the health outcomes of each county in the U.S. A common refrain is that poor counties perform worse than wealthier ones. This article examines that assumption and specifically analyzes characteristics of counties that have performed better in terms of health outcomes than their wealth alone would suggest. Data from the 2013 County Health Rankings were used, as were 2012 financial and demographic information collected by the U.S. Census Bureau. A logistic model was constructed to examine the odds of a county "overperforming" in the rankings relative to community wealth. Analyses were performed in 2016. Communities that were wealthier performed better on the rankings. However, more than 800 of 3,141 counties overperformed by ranking in a better health outcomes quartile than their county's wealth alone would suggest. Regression analyses found that for each additional percentage point of total public spending that was allocated toward community health care and public health, the odds of being an overperformer increased by 3.7%. Community wealth correlates with health, but not always. Population health outcomes in hundreds of counties overperform what would be expected given community wealth alone. These counties tend to invest more in community health care and public health spending and other social services. Although the level of a community's wealth is outside the control of practitioners, shifting the proportion of spending to certain social services may positively impact population health. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Establishing a Baseline: Community Benefit Spending by Not-for-Profit Hospitals Prior to Implementation of the Affordable Care Act.

Science.gov (United States)

Leider, Jonathon P; Tung, Greg J; Lindrooth, Richard C; Johnson, Emily K; Hardy, Rose; Castrucci, Brian C

Community Benefit spending by not-for-profit hospitals has served as a critical, formalized part of the nation's safety net for almost 50 years. This has occurred mostly through charity care. This article examines how not-for-profit hospitals spent Community Benefit dollars prior to full implementation of the Affordable Care Act (ACA). Using data from 2009 to 2012 hospital tax and other governmental filings, we constructed national, hospital-referral-region, and facility-level estimates of Community Benefit spending. Data were collected in 2015 and analyzed in 2015 and 2016. Data were matched at the facility level for a non-profit hospital's IRS tax filings (Form 990, Schedule H) and CMS Hospital Cost Report Information System and Provider of Service data sets. During 2009, hospitals spent about 8% of total operating expenses on Community Benefit. This increased to between 8.3% and 8.5% in 2012. The majority of spending (>80%) went toward charity care, unreimbursed Medicaid, and subsidized health services, with approximately 6% going toward both community health improvement and health professionals' education. By 2012, national spending on Community Benefit likely exceeded $60 billion. The largest hospital systems spent the vast majority of the nation's Community Benefit; the top 25% of systems spent more than 80 cents of every Community Benefit dollar. Community Benefit spending has remained relatively steady as a proportion of total operating expenses and so has increased over time-although charity care remains the major focus of Community Benefit spending overall. More than $60 billion was spent on Community Benefit prior to implementation of the ACA. New reporting and spending requirements from the IRS, alongside changes by the ACA, are changing incentives for hospitals in how they spend Community Benefit dollars. In the short term, and especially the long term, hospital systems would do well to partner with public health, other social services, and even

'Good Governance' dan 'Governability'

Directory of Open Access Journals (Sweden)

- Pratikno

2005-03-01

Full Text Available The article endeavors to trace the outset of governance concept, its dominant meanings and discourse, and its implication towards governability. The central role of government in the governing processes has predominantly been adopted. The concept of governance was emerged precisely in the context of the failure of government as key player in regulation, economic redistribution and political participation. Governance is therefore aimed to emphasize pattern of governing which are based both on democratic mechanism and sound development management. However, practices of such good governance concept –which are mainly adopted and promoted by donor states and agencies– tend to degrade state and/or government authority and legitimacy. Traditional function of the state as sole facilitator of equal societal, political and legal membership among citizens has been diminished. The logic of fair competition has been substituted almost completely by the logic of free competition in nearly all sectors of public life. The concept and practices of good governance have resulted in decayed state authority and failed state which in turn created a condition for "ungovernability". By promoting democratic and humane governance, the article accordingly encourages discourse to reinstall and bring the idea of accountable state back in.

Spending Time: The Impact of Hours Worked on Work-Family Conflict

Science.gov (United States)

Adkins, Cheryl L.; Premeaux, Sonya F.

2012-01-01

Scholars have long assumed that as workers spend more time at work fewer hours are available for their non-work lives leading to negative effects in both domains, and most studies examining the impact of work hours on work and life domains have supported this viewpoint. However, the majority of these studies have used one-dimensional measures of…

Development Center for Digital Government Cooperation Patterns of Small Medium Enterprises-Private to the Acceleration of Economic Increase in Tourist Areas

OpenAIRE

Suyono, Joko; Sudapet, Nyoman

2017-01-01

The infrastructure budget reached Rp 290 Billion in APBN-P (Budget spending Revenue State changes) in 2015 be consist of opportunities for investors and Government Areas, this will be trigger an increase in the central area of UKM. 2014 year Indonesia stock exchange noted the value of market capitalization (market cap) to the property sector, real estate, and construction of the building reached Rp 360 Billion (idx, 2014). Bank Indonesia survey showed a significant increase in the selling pri...

PROVIDING MORALE, WELFARE, AND RECREATION FUNDS AS INCENTIVES TO SAVE - ENDING THE END OF YEAR SPENDING FRENZY

Science.gov (United States)

2015-10-25

budget law as it applies to the Air Force. The issue of wasteful year end spending is rooted in the very laws originally passed to reduce abuses of...statutes, each layered upon the prior one… [t]his incremental growth has created something of a legal nettle .”21 7 One-year Incremental Budget...attitudes toward spending versus saving. 29 CONCLUSION In order to reach its conclusion, this research paper began by examining the roots of the

Income inequities in end-of-life health care spending in British Columbia, Canada: A cross-sectional analysis, 2004-2006

Directory of Open Access Journals (Sweden)

Hanley Gillian E

2011-03-01

Full Text Available Abstract Background This study aimed to measure the income-related inequalities and inequities - the inequalities that remain after accounting for differences in health need - in expenditure on fully publicly covered (hospital and ambulatory and partially publicly covered (prescription drugs services for those in their last year of life in the province of British Columbia (B.C., Canada. We focused on a decedent population for three reasons: to minimize unmeasured need differences among our cohort and therefore isolate income effects; to explore inequities for a high-spending window of health care use; and, because previous studies have found conflicting relationships between income and decedent health care spending, to further quantify this relationship. Methods We used linked administrative databases to describe spending on health services by income for all 58,820 deaths of B.C. residents 65 and older from 2004 to 2006. Regression analyses examined the association between income and health care spending, adjusting for age, sex, health status, cause of death, and other relevant factors. We then used concentration indexes to measure both inequalities and inequities separately for three key types of services. Analyses were also run separately for men and women. Results On average, per capita expenditure on acute health care in the last year of life was $20,705 (CDN2006. In need-adjusted regression analyses, we found decedents in the highest income quintile had 11% lower hospital expenditures, 15% higher specialist expenditures and 23% higher prescription drug expenditures than decedents in the lowest income quintile. Concentration index analysis suggested that spending for all types of care was concentrated among those with higher income before adjusting for need. Need-adjusted equity results mirrored regression findings and suggested patterns of inequities that were more pronounced among male decedents than females. Conclusions Despite the

Medicare Advantage Members' Expected Out-Of-Pocket Spending For Inpatient And Skilled Nursing Facility Services.

Science.gov (United States)

Keohane, Laura M; Grebla, Regina C; Mor, Vincent; Trivedi, Amal N

2015-06-01

Inpatient and skilled nursing facility (SNF) cost sharing in Medicare Advantage (MA) plans may reduce unnecessary use of these services. However, large out-of-pocket expenses potentially limit access to care and encourage beneficiaries at high risk of needing inpatient and postacute care to avoid or leave MA plans. In 2011 new federal regulations restricted inpatient and skilled nursing facility cost sharing and mandated limits on out-of-pocket spending in MA plans. After these regulations, MA members in plans with low premiums averaged $1,758 in expected out-of-pocket spending for an episode of seven hospital days and twenty skilled nursing facility days. Among members with the same low-premium plan in 2010 and 2011, 36 percent of members belonged to plans that added an out-of-pocket spending limit in 2011. However, these members also had a $293 increase in average cost sharing for an inpatient and skilled nursing facility episode, possibly to offset plans' expenses in financing out-of-pocket limits. Some MA beneficiaries may still have difficulty affording acute and postacute care despite greater regulation of cost sharing. Project HOPE—The People-to-People Health Foundation, Inc.

