WorldWideScience

Sample records for staffing tax-supported health

  1. Developing Staffing Models to Support Population Health Management And Quality Oucomes in Ambulatory Care Settings.

    Science.gov (United States)

    Haas, Sheila A; Vlasses, Frances; Havey, Julia

    2016-01-01

    There are multiple demands and challenges inherent in establishing staffing models in ambulatory heath care settings today. If health care administrators establish a supportive physical and interpersonal health care environment, and develop high-performing interprofessional teams and staffing models and electronic documentation systems that track performance, patients will have more opportunities to receive safe, high-quality evidence-based care that encourages patient participation in decision making, as well as provision of their care. The health care organization must be aligned and responsive to the community within which it resides, fully invested in population health management, and continuously scanning the environment for competitive, regulatory, and external environmental risks. All of these challenges require highly competent providers willing to change attitudes and culture such as movement toward collaborative practice among the interprofessional team including the patient.

  2. Support sought for petition on safer staffing levels in Wales.

    Science.gov (United States)

    2014-11-01

    RCN WALES is urging the public to sign an e-petition supporting draft legislation on safe staffing. The petition calls for support for the Safe Nursing Staffing Levels (Wales) Bill, drawn up by Welsh Liberal Democrat leader Kirsty Williams.

  3. A randomized experiment of issue framing and voter support of tax increases for health insurance expansion.

    Science.gov (United States)

    Rodriguez, Hector P; Laugesen, Miriam J; Watts, Carolyn A

    2010-12-01

    To assess the effect of issue framing on voter support of tax increases for health insurance expansion. During October 2008, a random sample of registered voters (n=1203) were randomized to a control and two different 'framing' groups prior to being asked about their support for tax increases. The 'framing' groups listened to one of two statements: one emphasized the externalities or negative effects of the uninsured on the insured, and the other raised racial and ethnic disparities in health insurance coverage as a problem. All groups were asked the same questions: would they support tax increases to provide adequate and reliable health insurance for three groups, (1) all American citizens, (2) all children, irrespective of citizenship, and (3) all military veterans. Support for tax increases varied substantially depending on which group benefited from the expansion. Consensus on coverage for military veterans was highest (83.3%), followed by all children, irrespective of citizenship (64.7%), and all American citizens (60.1%). There was no statistically significant difference between voter support in the 'framing' and control groups or between the two frames. In multivariable analyses, political party affiliation was the strongest predictor of support. Voters agree on the need for coverage of military veterans, but are less united on the coverage of all children and American citizens. Framing was less important than party affiliation, suggesting that voters consider coverage expansions and related tax increases in terms of the characteristics of the targeted group, and their own personal political views and values rather than the broader impact of maintaining the status quo. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  4. Excellence and evidence in staffing: a data-driven model for excellence in staffing (2nd edition).

    Science.gov (United States)

    Baggett, Margarita; Batcheller, Joyce; Blouin, Ann Scott; Behrens, Elizabeth; Bradley, Carol; Brown, Mary J; Brown, Diane Storer; Bolton, Linda Burnes; Borromeo, Annabelle R; Burtson, Paige; Caramanica, Laura; Caspers, Barbara A; Chow, Marilyn; Christopher, Mary Ann; Clarke, Sean P; Delucas, Christine; Dent, Robert L; Disser, Tony; Eliopoulos, Charlotte; Everett, Linda Q; Garcia, Amy; Glassman, Kimberly; Goodwin, Susan; Haagenson, Deb; Harper, Ellen; Harris, Kathy; Hoying, Cheryl L; Hughes-Rease, Marsha; Kelly, Lesly; Kiger, Anna J; Kobs-Abbott, Ann; Krueger, Janelle; Larson, Jackie; March, Connie; Martin, Deborah Maust; Mazyck, Donna; Meenan, Penny; McGaffigan, Patricia; Myers, Karen K; Nell, Kate; Newcomer, Britta; Cathy, Rick; O'Rourke, Maria; Rosa, Billy; Rose, Robert; Rudisill, Pamela; Sanford, Kathy; Simpson, Roy L; Snowden, Tami; Strickland, Bob; Strohecker, Sharon; Weems, Roger B; Welton, John; Weston, Marla; Valentine, Nancy M; Vento, Laura; Yendro, Susan

    2014-01-01

    The Patient Protection and Affordable Care Act (PPACA, 2010) and the Institute of Medicine's (IOM, 2011) Future of Nursing report have prompted changes in the U.S. health care system. This has also stimulated a new direction of thinking for the profession of nursing. New payment and priority structures, where value is placed ahead of volume in care, will start to define our health system in new and unknown ways for years. One thing we all know for sure: we cannot afford the same inefficient models and systems of care of yesterday any longer. The Data-Driven Model for Excellence in Staffing was created as the organizing framework to lead the development of best practices for nurse staffing across the continuum through research and innovation. Regardless of the setting, nurses must integrate multiple concepts with the value of professional nursing to create new care and staffing models. Traditional models demonstrate that nurses are a commodity. If the profession is to make any significant changes in nurse staffing, it is through the articulation of the value of our professional practice within the overall health care environment. This position paper is organized around the concepts from the Data-Driven Model for Excellence in Staffing. The main concepts are: Core Concept 1: Users and Patients of Health Care, Core Concept 2: Providers of Health Care, Core Concept 3: Environment of Care, Core Concept 4: Delivery of Care, Core Concept 5: Quality, Safety, and Outcomes of Care. This position paper provides a comprehensive view of those concepts and components, why those concepts and components are important in this new era of nurse staffing, and a 3-year challenge that will push the nursing profession forward in all settings across the care continuum. There are decades of research supporting various changes to nurse staffing. Yet little has been done to move that research into practice and operations. While the primary goal of this position paper is to generate research

  5. Policy lessons from health taxes: a systematic review of empirical studies.

    Science.gov (United States)

    Wright, Alexandra; Smith, Katherine E; Hellowell, Mark

    2017-06-19

    Taxes on alcohol and tobacco have long been an important means of raising revenues for public spending in many countries but there is increasing interest in using taxes on these, and other unhealthy products, to achieve public health goals. We present a systematic review of the research on health taxes, and aim to generate insights into how such taxes can: (i) reduce consumption of targeted products and related harms; (ii) generate revenues for health objectives and distribute the tax burden across income groups in an efficient and equitable manner; and (iii) be made politically sustainable. Six scientific and four grey-literature databases were searched for empirical studies of 'health taxes' - defined as those intended to increase the costs of manufacturing, distributing, retailing and/or consuming health-damaging products. Since reviews already exist of the evidence relating to traditional alcohol and tobacco excise taxes, we focus on other taxes such as taxes on retailers and manufacturers of unhealthy products, and consumer taxes targeting unhealthy foods, such as sugar-sweetened beverages. Ninety-one peer-reviewed and 11 grey-literature studies met our inclusion criteria. The review highlights a recent, rapid rise in research in this area, most of which focuses on high-income countries and on taxes on food products or nutrients. Findings demonstrate that high tax rates on sugar-sweetened beverages are likely to have a positive impact on health behaviours and outcomes, and, while taxes on products reduce demand, they add to fiscal revenues. Common concerns about health taxes are also discussed. If the primary policy goal of a health tax is to reduce consumption of unhealthy products, then evidence supports the implementation of taxes that increase the price of products by 20% or more. However, where taxes are effective in changing health behaviours, the predictability of the revenue stream is reduced. Hence, policy actors need to be clear about the primary

  6. Policy lessons from health taxes: a systematic review of empirical studies

    Directory of Open Access Journals (Sweden)

    Alexandra Wright

    2017-06-01

    Full Text Available Abstract Background Taxes on alcohol and tobacco have long been an important means of raising revenues for public spending in many countries but there is increasing interest in using taxes on these, and other unhealthy products, to achieve public health goals. We present a systematic review of the research on health taxes, and aim to generate insights into how such taxes can: (i reduce consumption of targeted products and related harms; (ii generate revenues for health objectives and distribute the tax burden across income groups in an efficient and equitable manner; and (iii be made politically sustainable. Methods Six scientific and four grey-literature databases were searched for empirical studies of ‘health taxes’ – defined as those intended to increase the costs of manufacturing, distributing, retailing and/or consuming health-damaging products. Since reviews already exist of the evidence relating to traditional alcohol and tobacco excise taxes, we focus on other taxes such as taxes on retailers and manufacturers of unhealthy products, and consumer taxes targeting unhealthy foods, such as sugar-sweetened beverages. Results Ninety-one peer-reviewed and 11 grey-literature studies met our inclusion criteria. The review highlights a recent, rapid rise in research in this area, most of which focuses on high-income countries and on taxes on food products or nutrients. Findings demonstrate that high tax rates on sugar-sweetened beverages are likely to have a positive impact on health behaviours and outcomes, and, while taxes on products reduce demand, they add to fiscal revenues. Common concerns about health taxes are also discussed. Conclusions If the primary policy goal of a health tax is to reduce consumption of unhealthy products, then evidence supports the implementation of taxes that increase the price of products by 20% or more. However, where taxes are effective in changing health behaviours, the predictability of the revenue stream

  7. Effective Staffing Takes a Village: Creating the Staffing Ecosystem.

    Science.gov (United States)

    Gavigan, Margaret; Fitzpatrick, Therese A; Miserendino, Carole

    2016-01-01

    The traditional approaches to staffing and scheduling are often ineffective in assuring sufficient budgeting and deployment of staff to assure the right nurse at the right time for the right cost. As hospital merger activity increases, this exercise is further complicated by the need to rationalize staffing across multiple enterprises and standardize systems and processes. This Midwest hospital system successfully optimized staffing at the unit and enterprise levels by utilizing operations research methodologies. Savings were reinvested to improve staffing models which provided sufficient nonproductive coverage and patient-driven ratios. Over/under-staffing was eliminated in support of the system's recognition that adequate resource planning and deployment are critical to the culture of safety.

  8. Tax levy financing for local public health: fiscal allocation, effort, and capacity.

    Science.gov (United States)

    Riley, William J; Gearin, Kimberly J; Parrotta, Carmen D; Briggs, Jill; Gyllstrom, M Elizabeth

    2013-12-01

    Local health departments (LHDs) rely on a wide variety of funding sources, and the level of financing is associated with both LHD performance in essential public health services and population health outcomes. Although it has been shown that funding sources vary across LHDs, there is no evidence regarding the relationship between fiscal allocation (local tax levy); fiscal effort (tax capacity); and fiscal capacity (community wealth). The purpose of this study is to analyze local tax levy support for LHD funding. Three research questions are addressed: (1) What are tax levy trends in LHD fiscal allocation? (2) What is the role of tax levy in overall LHD financing? and (3) How do local community fiscal capacity and fiscal effort relate to LHD tax levy fiscal allocation? This study focuses on 74 LHDs eligible for local tax levy funding in Minnesota. Funding and expenditure data for 5 years (2006 to 2010) were compiled from four governmental databases, including the Minnesota Department of Health, the State Auditor, the State Demographer, and the Metropolitan Council. Trends in various funding sources and expenditures are described for the time frame of interest. Data were analyzed in 2012. During the 2006-2010 time period, total average LHD per capita expenditures increased 13%, from $50.98 to $57.63. Although the overall tax levy increase in Minnesota was 25%, the local tax levy for public health increased 5.6% during the same period. There is a direct relationship between fiscal effort and LHD expenditures. Local funding reflects LHD community priorities and the relative importance in comparison to funding other local programs with tax dollars. In Minnesota, local tax levy support for local public health services is not keeping pace with local tax support for other local government services. These results raise important questions about the relationship between tax levy resource effort, resource allocation, and fiscal capacity as they relate to public health

  9. Nursing home staffing requirements and input substitution: effects on housekeeping, food service, and activities staff.

    Science.gov (United States)

    Bowblis, John R; Hyer, Kathryn

    2013-08-01

    To study the effect of minimum nurse staffing requirements on the subsequent employment of nursing home support staff. Nursing home data from the Online Survey Certification and Reporting (OSCAR) System merged with state nurse staffing requirements. Facility-level housekeeping, food service, and activities staff levels are regressed on nurse staffing requirements and other controls using fixed effect panel regression. OSCAR surveys from 1999 to 2004. Increases in state direct care and licensed nurse staffing requirements are associated with decreases in the staffing levels of all types of support staff. Increased nursing home nurse staffing requirements lead to input substitution in the form of reduced support staffing levels. © Health Research and Educational Trust.

  10. Could targeted food taxes improve health?

    Science.gov (United States)

    Mytton, Oliver; Gray, Alastair; Rayner, Mike; Rutter, Harry

    2007-08-01

    To examine the effects on nutrition, health and expenditure of extending value added tax (VAT) to a wider range of foods in the UK. A model based on consumption data and elasticity values was constructed to predict the effects of extending VAT to certain categories of food. The resulting changes in demand, expenditure, nutrition and health were estimated. Three different tax regimens were examined: (1) taxing the principal sources of dietary saturated fat; (2) taxing foods defined as unhealthy by the SSCg3d nutrient scoring system; and (3) taxing foods in order to obtain the best health outcome. Consumption patterns and elasticity data were taken from the National Food Survey of Great Britain. The health effects of changing salt and fat intake were from previous meta-analyses. (1) Taxing only the principal sources of dietary saturated fat is unlikely to reduce the incidence of cardiovascular disease because the reduction in saturated fat is offset by a rise in salt consumption. (2) Taxing unhealthy foods, defined by SSCg3d score, might avert around 2,300 deaths per annum, primarily by reducing salt intake. (3) Taxing a wider range of foods could avert up to 3,200 cardiovascular deaths in the UK per annum (a 1.7% reduction). Taxing foodstuffs can have unpredictable health effects if cross-elasticities of demand are ignored. A carefully targeted fat tax could produce modest but meaningful changes in food consumption and a reduction in cardiovascular disease.

  11. Taxing food: implications for public health nutrition.

    Science.gov (United States)

    Caraher, Martin; Cowburn, Gill

    2005-12-01

    To set out a policy analysis of food taxes as a way of influencing food consumption and behaviour. The study draws on examples of food taxes from the developed world imposed at national and local levels. Studies were identified from a systemised search in six databases with criteria designed to identity articles of policy relevance. The dominant approach identified from the literature was the imposition of food taxes on food to raise general revenue, such as Value Added Tax in the European Union. Food taxes can be applied in various ways, ranging from attempts to directly influence behaviour to those which collect taxes for identified campaigns on healthy eating through to those applied within closed settings such as schools. There is a case for combining taxes of unhealthy foods with subsidies of healthy foods. The evidence from the literature concerning the use and impact of food taxes on food behaviour is not clear and those cases identified are mainly retrospective descriptions of the process. Many food taxes have been withdrawn after short periods of time due to industry lobbying. CONCLUSIONS FOR POLICY: Small taxes with the clear purpose of promoting the health of key groups, e.g. children, are more likely to receive public support. The focus of many tax initiatives is unclear; although they are generally aimed at consumers, another focus could be food manufacturers, using taxes and subsidies to encourage the production of healthier foods, which could have an effect at a population level. Further consideration needs to be given to this aspect of food taxes. Taxing food (and subsidies) can influence food behaviour within closed systems such as schools and the workplace.

  12. Longitudinal comparative evaluation of the equivalence of an integrated peer-support and clinical staffing model for residential mental health rehabilitation: a mixed methods protocol incorporating multiple stakeholder perspectives.

    Science.gov (United States)

    Parker, Stephen; Dark, Frances; Newman, Ellie; Korman, Nicole; Meurk, Carla; Siskind, Dan; Harris, Meredith

    2016-06-02

    A novel staffing model integrating peer support workers and clinical staff within a unified team is being trialled at community based residential rehabilitation units in Australia. A mixed-methods protocol for the longitudinal evaluation of the outcomes, expectations and experiences of care by consumers and staff under this staffing model in two units will be compared to one unit operating a traditional clinical staffing. The study is unique with regards to the context, the longitudinal approach and consideration of multiple stakeholder perspectives. The longitudinal mixed methods design integrates a quantitative evaluation of the outcomes of care for consumers at three residential rehabilitation units with an applied qualitative research methodology. The quantitative component utilizes a prospective cohort design to explore whether equivalent outcomes are achieved through engagement at residential rehabilitation units operating integrated and clinical staffing models. Comparative data will be available from the time of admission, discharge and 12-month period post-discharge from the units. Additionally, retrospective data for the 12-month period prior to admission will be utilized to consider changes in functioning pre and post engagement with residential rehabilitation care. The primary outcome will be change in psychosocial functioning, assessed using the total score on the Health of the Nation Outcome Scales (HoNOS). Planned secondary outcomes will include changes in symptomatology, disability, recovery orientation, carer quality of life, emergency department presentations, psychiatric inpatient bed days, and psychological distress and wellbeing. Planned analyses will include: cohort description; hierarchical linear regression modelling of the predictors of change in HoNOS following CCU care; and descriptive comparisons of the costs associated with the two staffing models. The qualitative component utilizes a pragmatic approach to grounded theory, with

  13. The welfare gain from replacing the health insurance tax exclusion with lump-sum tax credits.

    Science.gov (United States)

    Liu, Liqun; Rettenmaier, Andrew J; Saving, Thomas R

    2011-06-01

    This paper analyzes the welfare gain from replacing the tax exclusion of employer-provided health insurance with a lump-sum tax credit. It differs from earlier studies in that we look at the welfare cost of health insurance tax exclusion as coming directly from excessive health insurance rather than from overconsumption of medical care and that we account for the labor market effect of the tax exclusion on welfare. Both differences work to produce a smaller tax reform welfare gain. For a set of mid-range parameter values, the welfare gain is about 21% of current health insurance tax expenditures. In addition, government tax expenditures would fall by 38%, and health insurance spending would fall by 77% after the reform.

  14. 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

  15. Nurse staffing, medical staffing and mortality in Intensive Care: An observational study.

    Science.gov (United States)

    West, Elizabeth; Barron, David N; Harrison, David; Rafferty, Anne Marie; Rowan, Kathy; Sanderson, Colin

    2014-05-01

    hospital mortality which gives the study additional credibility. This study supports claims that the availability of medical and nursing staff is associated with the survival of critically ill patients and suggests that future studies should focus on the resources of the health care team. The results emphasise the urgent need for a prospective study of staffing levels and the organisation of care in ICUs. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. The 2009 Health Confidence Survey: public opinion on health reform varies; strong support for insurance market reform and public plan option, mixed response to tax cap.

    Science.gov (United States)

    Fronstin, Paul; Helman, Ruth

    2009-07-01

    PUBLIC SUPPORT FOR HEALTH REFORM: Findings from the 2009 Health Confidence Survey--the 12th annual HCS--indicate that Americans have already formed strong opinions regarding various aspects of health reform, even before details have been released regarding various key factors. These issues include health insurance market reform, the availability of a public plan option, mandates on employers and individuals, subsidized coverage for the low-income population, changes to the tax treatment of job-based health benefits, and regulatory oversight of health care. These opinions may change as details surface, especially as they concern financing options. In the absence of such details, the 2009 HCS finds generally strong support for the concepts of health reform options that are currently on the table. U.S. HEALTH SYSTEM GETS POOR MARKS, BUT SO DOES A MAJOR OVERHAUL: A majority rate the nation's health care system as fair (30 percent) or poor (29 percent). Only a small minority rate it excellent (6 percent) or very good (10 percent). While 14 percent of Americans think the health care system needs a major overhaul, 51 percent agree with the statement "there are some good things about our health care system, but major changes are needed." NATIONAL HEALTH PLAN ELEMENTS RATED HIGHLY: Between 68 percent and 88 percent of Americans either strongly or somewhat support health reform ideas such as national health plans, a public plan option, guaranteed issue, expansion of Medicare and Medicaid, and employer and individual mandates. MIXED REACTION TO HEALTH BENEFITS TAX CAP: Reaction to capping the current tax exclusion of employment-based health benefits is mixed. Nearly one-half of Americans (47 percent) would switch to a lower-cost plan if the tax exclusion were capped, 38 percent would stay on their current plan and pay the additional taxes, and 9 percent don't know. CONTINUED FAITH IN EMPLOYMENT-BASED BENEFITS, BUT DOUBTS ON AFFORDABILITY: Individuals with employment

  17. 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

  18. Partisan Responses to Public Health Messages: Motivated Reasoning and Sugary Drink Taxes.

    Science.gov (United States)

    Gollust, Sarah E; Barry, Colleen L; Niederdeppe, Jeff

    2017-12-01

    This study examines the public's motivated reasoning of competitive messages about sugary drink taxes, a public health policy approach attempted with some recent success in the United States. In an experiment embedded in a nationally representative survey fielded in the fall of 2012, we randomized participants ( N  = 5,147) to receive one of four messages: control, a strong protax message, a two-sided message, or a message refuting arguments made in soda company antitax messages. The protax message showed no effects on tax support, while the two-sided message depressed Republicans' support. The refutation message boosted independents' support but produced backlash among Republicans. This motivated response was pronounced among Republicans who were plausibly previously exposed to the sugary drink tax debate. These findings reinforce the communication challenges in an increasingly politicized US health policy discourse. Copyright © 2017 by Duke University Press.

  19. Factors that affect implementation of a nurse staffing directive: results from a qualitative multi-case evaluation.

    Science.gov (United States)

    Robinson, Claire H; Annis, Ann M; Forman, Jane; Krein, Sarah L; Yankey, Nicholas; Duffy, Sonia A; Taylor, Beth; Sales, Anne E

    2016-08-01

    To assess implementation of the Veterans Health Administration staffing methodology directive. In 2010 the Veterans Health Administration promulgated a staffing methodology directive for inpatient nursing units to address staffing and budget forecasting. A qualitative multi-case evaluation approach assessed staffing methodology implementation. Semi-structured telephone interviews were conducted from March - June 2014 with Nurse Executives and their teams at 21 facilities. Interviews focused on the budgeting process, implementation experiences, use of data, leadership support, and training. An implementation score was created for each facility using a 4-point rating scale. The scores were used to select three facilities (low, medium and high implementation) for more detailed case studies. After analysing interview summaries, the evaluation team developed a four domain scoring structure: (1) integration of staffing methodology into budget development; (2) implementation of the Directive elements; (3) engagement of leadership and staff; and (4) use of data to support the staffing methodology process. The high implementation facility had leadership understanding and endorsement of staffing methodology, confidence in and ability to work with data, and integration of staffing methodology results into the budgeting process. The low implementation facility reported poor leadership engagement and little understanding of data sources and interpretation. Implementation varies widely across facilities. Implementing staffing methodology in facilities with complex and changing staffing needs requires substantial commitment at all organizational levels especially for facilities that have traditionally relied on historical levels to budget for staffing. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  20. Health insurance tax credits, the earned income tax credit, and health insurance coverage of single mothers.

    Science.gov (United States)

    Cebi, Merve; Woodbury, Stephen A

    2014-05-01

    The Omnibus Budget Reconciliation Act of 1990 enacted a refundable tax credit for low-income working families who purchased health insurance coverage for their children. This health insurance tax credit (HITC) existed during tax years 1991, 1992, and 1993, and was then rescinded. A difference-in-differences estimator applied to Current Population Survey data suggests that adoption of the HITC, along with accompanying increases in the Earned Income Tax Credit (EITC), was associated with a relative increase of about 4.7 percentage points in the private health insurance coverage of working single mothers with high school or less education. Also, a difference-in-difference-in-differences estimator, which attempts to net out the possible influence of the EITC increases but which requires strong assumptions, suggests that the HITC was responsible for about three-quarters (3.6 percentage points) of the total increase. The latter estimate implies a price elasticity of health insurance take-up of -0.42. Copyright © 2013 John Wiley & Sons, Ltd.

  1. Where there's a will: can highlighting future youth-targeted marketing increase support for soda taxes?

    Science.gov (United States)

    Roh, Sungjong; Schuldt, Jonathon P

    2014-12-01

    Amid concern about high rates of obesity and related diseases, the marketing of nutritionally poor foods to young people by the food industry has come under heavy criticism by public health advocates, who cite decades of youth-targeted marketing in arguing for reforms. In light of recent evidence that the same event evokes stronger emotional reactions when it occurs in the future versus the past, highlighting youth-targeted marketing that has yet to occur may evoke stronger reactions to such practices, and perhaps, greater support for related health policy initiatives. In a between-subjects experiment, Web participants (N = 285) read that a major soda company had already launched (past condition) or was planning to launch (future condition) an advertising campaign targeting children. Measures included support for a soda tax and affective responses to the company's actions. Greater support for the soda tax was observed in the future condition than in the past condition. Moreover, participants in the future condition reported heightened negative emotions about the company's actions, which mediated the observed effect on soda tax support. The same action undertaken by the food industry (here, marketing soda to children) may evoke stronger negative emotions and greater support for a health policy initiative when it is framed prospectively rather than retrospectively.

  2. [Impact of nurse, nurses' aid staffing and turnover rate on inpatient health outcomes in long term care hospitals].

    Science.gov (United States)

    Kim, Yunmi; Lee, Ji Yun; Kang, Hyuncheol

    2014-02-01

    This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.

  3. Health care evaluation, utilitarianism and distortionary taxes.

    Science.gov (United States)

    Calcott, P

    2000-09-01

    Cost Utility Analysis (CUA) and Cost Benefit Analysis (CBA) are methods to evaluate allocations of health care resources. Problems are raised for both methods when income taxes do not meet the first best optimum. This paper explores the implications of three ways that taxes may fall short of this ideal. First, taxes may be distortionary. Second, they may be designed and administered without reference to information that is used by providers of health care. Finally, the share of tax revenue that is devoted to health care may be suboptimal. The two methods are amended to account for these factors.

  4. ESTIMATION OF TAX BASE IN PERSONAL INCOME TAX AS A FORM OF SUPPORT FOR AGRICULTURE IN GERMANY

    Directory of Open Access Journals (Sweden)

    Renata BUDLEWSKA

    2015-08-01

    Full Text Available Taxes in most EU countries are designed to financially support farms through lower tax rates. The preferential tax allowances and exemptions motivate farmers to undertake specific activities, in accordance with the main objectives of the agricultural policy. As a result of such activities, the agricultural sector receives additional support, which officially is not subject to public control, at the same time contributing to a considerable burden of EU budgets. The aim of the article is to evaluate the selected tax expenditures addressed to farmers, contained in the German personal income tax. The paper is an attempt to answer the question, whether the method for estimating income from agricultural production used in the German personal income tax law has an impact on reducing tax burdens of farm owners and what the consequences are for the agricultural sector, especially in the area of changes in the area structure of farms.

  5. Framing the tax and health nexus: a neglected aspect of public health concern.

    Science.gov (United States)

    Mccoy, David; Chigudu, Simukai; Tillmann, Taavi

    2017-04-01

    Previous studies have described various associations between tax policy and health. Here we propose a unifying conceptual framework of 'Five R's' to stimulate awareness about the importance of tax to health improvement. First, tax can improve representation and democratic accountability, and help make governments more responsive to the needs of its citizens. Second, tax can create a revenue stream for a universal pool of public finance for health care and other public services. Third, progressive taxation when combined with appropriate public spending can help redistribute wealth and income and mitigate social and health inequalities. Fourth, the re-pricing of harmful products (e.g. tobacco, alcohol and unhealthy food) can help reduce their consumption. Fifth, taxation provides a route by which certain harmful industries can be regulated. The paper also discusses the barriers that hinder the full potential for taxation to be used to improve health, including: weak tax administrations, large 'shadow economies', international trade liberalisation, tax avoidance, transfer pricing by transnational corporations and banking secrecy. We suggest that a greater awareness of the manifold associations between tax and health will encourage health practitioners to actively promote fairer and better taxation, thereby helping to improve health and reduce health inequalities.

  6. Staffing in Radiotherapy: An Activity Based Approach

    International Nuclear Information System (INIS)

    2015-01-01

    Radiotherapy requires competent professional staff to ensure safe and effective patient treatment and management. There is a need to provide guidelines that recommend appropriate staffing levels to support the initiation of new services as well as the expansion or upgrade of existing services as even simple upgrades or replacement of existing equipment may have a significant impact on staffing needs. Similarly, the introduction of education and training programmes will require staffing adjustments. A calculation algorithm was developed to predict staffing levels based on the inputs that are known or can be easily estimated. This publication complements other IAEA publications used to support the initiation of basic radiation medicine services including Setting up a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects, published in 2008

  7. Obesity prevention strategies: could food or soda taxes improve health?

    Science.gov (United States)

    Encarnação, R; Lloyd-Williams, F; Bromley, H; Capewell, S

    2016-03-01

    Evidence shows that one of the main causes for rising obesity rates is excessive consumption of sugar, which is due in large part to the high sugar content of most soda and juice drinks and junk foods. Worryingly, UK and global populations are consuming increasing amounts of sugary drinks and junk foods (high in salt, sugar and saturated fats). However, there is raised public awareness, and parents in particular want something to be done to curb the alarming rise in childhood obesity. Population-wide policies (i.e. taxation, regulation, legislation, reformulation) consistently achieve greater public health gains than interventions and strategies targeted at individuals. Junk food and soda taxes are supported by increasing evidence from empirical and modelling studies. The strongest evidence base is for a tax on sugar sweetened beverages, but in order to effectively reduce consumption, that taxation needs to be at least 20%. Empirical data from a number of countries which have implemented a duty on sugar or sugary drinks shows rapid, substantial benefits. In the UK, increasing evidence from recent scientific reports consistently support substantial reductions in sugar consumption through comprehensive strategies which include a tax. Furthermore, there is increasing public support for such measures. A sugar sweetened beverages tax will happen in the UK so the question is not 'If?' but 'When?' this tax will be implemented. And, crucially, which nation will get there first? England, Ireland, Scotland or Wales?