Medicare Advantage Members’ Expected Out-Of-Pocket Spending For Inpatient And Skilled Nursing Facility Services

Science.gov (United States)

Keohane, Laura M.; Grebla, Regina C.; Mor, Vincent; Trivedi, Amal N.

2015-01-01

Inpatient and skilled nursing facility (SNF) cost sharing in Medicare Advantage (MA) plans may reduce unnecessary use of these services. However, large out-of-pocket expenses potentially limit access to care and encourage beneficiaries at high risk of needing inpatient and postacute care to avoid or leave MA plans. In 2011 new federal regulations restricted inpatient and skilled nursing facility cost sharing and mandated limits on out-of-pocket spending in MA plans. After these regulations, MA members in plans with low premiums averaged $1,758 in expected out-of-pocket spending for an episode of seven hospital days and twenty skilled nursing facility days. Among members with the same low-premium plan in 2010 and 2011, 36 percent of members belonged to plans that added an out-of-pocket spending limit in 2011. However, these members also had a $293 increase in average cost sharing for an inpatient and skilled nursing facility episode, possibly to offset plans’ expenses in financing out-of-pocket limits. Some MA beneficiaries may still have difficulty affording acute and postacute care despite greater regulation of cost sharing. PMID:26056208

Michigan's fee-for-value physician incentive program reduces spending and improves quality in primary care.

Science.gov (United States)

Lemak, Christy Harris; Nahra, Tammie A; Cohen, Genna R; Erb, Natalie D; Paustian, Michael L; Share, David; Hirth, Richard A

2015-04-01

As policy makers and others seek to reduce health care cost growth while improving health care quality, one approach gaining momentum is fee-for-value reimbursement. This payment strategy maintains the traditional fee-for-service arrangement but includes quality and spending incentives. We examined Blue Cross Blue Shield of Michigan's Physician Group Incentive Program, which uses a fee-for-value approach focused on primary care physicians. We analyzed the program's impact on quality and spending from 2008 to 2011 for over three million beneficiaries in over 11,000 physician practices. Participation in the incentive program was associated with approximately 1.1 percent lower total spending for adults (5.1 percent lower for children) and the same or improved performance on eleven of fourteen quality measures over time. Our findings contribute to the growing body of evidence about the potential effectiveness of models that align payment with cost and quality performance, and they demonstrate that it is possible to transform reimbursement within a fee-for-service framework to encourage and incentivize physicians to provide high-quality care, while also reducing costs. Project HOPE—The People-to-People Health Foundation, Inc.

Economic Growth and Defense Spending in Greece, Turkey and Cyprus: Evidence from Cointegrated Panel Analysis

Directory of Open Access Journals (Sweden)

Stylianou Tasos

2012-06-01

Full Text Available This paper investigates the nexus between economic growth and defense spending for three adjacent countries, namely Greece, Turkey and Cyprus. Greece and Cyprus, members-countries of European Union spend much more money than other member countries of EU relatively to their GDP. Turkey is in accession negotiations with EU and is among the top 15 countries with the highest military expenditure. These three countries are particularly interesting case studies because of their high military burdens and the bad relations between them (Greece and Cyprus opposite Turkey. The empirical analysis is based on panel data analysis of data over the period 1960 – 2006.

Budgetary and Economic Outcomes Under Paths for Federal Revenues and Noninterest Spending Specified by Chairman Price, March 2016

Science.gov (United States)

2016-03-01

Budgetary and Economic Outcomes Under Paths for Federal Revenues and Noninterest Spending Specified by Chairman Price , March 2016 March 2016CONGRESS... Price and His Staff 1 The Extended Baseline and Three Illustrative Paths 1 How CBO Analyzed the Effects of the Budgetary Paths 3 What Would Outcomes...Be Under Current Law? 4 What Paths for Federal Revenues and Noninterest Spending Did Chairman Price Specify? 6 What Would Budgetary and Economic

Trying Harder and Doing Worse : How Grocery Shoppers Track In-Store Spending

NARCIS (Netherlands)

van Ittersum, Koert; Pennings, Joost M. E.; Wansink, Brian

Although almost one in three U.S. households shops on a budget, it remains unclear whether and how shoppers track their in-store spending to stay within those budgets. A field study and two laboratory studies offer four key generalizations about budget shoppers in grocery stores: (1) They

Trying Harder and Doing Worse: How Grocery Shoppers Track In-Store Spending

NARCIS (Netherlands)

Ittersum, van K.; Pennings, J.M.E.; Wansink, B.

2010-01-01

Although almost one in three U.S. households shops on a budget, it remains unclear whether and how shoppers track their in-store spending to stay within those budgets. A field study and two laboratory studies offer four key generalizations about budget shoppers in grocery stores: (1) They

The refugee crisis in Lebanon and Jordan: the need for economic development spending

Directory of Open Access Journals (Sweden)

Omar Dahi

2014-09-01

Full Text Available The most effective way to tackle the Syrian refugee crisis is for neighbouring states to assume a leading role in development spending, infrastructure upgrading and job creation, particularly in the most underdeveloped regions of those countries.

The slowdown in health care spending in 2009-11 reflected factors other than the weak economy and thus may persist.

Science.gov (United States)

Ryu, Alexander J; Gibson, Teresa B; McKellar, M Richard; Chernew, Michael E

2013-05-01

During and immediately after the recent recession, national health expenditures grew exceptionally slowly. During 2009-11 per capita national health spending grew about 3 percent annually, compared to an average of 5.9 percent annually during the previous ten years. Policy experts disagree about whether the slower health spending growth was temporary or represented a long-term shift. This study examined two factors that might account for the slowdown: job loss and benefit changes that shifted more costs to insured people. Based on an examination of data covering more than ten million enrollees with health care coverage from large firms in 2007-11, we found that these enrollees' out-of-pocket costs increased as the benefit design of their employer-provided coverage became less generous in this period. We conclude that such benefit design changes accounted for about one-fifth of the observed decrease in the rate of growth. However, we also observed a slowdown in spending growth even when we held benefit generosity constant, which suggests that other factors, such as a reduction in the rate of introduction of new technology, were also at work. Our findings suggest cautious optimism that the slowdown in the growth of health spending may persist--a change that, if borne out, could have a major impact on US health spending projections and fiscal challenges facing the country.

Unveiling the relationship between the transaction timing, spending and dropout behavior of customers

NARCIS (Netherlands)

Glady, N.; Lemmens, A.; Croux, C.

The customer lifetime value combines into one construct the transaction timing, spending and dropout processes that characterize the purchase behavior of customers. Recently, the potential relationship between these processes, either at the individual customer level (i.e. intra-customer correlation)

THE EFFECT OF TAX PREFERENCES ON HEALTH SPENDING

Science.gov (United States)

Cogan, John F.; Hubbard, R. Glenn; Kessler, Daniel P.

2011-01-01

In this paper, we estimate the effect of the tax preference for health insurance on health care spending using data from the Medical Expenditure Panel Surveys from 1996–2005. We use the fact that Social Security taxes are only levied on earnings below a statutory threshold to identify the impact of the tax preference. Because employer-sponsored health insurance premiums are excluded from Social Security payroll taxes, workers who earn just below the Social Security tax threshold receive a larger tax preference for health insurance than workers who earn just above it. We find a significant effect of the tax preference, consistent with previous research. PMID:22500056

Defense Spending Databases for Countries in the Asia-Pacific Region: An Analysis and Comparison

National Research Council Canada - National Science Library

Reuning, Charles

2001-01-01

The purpose of this research was to identify and analyze a select number of unclassified databases that cover defense spending and other defense related criteria for countries in the Asia-Pacific region...

Disneyland Dads, Disneyland Moms? How Nonresident Parents Spend Time with Absent Children.

Science.gov (United States)

Stewart, Susan D.

1999-01-01

Examines gender differences in how nonresident parents spend time with their absent children. Results suggest that nonresident mothers and fathers exhibit a similar pattern of participation in activities with their absent children. Most nonresident parents either engage in only leisure activities with their children or have no contact. (Author/MKA)

Spending Natural Resource Revenues in an Altruistic Growth Model

DEFF Research Database (Denmark)

Frederiksen, Elisabeth Hermann

This paper examines how revenues from a natural resource interact with growth and welfare in an overlapping generations model with altruism. The revenues are allocated between public productive services and direct transfers to members of society by spending policies. We analyze how these policies...... influence the dynamics, and how the dynamics are influenced by the abundance of the revenue. Abundant revenues may harm growth, but growth and welfare can be oppositely affected. We also provide the socially optimal policy. Overall, the analysis suggests that variation in the strength of altruism...