  8. Nurse Staffing and Quality of Care of Nursing Home Residents in Korea.

    Science.gov (United States)

    Shin, Juh Hyun; Hyun, Ta Kyung

    2015-11-01

    To investigate the relationship between nurse staffing and quality of care in nursing homes in Korea. This study used a cross-sectional design to describe the relationship between nurse staffing and 15 quality-of-care outcomes. Independent variables were hours per resident day (HPRD), skill mix, and turnover of each nursing staff, developed with the definitions of the Centers for Medicare & Medicaid Services and the American Health Care Association. Dependent variables were prevalence of residents who experienced more than one fall in the recent 3 months, aggressive behaviors, depression, cognitive decline, pressure sores, incontinence, prescribed antibiotics because of urinary tract infection, weight loss, dehydration, tube feeding, bed rest, increased activities of daily living, decreased range of motion, use of antidepressants, and use of restraints. Outcome variables were quality indicators from the U.S. Centers for Medicare & Medicaid and 2013 nursing home evaluation manual by the Korean National Health Insurance Service. The effects of registered nurse (RN) HPRD was supported in fall prevention, decreased tube feeding, decreased numbers of residents with deteriorated range of motion, and decreased aggressive behavior. Higher turnover of RNs related to more residents with dehydration, bed rest, and use of antipsychotic medication. Study results supported RNs' unique contribution to resident outcomes in comparison to alternative nurse staffing in fall prevention, decreased use of tube feeding, better range of motion for residents, and decreased aggressive behaviors in nursing homes in Korea. More research is required to confirm the effects of nurse staffing on residents' outcomes in Korea. We found consistency in the effects of RN staffing on resident outcomes acceptable. By assessing nurse staffing levels and compositions of nursing staffs, this study contributes to more effective long-term care insurance by reflecting on appropriate policies, and ultimately

  9. 77 FR 30377 - Health Insurance Premium Tax Credit

    Science.gov (United States)

    2012-05-23

    ... Health Insurance Premium Tax Credit AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Final regulations. SUMMARY: This document contains final regulations relating to the health insurance premium tax... categories of immigrants described in the Children's Health Insurance Program Reauthorization Act. One...

  10. 76 FR 50931 - Health Insurance Premium Tax Credit

    Science.gov (United States)

    2011-08-17

    ... Health Insurance Premium Tax Credit AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of... relating to the health insurance premium tax credit enacted by the Patient Protection and Affordable Care... be able to purchase private health insurance through State-based competitive marketplaces called...

  11. The logic of tax-based financing for health care.

    Science.gov (United States)

    Bodenheimer, T; Sullivan, K

    1997-01-01

    Employment-based health insurance faces serious problems. For the first time, the number of Americans covered by such health insurance is falling. Employers strongly oppose the employer mandate approach to extending health insurance. Employment-based financing is regressive and complex. Serious debate is needed on an alternative solution to financing health care for all Americans. Taxation represents a clear alternative to employment-based health care financing. The major criterion for choosing a tax is equity, with simplicity a second criterion. An earmarked, progressive individual income tax is a fair and potentially simple tax with which to finance health care. The political feasibility of such a tax is greater than that of employer mandate legislation.

  12. Do healthcare tax credits help poor-health individuals on low incomes?

    Science.gov (United States)

    Di Novi, Cinzia; Marenzi, Anna; Rizzi, Dino

    2018-03-01

    In several countries, personal income tax permits tax credits for out-of-pocket healthcare expenditure. Tax credits benefit taxpayers at all income levels by reducing their net tax liability and modify the price of out-of-pocket expenditure. To the extent that consumer demand is price elastic, they may influence the amount of eligible healthcare expenditure for which taxpayers may claim a credit. These effects influence, in turn, income distributions and taxpayers' health status and therefore income-related inequality in health. Redistributive consequences of tax credits have been widely investigated. However, little is known about the ability of tax credits to alleviate health inequality. In this paper, we study the potential effects that tax credits for health expenses may have on income-related inequality in health status with reference to the Italian institutional setting. The analysis is performed using a tax-benefit microsimulation model that reproduces the personal income tax and incorporates taxpayers' behavioral responses to changes in tax credit rate. Our results suggest that the current healthcare tax credit design tends to favor the richest part of the population.

  13. Health insurance premium tax credit. Final regulations.

    Science.gov (United States)

    2013-02-01

    This document contains final regulations relating to the health insurance premium tax credit enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010.These final regulations provide guidance to individuals related to employees who may enroll in eligible employer-sponsored coverage and who wish to enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges) and claim the premium tax credit.

  14. Twenty years of staffing, practice environment, and outcomes research in military nursing.

    Science.gov (United States)

    Patrician, Patricia A; Loan, Lori A; McCarthy, Mary S; Swiger, Pauline; Breckenridge-Sproat, Sara; Brosch, Laura Ruse; Jennings, Bonnie Mowinski

    Two decades ago, findings from an Institute of Medicine (IOM) report sparked the urgent need for evidence supporting relationships between nurse staffing and patient outcomes. This article provides an overview of nurse staffing, practice environment, and patient outcomes research, with an emphasis on findings from military studies. Lessons learned also are enumerated. This study is a review of the entire Military Nursing Outcomes Database (MilNOD) program of research. The MilNOD, in combination with evidence from other health care studies, provides nurses and leaders with information about the associations between staffing, patient outcomes, and the professional practice environment of nursing in the military. Leaders, therefore, have useful empirical evidence to make data-driven decisions. The MilNOD studies are the basis for the current Army nursing dashboard, and care delivery framework, called the Patent CaringTouch System. Future research is needed to identify ideal staffing based on workload demands, and provide leaders with factors to consider when operationalizing staffing recommendations. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Geographic proximity to coal plants and U.S. public support for extending the Production Tax Credit

    International Nuclear Information System (INIS)

    Goldfarb, Jillian L.; Buessing, Marric; Kriner, Douglas L.

    2016-01-01

    The Production Tax Credit (PTC) is an important policy instrument through which the federal government promotes renewable energy development in the United States. However, the efficacy of the PTC is hampered by repeated expirations and short-term extensions, and by the general uncertainty surrounding its future status. We examine the factors driving variation in public support for the extension of the PTC using a nationally representative, internet-based survey. Americans living near a coal-fired power plant are significantly more likely to support extending the PTC than are their peers who are more insulated from the externalities of burning coal. The evidence for this dynamic was strongest and most statistically significant among subjects experimentally primed to think about the adverse health effects of burning coal. Raising awareness of the public health ramifications of generating electricity from fossil fuels holds the potential to increase support for renewable energy policies among those living in proximity to coal plants, even in a highly politicized policy debate. - Highlights: • Proximity to coal power plant increases support for Production Tax Credit. • Attitudes toward global warming influence support for PTC. • Raising awareness of health threat increases PTC support if living near coal plant.

  16. 78 FR 7264 - Health Insurance Premium Tax Credit

    Science.gov (United States)

    2013-02-01

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 1 [TD 9611] RIN 1545-BL49 Health Insurance Premium Tax Credit AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Final regulations. SUMMARY: This document contains final regulations relating to the health insurance premium tax credit...

  17. 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 ...

  18. Texas Nurse Staffing Trends Before and After Mandated Nurse Staffing Committees.

    Science.gov (United States)

    Jones, Terry; Heui Bae, Sung; Murry, Nicole; Hamilton, Patti

    2015-08-01

    This article describes the evolution of mandated nurse staffing committees in Texas from 2002 to 2009 and presents a study that analyzed nurse staffing trends in Texas using a secondary analysis of hospital staffing data (N = 313 hospitals) from 2000 to 2012 obtained from the American Hospital Association Annual Survey. Nurse staffing patterns based on three staffing variables for registered nurses (RNs), licensed vocational nurses (LVNs), and total licensed nurses were identified: full-time equivalents per 1,000 adjusted patient days, productive hours per adjusted patient day, and RN skill mix. Similar to national trends between 2000 and 2012, most Texas hospitals experienced an increase in RN and total nurse staffing, decrease in LVN staffing, and an increase in RN skill mix. The magnitude of total nurse staffing changes in Texas (5% increase) was smaller than national trends (13.6% increase). Texas's small, rural, government hospitals and those with the highest preregulation staffing levels experienced the least change in staffing between 2000 and 2012: median change of 0 to .13 full-time equivalents per 1,000 adjusted patient days and median change in productive hours per patient day of 0 to .23. The varying effects of staffing committees in different organizational contexts should be considered in future staffing legislative proposals and other policy initiatives. © The Author(s) 2015.

  19. Increasing tobacco taxes : A cheap tool to increase public health

    NARCIS (Netherlands)

    van Baal, Pieter H. M.; Brouwer, Werner B. F.; Hoogenveen, Rudolf T.; Feenstra, Talitha L.

    Introduction: Several studies have estimated health effects resulting from tobacco tax increases. However, studies on the cost effectiveness of tobacco taxes are scarce. The aim of this study was to estimate the cost effectiveness of tobacco tax increases from a health care perspective, explicitly

  20. Financing universal health coverage—effects of alternative tax structures on public health systems: cross-national modelling in 89 low-income and middle-income countries

    Science.gov (United States)

    Reeves, Aaron; Gourtsoyannis, Yannis; Basu, Sanjay; McCoy, David; McKee, Martin; Stuckler, David

    2015-01-01

    Summary Background How to finance progress towards universal health coverage in low-income and middle-income countries is a subject of intense debate. We investigated how alternative tax systems affect the breadth, depth, and height of health system coverage. Methods We used cross-national longitudinal fixed effects models to assess the relationships between total and different types of tax revenue, health system coverage, and associated child and maternal health outcomes in 89 low-income and middle-income countries from 1995–2011. Findings Tax revenue was a major statistical determinant of progress towards universal health coverage. Each US$100 per capita per year of additional tax revenues corresponded to a yearly increase in government health spending of $9·86 (95% CI 3·92–15·8), adjusted for GDP per capita. This association was strong for taxes on capital gains, profits, and income ($16·7, 9·16 to 24·3), but not for consumption taxes on goods and services (−$4·37, −12·9 to 4·11). In countries with low tax revenues (tax revenue per year substantially increased the proportion of births with a skilled attendant present by 6·74 percentage points (95% CI 0·87–12·6) and the extent of financial coverage by 11·4 percentage points (5·51–17·2). Consumption taxes, a more regressive form of taxation that might reduce the ability of the poor to afford essential goods, were associated with increased rates of post-neonatal mortality, infant mortality, and under-5 mortality rates. We did not detect these adverse associations with taxes on capital gains, profits, and income, which tend to be more progressive. Interpretation Increasing domestic tax revenues is integral to achieving universal health coverage, particularly in countries with low tax bases. Pro-poor taxes on profits and capital gains seem to support expanding health coverage without the adverse associations with health outcomes observed for higher consumption taxes. Progressive tax

  1. Financing universal health coverage--effects of alternative tax structures on public health systems: cross-national modelling in 89 low-income and middle-income countries.

    Science.gov (United States)

    Reeves, Aaron; Gourtsoyannis, Yannis; Basu, Sanjay; McCoy, David; McKee, Martin; Stuckler, David

    2015-07-18

    How to finance progress towards universal health coverage in low-income and middle-income countries is a subject of intense debate. We investigated how alternative tax systems affect the breadth, depth, and height of health system coverage. We used cross-national longitudinal fixed effects models to assess the relationships between total and different types of tax revenue, health system coverage, and associated child and maternal health outcomes in 89 low-income and middle-income countries from 1995-2011. Tax revenue was a major statistical determinant of progress towards universal health coverage. Each US$100 per capita per year of additional tax revenues corresponded to a yearly increase in government health spending of $9.86 (95% CI 3.92-15.8), adjusted for GDP per capita. This association was strong for taxes on capital gains, profits, and income ($16.7, 9.16 to 24.3), but not for consumption taxes on goods and services (-$4.37, -12.9 to 4.11). In countries with low tax revenues (tax revenue per year substantially increased the proportion of births with a skilled attendant present by 6.74 percentage points (95% CI 0.87-12.6) and the extent of financial coverage by 11.4 percentage points (5.51-17.2). Consumption taxes, a more regressive form of taxation that might reduce the ability of the poor to afford essential goods, were associated with increased rates of post-neonatal mortality, infant mortality, and under-5 mortality rates. We did not detect these adverse associations with taxes on capital gains, profits, and income, which tend to be more progressive. Increasing domestic tax revenues is integral to achieving universal health coverage, particularly in countries with low tax bases. Pro-poor taxes on profits and capital gains seem to support expanding health coverage without the adverse associations with health outcomes observed for higher consumption taxes. Progressive tax policies within a pro-poor framework might accelerate progress toward achieving major

  2. Tax-Assisted Approaches for Helping Canadians Meet Out-of-Pocket Health-Care Costs

    Directory of Open Access Journals (Sweden)

    J.C. Herbert Emery

    2016-06-01

    Full Text Available Canadians are not saving for the inevitable costs of drugs and long-term care which they will have to pay for out of pocket in their old age, and these costs could potentially be financially devastating for them. Later in life, when out-of-pocket health-care costs mount, those who previously enjoyed the security of a workplace insurance plan to cover such expenses will face a grim financial reality. Many aspects of care for older Canadians aren’t covered by this country’s single-payer health-care system. Besides prescription drugs, these include management of chronic conditions by ancillary health professionals, home care, long-term care, and dental and vision care. Statistics show that in 2012, Canadians’ private spending on health care totaled $60 billion, with private health insurance covering $24.5 billion of that amount. Coverage of health-care costs that don’t fall under Medicare’s purview is at present rather piecemeal. The non-refundable federal Medical Expense Tax Credit covers expenses only after the three-per-cent minimum, or first $2,171, of out-of-pocket costs have been paid by the individual. The Disability Tax Credit is available to those with a certified chronic disability, and these individuals are eligible for further support via the Registered Disability Savings Plan. A Caregiver Tax Credit is also available. The federal government has a golden opportunity to provide an incentive for Canadians to set aside money to pay not only for the often catastrophic medical and drug costs that can come with aging, but also to save so they can afford long-term care, or purchase private health insurance. Too many Canadians, unfortunately, believe that the federal government picks up the tab for long-term care. In fact, provincial subsidies are provided on a means-testing basis, thus leaving many better-off Canadians in the lurch when they can no longer live alone and must make the transition to long-term care. Providing more

  3. The coming changes in tax-exempt health care finance.

    Science.gov (United States)

    Carlile, L L; Serchuk, B M

    1995-01-01

    On December 30, 1994, the Internal Revenue Service (IRS) published proposed regulations (Proposed Regulations) that if enacted would significantly change the climate and rules of federal income tax law controlling the issuance and maintenance of tax-exempt bonds for governmental and 501(c)(3) health care borrowers. This article (1) summarizes the aspects of the Proposed Regulations dealing with private activity tests, management contracts, allocation and accounting rules, change in use of financed facilities, and antiabuse rules, and (2) summarizes the possible interrelationship of the IRS's audit program for tax-exempt bonds and the Proposed Regulations. The article reviews features of the Proposed Regulations that will affect either the costs or administrative burdens of managing the federal tax compliance of future tax-exempt health care borrowings.