"We want the world and we want it now": Materialism, time perspectives and problem spending tendency of Chinese

OpenAIRE

Ku, L.; Wu, Anise M. S.; Lao, Angie K. P.; Lam, Kerwin I. N.

2016-01-01

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. Chinese consumers' spending has been expanding rapidly in the past decade, and along with it household and credit card debt. The present research collected evidenced to triangulate the contention that materialism is positively related with Chinese's problem spending tendency (PST), and that present- and future-time perspectives interact systema...

Looking for a road to get out of poverty. Is the current allocation of public spending on education in Colombia helping?

Directory of Open Access Journals (Sweden)

Blanca Cecilia Zuluaga Díaz

2004-01-01

Full Text Available This paper presents a methodology to explore the impact on poverty of the public spending on education. The methodology consists of two approaches: Benefit Incidence Analysis (BIA and behavioral approach. BIA considers the cost and use of the educational service, and the distribution of the benefits among groups of income. Regarding the behavioral approach, we use a Probit model of schooling attendance, in order to determine the influence of public spending on the probability for the poor to attend the school. As a complement, a measurement of targeting errors in the allocation of public spending is included in the methodology.

Health Care Spending in the United States and Other High-Income Countries.

Science.gov (United States)

Papanicolas, Irene; Woskie, Liana R; Jha, Ashish K

2018-03-13

Health care spending in the United States is a major concern and is higher than in other high-income countries, but there is little evidence that efforts to reform US health care delivery have had a meaningful influence on controlling health care spending and costs. To compare potential drivers of spending, such as structural capacity and utilization, in the United States with those of 10 of the highest-income countries (United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland, and Denmark) to gain insight into what the United States can learn from these nations. Analysis of data primarily from 2013-2016 from key international organizations including the Organisation for Economic Co-operation and Development (OECD), comparing underlying differences in structural features, types of health care and social spending, and performance between the United States and 10 high-income countries. When data were not available for a given country or more accurate country-level estimates were available from sources other than the OECD, country-specific data sources were used. In 2016, the US spent 17.8% of its gross domestic product on health care, and spending in the other countries ranged from 9.6% (Australia) to 12.4% (Switzerland). The proportion of the population with health insurance was 90% in the US, lower than the other countries (range, 99%-100%), and the US had the highest proportion of private health insurance (55.3%). For some determinants of health such as smoking, the US ranked second lowest of the countries (11.4% of the US population ≥15 years smokes daily; mean of all 11 countries, 16.6%), but the US had the highest percentage of adults who were overweight or obese at 70.1% (range for other countries, 23.8%-63.4%; mean of all 11 countries, 55.6%). Life expectancy in the US was the lowest of the 11 countries at 78.8 years (range for other countries, 80.7-83.9 years; mean of all 11 countries, 81.7 years), and infant

DECENTRALIZATION, FISCAL CAPABILITY AND PUBLIC SPENDING EFFICIENCY

Directory of Open Access Journals (Sweden)

Abdul Hakim

2012-01-01

Full Text Available Assigning autonomy to regency governments in Indonesia has failed to increase regency’s economies.While it increases regency government role in planning and initiating policies, its impact oneconomic development has been insignificant. This stems from the lack of institution’s capacity inorganizing the bulk funds transfer from the central government which leads to inefficiency in resourceallocation. This paper maps these regencies based on their fiscal dependency. This paperalso applies Data Envelopment Analysis to identify the efficient and non efficient regencies in sucha way that the non efficient regencies might use the efficient ones as the benchmark to increase theirefficiency.Keywords: Autonomy, regency government, efficiencyJEL classification numbers: H21, H53, H71, H72

Increasing Public Expenditure

Directory of Open Access Journals (Sweden)

Ammar Ben Zaed

2017-04-01

Full Text Available This article aims to analyze and interpret the phenomenon of increased public expenditures and test explanatory theories as well as to analyze Abstract the relationship between public spending and GDP in the short and long term where you see the Wagner hypothesis that causal heading of GDP to government spending while there is a causal relationship analysis positive trending of government spending to GDP according to the Keynesian hypothesis in this study will be used descriptive analytical method to validate these hypotheses. Results in the short and long term made it clear that there is a difference in the outcome of Applied Studies where we find that each supports a relationship Wagner in the sense that the causal trending of real GDP to government spending and more precisely to increase the economic growth lead to increased aggregate demand which leads in turn increasing the need to increase government spending and to increase the resources available to the government sector to finance the increase in spending by the additional resources resulting from the economic growth while others opines opposes the existence of the relationship.

Welfare Financing : Grant Allocation and Efficiency

NARCIS (Netherlands)

Toolsema, L.A.; Allers, Maarten A.

Welfare is often administered locally, but financed through grants from the central government. This raises the question how the central government can prevent local governments from spending more than necessary. We analyze block grants used in The Netherlands, which depend on exogenous spending

Visitor spending effects: assessing and showcasing America's investment in national parks

Science.gov (United States)

Koontz, Lynne; Cullinane Thomas, Catherine; Ziesler, Pamela; Olson, Jeffrey; Meldrum, Bret

2017-01-01

This paper provides an overview of the evolution, future, and global applicability of the U.S. National Park Service's (NPS) visitor spending effects framework and discusses the methods used to effectively communicate the economic return on investment in America's national parks. The 417 parks represent many of America's most iconic destinations: in 2016, they received a record 331 million visits. Competing federal budgetary demands necessitate that, in addition to meeting their mission to preserve unimpaired natural and cultural resources for the enjoyment of the people, parks also assess and showcase their contributions to the economic vitality of their regions and the nation. Key approaches explained include the original Money Generation Model (MGM) from 1990, MGM2 used from 2001, and the visitor spending effects model which replaced MGM2 in 2012. Detailed discussion explains the NPS's visitor use statistics system, the formal program for collecting, compiling, and reporting visitor use data. The NPS is now establishing a formal socioeconomic monitoring (SEM) program to provide a standard visitor survey instrument and a long-term, systematic sampling design for in-park visitor surveys. The pilot SEM survey is discussed, along with the need for international standardization of research methods.

The Governance of Digital Technology, Big Data, and the Internet

DEFF Research Database (Denmark)

Flyverbom, Mikkel; Deibert, Ronald; Matten, Dirk

2017-01-01

The importance of digital technologies for social and economic developments and a growing focus on data collection and privacy concerns have made the Internet a salient and visible issue in global politics. Recent developments have increased the awareness that the current approach of governments...... and business to the governance of the Internet and the adjacent technological spaces raises a host of ethical issues. The significance and challenges of the digital age have been further accentuated by a string of highly exposed cases of surveillance and a growing concern about issues of privacy and the power...... of this new industry. This special issue explores what some have referred to as the “Internet-industrial complex”—the intersections between business, states, and other actors in the shaping, development, and governance of the Internet....

State Medicaid Spending and Financial Burden of Families Raising Children with Autism

Science.gov (United States)

Parish, Susan L.; Thomas, Kathleen C.; Rose, Roderick; Kilany, Mona; Shattuck, Paul T.

2012-01-01

We examined the association between state Medicaid spending for children with disabilities and the financial burden reported by families of children with autism. Child and family data were from the 2005-2006 National Survey of Children with Special Health Care Needs (n = 2,011 insured children with autism). State characteristics were from public…

Global Megacities Differing Adaptation Responses to Climate Change: an Analysis of Annual Spend of Ten Major cities on the adaptation economy

Science.gov (United States)

Maslin, M. A.; Georgeson, L.

2015-12-01

Urban areas are increasingly at risk from climate change with negative impacts predicted for human health, the economy and ecosystems. These risks require responses from cities, to improve the resilience of their infrastructure, economy and environment to climate change. Policymakers need to understand what is already being spent on adaptation so that they can make more effective and comprehensive adaptation plans. Through the measurement of spend in the newly defined 'Adaptation Economy' we analysis the current efforts of 10 global megacities in adapting to climate change. These cities were chosen based on their size, geographical location and their developmental status. The cities are London, Paris, New York, Mexico City, Sao Paulo, Beijing, Mumbai, Jakarta, Lagos and Addis Ababa. It is important to study a range of cities in different regions of the world, with different climates and at different states of socio-economic development. While in economic terms, disaster losses from weather, climate and geophysical events are greater in developed countries, fatalities and economic losses as a proportion of GDP are higher in developing countries. In all cities examined the Adaptation Economy is still a small part of the overall economy accounting for a maximum of 0.3% of the Cities total GDP (GDPc). The differences in total spend are significant between cities in developed and rapidly emerging countries, compared to those in developing countries with a spend ranging from £16 million to £1,500 million. Comparing key sub sectors, we demonstrate that there are distinctive adaptation profiles with developing cities having a higher relative spend on health, while developed cities have a higher spend on disaster preparedness, ICT and professional services. Comparing spend per capita and as a percentage of GDPc demonstrates even more clearly disparities between the cities in the study; developing country cities spend half as much as a proportion of GPCc in some cases, and

The future of utility customer-funded energy efficiency programs in the USA. Projected spending and savings to 2025

Energy Technology Data Exchange (ETDEWEB)

Barbose, G.L.; Goldman, C.A.; Hoffman, I.M.; Billingsley, M. [Ernest Orlando Lawrence Berkeley National Laboratory, One Cyclotron Road, MS 90R4000, Berkeley, CA 94720-8136 (United States)

2013-08-15

We develop projections of future spending on, and savings from, energy efficiency programs funded by electric and gas utility customers in the USA, under three scenarios through 2025. Our analysis, which updates a previous LBNL study, relies on detailed bottom-up modeling of current state energy efficiency policies, regulatory decisions, and demand-side management and utility resource plans. The three scenarios are intended to represent a range of potential outcomes under the current policy environment (i.e., without considering possible major new policy developments). Key findings from the analysis are as follows: (1) By 2025, spending on electric and gas efficiency programs (excluding load management programs) is projected to double from 2010 levels to USD 9.5 billion in the medium case, compared to USD 15.6 billion in the high case and USD 6.5 billion in the low case; (2) Compliance with statewide legislative or regulatory savings or spending targets is the primary driver for the increase in electric program spending through 2025, though a significant share of the increase is also driven by utility DSM planning activity and integrated resource planning; (3) Our analysis suggests that electric efficiency program spending may approach a more even geographic distribution over time in terms of absolute dollars spent, with the Northeastern and Western states declining from over 70 % of total USA spending in 2010 to slightly more than 50 % in 2025, and the South and Midwest splitting the remainder roughly evenly; (4) Under our medium case scenario, annual incremental savings from customer-funded electric energy efficiency programs increase from 18.4 TWh in 2010 in the USA (which is about 0.5 % of electric utility retail sales) to 28.8 TWh in 2025 (0.8 % of retail sales); (5) These savings would offset the majority of load growth in the Energy Information Administration's most recent reference case forecast, given specific assumptions about the extent to which future

Racial Prejudice and Spending on Drug Rehabilitation: The Role of Attitudes Toward Blacks and Latinos

Science.gov (United States)

Bonn, Scott; Wilson, George

2011-01-01

We enhance understanding of the prejudice-induced “color coding” phenomenon among whites by determining whether racial and ethnic prejudices are associated with a previously unexplored policy outcome, spending on drug rehabilitation. We examine attitudes toward both blacks and Latinos; the latter is a group largely ignored in previous research. We assess the impact of several types of racial/ethnic views, including those that manifest modern/indirect prejudice (e.g., stereotypes about violence, individualistic causal attributions) and those that reflect social-distance-based traditional prejudice (opposition to residential proximity and to interracial marriage). These relationships are examined using data from the General Social Survey. Bivariate results support the linkage between both traditional and modern prejudice and rehabilitation spending. Logistic regression analyses also indicate that support for rehabilitation is racialized: Attributing race differences in socioeconomic outcomes to “structural” factors, namely discrimination and lack of chance for education, is associated with believing rehabilitation spending is inadequate, controlling for the effects of other racial/ethnic attitudes and background factors. The relationship between this measure of modern prejudice and the outcome is consistent with color coding. The implications of the findings are discussed, and suggestions for future research that further examine the scope of color coding are offered. PMID:21532926

Lower- Versus Higher-Income Populations In The Alternative Quality Contract: Improved Quality And Similar Spending.

Science.gov (United States)

Song, Zirui; Rose, Sherri; Chernew, Michael E; Safran, Dana Gelb

2017-01-01

As population-based payment models become increasingly common, it is crucial to understand how such payment models affect health disparities. We evaluated health care quality and spending among enrollees in areas with lower versus higher socioeconomic status in Massachusetts before and after providers entered into the Alternative Quality Contract, a two-sided population-based payment model with substantial incentives tied to quality. We compared changes in process measures, outcome measures, and spending between enrollees in areas with lower and higher socioeconomic status from 2006 to 2012 (outcome measures were measured after the intervention only). Quality improved for all enrollees in the Alternative Quality Contract after their provider organizations entered the contract. Process measures improved 1.2 percentage points per year more among enrollees in areas with lower socioeconomic status than among those in areas with higher socioeconomic status. Outcome measure improvement was no different between the subgroups; neither were changes in spending. Larger or comparable improvements in quality among enrollees in areas with lower socioeconomic status suggest a potential narrowing of disparities. Strong pay-for-performance incentives within a population-based payment model could encourage providers to focus on improving quality for more disadvantaged populations. Project HOPE—The People-to-People Health Foundation, Inc.

Role of location in the attendance and spending of Festinos

Directory of Open Access Journals (Sweden)

Veronique Labuschagne

2014-01-01

Full Text Available The purpose of this research was to identify the determinants of spending by the visitors at Innibos, Vryfees en Kierieklapper arts festivals with special focus on the different locations, using the same questionnaire and methodology. The survey measured the attendance and spending of different arts festivals in different locations in order to determine whether any differences exist and if so what these differences are. The research was conducted by means of a visitor survey at the three arts festivals during the same year with questionnaires administered at Innibos (428, Vryfees (336 and Kierieklapper (202, respectively. A factor analysis, Tukey d test and chi-square test were performed. The results indicate that the location and size of the town is not an important factor regarding the impact an event has on the town and the region. Findings that were meaningful included that small, medium type arts festivals differ from each other and also from larger arts festivals in a number of ways. The travel motives revealed four factors, namely: Family and arts; Meet new people; Productions and uniqueness and Escape. The latter was the most significant travel motive and this information can be used in future marketing exercises of arts festivals in different locations – to escape one’s own province and immediate surroundings.

Program spending to increase adherence: South African cervical cancer screening.

Directory of Open Access Journals (Sweden)

Jeremy D Goldhaber-Fiebert

2009-05-01

Full Text Available Adherence is crucial for public health program effectiveness, though the benefits of increasing adherence must ultimately be weighed against the associated costs. We sought to determine the relationship between investment in community health worker (CHW home visits and increased attendance at cervical cancer screening appointments in Cape Town, South Africa.We conducted an observational study of 5,258 CHW home visits made in 2003-4 as part of a community-based screening program. We estimated the functional relationship between spending on these visits and increased appointment attendance (adherence. Increased adherence was noted after each subsequent CHW visit. The costs of making the CHW visits was based on resource use including both personnel time and vehicle-related expenses valued in 2004 Rand. The CHW program cost R194,018, with 1,576 additional appointments attended. Adherence increased from 74% to 90%; 55% to 87%; 48% to 77%; and 56% to 80% for 6-, 12-, 24-, and 36-month appointments. Average per-woman costs increased by R14-R47. The majority of this increase occurred with the first 2 CHW visits (90%, 83%, 74%, and 77%; additional cost: R12-R26.We found that study data can be used for program planning, identifying spending levels that achieve adherence targets given budgetary constraints. The results, derived from a single disease program, are retrospective, and should be prospectively replicated.

Principles governing medical first aid to workers exposed to internal contamination

International Nuclear Information System (INIS)

Jammet, H.; Nenot, J.C.

1976-01-01

The growing use of radionuclides, whether at hospital, laboratory or nuclear facility level, increases the risk of internal contamination. Not only that, some particularly dangerous elements are being handled more and more frequently. Hence the importance of therapeutic concepts based on the general principles governing action to be taken in cases of internal contamination. These principles should be applicable without the nature of the contaminant having to be taken into account, and irrespective of whether it is transferable and of the route of entry, i.e. healthy skin, wound or bronchial tree. The basic principle is the concept of urgency: ''blind'' treatment should be applied merely on the supposition of internal contamination. It is desirable, moreover, that the first aid should be given at the site of the accident. Hence, the product used should be non-toxic under normal conditions of use and should be simple to apply, as, for example, the administration of an aerosol. It is not until later that the doctor should undertake treatment in the proper sense of the term, the emergency treatment having afforded him sufficient time to carry out the preliminary examination required to gain an exact idea of the internal contamination. (author)

The Effects of Socioeconomic Vulnerability, Psychosocial Services, and Social Service Spending on Family Reunification: A Multilevel Longitudinal Analysis.