  4. Economic evaluation of nurse staffing and nurse substitution in health care: a scoping review.

    Science.gov (United States)

    Goryakin, Yevgeniy; Griffiths, Peter; Maben, Jill

    2011-04-01

    Several systematic reviews have suggested that greater nurse staffing as well as a greater proportion of registered nurses in the health workforce is associated with better patient outcomes. Others have found that nurses can substitute for doctors safely and effectively in a variety of settings. However, these reviews do not generally consider the effect of nurse staff on both patient outcomes and costs of care, and therefore say little about the cost-effectiveness of nurse-provided care. Therefore, we conducted a scoping literature review of economic evaluation studies which consider the link between nurse staffing, skill mix within the nursing team and between nurses and other medical staff to determine the nature of the available economic evidence. Scoping literature review. English-language manuscripts, published between 1989 and 2009, focussing on the relationship between costs and effects of care and the level of registered nurse staffing or nurse-physician substitution/nursing skill mix in the clinical team, using cost-effectiveness, cost-utility, or cost-benefit analysis. Articles selected for the review were identified through Medline, CINAHL, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and Google Scholar database searches. After selecting 17 articles representing 16 unique studies for review, we summarized their main findings, and assessed their methodological quality using criteria derived from recommendations from the guidelines proposed by the Panel on Cost-Effectiveness in Health Care. In general, it was found that nurses can provide cost effective care, compared to other health professionals. On the other hand, more intensive nurse staffing was associated with both better outcomes and more expensive care, and therefore cost effectiveness was not easy to assess. Although considerable progress in economic evaluation studies has been reached in recent years, a number of methodological issues remain. In the future

  5. 77 FR 41048 - Health Insurance Premium Tax Credit; Correction

    Science.gov (United States)

    2012-07-12

    ... the health insurance premium tax credit enacted by the Patient Protection and Affordable Care Act and... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 1 [TD 9590] RIN 1545-BJ82 Health Insurance Premium Tax Credit; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION...

  6. 42 CFR 9.9 - Facility staffing.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Facility staffing. 9.9 Section 9.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS STANDARDS OF CARE FOR... Biosafety Officer must have experience in developing and monitoring biohazards and dealing with biosafety...

  7. Alcohol tax, consumption and mortality in tsarist Russia: is a public health perspective applicable?

    Science.gov (United States)

    Norström, Thor; Stickley, Andrew

    2013-04-01

    The public health perspective on alcohol comprises two main tenets: (i) population drinking impacts on alcohol-related harm and (ii) population drinking is affected by the physical and economic availability of alcohol, where alcohol taxes are the most efficient measure for regulating consumption. This perspective has received considerable empirical support from analyses of contemporary data mainly from Europe and North America. However, as yet, it has been little examined in a historical context. The aims of the present article are to use data from tsarist Russia to explore (i) the relation between changes in the tax on alcohol and per capita alcohol consumption and (ii) the relation between per capita alcohol consumption and alcohol mortality. The material comprised annual data on alcohol taxes, alcohol consumption and alcohol mortality. The tax and alcohol consumption series spanned the period 1864-1907 and the mortality data covered the period 1870-94. The data were analysed by estimating autoregressive integrated moving average models on differenced data. Changes in alcohol taxes were significantly associated with alcohol consumption in the expected direction. Increases in alcohol consumption, in turn, were significantly related to increases in alcohol mortality. This study provides support for the utility of the public health perspective on alcohol in explaining changes in consumption and alcohol-related harm in a historical context. We discuss our findings from tsarist Russia in the light of experiences from more recent alcohol policy changes in Russia.

  8. 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.

  9. Insurance choice and tax-preferred health savings accounts.

    Science.gov (United States)

    Cardon, James H; Showalter, Mark H

    2007-03-01

    We develop an infinite horizon utility maximization model of the interaction between insurance choice and tax-preferred health savings accounts. The model can be used to examine a wide range of policy options, including flexible spending accounts, health savings accounts, and health reimbursement accounts. We also develop a 2-period model to simulate various implications of the model. Key results from the simulation analysis include the following: (1) with no adverse selection, use of unrestricted health savings accounts leads to modest welfare gains, after accounting for the tax revenue loss; (2) with adverse selection and an initial pooling equilibrium comprised of "sick" and "healthy" consumers, introducing HSAs can, but does not necessarily, lead to a new pooling equilibrium. The new equilibrium results in a higher coinsurance rate, an increase in expected utility for healthy consumers, and a decrease in expected utility for sick consumers; (3) with adverse selection and a separating equilibrium, both sick and healthy consumers are better off with a health savings account; (4) efficiency gains are possible when insurance contracts are explicitly linked to tax-preferred health savings accounts.

  10. Revenue and Health Impacts of Restructuring Tobacco Excise Tax ...

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

    Revenue and Health Impacts of Restructuring Tobacco Excise Tax in the Philippines. A proposed law in the Philippines to increase the excise tax on tobacco by 215% will likely have implications for tobacco control and consumption, and public health, not just for that country but for the region. Although half of deaths due to ...

  11. Does mental health staffing level affect antipsychotic prescribing? Analysis of Italian national statistics.

    Science.gov (United States)

    Starace, Fabrizio; Mungai, Francesco; Barbui, Corrado

    2018-01-01

    In mental healthcare, one area of major concern identified by health information systems is variability in antipsychotic prescribing. While most studies have investigated patient- and prescriber-related factors as possible reasons for such variability, no studies have investigated facility-level characteristics. The present study ascertained whether staffing level is associated with antipsychotic prescribing in community mental healthcare. A cross-sectional analysis of data extracted from the Italian national mental health information system was carried out. For each Italian region, it collects data on the availability and use of mental health facilities. The rate of individuals exposed to antipsychotic drugs was tested for evidence of association with the rate of mental health staff availability by means of univariate and multivariate analyses. In Italy there were on average nearly 60 mental health professionals per 100,000 inhabitants, with wide regional variations (range 21 to 100). The average rate of individuals prescribed antipsychotic drugs was 2.33%, with wide regional variations (1.04% to 4.01%). Univariate analysis showed that the rate of individuals prescribed antipsychotic drugs was inversely associated with the rate of mental health professionals available in Italian regions (Kendall's tau -0.438, p = 0.006), with lower rates of antipsychotic prescriptions in regions with higher rates of mental health professionals. After adjustment for possible confounders, the total availability of mental health professionals was still inversely associated with the rate of individuals exposed to antipsychotic drugs. The evidence that staffing level was inversely associated with antipsychotic prescribing indicates that any actions aimed at decreasing variability in antipsychotic prescribing need to take into account aspects related to the organization of the mental health system.

  12. Medical staffing in Ontario neonatal intensive care units.

    Science.gov (United States)

    Paes, B; Mitchell, A; Hunsberger, M; Blatz, S; Watts, J; Dent, P; Sinclair, J; Southwell, D

    1989-06-01

    Advances in technology have improved the survival rates of infants of low birth weight. Increasing service commitments together with cutbacks in Canadian training positions have caused concerns about medical staffing in neonatal intensive care units (NICUs) in Ontario. To determine whether an imbalance exists between the supply of medical personnel and the demand for health care services, in July 1985 we surveyed the medical directors, head nurses and staff physicians of nine tertiary level NICUs and the directors of five postgraduate pediatric residency programs. On the basis of current guidelines recommending an ideal neonatologist:patient ratio of 1:6 (assuming an adequate number of support personnel) most of the NICUs were understaffed. Concern about the heavy work pattern and resulting lifestyle implications has made Canadian graduates reluctant to enter this subspecialty. We propose strategies to correct staffing shortages in the context of rapidly increasing workloads resulting from a continuing cutback of pediatric residency positions and restrictions on immigration of foreign trainees.

  13. Meeting human resources for health staffing goals by 2018: a quantitative analysis of policy options in Zambia

    Directory of Open Access Journals (Sweden)

    Schroder Kate

    2010-06-01

    Full Text Available Abstract Background The Ministry of Health (MOH in Zambia is currently operating with fewer than half of the health workers required to deliver basic health services. The MOH has developed a human resources for health (HRH strategic plan to address the crisis through improved training, hiring, and retention. However, the projected success of each strategy or combination of strategies is unclear. Methods We developed a model to forecast the size of the public sector health workforce in Zambia over the next ten years to identify a combination of interventions that would expand the workforce to meet staffing targets. The key forecasting variables are training enrolment, graduation rates, public sector entry rates for graduates, and attrition of workforce staff. We model, using Excel (Office, Microsoft; 2007, the effects of changes in these variables on the projected number of doctors, clinical officers, nurses and midwives in the public sector workforce in 2018. Results With no changes to current training, hiring, and attrition conditions, the total number of doctors, clinical officers, nurses, and midwives will increase from 44% to 59% of the minimum necessary staff by 2018. No combination of changes in staff retention, graduation rates, and public sector entry rates of graduates by 2010, without including training expansion, is sufficient to meet staffing targets by 2018 for any cadre except midwives. Training enrolment needs to increase by a factor of between three and thirteen for doctors, three and four for clinical officers, two and three for nurses, and one and two for midwives by 2010 to reach staffing targets by 2018. Necessary enrolment increases can be held to a minimum if the rates of retention, graduation, and public sector entry increase to 100% by 2010, but will need to increase if these rates remain at 2008 levels. Conclusions Meeting the minimum need for health workers in Zambia this decade will require an increase in health

  14. Higher cigarette taxes--healthier people, wealthier state: the Hungarian experience.

    Science.gov (United States)

    Szilágyi, Tibor

    2007-09-01

    To prove that higher cigarette taxes eventually decrease smoking and do also increase state incomes from tobacco taxes by using Hungarian figures. Collection and analysis of available data on tobacco use, levels of excise and value added taxes on tobacco products and state incomes originating from the tobacco sector. In Hungary, regular tobacco tax increases resulted in decreased cigarette consumption and its lower prevalence figures in some population groups. State incomes have increased in spite of regular cigarette tax raises. Therefore, there is on conflict of interest between the health and finance portfolios in supporting further tobacco tax increases. Hungary should use regular, above the inflation tobacco tax raises as means for improving population health. Tobacco control advocates should prevent tobacco companies' attempts aimed at deterring decision makers from supporting such tax policies.

  15. The association between nurse staffing and omissions in nursing care: A systematic review.

    Science.gov (United States)

    Griffiths, Peter; Recio-Saucedo, Alejandra; Dall'Ora, Chiara; Briggs, Jim; Maruotti, Antonello; Meredith, Paul; Smith, Gary B; Ball, Jane

    2018-03-08

    To identify nursing care most frequently missed in acute adult inpatient wards and to determine evidence for the association of missed care with nurse staffing. Research has established associations between nurse staffing levels and adverse patient outcomes including in-hospital mortality. However, the causal nature of this relationship is uncertain and omissions of nursing care (referred as missed care, care left undone or rationed care) have been proposed as a factor which may provide a more direct indicator of nurse staffing adequacy. Systematic review. We searched the Cochrane Library, CINAHL, Embase and Medline for quantitative studies of associations between staffing and missed care. We searched key journals, personal libraries and reference lists of articles. Two reviewers independently selected studies. Quality appraisal was based on the National Institute for Health and Care Excellence quality appraisal checklist for studies reporting correlations and associations. Data were abstracted on study design, missed care prevalence and measures of association. Synthesis was narrative. Eighteen studies gave subjective reports of missed care. Seventy-five per cent or more nurses reported omitting some care. Fourteen studies found low nurse staffing levels were significantly associated with higher reports of missed care. There was little evidence that adding support workers to the team reduced missed care. Low Registered Nurse staffing is associated with reports of missed nursing care in hospitals. Missed care is a promising indicator of nurse staffing adequacy. The extent to which the relationships observed represent actual failures, is yet to be investigated. © 2018 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

  16. New Leverage for Increasing Tax Revenues in Turkey: Traditional Tax Applications Supported by Electronic Tax Audits

    Directory of Open Access Journals (Sweden)

    Ozge Onkan

    2016-07-01

    Full Text Available In this study, it is examined for the period 2000- 2015 in Turkey that increasing the electronic applications regarding tax audits had the effects on the required amount of tax levied as a result of tax audits. Tax Inspectors reach strategic information without uneasiness by means of electronic applications developed by some institutions such as Electronic Risk Analysis that Tax Inspection Board founded in 2011 and Revenue Administration as institutions designated by law for auditing tax in Turkey. Thus, this leads to an increase the tax revenues obtained in the course of tax audits compared to the times when there is not electronic applications.

  17. Strategies for integrating mental health into schools via a multitiered system of support.

    Science.gov (United States)

    Stephan, Sharon Hoover; Sugai, George; Lever, Nancy; Connors, Elizabeth

    2015-04-01

    To fully realize the potential of mental health supports in academic settings, it is essential to consider how to effectively integrate the mental health and education systems and their respective resources, staffing, and structures. Historically, school mental health services have not effectively spanned a full continuum of care from mental health promotion to treatment, and several implementation and service challenges have evolved. After an overview of these challenges, best practices and strategies for school and community partners are reviewed to systematically integrate mental health interventions within a school's multitiered system of student support. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions.

    Science.gov (United States)

    Ms, Suzie Aparicio; Welch Bacon, Cailee E; Parsons, John T; Bay, R Curtis; Cohen, Randy P; DeZeeuw, Terry; McLeod, Tamara C Valovich

    2015-12-01

    The "Appropriate Medical Coverage for Intercollegiate Athletics" (AMCIA) document was created to support assessment and calculation of athletic training personnel requirements. However, little is known regarding disparities between current and recommended staffing practices. To identify the staffing and employment characteristics of athletic health care services at Football Bowl Subdivision-level institutions. Cross-sectional study. Web-based survey. Head athletic trainers and athletic training staff members who were knowledgeable about budget and staff. The survey, Assessment of Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions, was used to evaluate personal, university, and staff demographics; staffing and employment topics; and AMCIA variables and use. The survey was accessed and partially completed by 104 individuals (response rate = 84.6%). A total of 79 athletic trainers (response rate = 76%) completed the entire survey. One-third of the respondents (34.2%, n = 26) met the recommended number of full-time equivalents (FTEs) for football, two-thirds of the respondents (65.7%, n = 50) failed to meet the recommendation, and 26.2% (n = 27) were missing data needed for FTE calculation. Among those who did not meet the recommended FTEs (n = 50), 38.0% (n = 19) were within 1 FTE of being compliant, 26.0% (n = 13) were within 2 FTEs, and 24.0% (n = 12) were within 3 FTEs. About one-third of respondents (35.9%, n = 37) reported not using the AMCIA, citing lack of funding (29.7%, n = 11), lack of administrative support (21.6%, n = 8), and other reasons (37.8%, n = 14). The majority of institutions that used the AMCIA were able to provide justification for staffing. For most of the institutions that failed to meet their recommendation, adding 1-3 FTE athletic trainers for football would change their compliance status. A uniform definition of the term FTE within collegiate athletics is needed to allow for structured

  19. Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions

    Science.gov (United States)

    MS, Suzie Aparicio; Welch Bacon, Cailee E.; Parsons, John T.; Bay, R. Curtis; Cohen, Randy P.; DeZeeuw, Terry; McLeod, Tamara C. Valovich

    2015-01-01

    Context The “Appropriate Medical Coverage for Intercollegiate Athletics” (AMCIA) document was created to support assessment and calculation of athletic training personnel requirements. However, little is known regarding disparities between current and recommended staffing practices. Objective To identify the staffing and employment characteristics of athletic health care services at Football Bowl Subdivision-level institutions. Design Cross-sectional study. Setting Web-based survey. Patients or Other Participants Head athletic trainers and athletic training staff members who were knowledgeable about budget and staff. Main Outcome Measure(s) The survey, Assessment of Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions, was used to evaluate personal, university, and staff demographics; staffing and employment topics; and AMCIA variables and use. Results The survey was accessed and partially completed by 104 individuals (response rate = 84.6%). A total of 79 athletic trainers (response rate = 76%) completed the entire survey. One-third of the respondents (34.2%, n = 26) met the recommended number of full-time equivalents (FTEs) for football, two-thirds of the respondents (65.7%, n = 50) failed to meet the recommendation, and 26.2% (n = 27) were missing data needed for FTE calculation. Among those who did not meet the recommended FTEs (n = 50), 38.0% (n = 19) were within 1 FTE of being compliant, 26.0% (n = 13) were within 2 FTEs, and 24.0% (n = 12) were within 3 FTEs. About one-third of respondents (35.9%, n = 37) reported not using the AMCIA, citing lack of funding (29.7%, n = 11), lack of administrative support (21.6%, n = 8), and other reasons (37.8%, n = 14). Conclusions The majority of institutions that used the AMCIA were able to provide justification for staffing. For most of the institutions that failed to meet their recommendation, adding 1–3 FTE athletic trainers for football would change their

  20. Support for a tax increase to provide unrestricted access to an Alzheimer's disease medication: a survey of the general public in Canada.