Science.gov (United States)

Esposito, Tonino; Delaye, Ashleigh; Chabot, Martin; Trocmé, Nico; Rothwell, David; Hélie, Sonia; Robichaud, Marie-Joelle

2017-09-09

Socio-environmental factors such as poverty, psychosocial services, and social services spending all could influence the challenges faced by vulnerable families. This paper examines the extent to which socioeconomic vulnerability, psychosocial service consultations, and preventative social services spending impacts the reunification for children placed in out-of-home care. This study uses a multilevel longitudinal research design that draws data from three sources: (1) longitudinal administrative data from Quebec's child protection agencies; (2) 2006 and 2011 Canadian Census data; and, (3) intra-province health and social services data. The final data set included all children ( N = 39,882) placed in out-of-home care for the first time between 1 April 2002 and 31 March 2013, and followed from their initial out-of-home placement. Multilevel hazard results indicate that socioeconomic vulnerability, controlling for psychosocial services and social services spending, contributes to the decreased likelihood of reunification. Specifically, socioeconomic vulnerability, psychosocial services, and social services spending account for 24.0% of the variation in jurisdictional reunification for younger children less than 5 years of age, 12.5% for children age 5 to 11 years and 21.4% for older children age 12 to 17 years. These findings have implications for decision makers, funding agencies, and child protection agencies to improve jurisdictional resources to reduce the socioeconomic vulnerabilities of reunifying families.

Offering A Price Transparency Tool Did Not Reduce Overall Spending Among California Public Employees And Retirees.

Science.gov (United States)

Desai, Sunita; Hatfield, Laura A; Hicks, Andrew L; Sinaiko, Anna D; Chernew, Michael E; Cowling, David; Gautam, Santosh; Wu, Sze-Jung; Mehrotra, Ateev

2017-08-01

Insurers, employers, and states increasingly encourage price transparency so that patients can compare health care prices across providers. However, the evidence on whether price transparency tools encourage patients to receive lower-cost care and reduce overall spending remains limited and mixed. We examined the experience of a large insured population that was offered a price transparency tool, focusing on a set of "shoppable" services (lab tests, office visits, and advanced imaging services). Overall, offering the tool was not associated with lower shoppable services spending. Only 12 percent of employees who were offered the tool used it in the first fifteen months after it was introduced, and use of the tool was not associated with lower prices for lab tests or office visits. The average price paid for imaging services preceded by a price search was 14 percent lower than that paid for imaging services not preceded by a price search. However, only 1 percent of those who received advanced imaging conducted a price search. Simply offering a price transparency tool is not sufficient to meaningfully decrease health care prices or spending. Project HOPE—The People-to-People Health Foundation, Inc.

Reductions in global biodiversity loss predicted from conservation spending

Science.gov (United States)

Waldron, Anthony; Miller, Daniel C.; Redding, Dave; Mooers, Arne; Kuhn, Tyler S.; Nibbelink, Nate; Roberts, J. Timmons; Tobias, Joseph A.; Gittleman, John L.

2017-11-01

Halting global biodiversity loss is central to the Convention on Biological Diversity and United Nations Sustainable Development Goals, but success to date has been very limited. A critical determinant of success in achieving these goals is the financing that is committed to maintaining biodiversity; however, financing decisions are hindered by considerable uncertainty over the likely impact of any conservation investment. For greater effectiveness, we need an evidence-based model that shows how conservation spending quantitatively reduces the rate of biodiversity loss. Here we demonstrate such a model, and empirically quantify how conservation investment between 1996 and 2008 reduced biodiversity loss in 109 countries (signatories to the Convention on Biological Diversity and Sustainable Development Goals), by a median average of 29% per country. We also show that biodiversity changes in signatory countries can be predicted with high accuracy, using a dual model that balances the effects of conservation investment against those of economic, agricultural and population growth (human development pressures). Decision-makers can use this model to forecast the improvement that any proposed biodiversity budget would achieve under various scenarios of human development pressure, and then compare these forecasts to any chosen policy target. We find that the impact of spending decreases as human development pressures grow, which implies that funding may need to increase over time. The model offers a flexible tool for balancing the Sustainable Development Goals of human development and maintaining biodiversity, by predicting the dynamic changes in conservation finance that will be needed as human development proceeds.

Reductions in global biodiversity loss predicted from conservation spending.

Science.gov (United States)

Waldron, Anthony; Miller, Daniel C; Redding, Dave; Mooers, Arne; Kuhn, Tyler S; Nibbelink, Nate; Roberts, J Timmons; Tobias, Joseph A; Gittleman, John L

2017-11-16

Halting global biodiversity loss is central to the Convention on Biological Diversity and United Nations Sustainable Development Goals, but success to date has been very limited. A critical determinant of success in achieving these goals is the financing that is committed to maintaining biodiversity; however, financing decisions are hindered by considerable uncertainty over the likely impact of any conservation investment. For greater effectiveness, we need an evidence-based model that shows how conservation spending quantitatively reduces the rate of biodiversity loss. Here we demonstrate such a model, and empirically quantify how conservation investment reduced biodiversity loss in 109 countries (signatories to the Convention on Biological Diversity and Sustainable Development Goals), by a median average of 29% per country between 1996 and 2008. We also show that biodiversity changes in signatory countries can be predicted with high accuracy, using a dual model that balances the effects of conservation investment against those of economic, agricultural and population growth (human development pressures). Decision-makers can use this model to forecast the improvement that any proposed biodiversity budget would achieve under various scenarios of human development pressure, and then compare these forecasts to any chosen policy target. We find that the impact of spending decreases as human development pressures grow, which implies that funding may need to increase over time. The model offers a flexible tool for balancing the Sustainable Development Goals of human development and maintaining biodiversity, by predicting the dynamic changes in conservation finance that will be needed as human development proceeds.

On the value relevance of retailer advertising spending and same-store sales growth

NARCIS (Netherlands)

Tuli, K.; Mukherjee, A.; Dekimpe, M.G.

2012-01-01

In response to recent calls to study factors that determine a retailer's stock price, this study draws on signaling theory to examine the impact of two key marketing metrics that are widely disclosed by retailers to investors, advertising spending and growth in same-store sales (COMPS), and

Not Out of Control: Analysis of the Federal Disaster Spending Trend

Science.gov (United States)

2016-03-01

continue to benefit politically from large emergency supplemental spending bills for their constituents after a disaster, no incentive to change the...not need to compete for emergency funds as they must do in the regular appropriations process.69 They explain the political benefits of this...reflect true market prices, and was in essence, a subsidy to homeowners living in hazard areas.245 Resulting rate hikes and increased premiums were not

Does Everyone Want Social Justice? Conflicting School Governance Perspectives Regarding Social Justice

Science.gov (United States)

Bialik, Gadi; Kalfri, Adv. Yael; Livneh, Idit

2013-01-01

The theoretical grounds underlying this paper are the variety of governance perspectives, which represent different political and economic ideologies (Green, 2005; Manzer, 2003). The coexistence of these often clashing attitudes is one of the reasons for policy ambiguity and policy implementation gaps (Malen, 2006). It can also expose disputing…

Performance Assessment for e-Government Services: An Experience Report

Energy Technology Data Exchange (ETDEWEB)

Liu, Yan; Zhu, Liming; Gorton, Ian

2007-08-14

The transformation and integration of government services, enabled by the use of new technologies such as application servers and Web services, is fundamental to reduce the cost of government and improving service outcomes to citizens. Many core Government information systems comprise applications running on legacy mainframes, databases and transaction processing monitors. As Governments worldwide provide direct access over the Internet to these legacy applications from the general public, they may be exposed to workloads well above the origin design parameters of these back-end systems. This creates a significant risk of high profile failures for Government agencies whose newly integrated systems become overloaded. In this paper we describe how we conducted a performance assessment of a business-critical, Internet-facing Web services that integrated new and legacy systems from two Australian Government agencies. We leveraged prototype tools from our own research along with known techniques in performance modeling. We were able to clearly demonstrate that the existing hardware and software would be adequate to handle the predicted workload for the next financial year. We were also able to do ‘what-if’ analysis and predict how the system can perform with alternative strategies to scale the system. We conclude by summarizing the lessons learnt, including the importance of architecture visibility, benchmarking data quality, and measurement feasibility due to issues of outsourcing, privacy legislation and cross-agency involvement.

Shadow Education in Malaysia: Identifying the Determinants of Spending and Amount of Time Attending Private Supplementary Tutoring of Upper Secondary School Students

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Chang Da Wan

2017-10-01

Full Text Available This paper examines the determinants of spending and the amount of time attending private supplementary tutoring, or commonly known as private tuition, in Malaysia. Based on 343 self-reported questionnaires with upper secondary students across three states in Malaysia and using multiple regression analysis, we identified ethnicity, father’s level of education and past academic performance as significant determinants of spending and amount of time attending private tuition. However, interestingly, we found that while geographical location and participation in internal tuition in schools were also determinants of spending, these two were not significant in determining the amount of time attending private supplementary tutoring. The identification of determinants of spending and amount of time, and in addition, the differences between these two illustrates the economic and educational dimensions of shadow education. More importantly, the insight also contributes to the formulation of possible interventions that can improve quality and reduce inequality in the mainstream education system.

Intermunicipal cooperation, public spending and service levels

NARCIS (Netherlands)

Allers, Maarten A.; de Greef, J.A.

2018-01-01

Local governments can increase size in particular policy fields through cooperation with other local governments. This is often thought to improve efficiency, but there is little empirical evidence supporting this hypothesis. We study the case of the Netherlands, which has been a veritable

Lowering Regional Inflation? Improve Budget Absorption

Directory of Open Access Journals (Sweden)

Vid Adrison

2016-08-01

Full Text Available The subnational government spending in Indonesia exhibit a highly skewed distribution, i.e., it is very low in the first two-quarters and then increases significantly in the last two-quarters. Such explosive pattern poses two disadvantages. First, the regional output will fall below its optimal level as the low government capital expenditure leads to a fewer provision of public goods. Second, a significant increase in government spending in the later quarter pushes the short run aggregate demand to the northeast and creates an inflationary pressure in the following quarters. In this study, we analyze the effect of quarterly regional government expenditure growth on regional inflation during 2010–2014. Using Arellano Bond GMM estimation, we find government expenditure growth leads to higher inflation in the same quarter. A percentage increase in non-capital expenditure spending results in a higher inflation than a percentage increase in capital spending.

The Future of Utility Customer-Funded Energy Efficiency Programs in the United States: Projected Spending and Savings to 2025

Energy Technology Data Exchange (ETDEWEB)

Barbose, Galen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, Charles [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hoffman, Ian [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Billingsley, Megan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2012-09-11

We develop projections of future spending on, and savings from, energy efficiency programs funded by electric and gas utility customers in the United States, under three scenarios through 2025. Our analysis, which updates a previous LBNL study, relies on detailed bottom-up modeling of current state energy efficiency policies, regulatory decisions, and demand-side management and utility resource plans. The three scenarios are intended to represent a range of potential outcomes under the current policy environment (i.e., without considering possible major new policy developments). By 2025, spending on electric and gas efficiency programs (excluding load management programs) is projected to double from 2010 levels to $9.5 billion in the medium case, compared to $15.6 billion in the high case and $6.5 billion in the low case. Compliance with statewide legislative or regulatory savings or spending targets is the primary driver for the increase in electric program spending through 2025, though a significant share of the increase is also driven by utility DSM planning activity and integrated resource planning. Our analysis suggests that electric efficiency program spending may approach a more even geographic distribution over time in terms of absolute dollars spent, with the Northeastern and Western states declining from over 70% of total U.S. spending in 2010 to slightly more than 50% in 2025, with the South and Midwest splitting the remainder roughly evenly. Under our medium case scenario, annual incremental savings from customer-funded electric energy efficiency programs increase from 18.4 TWh in 2010 in the U.S. (which is about 0.5% of electric utility retail sales) to 28.8 TWh in 2025 (0.8% of retail sales). These savings would offset the majority of load growth in the Energy Information Administration’s most recent reference case forecast, given specific assumptions about the extent to which future energy efficiency program savings are captured in that forecast

Higher fees paid to US physicians drive higher spending for physician services compared to other countries.

Science.gov (United States)

Laugesen, Miriam J; Glied, Sherry A

2011-09-01

Higher health care prices in the United States are a key reason that the nation's health spending is so much higher than that of other countries. Our study compared physicians' fees paid by public and private payers for primary care office visits and hip replacements in Australia, Canada, France, Germany, the United Kingdom, and the United States. We also compared physicians' incomes net of practice expenses, differences in financing the cost of medical education, and the relative contribution of payments per physician and of physician supply in the countries' national spending on physician services. Public and private payers paid somewhat higher fees to US primary care physicians for office visits (27 percent more for public, 70 percent more for private) and much higher fees to orthopedic physicians for hip replacements (70 percent more for public, 120 percent more for private) than public and private payers paid these physicians' counterparts in other countries. US primary care and orthopedic physicians also earned higher incomes ($186,582 and $442,450, respectively) than their foreign counterparts. We conclude that the higher fees, rather than factors such as higher practice costs, volume of services, or tuition expenses, were the main drivers of higher US spending, particularly in orthopedics.

Prioritization of the essentials in the spending patterns of Canadian households experiencing food insecurity.

Science.gov (United States)

Fafard St-Germain, Andrée-Anne; Tarasuk, Valerie

2018-03-21

Food insecurity is a potent determinant of health and indicator of material deprivation in many affluent countries. Food insecurity is associated with compromises in food and housing expenditures, but how it relates to other expenditures is unknown. The present study described households' resource allocation over a 12-month period by food insecurity status. Expenditure data from the 2010 Survey of Household Spending were aggregated into four categories (basic needs, other necessities, discretionary, investments/assets) and ten sub-categories (food, clothing, housing, transportation, household/personal care, health/education, leisure, miscellaneous, personal insurance/pension, durables/assets). A four-level food insecurity status was created using the adult-specific items of the Household Food Security Survey Module. Mean dollars spent and budget share by food insecurity status were estimated with generalized linear models adjusted first for household size and composition, and subsequently for after-tax income quartiles. Canada. Population-based sample of households from the ten provinces (n 9050). Food-secure households had higher mean total expenditures than marginally, moderately and severely food-insecure households (P-trend insecurity increased, households spent less on all categories and sub-categories, except transportation, but they allocated a larger budget share to basic needs and smaller shares to discretionary spending and investments/assets. The downward trends for dollars spent on basic needs and other necessities became non-significant after accounting for income, but the upward trend in the budget shares for basic needs persisted. The spending patterns of food-insecure households suggest that they prioritized essential needs above all else.

Stability of rifampin in SyrSpend SF.

Science.gov (United States)

Sorenson, Bridget; Whaley, Paul

2013-01-01

Rifampin is a bactericidal antibiotic drug of the rifamycin group. It is a semisynthetic drug produced from the bacterium Streptomyces mediterranei. Rifampin is commonly manufactured in capsule, tablet, and syrup dosage solutions containing alcohol or sorbitol. The objective of this study was to determine the stability of rifampin in SyrSpend SF. The studied samples were compounded into 25-mg/mL suspensions and stored in low-actinic bottles at room temperature and refrigerated conditions. Samples were assayed at each time point out to 60 days by a stability-indicating high-performance liquid chromatography method. The method was validated for its specificity through forced-degradation studies. The sample remained within 90% to 110% of the initial concentration throughout the course of the study. Based on data collected, the beyond-use date of the preparation is at least 60 days when refrigerated or stored at room temperature and protected from light.

Funding New Zealand's public healthcare system: time for an honest appraisal and public debate.

Science.gov (United States)

Keene, Lyndon; Bagshaw, Philip; Nicholls, M Gary; Rosenberg, Bill; Frampton, Christopher M; Powell, Ian

2016-05-27

Successive New Zealand governments have claimed that the cost of funding the country's public healthcare services is excessive and unsustainable. We contest that these claims are based on a misrepresentation of healthcare spending. Using data from the New Zealand Treasury and the Organisation for Economic Cooperation and Development (OECD), we show how government spending as a whole is low compared with most other OECD countries and is falling as a proportion of GDP. New Zealand has a modest level of health spending overall, but government health spending is also falling as a proportion of GDP. Together, the data indicate the New Zealand Government can afford to spend more on healthcare. We identify compelling reasons why it should do so, including forecast growing health need, signs of increasing unmet need, and the fact that if health needs are not met the costs still have to be borne by the economy. The evidence further suggests it is economically and socially beneficial to meet health needs through a public health system. An honest appraisal and public debate is needed to determine more appropriate levels of healthcare spending.