    Science.gov (United States)

    Oremus, Mark; Tarride, Jean-Eric; Clayton, Natasha; Raina, Parminder

    2009-12-29

    Public drug insurance plans provide limited reimbursement for Alzheimer's disease (AD) medications in many jurisdictions, including Canada and the United Kingdom. This study was conducted to assess Canadians' level of support for an increase in annual personal income taxes to fund a public program of unrestricted access to AD medications. A telephone survey was administered to a national sample of 500 adult Canadians. The survey contained four scenarios describing a hypothetical, new AD medication. Descriptions varied across scenarios: the medication was alternatively described as being capable of treating the symptoms of cognitive decline or of halting the progression of cognitive decline, with either no probability of adverse effects or a 30% probability of primarily gastrointestinal adverse effects. After each scenario, participants were asked whether they would support a tax increase to provide unrestricted access to the drug. Participants who responded affirmatively were asked whether they would pay an additional $75, $150, or $225 per annum in taxes. Multivariable logistic regression analysis was conducted to examine the determinants of support for a tax increase. Eighty percent of participants supported a tax increase for at least one scenario. Support was highest (67%) for the most favourable scenario (halt progression - no adverse effects) and lowest (49%) for the least favourable scenario (symptom treatment - 30% chance of adverse effects). The odds of supporting a tax increase under at least one scenario were approximately 55% less for participants who attached higher ratings to their health state under the assumption that they had moderate AD and almost five times greater if participants thought family members or friends would somewhat or strongly approve of their decision to support a tax increase. A majority of participants would pay an additional $150 per annum in taxes, regardless of scenario. Less than 50% would pay $225. Four out of five persons

  1. 77 FR 14832 - Plumchoice, Inc., Including On-Site Leased Workers From Balance Staffing, Insight Global Staffing...

    Science.gov (United States)

    2012-03-13

    ...., Including On-Site Leased Workers From Balance Staffing, Insight Global Staffing, and Technisource..., Insight Global Staffing, and Technisource, Scarborough, Maine. The workers are engaged in activities... leased workers from Balance Staffing, Insight Global Staffing, and Technisource, Scarborough, Maine, who...

  2. State-of-the-art for food taxes to promote public health.

    Science.gov (United States)

    Jensen, J D; Smed, S

    2018-05-01

    The use of taxes to promote healthy nutritional behaviour has gained ground in the past decade. The present paper reviews existing applications of fiscal instruments in nutrition policy and derives some perspectives and recommendations from the experiences gained with these instruments. Many countries in different parts of the world have experiences with the taxation of sugar-sweetened beverages, in some cases in combination with taxes on unhealthy food commodities such as confectionery or high-fat foods. These tax schemes have many similarities, but also differ in their definitions of tax objects and in the applied tax rates. Denmark has been the only country in the world to operate a tax on saturated fat content in foods, from 2011 to 2012. Most of the existing food tax schemes have been introduced from fiscal motivations, with health promotion as a secondary objective, but a few have been introduced with health promotion as the primary objective. The diversity in experiences from existing tax schemes can provide valuable insights for future use of fiscal instruments to promote healthy nutrition, in terms of designing effective and efficient tax or subsidy instruments, and in terms of smooth and politically viable implementation of the instruments.

  3. Tax incentives and the demand for private health insurance.

    Science.gov (United States)

    Stavrunova, Olena; Yerokhin, Oleg

    2014-03-01

    We analyze the effect of an individual insurance mandate (Medicare Levy Surcharge) on the demand for private health insurance (PHI) in Australia. With administrative income tax return data, we show that the mandate has several distinct effects on taxpayers' behavior. First, despite the large tax penalty for not having PHI coverage relative to the cost of the cheapest eligible insurance policy, compliance with mandate is relatively low: the proportion of the population with PHI coverage increases by 6.5 percentage points (15.6%) at the income threshold where the tax penalty starts to apply. This effect is most pronounced for young taxpayers, while the middle aged seem to be least responsive to this specific tax incentive. Second, the discontinuous increase in the average tax rate at the income threshold created by the policy generates a strong incentive for tax avoidance which manifests itself through bunching in the taxable income distribution below the threshold. Finally, after imposing some plausible assumptions, we extrapolate the effect of the policy to other income levels and show that this policy has not had a significant impact on the overall demand for private health insurance in Australia. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Guest Commentary: Fat and other taxes, lessons for the implementation of preventive policies.

    Science.gov (United States)

    Caraher, Martin; Cowburn, Gill

    2015-08-01

    Fat, sugar or sweetened beverage taxes are part of an overall public health nutrition approach to healthy eating. They are not approaches that on their own are likely to bring about change. Policy evidence from existing food tax implementation suggest that taxes need to be paralleled by subsidies and other interventions to encourage healthy eating. Such dual methods help not only contribute to nutrition outcomes but also ensure political support for food taxes. Politicians and policy makers are suspicious of taxes, using subsidies and revenue monies from taxes to support healthy eating is more likely to encourage both political and public support. Building support for policies is never just a matter of academic evidence. Public health advocates need to show more ambition by developing skills in implementing pricing policies to support healthy eating. Key opponents to taxes are the food industry who use a range of arguments to prevent taxation being implemented. Public health advocates are weak in tackling the issues of corporate power and providing evidence to maintain policy and political support. The public health movement needs to continue to develop the political will among politicians and the public for taxes on food. A new way of looking at policy formation is required and this includes addressing the power of corporate interests and the role of professionals in shaping or combating these influences. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Should We Trust in Values? Explaining Public Support for Pro-Environmental Taxes

    Directory of Open Access Journals (Sweden)

    Sverker C. Jagers

    2013-01-01

    Full Text Available In this paper we are concerned with what explains public acceptance and support of environmental taxes. We examine findings in environmental psychology emphasizing that people’s (environmental value-orientation is the dominant driver determining individuals’ support for pro-environmental policy instruments. We introduce a complementary model, mainly drawing upon findings in political science, suggesting that people’s support for policy instruments is dependent on their level of political trust and their trust in other citizens. More specifically, we analyze whether political trust and inter-personal trust affect individuals’ support for an increased carbon dioxide tax in Sweden, while checking their value orientation, self-interest, and various socio-economic values. We make use of survey data obtained from a mail questionnaire sent out to a random sample of 3,000 individuals in 2009. We find that apart from people’s values, beliefs, and norms, both political trust and interpersonal trust have significant effects on people's attitudes toward an increased tax on carbon dioxide.

  6. Staffing and structure of infection prevention and control programs.

    Science.gov (United States)

    Stone, Patricia W; Dick, Andrew; Pogorzelska, Monika; Horan, Teresa C; Furuya, E Yoko; Larson, Elaine

    2009-06-01

    The nature of infection prevention and control is changing; however, little is known about current staffing and structure of infection prevention and control programs. Our objectives were to provide a snapshot of the staffing and structure of hospital-based infection prevention and control programs in the United States. A Web-based survey was sent to 441 hospitals that participate in the National Healthcare Safety Network. The response rate was 66% (n = 289); data were examined on 821 professionals. Infection preventionist (IP) staffing was significantly negatively related to bed size, with higher staffing in smaller hospitals (P hospital epidemiologists were reported to have authority to close beds for outbreaks always or most of the time (n = 225, 78%). Only 32% (n = 92) reported using an electronic surveillance system to track infections. This study is the first to provide a comprehensive description of current infection prevention and control staffing, organization, and support in a select group of hospitals across the nation. Further research is needed to identify effective staffing levels for various hospital types as well as examine how the IP role is changing over time.

  7. The Impact of a Tax on Sugar-Sweetened Beverages on Health and Health Care Costs: A Modelling Study.

    Science.gov (United States)

    Veerman, J Lennert; Sacks, Gary; Antonopoulos, Nicole; Martin, Jane

    2016-01-01

    This paper aims to estimate the consequences of an additional 20% tax on sugar-sweetened beverages (SSBs) on health and health care expenditure. Participants were adult (aged > = 20) Australians alive in 2010, who were modelled over their remaining lifetime. We used lifetable-based epidemiological modelling to examine the potential impact of a 20% valoric tax on SSBs on total lifetime disability-adjusted life years (DALYs), incidence, prevalence, and mortality of obesity-related disease, and health care expenditure. Over the lifetime of adult Australian alive in 2010, seemingly modest estimated changes in average body mass as a result of the SSB tax translated to gains of 112,000 health-adjusted life years for men (95% uncertainty interval [UI]: 73,000-155,000) and 56,000 (95% UI: 36,000-76,000) for women, and a reduction in overall health care expenditure of AUD609 million (95% UI: 368 million- 870 million). The tax is estimated to reduce the number of new type 2 diabetes cases by approximately 800 per year. Twenty-five years after the introduction of the tax, there would be 4,400 fewer prevalent cases of heart disease and 1,100 fewer persons living with the consequences of stroke, and an estimated 1606 extra people would be alive as a result of the tax. The tax would generate an estimated AUD400 million in revenue each year. Governments should consider increasing the tax on sugared drinks. This would improve population health, reduce health care costs, as well as bring in direct revenue.

  8. The Impact of a Tax on Sugar-Sweetened Beverages on Health and Health Care Costs: A Modelling Study.

    Directory of Open Access Journals (Sweden)

    J Lennert Veerman

    Full Text Available This paper aims to estimate the consequences of an additional 20% tax on sugar-sweetened beverages (SSBs on health and health care expenditure. Participants were adult (aged > = 20 Australians alive in 2010, who were modelled over their remaining lifetime. We used lifetable-based epidemiological modelling to examine the potential impact of a 20% valoric tax on SSBs on total lifetime disability-adjusted life years (DALYs, incidence, prevalence, and mortality of obesity-related disease, and health care expenditure. Over the lifetime of adult Australian alive in 2010, seemingly modest estimated changes in average body mass as a result of the SSB tax translated to gains of 112,000 health-adjusted life years for men (95% uncertainty interval [UI]: 73,000-155,000 and 56,000 (95% UI: 36,000-76,000 for women, and a reduction in overall health care expenditure of AUD609 million (95% UI: 368 million- 870 million. The tax is estimated to reduce the number of new type 2 diabetes cases by approximately 800 per year. Twenty-five years after the introduction of the tax, there would be 4,400 fewer prevalent cases of heart disease and 1,100 fewer persons living with the consequences of stroke, and an estimated 1606 extra people would be alive as a result of the tax. The tax would generate an estimated AUD400 million in revenue each year. Governments should consider increasing the tax on sugared drinks. This would improve population health, reduce health care costs, as well as bring in direct revenue.

  9. Limited take-up of health coverage tax credits: a challenge to future tax credit design.

    Science.gov (United States)

    Dorn, Stan; Varon, Janet; Pervez, Fouad

    2005-10-01

    The Trade Act of 2002 created federal tax credits to subsidize health coverage for certain early retirees and workers displaced by international trade. Though small, this program offers the opportunity to learn how to design future tax credits for larger groups of uninsured. During September 2004, the most recent month for which there are data about all forms of Trade Act credits, roughly 22 percent of eligible individuals received credits. The authors find that health insurance tax credits are more likely to reach their target populations if such credits: 1) limit premium costs for the low-income uninsured and do not require full premium payments while applications are pending; 2) provide access to coverage that beneficiaries value, including care for preexisting conditions; 3) are combined with outreach that uses easily understandable, multilingual materials and proactive enrollment efforts; and 4) feature a simple application process involving one form filed with one agency.

  10. Requirements for SSC central computing staffing (conceptual)

    International Nuclear Information System (INIS)

    Pfister, J.

    1985-01-01

    Given a computation center with --10,000 MIPS supporting --1,000 users, what are the staffing requirements? The attempt in this paper is to list the functions and staff size required in a central computing or centrally supported computing complex. The organization assumes that although considerable computing power would exist (mostly for online) in the four interaction regions (IR) that there are functions/capabilities better performed outside the IR and in this model at a ''central computing facility.'' What follows is one staffing approach, not necessarily optimal, with certain assumptions about numbers of computer systems, media, networks and system controls, that is, one would get the best technology available. Thus, it is speculation about what the technology may bring and what it takes to operate it. From an end user support standpoint it is less clear, given the geography of an SSC, where and what the consulting support should look like and its location

  11. Sugar Price Supports and Taxation: A Public Health Policy Paradox.

    Science.gov (United States)

    Dilk, Abby; Savaiano, Dennis A

    2017-05-01

    Domestic US sugar production has been protected by government policy for the past 82 years, resulting in elevated domestic prices and an estimated annual (2013) $1.4 billion dollar "tax" on consumers. These elevated prices and the simultaneous federal support for domestic corn production have ensured a strong market for high-fructose corn syrup. Americans have dramatically increased their consumption of caloric sweeteners during the same period. Consumption of "empty" calories (ie, foods with low-nutrient/high-caloric density)-sugar and high-fructose corn syrup being the primary sources-is considered by most public health experts to be a key contributing factor to the rise in obesity. There have been substantial efforts to tax sugar-sweetened beverages (SSBs) to both reduce consumption and provide a source of funds for nutrition education, thereby emulating the tobacco tax model. Volume-based SSB taxes levy the tax rate per ounce of liquid, where some are only imposed on beverages with added sugar content exceeding a set threshold. Nonetheless, volume-based taxes have significant limitations in encouraging consumers to reduce their caloric intake due to a lack of transparency at the point of purchase. Thus, it is hypothesized that point-of-purchase, nutrient-specific excise taxes on SSBs would be more effective at reducing sugar consumption. However, all SSB taxes are limited by the possibility that consumers may compensate their decreased intake from SSBs with other high-calorie junk foods. Furthermore, there are no existing studies to provide evidence on how SSB taxes will impact obesity rates in the long term. The paradox of sugar prices is that Americans have paid higher prices for sugar to protect domestic production for more than 80 years, and now, Americans are being asked to pay even more to promote public health. The effective use of sugar taxes should be considered based on their merits in reducing sugar consumption and making available a new source of

  12. Paying for individual health insurance through tax-sheltered cafeteria plans.

    Science.gov (United States)

    Hall, Mark A; Monahan, Amy B

    2010-01-01

    When employees without group health insurance buy individual coverage, they do so using after-tax income--costing them from 20% to 50% more than others pay for equivalent coverage. Prior to the passage of the Patient Protection and Affordable Care Act (PPACA), several states promoted a potential solution that would allow employees to buy individual insurance through tax-sheltered payroll deduction. This technical but creative approach would allow insurers to combine what is known as "list-billing" with a Section 125 "cafeteria plan." However, these state-level reform attempts have failed to gain significant traction because state small-group reform laws and federal restrictions on medical underwriting cloud the legality of tax-sheltered list-billing. Several authorities have taken the position that insurance paid for through a cafeteria plan must meet the nondiscrimination requirements of the Health Insurance Portability and Accountability Act with respect to eligibility, premiums, and benefits. The recently enacted Patient Protection and Affordable Care Act addresses some of the legal uncertainty in this area, but much remains. For health reform to have its greatest effect, federal regulators must clarify whether individual health insurance can be purchased on a pre-tax basis through a cafeteria plan.

  13. A staffing decision support methodology using a quality loss function : a cross-disciplinary quantitative study

    NARCIS (Netherlands)

    Mincsovics, G.Z.

    2009-01-01

    Background Understanding the quality loss implications of short staffing is essential in maintaining service quality on a limited budget. Objectives For elaborate financial control on staffing decisions, it is necessary to quantify the cost of the incidental quality loss that a given workload and

  14. Spent Nuclear Fuel Project operational staffing plan

    International Nuclear Information System (INIS)

    Debban, B.L.

    1996-03-01

    Using the Spent Nuclear Fuel (SNF) Project's current process flow concepts and knowledge from cognizant engineering and operational personnel, an initial assessment of the SNF Project radiological exposure and resource requirements was completed. A small project team completed a step by step analysis of fuel movement in the K Basins to the new interim storage location, the Canister Storage Building (CSB). This analysis looked at fuel retrieval, conditioning of the fuel, and transportation of the fuel. This plan describes the staffing structure for fuel processing, fuel movement, and the maintenance and operation (M ampersand O) staffing requirements of the facilities. This initial draft does not identify the support function resources required for M ampersand O, i.e., administrative and engineering (technical support). These will be included in future revisions to the plan. This plan looks at the resource requirements for the SNF subprojects, specifically, the operations of the facilities, balances resources where applicable, rotates crews where applicable, and attempts to use individuals in multi-task assignments. This plan does not apply to the construction phase of planned projects that affect staffing levels of K Basins

  15. State-of-the-art for food taxes to promote public health

    DEFF Research Database (Denmark)

    Jensen, Jørgen Dejgård; Smed, Sinne

    2017-01-01

    countries in different parts of the world have experiences with the taxation of sugar-sweetened beverages, in some cases in combination with taxes on unhealthy food commodities such as confectionery or high-fat foods. These tax schemes have many similarities, but also differ in their definitions of tax...... objects and in the applied tax rates. Denmark has been the only country in the world to operate a tax on saturated fat content in foods, from 2011 to 2012. Most of the existing food tax schemes have been introduced from fiscal motivations, with health promotion as a secondary objective, but a few have...

  16. Consequences of Inadequate Staffing Include Missed Care, Potential Failure to Rescue, and Job Stress and Dissatisfaction.

    Science.gov (United States)

    Simpson, Kathleen Rice; Lyndon, Audrey; Ruhl, Catherine

    2016-01-01

    To evaluate responses of registered nurse members of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) to a survey that sought their recommendations for staffing guidelines and their perceptions of the consequences of inadequate nurse staffing. The goal was to use these member data to inform the work of the AWHONN nurse staffing research team. Secondary analysis of responses to the 2010 AWHONN nurse staffing survey. Online. AWHONN members (N = 884). Review of data from an online survey of AWHONN members through the use of thematic analysis for descriptions of the consequences of inadequate nurse staffing during the childbirth process. Three main themes emerged as consequences of inadequate staffing or being short-staffed: Missed Care, Potential for Failure to Rescue, and Job-Related Stress and Dissatisfaction. These themes are consistent with those previously identified in the literature related to inadequate nurse staffing. Based on the responses from participants in the 2010 AWHONN nurse staffing survey, consequences of inadequate staffing can be quite serious and may put patients at risk for preventable harm. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  17. Staffing Patterns in Public School Systems: Current Status and Trends, Update 2001. Research Snapshot.

    Science.gov (United States)

    Williams, Alicia D.; Protheroe, Nancy; Parks, Michael C.

    Staffing patterns in American public-school systems are presented in this report of the 2000-01 school year. The report addresses the following: why information about staffing ratios is important; how many people currently work in public schools; what proportion of these are teachers, administrators, and support staff; current staffing patterns in…

  18. 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.

  19. Cost-Effective Adjustments to Nursing Home Staffing to Improve Quality.

    Science.gov (United States)

    Bowblis, John R; Roberts, Amy Restorick

    2018-06-01

    Health care providers face fixed reimbursement rates from government sources and need to carefully adjust staffing to achieve the highest quality within a given cost structure. With data from the Certification and Survey Provider Enhanced Reports (1999-2015), this study holistically examined how staffing levels affect two publicly reported measures of quality in the nursing home industry, the number of deficiency citations and the deficiency score. While higher staffing consistently yielded better quality, the largest quality improvements resulted from increasing administrative registered nurses and social service staffing. After adjusting for wages, the most cost-effective investment for improving overall deficiency outcomes was increasing social services. Deficiencies related to quality of care were improved most by increasing administrative nursing and social service staff. Quality of life deficiencies were improved most by increasing social service and activities staff. Approaches to improve quality through staffing adjustments should target specific types of staff to maximize return on investment.

  20. Employment impacts of alcohol taxes.

    Science.gov (United States)

    Wada, Roy; Chaloupka, Frank J; Powell, Lisa M; Jernigan, David H

    2017-12-01

    There is strong scientific evidence supporting the effectiveness of increasing alcohol taxes for reducing excessive alcohol consumption and related problems. Opponents have argued that alcohol tax increases lead to job losses. However, there has been no comprehensive economic analysis of the impact of alcohol taxes on employment. To fill this gap, a regional macroeconomic simulation model was used to assess the net impact of two hypothetical alcohol tax increases (a 5-cent per drink excise tax increase and a 5% sales tax increase on beer, wine, and distilled spirits, respectively) on employment in Arkansas, Florida, Massachusetts, New Mexico, and Wisconsin. The model accounted for changes in alcohol demand, average state income, and substitution effects. The employment impact of spending the new tax revenue on general expenditures versus health care was also assessed. Simulation results showed that a 5-cent per drink additional excise tax on alcoholic beverages with new tax revenues allocated to general expenditures increased net employment in Arkansas (802 jobs); Florida (4583 jobs); Massachusetts (978 jobs); New Mexico (653 jobs); and Wisconsin (1167 jobs). A 5% additional sales tax also increased employment in Arkansas (789 jobs; Florida (4493 jobs); Massachusetts (898 jobs); New Mexico (621 jobs); and Wisconsin (991 jobs). Using new alcohol tax revenues to fund health care services resulted in slightly lower net increases in state employment. The overall economic impact of alcohol tax increases cannot be fully assessed without accounting for the job gains resulting from additional tax revenues. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. The ethics of sin taxes.

    Science.gov (United States)

    Green, Rebecca

    2011-01-01

    ABSTRACT The current global economic crisis is forcing governments to consider a variety of methods to generate funds for infrastructure. In the United States, smoking-related illness and an obesity epidemic are forcing public health institutions to consider a variety of methods to influence health behaviors of entire target groups. In this paper, the author uses a public health nursing model, the Public Health Code of Ethics (Public Health Leadership Society, 2002), the American Nurses' Association (ANA) Code of Ethics (2001), and other relevant ethical theory to weigh and balance the arguments for and against the use of sin taxes. A position advocating the limited use of sin taxes is supported as a reasonable stance for the public health professional. © 2010 Wiley Periodicals, Inc.

  2. Impact of an electronic health record operating room management system in ophthalmology on documentation time, surgical volume, and staffing.

    Science.gov (United States)

    Sanders, David S; Read-Brown, Sarah; Tu, Daniel C; Lambert, William E; Choi, Dongseok; Almario, Bella M; Yackel, Thomas R; Brown, Anna S; Chiang, Michael F

    2014-05-01

    Although electronic health record (EHR) systems have potential benefits, such as improved safety and quality of care, most ophthalmology practices in the United States have not adopted these systems. Concerns persist regarding potential negative impacts on clinical workflow. In particular, the impact of EHR operating room (OR) management systems on clinical efficiency in the ophthalmic surgery setting is unknown. To determine the impact of an EHR OR management system on intraoperative nursing documentation time, surgical volume, and staffing requirements. For documentation time and circulating nurses per procedure, a prospective cohort design was used between January 10, 2012, and January 10, 2013. For surgical volume and overall staffing requirements, a case series design was used between January 29, 2011, and January 28, 2013. This study involved ophthalmic OR nurses (n = 13) and surgeons (n = 25) at an academic medical center. Electronic health record OR management system implementation. (1) Documentation time (percentage of operating time documenting [POTD], absolute documentation time in minutes), (2) surgical volume (procedures/time), and (3) staffing requirements (full-time equivalents, circulating nurses/procedure). Outcomes were measured during a baseline period when paper documentation was used and during the early (first 3 months) and late (4-12 months) periods after EHR implementation. There was a worsening in total POTD in the early EHR period (83%) vs paper baseline (41%) (P system implementation was associated with worsening of intraoperative nursing documentation time especially in shorter procedures. However, it is possible to implement an EHR OR management system without serious negative impacts on surgical volume and staffing requirements.

  3. The sugar tax - An opportunity to advance oral health.

    Science.gov (United States)

    Wordley, V; Lee, H; Lomazzi, M; Bedi, R

    2017-07-07

    The new sugar tax was recently announced by Government, aiming to combat obesity through investment in school sports. Dental professionals should seize this rare opportunity to raise awareness of the other adverse effects of sugar; young children continue to suffer alarmingly high rates of dental cavities in the UK. A significant amount of money raised through the levy must be reinvested into ensuring fluoride toothpaste is more affordable. Since daily use of fluoride toothpaste is the most effective evidence-based oral health preventative measure that is widely used, this should receive tax exemption status from the government as a means of universal oral health prevention. There must also be a re-investment in innovative oral health education so that the next generation of children will alter their mind set about sugar. Oral health prevention advice must be tightly integrated into general health messages.

  4. Development of the staffing evaluation technique for mental tasks of the advanced main control room

    International Nuclear Information System (INIS)

    Hsieh Tsungling; Yang Chihwei; Lin Chiuhsiangjoe

    2011-01-01

    The key goals of staffing and qualifications review element are to ensure that the right numbers of people with the appropriate skills and abilities are available to support plant operations and events. If the staffing level is too few, excessive stress that caused human errors possibly will be placed on the operators. Accordingly, this study developed a staffing evaluation technique based on CPM-GOMS for the mental tasks such as operations in the advanced main control room. A within-subject experiment was designed to examine the validity of the staffing evaluation technique. The results indicated the performance of evaluated staffing level via the staffing evaluation technique was significantly higher than that of non-evaluated staffing level; thus, validity of the staffing evaluation technique can be accepted. Finally, the implications for managerial practice on the findings of this study were discussed. (author)

  5. 78 FR 52719 - Tax Credit for Employee Health Insurance Expenses of Small Employers

    Science.gov (United States)

    2013-08-26

    ... Tax Credit for Employee Health Insurance Expenses of Small Employers AGENCY: Internal Revenue Service... Section 45R(a) provides for a health insurance tax credit in the case of an eligible small employer for... employee enrolled in health insurance coverage offered by the employer in an amount equal to a uniform...

  6. Economic evaluation of nurse staffing and nurse substitution in health care: a scoping review

    OpenAIRE

    Griffiths, P; Goryakin, Y.; Maben, J.

    2010-01-01

    OBJECTIVE: Several systematic reviews have suggested that greater nurse staffing as well as a greater proportion of registered nurses in the health workforce is associated with better patient outcomes. Others have found that nurses can substitute for doctors safely and effectively in a variety of settings. However, these reviews do not generally consider the effect of nurse staff on both patient outcomes and costs of care, and therefore say little about the cost-effectiveness of nurse-provide...

  7. 42 CFR 433.57 - General rules regarding revenues from provider-related donations and health care-related taxes.

    Science.gov (United States)

    2010-10-01

    ...-related donations and health care-related taxes. 433.57 Section 433.57 Public Health CENTERS FOR MEDICARE... rules regarding revenues from provider-related donations and health care-related taxes. Effective... FFP, funds from provider-related donations and revenues generated by health care-related taxes...

  8. Bringing health and social policy together: the case of the earned income tax credit.

    Science.gov (United States)

    Arno, Peter S; Sohler, Nancy; Viola, Deborah; Schechter, Clyde

    2009-07-01

    The principal objective of our research is to examine whether the earned income tax credit (EITC), a broad-based income support program that has been shown to increase employment and income among poor working families, also improves their health and access to care. A finding that the EITC has a positive impact on the health of the American public may help guide deliberations about its future at the federal, state, and local levels. The authors contend that a better understanding of the relationship between major socioeconomic policies such as the EITC and the public's health will inform the fields of health and social policy in the pursuit of improving population health.

  9. Who Hires Social Workers? Structural and Contextual Determinants of Social Service Staffing in Nursing Homes.

    Science.gov (United States)

    Roberts, Amy Restorick; Bowblis, John R

    2017-02-01

    Although nurse staffing has been extensively studied within nursing homes (NHs), social services has received less attention. The study describes how social service departments are organized in NHs and examines the structural characteristics of NHs and other macro-focused contextual factors that explain differences in social service staffing patterns using longitudinal national data (Certification and Survey Provider Enhanced Reports, 2009-2012). NHs have three patterns of staffing for social services, using qualified social workers (QSWs); paraprofessional social service staff; and interprofessional teams, consisting of both QSWs and paraprofessionals. Although most NHs employ a QSW (89 percent), nearly half provide social services through interprofessional teams, and 11 percent rely exclusively on paraprofessionals. Along with state and federal regulations that depend on facility size, other contextual and structural factors within NHs also influence staffing. NHs most likely to hire QSWs are large facilities in urban areas within a health care complex, owned by nonprofit organizations, with more payer mixes associated with more profitable reimbursement. QSWs are least likely to be hired in small facilities in rural areas. The influence of policy in supporting the professionalization of social service staff and the need for QSWs with expertise in gerontology, especially in rural NHs, are discussed. © 2016 National Association of Social Workers.