Sources of Cost Expansion: Primary Education in Norway 1946-90.

Science.gov (United States)

Falch, Torberg; Rattso, Jorn

1996-01-01

Shows that primary education spending growth in Norway resulted from cost factors determined at the national level, together with lack of adjustment to rising costs in local governments. Policies to control school spending must address the central government's bargaining strength to hold back on teacher wages and employment and local governments'…

US spending on complementary and alternative medicine during 2002-08 plateaued, suggesting role in reformed health system.

Science.gov (United States)

Davis, Matthew A; Martin, Brook I; Coulter, Ian D; Weeks, William B

2013-01-01

Complementary and alternative medicine services in the United States are an approximately $9 billion market each year, equal to 3 percent of national ambulatory health care expenditures. Unlike conventional allopathic health care, complementary and alternative medicine is primarily paid for out of pocket, although some services are covered by most health insurance. Examining trends in demand for complementary and alternative medicine services in the United States reported in the Medical Expenditure Panel Survey during 2002-08, we found that use of and spending on these services, previously on the rise, have largely plateaued. The higher proportion of out-of-pocket responsibility for payment for services may explain the lack of growth. Our findings suggest that any attempt to reduce national health care spending by eliminating coverage for complementary and alternative medicine would have little impact at best. Should some forms of complementary and alternative medicine-for example, chiropractic care for back pain-be proven more efficient than allopathic and specialty medicine, the inclusion of complementary and alternative medicine providers in new delivery systems such as accountable care organizations could help slow growth in national health care spending.

Women Saw Large Decrease In Out-Of-Pocket Spending For Contraceptives After ACA Mandate Removed Cost Sharing.

Science.gov (United States)

Becker, Nora V; Polsky, Daniel

2015-07-01

The Affordable Care Act mandates that private health insurance plans cover prescription contraceptives with no consumer cost sharing. The positive financial impact of this new provision on consumers who purchase contraceptives could be substantial, but it has not yet been estimated. Using a large administrative claims data set from a national insurer, we estimated out-of-pocket spending before and after the mandate. We found that mean and median per prescription out-of-pocket expenses have decreased for almost all reversible contraceptive methods on the market. The average percentages of out-of-pocket spending for oral contraceptive pill prescriptions and intrauterine device insertions by women using those methods both dropped by 20 percentage points after implementation of the ACA mandate. We estimated average out-of-pocket savings per contraceptive user to be $248 for the intrauterine device and $255 annually for the oral contraceptive pill. Our results suggest that the mandate has led to large reductions in total out-of-pocket spending on contraceptives and that these price changes are likely to be salient for women with private health insurance. Project HOPE—The People-to-People Health Foundation, Inc.

Parenting and Time Adolescents Spend in Criminogenic Settings : A Between- and Within-person Analysis

NARCIS (Netherlands)

Janssen, Heleen J.; Dekovic, Maja; Bruinsma, Gerben J. N.

Although there has been increasing interest in explaining adolescents' crime involvement by the time adolescents spend in criminogenic settings, little is known about its determinants. We examine the extent to which (change in) parenting is related to (change in) time spent in criminogenic settings.

Save or (over-)spend? : The impact of hard-discounter shopping on consumers' grocery outlay

NARCIS (Netherlands)

Gijsbrechts, Els; Campo, K.; Vroegrijk, M.J.J.

An increasing number of consumers have come to patronize a hard discounter (HD) to save on their grocery budget. Given the HDs' rock-bottom prices, a complete switch from the traditional supermarket (TS) to the HD format would, indeed, substantially reduce grocery spending. However, consumers

Spending on social and public health services and its association with homicide in the USA: an ecological study.

Science.gov (United States)

Sipsma, Heather L; Canavan, Maureen E; Rogan, Erika; Taylor, Lauren A; Talbert-Slagle, Kristina M; Bradley, Elizabeth H

2017-10-12

To examine whether state-level spending on social and public health services is associated with lower rates of homicide in the USA. Ecological study. USA. All states in the USA and the District of Columbia for which data were available (n=42). Homicide rates for each state were abstracted from the US Department of Justice Federal Bureau of Investigation's Uniform Crime Reporting. After adjusting for potential confounding variables, we found that every $10 000 increase in spending per person living in poverty was associated with 0.87 fewer homicides per 100 000 population or approximately a 16% decrease in the average homicide rate (estimate=-0.87, SE=0.15, phomicide rates at the state level. Although we cannot infer causality from this research, such spending may provide promising avenues for homicide reduction in the USA, particularly among states with lower levels of poverty. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Evaluating e-Government and Good Governance Correlation

Directory of Open Access Journals (Sweden)

Suhardi Suhardi

2016-03-01

Full Text Available Assessing the achievement of Indonesian government institutions in implementing e-government has been conducted since around a decade ago. Several national assessments are available with almost the same ranking results. There is an agreement that the ultimate goal of e-government implementation is to achieve good government governance (GGG, while success stories of e-government require good governance practices. This study explored the correlation between e-government achievement and GGG achievement in Indonesia. Spearman’s rank correlation was used to characterize the relationship strength between e-government assessment results and good governance assessment results. The data were collected from institutions that participated in e-government and good governance assessments. The results showed that the correlation between these two entities is not very strong. Most cases showed that e-government implementation and the achievement of good governance have only a moderate positive correlation and none of the studied cases indicated a significant connection. This result can be attributed to the lack of emphasis on goals achievement in the assessments. Thus, it is recommended that future Indonesian e-government assessments should involve impact indicators.

Will It Be Deja Vu All Over Again?

Directory of Open Access Journals (Sweden)

J.C. Herbert Emery

2009-04-01

Full Text Available The boom and bust in energy prices experienced recently has its parallels in the boom and bust of energy prices in the 1970s and 1980s. The earlier boom period saw the Government of Alberta struggle with restraining spending and so became heavily dependent on high energy prices. When in 1986 energy prices crashed the government suff ered a string of large defi cits that was followed by draconian cuts to spending. From 2000 to 2008 the government enjoyed another boom in energy prices and again found it diffi cult to restrain spending. The recent crash in energy prices threatens the government with repea ng the earlier experience of defi cits followed by drama c spending cuts. As it prepares its 2009 budget the government has an opportunity to learn from the past and to quickly and decisively put its budget on a path toward a much smaller reliance on energy-related revenues.

Changes in drug utilization during a gap in insurance coverage: an examination of the medicare Part D coverage gap.

Directory of Open Access Journals (Sweden)

Jennifer M Polinski

2011-08-01

Full Text Available Nations are struggling to expand access to essential medications while curbing rising health and drug spending. While the US government's Medicare Part D drug insurance benefit expanded elderly citizens' access to drugs, it also includes a controversial period called the "coverage gap" during which beneficiaries are fully responsible for drug costs. We examined the impact of entering the coverage gap on drug discontinuation, switching to another drug for the same indication, and drug adherence. While increased discontinuation of and adherence to essential medications is a regrettable response, increased switching to less expensive but therapeutically interchangeable medications is a positive response to minimize costs.We followed 663,850 Medicare beneficiaries enrolled in Part D or retiree drug plans with prescription and health claims in 2006 and/or 2007 to determine who reached the gap spending threshold, n = 217,131 (33%. In multivariate Cox proportional hazards models, we compared drug discontinuation and switching rates in selected drug classes after reaching the threshold between all 1,993 who had no financial assistance during the coverage gap (exposed versus 9,965 multivariate propensity score-matched comparators with financial assistance (unexposed. Multivariate logistic regressions compared drug adherence (≤ 80% versus >80% of days covered. Beneficiaries reached the gap spending threshold on average 222 d ±79. At the drug level, exposed beneficiaries were twice as likely to discontinue (hazard ratio [HR]  = 2.00, 95% confidence interval [CI] 1.64-2.43 but less likely to switch a drug (HR  = 0.60, 0.46-0.78 after reaching the threshold. Gap-exposed beneficiaries were slightly more likely to have reduced adherence (OR  = 1.07, 0.98-1.18.A lack of financial assistance after reaching the gap spending threshold was associated with a doubling in discontinuing essential medications but not switching drugs in 2006 and 2007

The Treadmill of Destruction in Comparative Perspective: A Panel Study of Military Spending and Carbon Emissions, 1960-2014

Directory of Open Access Journals (Sweden)

John Hamilton Bradford

2017-08-01

Full Text Available This article analyzes a unique panel data set to assess the effect of militarism on per capita carbon dioxide emissions.   We extend previous research examining the effects of military expenditures on carbon emissions by including in our analyses over 30 years of additional data.  In addition, we compare our preliminary results to those obtained from other estimation procedures.  Specifically, we report and visually illustrate the results of 54 cross-sectional models (one for each year and 36 unique panel regression models on both balanced and unbalanced panels.  We assess how this relationship has changed over time by testing for interactions between military spending and time and by systematically re-analyzing our data across 180 panel regressions with varying time frames.  A strong and enduring association between military spending and per capita carbon emissions is indicated in cross-sectional comparisons.  Our panel analyses reveal a much weaker and varying relationship that has become stronger in recent decades. Moreover, we find that the effect of military spending on per capita carbon emissions is moderated by countries’ level of economic development, with military spending of more wealthy countries having relatively larger net effects on carbon emissions.  We partially confirm previous findings on the temporal stability of the environmental impacts of militarism.  Our analyses show, however, that this temporal stability has emerged relatively recently, and that the relationship between military expenditures and carbon emissions is weaker prior to the 1990s.

Mental Health Spending and Intensity of Service Use Among Individuals With Diagnoses of Eating Disorders Following Federal Parity.

Science.gov (United States)

Huskamp, Haiden A; Samples, Hillary; Hadland, Scott E; McGinty, Emma E; Gibson, Teresa B; Goldman, Howard H; Busch, Susan H; Stuart, Elizabeth A; Barry, Colleen L

2018-02-01

The Mental Health Parity and Addiction Equity Act (MHPAEA) was intended to eliminate differences in insurance coverage for mental health and substance use disorder services and medical-surgical care. No studies have examined mental health service use after federal parity implementation among individuals with diagnoses of eating disorders, for whom financial access to care has often been limited. This study examined whether MHPAEA implementation was associated with changes in use of mental health services and spending in this population. Using Truven Health MarketScan data from 2007 to 2012, this study examined trends in mental health spending and intensity of use of specific mental health services (inpatient days, total outpatient visits, psychotherapy visits, and medication management visits) among individuals ages 13-64 with a diagnosis of an eating disorder (N=27,594). MHPAEA implementation was associated with a small increase in total mental health spending ($1,271.92; p<.001) and no change in out-of-pocket spending ($112.99; p=.234) in the first year after enforcement of the parity law. The law's implementation was associated with an increased number of outpatient mental health visits among users, corresponding to an additional 5.8 visits on average during the first year (p<.001). This overall increase was driven by an increase in psychotherapy use of 2.9 additional visits annually among users (p<.001). MHPAEA implementation was associated with increased intensity of outpatient mental health service use among individuals with diagnoses of eating disorders but no increase in out-of-pocket expenditures, suggesting improvements in financial protection.

Place of death among older Americans: does state spending on home- and community-based services promote home death?

Science.gov (United States)

Muramatsu, Naoko; Hoyem, Ruby L; Yin, Hongjun; Campbell, Richard T

2008-08-01

The majority of Americans die in institutions although most prefer to die at home. States vary greatly in their proportion of home deaths. Although individuals' circumstances largely determine where they die, health policies may affect the range of options available to them. To examine whether states' spending on home- and community-based services (HCBS) affects place of death, taking into consideration county health care resources and individuals' family, sociodemographic, and health factors. Using exit interview data from respondents in the Health and Retirement Study born in 1923 or earlier who died between 1993 and 2002 (N = 3362), we conducted discrete-time survival analysis of the risk of end-of-life nursing home relocation to examine whether states' HCBS spending would delay or prevent end-of-life nursing home admission. Then we ran logistic regression analysis to investigate the HCBS effects on place of death separately for those who relocated to a nursing home and those who remained in the community. Living in a state with higher HCBS spending was associated with lower risk of end-of-life nursing home relocation, especially among people who had Medicaid. However, state HCBS support was not directly associated with place of death. States' generosity for HCBS increases the chance of dying at home via lowering the risk of end-of-life nursing home relocation. State-to-state variation in HCBS spending may partly explain variation in home deaths. Our findings add to the emerging encouraging evidence for continued efforts to enhance support for HCBS.

Examination of the effects of public spending and trade policy on real exchange rate in Cameroon

Directory of Open Access Journals (Sweden)

Victalice Ngimanang ACHAMOH

2015-11-01

Full Text Available The study adopts the inter-temporal model of Rodríguez (1989 and Edward (1989 extended in Elbadawi and Soto (1997 to empirically examine the effect of public expenditure and trade openness on the real exchange rate using Cameroon data from 1977 to 2010. After exploring some issues on exchange rate and reviewing the relevant literature, the study employs residual based-cointegration technique. All the variables were stationary at level form or first differences. Public spending significantly appreciates the real exchange likewise the trade openness variable in the longrun. The results of the study suggests that appreciation of real exchange rate could be prevented by contracting public spending or adopting restrictive trade measures especially in the long run.

ASPECTS REGARDING VACATION SPENDING IN THE ROMANIAN TOURISM

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Cristina ŞOŞEA

2011-12-01

Full Text Available For most of the time, tourism has been the privilege of rich people however, during the last century; it became a mass phenomenon, as its genetic (economic, social and demographic factors have changed considerably. Unlike the developed countries which account for the main international tourist flows, Romania is a state with a much lower number of potential tourists as a result of the lower income of the population, but which witness a revival of the tourist phenomenon at the beginning of the 21st century. Based on statistical data, the present paper focuses on the factors that influence the choice of holiday destinations for the Europeans and for Romanians as well, some aspects regarding vacation spending, types of destinations that Romanians choose and their expenses for holiday trips.

Correlation between Government and Economic Growth –Fiscal Policy during the Transition in Albania

Directory of Open Access Journals (Sweden)

MSc. Xhenet Syka

2013-12-01

Full Text Available In this paper we tried to analyze some aspects of fiscal policy in our country, without pretending to give our own sample. Fiscal policy is the use of government expenditures and taxes which affect economic activity. Determination of fiscal policy in a given year takes into account the time virtually the past (current socio-economic status and the implications for the future (fiscal sustainability. In general the cases dealt the role fiscal policy plays toward economic growth. The analysis many focused both in the theoretical treatment as well as the role that fiscal policy has played in our country, going even further in some suggestions for the future. The most important issue was addressed in the long-term fiscal policy view, fiscal sustainability. In the final everything is addressed to the role of fiscal policy on social issues. The role that fiscal policy should play in economic and social development has long been a controversial issue and is still different among economists. While a restrictive fiscal policy means increasing taxes and cut government spending. Fiscal policy may be expansionary or restrictive. An expansionary fiscal policy means a reduction of direct and indirect taxes and increased government expenditures. Choose between two types of fiscal policy is not an easy decision, both in terms of the current state of the economy, as well as political decisions.

Feasibility of solar powered traffic signs in Houston : a step toward sustainable control devices.

Science.gov (United States)

2012-08-01

"With the economy fluctuating all the time, the federal and some city governments at times spend more : money than they take in from taxes. It is important for these governments to find ways to reduce : spending while still providing sufficient opera...

An Analysis of Year-End Spending and the Feasibility of a Carryover Incentive for Federal Agencies

National Research Council Canada - National Science Library

McPherson, Michael F

2007-01-01

This project investigates the year-end rush to spend and the origins. A secondary examination considers the feasibility of using carryover incentives to extend the obligation period by up to twelve months...

Caught in the Cloud: Privacy, Encryption, and Government Back Doors in the Web 2.0 Era

OpenAIRE

Soghoian, Christopher

2017-01-01

Over the last few years, consumers, corporations and governments have rushed to move their data to “the cloud,” adopting web-based applications and storage solutions provided by companies that include Amazon, Google, Microsoft and Yahoo. Unfortunately the shift to cloud computing needlessly exposes users to privacy invasion and fraud by hackers. Cloud based services also leave end users vulnerable to significant invasions of privacy by the government, resulting in the evisceration of traditio...