  10. Can trust in politicians explain individuals' support for climate policy? The case of CO2 tax

    International Nuclear Information System (INIS)

    Hammar, Henrik; Jagers, Sverker C.

    2006-01-01

    This article provides an analysis of the support for public policies from a trust perspective. The empirical focus is on the use of a tax on carbon dioxide (CO 2 ), a policy tool aimed at coordinating national emissions targets in Sweden. Among economists and experts in the field of climate policy, a CO 2 tax is viewed as a cost-effective policy. The policy problem is that public support for CO 2 taxes is very low, leaving policy makers with high-cost options. Apart from traditional explanatory variables such as demographic factors, level of education, ideology and self-interest, what can explain this public opposition? Using individual level data, we analyse whether support for increases in the CO 2 tax on gasoline can be explained by citizens' generalized trust in other individuals (who they do not necessarily know) or by their trust in politicians. We find that only the latter measure gains support in a regression analysis. Moreover, when splitting the sample into high-trusting and low-trusting individuals, we find that high-trusting individuals who have access to a car (compared with those without access) are statistically no more likely to resist increases in CO 2 taxes than people without access to a car. Rather, it is individuals with access to a car and who do not trust their politicians who are likely to resist CO 2 taxes. (Author)

  11. Capping the tax exclusion for employment-based health coverage: implications for employers and workers.

    Science.gov (United States)

    Fronstin, Paul

    2009-01-01

    HEALTH CARE TAX CAP: With health reform a major priority of the new 111th Congress and President Barack Obama, this Issue Briefexamines the administrative and implementation issues that arise from one of the major reform proposals: Capping the exclusion of employment-based health coverage from workers' taxable income. The amount that employers contribute toward workers' health coverage is generally excluded, without limit, from workers' taxable income. In addition, workers whose employers sponsor flexible spending accounts are able to pay out-of-pocket expenses with pretax dollars. Employers can also make available a premium conversion arrangement, which allows workers to pay their share of the premium for employment-based coverage with pretax dollars. In 2005, a presidential advisory board concluded that limiting the amount of tax-preferred health coverage could lower overall private-sector health spending. The panel recommended a cap on the amount of employment-based health coverage individuals can exclude from their income tax, as a way to reduce health spending. In his 2008 "Call to Action" for health care reform, Sen. Max Baucus (D-MT), chairman of the Senate Finance Committee, states that "Congress should explore ways to restructure the current tax incentives to encourage more efficient spending on health and to target our tax dollars more effectively and fairly." While a tax cap on health coverage sounds simple, for many employers, it could be difficult to administer and results would vary by employer based on the type of health benefit plan, the size and demographics of their work force, and even where the workers live. The change would be especially difficult for self-insured employers that do not pay insurance premiums, since they would have to set the "premium equivalent" for each worker. This would not only be costly for employers, depending upon the requirements set out by law, but could also create fairness and tax issues for many affected workers

  12. Considering the health care entity C corporation conversion to tax pass-through entity status.

    Science.gov (United States)

    Reilly, Robert F

    2012-01-01

    The double taxation of C corporation income from operations and from the ultimate sale of its assets makes the C corporation an inefficient tax status for many health care entities. At the time of this writing, the changes in the federal tax law that are scheduled to take effect in 2013 will increase this level of double-taxation inefficiency. The owners of a C corporation practice can avoid the C corporation status tax inefficiency by converting the practice to either (1) S corporation status or (2) LLC status. The conversion of the health care C corporation to an S corporation may be accomplished without a current tax cost. However, the conversion of a health care C corporation to an LLC status can result in a current tax at both the corporation level and the shareholder level. Nonetheless, the current conversion tax cost may be less than the future tax cost (1) of operating the practice as a C corporation and incurring double taxation at what may be higher tax rates or (2) of incurring the higher tax cost (or reduced price) on the ultimate disposition of the practice assets and the attendant double taxation of the appreciation in the value of the practice assets. Since individual income tax rates on qualifying dividends from C corporations and on capital gains are currently at very low rates, this may be a good time for C corporation practice owners to consider the costs and benefits of a conversion to either S corporation status or LLC status. The practice owners should consult with their accounting, legal, and valuation advisors in order to consider all of the costs and benefits of a possible corporate tax status conversion. An estimation of both the costs and benefits of the corporate tax status conversion depends on the concluded fair market values of the medical practice, dental practice, or other health care entity assets. And, that practice asset appraisal should encompass all of the practice assets, both tangible assets and intangible assets.

  13. Optimizing staffing, quality, and cost in home healthcare nursing: theory synthesis.

    Science.gov (United States)

    Park, Claire Su-Yeon

    2017-08-01

    To propose a new theory pinpointing the optimal nurse staffing threshold delivering the maximum quality of care relative to attendant costs in home health care. Little knowledge exists on the theoretical foundation addressing the inter-relationship among quality of care, nurse staffing, and cost. Theory synthesis. Cochrane Library, PubMed, CINAHL, EBSCOhost Web and Web of Science (25 February - 26 April 2013; 20 January - 22 March 2015). Most of the existing theories/models lacked the detail necessary to explain the relationship among quality of care, nurse staffing and cost. Two notable exceptions are: 'Production Function for Staffing and Quality in Nursing Homes,' which describes an S-shaped trajectory between quality of care and nurse staffing and 'Thirty-day Survival Isoquant and Estimated Costs According to the Nurse Staff Mix,' which depicts a positive quadric relationship between nurse staffing and cost according to quality of care. A synthesis of these theories led to an innovative multi-dimensional econometric theory helping to determine the maximum quality of care for patients while simultaneously delivering nurse staffing in the most cost-effective way. The theory-driven threshold, navigated by Mathematical Programming based on the Duality Theorem in Mathematical Economics, will help nurse executives defend sufficient nurse staffing with scientific justification to ensure optimal patient care; help stakeholders set an evidence-based reasonable economical goal; and facilitate patient-centred decision-making in choosing the institution which delivers the best quality of care. A new theory to determine the optimum nurse staffing maximizing quality of care relative to cost was proposed. © 2017 The Author. Journal of Advanced Nursing © John Wiley & Sons Ltd.

  14. Tax credits, insurance, and in vitro fertilization in the U.S. military health care system.

    Science.gov (United States)

    Wu, Mae; Henne, Melinda; Propst, Anthony

    2012-06-01

    The FAMILY Act, an income tax credit for infertility treatments, was introduced into the U.S. Senate on May 12, 2011. We estimated the costs and utilization of in vitro fertilization (IVF) in the military if infertility treatment became a tax credit or TRICARE benefit. We surveyed 7 military treatment facilities (MTFs) that offer IVF, with a 100% response rate. We first modeled the impact of the FAMILY Act on the MTFs. We then assessed the impact and costs of a TRICARE benefit for IVF. In 2009, MTFs performed 810 IVF cycles with average patient charges of $4961 and estimated pharmacy costs of $2K per cycle. With implementation of the FAMILY Act, we estimate an increase in IVF demand at the MTFs to 1165 annual cycles. With a TRICARE benefit, estimated demand would increase to 6,924 annual IVF cycles. MTF pharmacy costs would increase to $7.3 annually. TRICARE medical and pharmacy costs would exceed $24.4 million and $6.5 million, respectively. In conclusion, if the FAMILY Act becomes law, demand for IVF at MTFs will increase 29%, with a 50% decrease in patient medical expenses after tax credits. MTF pharmacy costs will rise, and additional staffing will be required to meet the demand. If IVF becomes a TRICARE benefit, demand for IVF will increase at least 2-fold. Current MTFs would be unable to absorb the increased demand, leading to increased TRICARE treatment costs at civilian centers.

  15. A flexible benefits tax credit for health insurance and more.

    Science.gov (United States)

    Etheredge, Lynn

    2001-01-01

    This essay outlines a concept for a "flexible benefits" tax credit for expanding health insurance coverage and other purposes such as retirement savings plans (with potential withdrawals for higher education, first-home ownership, and catastrophic medical expenses). Two examples are presented. The advantages of a flexible benefits tax credit are considered in terms of efficient use of the budget surplus to help meet the varied (and changing) needs of American families, to eliminate major national gaps in health insurance and pension coverage, and to advance other objectives. If the budget surplus is used wisely, political decisionmakers could achieve health insurance coverage for most uninsured workers and children and assure a future with real economic security for American families.

  16. Nurse staffing issues are just the tip of the iceberg: a qualitative study about nurses' perceptions of nurse staffing

    NARCIS (Netherlands)

    van Oostveen, Catharina J.; Mathijssen, Elke; Vermeulen, Hester

    2015-01-01

    To obtain in-depth insight into the perceptions of nurses in the Netherlands regarding current nurse staffing levels and use of nurse-to-patient-ratios (NPR) and patient classification systems (PCS). In response to rising health care demands due to ageing of the patient population and increasing

  17. Tax administration as health policy: hospitals, the Internal Revenue Service, and the courts.

    Science.gov (United States)

    Fox, D M; Schaffer, D C

    1991-01-01

    Since 1969 federal tax policy has permitted nonprofit hospitals to turn away indigent patients or to transfer them to public hospitals. The Internal Revenue Service made health policy, but its officials remain convinced that they were not making policy at all. Convinced that it was reasoning from legal principles, the Revenue Service accepted the hospital industry's view of the history and purpose of hospitals. The federal courts further obscured the problem. Moreover, the Revenue Service took no interest in the effects of its ruling on the services provided by tax-exempt hospitals until 1989. We describe these events and seek to explain them by linking the recent history of health policy to the assumptions that govern the making of tax policy. We conclude that the making of health policy by tax officials who are not accountable for it and who believe that they are not making policy at all is not in the public interest.

  18. Health, Health Inequality, and Cost Impacts of Annual Increases in Tobacco Tax: Multistate Life Table Modeling in New Zealand.

    Directory of Open Access Journals (Sweden)

    Tony Blakely

    2015-07-01

    Full Text Available Countries are increasingly considering how to reduce or even end tobacco consumption, and raising tobacco taxes is a potential strategy to achieve these goals. We estimated the impacts on health, health inequalities, and health system costs of ongoing tobacco tax increases (10% annually from 2011 to 2031, compared to no tax increases from 2011 ["business as usual," BAU], in a country (New Zealand with large ethnic inequalities in smoking-related and noncommunicable disease (NCD burden.We modeled 16 tobacco-related diseases in parallel, using rich national data by sex, age, and ethnicity, to estimate undiscounted quality-adjusted life-years (QALYs gained and net health system costs over the remaining life of the 2011 population (n = 4.4 million. A total of 260,000 (95% uncertainty interval [UI]: 155,000-419,000 QALYs were gained among the 2011 cohort exposed to annual tobacco tax increases, compared to BAU, and cost savings were US$2,550 million (95% UI: US$1,480 to US$4,000. QALY gains and cost savings took 50 y to peak, owing to such factors as the price sensitivity of youth and young adult smokers. The QALY gains per capita were 3.7 times greater for Māori (indigenous population compared to non-Māori because of higher background smoking prevalence and price sensitivity in Māori. Health inequalities measured by differences in 45+ y-old standardized mortality rates between Māori and non-Māori were projected to be 2.31% (95% UI: 1.49% to 3.41% less in 2041 with ongoing tax rises, compared to BAU. Percentage reductions in inequalities in 2041 were maximal for 45-64-y-old women (3.01%. As with all such modeling, there were limitations pertaining to the model structure and input parameters.Ongoing tobacco tax increases deliver sizeable health gains and health sector cost savings and are likely to reduce health inequalities. However, if policy makers are to achieve more rapid reductions in the NCD burden and health inequalities, they will also

  19. Health, Health Inequality, and Cost Impacts of Annual Increases in Tobacco Tax: Multistate Life Table Modeling in New Zealand

    Science.gov (United States)

    Blakely, Tony; Cobiac, Linda J.; Cleghorn, Christine L.; Pearson, Amber L.; van der Deen, Frederieke S.; Kvizhinadze, Giorgi; Nghiem, Nhung; McLeod, Melissa; Wilson, Nick

    2015-01-01

    Background Countries are increasingly considering how to reduce or even end tobacco consumption, and raising tobacco taxes is a potential strategy to achieve these goals. We estimated the impacts on health, health inequalities, and health system costs of ongoing tobacco tax increases (10% annually from 2011 to 2031, compared to no tax increases from 2011 [“business as usual,” BAU]), in a country (New Zealand) with large ethnic inequalities in smoking-related and noncommunicable disease (NCD) burden. Methods and Findings We modeled 16 tobacco-related diseases in parallel, using rich national data by sex, age, and ethnicity, to estimate undiscounted quality-adjusted life-years (QALYs) gained and net health system costs over the remaining life of the 2011 population (n = 4.4 million). A total of 260,000 (95% uncertainty interval [UI]: 155,000–419,000) QALYs were gained among the 2011 cohort exposed to annual tobacco tax increases, compared to BAU, and cost savings were US$2,550 million (95% UI: US$1,480 to US$4,000). QALY gains and cost savings took 50 y to peak, owing to such factors as the price sensitivity of youth and young adult smokers. The QALY gains per capita were 3.7 times greater for Māori (indigenous population) compared to non-Māori because of higher background smoking prevalence and price sensitivity in Māori. Health inequalities measured by differences in 45+ y-old standardized mortality rates between Māori and non-Māori were projected to be 2.31% (95% UI: 1.49% to 3.41%) less in 2041 with ongoing tax rises, compared to BAU. Percentage reductions in inequalities in 2041 were maximal for 45–64-y-old women (3.01%). As with all such modeling, there were limitations pertaining to the model structure and input parameters. Conclusions Ongoing tobacco tax increases deliver sizeable health gains and health sector cost savings and are likely to reduce health inequalities. However, if policy makers are to achieve more rapid reductions in the NCD

  20. Impact of staffing parameters on operational reliability

    International Nuclear Information System (INIS)

    Hahn, H.A.; Houghton, F.K.

    1993-01-01

    This paper reports on a project related to human resource management of the Department of Energy's (DOE's) High-Level Waste (HLW) Tank program. Safety and reliability of waste tank operations is impacted by several issues, including not only the design of the tanks themselves, but also how operations and operational personnel are managed. As demonstrated by management assessments performed by the Tiger Teams, DOE believes that the effective use of human resources impacts environment safety, and health concerns. For the of the current paper, human resource management activities are identified as ''Staffing'' and include the of developing the functional responsibilities and qualifications of technical and administrative personnel. This paper discusses the importance of staff plans and management in the overall view of safety and reliability. The work activities and procedures associated with the project, a review of the results of these activities, including a summary of the literature and a preliminary analysis of the data. We conclude that although identification of staffing issues and the development of staffing plans contributes to the overall reliability and safety of the HLW tanks, the relationship is not well understood and is in need of further development

  1. Impact of staffing parameters on operational reliability

    International Nuclear Information System (INIS)

    Hahn, H.A.; Houghton, F.K.

    1993-01-01

    This paper reports on a project related to human resource management of the Department of Energy (DOEs) High-Level Waste (HLW) Tank program. Safety and reliability of waste tank operations is impacted by several issues, including not only the design of the tanks themselves, but also how operations and operational personnel are managed. As demonstrated by management assessments performed by the Tiger Teams, DOE believes that the effective use of human resources impacts environment, safety, and health concerns. For the purposes of the current paper, human resource management activities are identified as 'Staffing' and include the process of developing the functional responsibilities and qualifications of technical and administrative personnel. This paper discusses the importance of staff plans and management in the overall view of safety and reliability, the work activities and procedures associated with the project, a review of the results of these activities, including a summary of the literature and a preliminary analysis of the data. We conclude that, although identification of staffing issues and the development of staffing plans contributes to the overall reliability and safety of the HLW tanks, the relationship is not well understood and is in need of further development

  2. Tax Potential vs. Tax Effort; A Cross-Country Analysis of Armenia's Stubbornly Low Tax Collection

    OpenAIRE

    David A. Grigorian; Hamid R Davoodi

    2007-01-01

    Despite recording double digit growth since 2000, Armenia's tax-to-GDP ratio has been fairly stable at about 14½ percent. This paper catalogues a range of factors that may account for Armenia's stubbornly for tax collection by benchmarking Armenia's tax-to-GDP against some comparator countries and conducting an extensive econometric study of the main determinants of tax collection. We find empirical support for the hypothesis that the persistence of Armenia's low tax-GDP ratio can be traced t...

  3. Nurses' perceptions of critical issues requiring consideration in the development of guidelines for professional registered nurse staffing for perinatal units.

    Science.gov (United States)

    Simpson, Kathleen Rice; Lyndon, Audrey; Wilson, Jane; Ruhl, Catherine

    2012-01-01

    To solicit input from registered nurse members of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) on critical considerations for review and revision of existing nurse staffing guidelines. Thematic analysis of responses to a cross-sectional on-line survey question: "Please give the staffing task force your input on what they should consider in the development of recommendations for staffing of perinatal units." Members of AWHONN (N = 884). Descriptions of staffing concerns that should be considered when evaluating and revising existing perinatal nurse staffing guidelines. Consistent themes identified included the need for revision of nurse staffing guidelines due to requirements for safe care, increases in patient acuity and complexity, invisibility of the fetus and newborn as separate and distinct patients, difficulties in providing comprehensive care during labor and for mother-baby couplets under current conditions, challenges in staffing small volume units, and the negative effect of inadequate staffing on nurse satisfaction and retention. Participants overwhelmingly indicated current nurse staffing guidelines were inadequate to meet the needs of contemporary perinatal clinical practice and required revision based on significant changes that had occurred since 1983 when the original staffing guidelines were published. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  4. Public support for social financing of health care in Switzerland.

    Science.gov (United States)

    Perneger, Thomas V; Hudelson, Patricia M

    2005-01-01

    The purpose of this study was to identify factors associated with the public's preference for financing health care according to people's ability to pay. The authors compared voters' support in 26 Swiss cantons for a legislative proposal to replace regionally rated health insurance premiums (current system) with premiums proportional to income and wealth, and co-financed through the value added tax. The vote took place in May 2003, and the initiative was rejected, with only 27 percent of support nationwide. However, support varied more than threefold, from 13 to 44 percent, among cantons. In multivariate analysis, support was most strongly correlated with the approval rate of the 1994 law on health insurance, which strengthened solidarity between the sick and the healthy. More modest associations were seen between support for the initiative and the health insurance premium of 2003, and proportions of elderly and urban residents in the population. Hence support for more social financing of health care was best explained by past preference for a social health insurance system in the local community.

  5. Taxes and Subsidies for Improving Diet and Population Health in Australia: A Cost-Effectiveness Modelling Study.

    Directory of Open Access Journals (Sweden)

    Linda J Cobiac

    2017-02-01

    Full Text Available An increasing number of countries are implementing taxes on unhealthy foods and drinks to address the growing burden of dietary-related disease, but the cost-effectiveness of combining taxes on unhealthy foods and subsidies on healthy foods is not well understood.Using a population model of dietary-related diseases and health care costs and food price elasticities, we simulated the effect of taxes on saturated fat, salt, sugar, and sugar-sweetened beverages and a subsidy on fruits and vegetables, over the lifetime of the Australian population. The sizes of the taxes and subsidy were set such that, when combined as a package, there would be a negligible effect on average weekly expenditure on food (<1% change. We evaluated the cost-effectiveness of the interventions individually, then determined the optimal combination based on maximising net monetary benefit at a threshold of AU$50,000 per disability-adjusted life year (DALY. The simulations suggested that the combination of taxes and subsidy might avert as many as 470,000 DALYs (95% uncertainty interval [UI]: 420,000 to 510,000 in the Australian population of 22 million, with a net cost-saving of AU$3.4 billion (95% UI: AU$2.4 billion to AU$4.6 billion; US$2.3 billion to the health sector. Of the taxes evaluated, the sugar tax produced the biggest estimates of health gain (270,000 [95% UI: 250,000 to 290,000] DALYs averted, followed by the salt tax (130,000 [95% UI: 120,000 to 140,000] DALYs, the saturated fat tax (97,000 [95% UI: 77,000 to 120,000] DALYs, and the sugar-sweetened beverage tax (12,000 [95% UI: 2,100 to 21,000] DALYs. The fruit and vegetable subsidy (-13,000 [95% UI: -44,000 to 18,000] DALYs was a cost-effective addition to the package of taxes. However, it did not necessarily lead to a net health benefit for the population when modelled as an intervention on its own, because of the possible adverse cross-price elasticity effects on consumption of other foods (e.g., foods high in

  6. 31 CFR 285.3 - Offset of tax refund payments to collect past-due support.

    Science.gov (United States)

    2010-07-01

    ... may take in order to secure his or her proper share of the tax refund; and (iii) In cases when a debt... review with the State enforcing collection or the State issuing the support order as prescribed by the... spouse may take in order to secure his or her proper share of the tax refund. See paragraph (f) of this...

  7. Medicaid program; health care-related taxes. Final rule.

    Science.gov (United States)

    2009-06-30

    This rule finalizes our proposal to delay enforcement of certain clarifications regarding standards for determining hold harmless arrangements in the final rule entitled, "Medicaid Program; Health Care-Related Taxes" from the expiration of a Congressional moratorium on enforcement from July 1, 2009 to June 30, 2010.

  8. Effects of Education and Income on Treatment and Outcome in Patients With Acute Myeloid Leukemia in a Tax-Supported Health Care System

    DEFF Research Database (Denmark)

    Ostgard, Lene Sofie Granfeldt; Norgaard, Mette; Medeiros, Bruno C.

    2017-01-01

    Purpose Previous US studies have shown that socioeconomic status (SES) affects survival in acute myeloid leukemia (AML). However, no large study has investigated the association between education or income and clinical characteristics, treatment, and outcome in AML. Methods To investigate...... the effects of education and income in a tax-supported health care system, we conducted a population-based study using individual-level SES and clinical data on all Danish patients with AML (2000 to 2014). We compared treatment intensity, allogeneic transplantation, and response rates by education and income...... level using logistic regression (odds ratios). We used Cox regression (hazard ratios [HRs]) to compare survival, adjusting for age, sex, SES, and clinical prognostic markers. Results Of 2,992 patients, 1,588 (53.1%) received intensive chemotherapy. Compared with low-education patients, highly educated...

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

    African Journals Online (AJOL)

    financing of health care services and a weak health system. Malawi is one of the ... and two-thirds of adults, who need antiretroviral treatment for HIV are ... health service delivery”4. There are two ... estimated the cost for the provision of minimal services .... However, the key issue is to differentiate between tax incentives that.

  10. Smoking: Taxing health and social security

    OpenAIRE

    Armour, Brian S.; Pitts, M. Melinda

    2006-01-01

    Cigarette smoking is costly in terms of not only its effects on smokers' health but also the direct and indirect financial costs it imposes on smokers and their families. For instance, premature death caused by smoking may redistribute Social Security income in unexpected ways that affect behavior and reduce the economic well-being of smokers and their dependents. ; This article examines the effects of smoking-attributable mortality on the net marginal Social Security tax rate (NMSSTR)—the di...

  11. Taxes and Subsidies for Improving Diet and Population Health in Australia: A Cost-Effectiveness Modelling Study.

    Science.gov (United States)

    Cobiac, Linda J; Tam, King; Veerman, Lennert; Blakely, Tony

    2017-02-01

    An increasing number of countries are implementing taxes on unhealthy foods and drinks to address the growing burden of dietary-related disease, but the cost-effectiveness of combining taxes on unhealthy foods and subsidies on healthy foods is not well understood. Using a population model of dietary-related diseases and health care costs and food price elasticities, we simulated the effect of taxes on saturated fat, salt, sugar, and sugar-sweetened beverages and a subsidy on fruits and vegetables, over the lifetime of the Australian population. The sizes of the taxes and subsidy were set such that, when combined as a package, there would be a negligible effect on average weekly expenditure on food (beverage tax (12,000 [95% UI: 2,100 to 21,000] DALYs). The fruit and vegetable subsidy (-13,000 [95% UI: -44,000 to 18,000] DALYs) was a cost-effective addition to the package of taxes. However, it did not necessarily lead to a net health benefit for the population when modelled as an intervention on its own, because of the possible adverse cross-price elasticity effects on consumption of other foods (e.g., foods high in saturated fat and salt). The study suggests that taxes and subsidies on foods and beverages can potentially be combined to achieve substantial improvements in population health and cost-savings to the health sector. However, the magnitude of health benefits is sensitive to measures of price elasticity, and further work is needed to incorporate potential benefits or harms associated with changes in other foods and nutrients that are not currently modelled, such as red and processed meats and fibre. With potentially large health benefits for the Australian population and large benefits in reducing health sector spending on the treatment of non-communicable diseases, the formulation of a tax and subsidy package should be given a more prominent role in Australia's public health nutrition strategy.

  12. Medical physics staffing for radiation oncology: a decade of experience in Ontario, Canada

    Science.gov (United States)

    Battista, Jerry J.; Patterson, Michael S.; Beaulieu, Luc; Sharpe, Michael B.; Schreiner, L. John; MacPherson, Miller S.; Van Dyk, Jacob

    2012-01-01

    The January 2010 articles in The New York Times generated intense focus on patient safety in radiation treatment, with physics staffing identified frequently as a critical factor for consistent quality assurance. The purpose of this work is to review our experience with medical physics staffing, and to propose a transparent and flexible staffing algorithm for general use. Guided by documented times required per routine procedure, we have developed a robust algorithm to estimate physics staffing needs according to center‐specific workload for medical physicists and associated support staff, in a manner we believe is adaptable to an evolving radiotherapy practice. We calculate requirements for each staffing type based on caseload, equipment inventory, quality assurance, educational programs, and administration. Average per‐case staffing ratios were also determined for larger‐scale human resource planning and used to model staffing needs for Ontario, Canada over the next 10 years. The workload specific algorithm was tested through a survey of Canadian cancer centers. For center‐specific human resource planning, we propose a grid of coefficients addressing specific workload factors for each staff group. For larger scale forecasting of human resource requirements, values of 260, 700, 300, 600, 1200, and 2000 treated cases per full‐time equivalent (FTE) were determined for medical physicists, physics assistants, dosimetrists, electronics technologists, mechanical technologists, and information technology specialists, respectively. PACS numbers: 87.55.N‐, 87.55.Qr PMID:22231223

  13. Maintenance Staffing Standards for Zero-Based Budgeting.

    Science.gov (United States)

    Adams, Matthew C.; And Others

    1998-01-01

    Discusses school preventive maintenance and the variables associated with maintenance staffing standards that address a zero-based budgeting environment. Explores preventive-maintenance measurement for staffing requirements, defines staffing levels and job descriptions, and outlines the factors to consider when creating a maintenance program and…

  14. Nuclear power plant organization and staffing for improved performance: Lessons learned

    International Nuclear Information System (INIS)

    1998-11-01

    Experience from well operated nuclear power plants (NPPs) around the world indicates that an organizational structure which efficiently supports plant operation is essential in economically achieving both high level of safety and operational performance. At the same time energy markets are being opened to competition in many Member States. It is in consideration of this new competitive energy market that the overall objective of this document is to provide NPP managers information on lessons learned on improving the organization and staffing of NPP activities. Within this overall objective, specific objectives are to: Identify organisational design and staffing principles, Provide examples of how NPPs implement these principles, Identify typical NPP staffing levels, Factors affecting these levels, and staffing trends among various NPP types. Although it is not expected that any particular utility or NPP manager would consider all of the suggestions provided here to be appropriate, it is anticipated that nearly every NPP manager in IAEA Member States would find some ideas useful in improving the efficiency and effectiveness of NPP activities

  15. Raising the Bar with Trades Staffing Guidelines.

    Science.gov (United States)

    Weidner, Theodore J.

    2000-01-01

    Examines the APPA's Trades Staffing Guidelines Task Force for college campus building maintenance and presents descriptions of the proposed guideline levels and a matrix of indicators for the Trades Staffing Guidelines. The levels and matrix are intended to mimic features of the custodial staffing guidelines. (GR)

  16. Earmarking Tobacco Taxes for Health Purposes via Median Entities

    Directory of Open Access Journals (Sweden)

    Michael Igoumenidis

    2014-08-01

    Full Text Available Fiscal policies are an especially promising lever for reducing the burden of non-communicable diseases and injuries (1. On World No Tobacco Day 2014, World Health Organization (WHO repeated with greater intensity its well-known proposal (2 on raising tobacco taxes to encourage users to stop or reduce consumption, and to prevent potential users from taking up smoking. Evidence as to why this is an effective strategy abounds (3. Despite concerns over manufacturers’ political influence, technical problems such as tax manipulation, and increased smuggling considerations, it is hoped that governments shall be scaling their efforts toward this direction in the next few years, by enforcing increases in specific excise taxes. A 2011 review of more than 100 econometric studies estimates that doubling inflation-adjusted prices should reduce consumption by about one third (4. In terms of revenue, WHO estimates that raising specific excise taxes on tobacco to double prices would raise about 100 billion US dollars per year worldwide, in addition to the approximately 300 billion US dollars that governments already collect on tobacco (5. Each country enforcing such taxes must decide how to allocate their share of this prospective additional revenue in advance. Careful consideration is particularly important; this is a chance for tobacco to atone, partly at least, for the damage it has inflicted throughout the years of its uncontrollable use.

  17. Can trust in politicians explain individuals' support for climate policy? The case of CO{sub 2} tax

    Energy Technology Data Exchange (ETDEWEB)

    Hammar, Henrik [Goeteborg Univ., Dept. of Economics, Goeteborg (Sweden); National Inst. of Economic Research (NIER), Stockholm (Sweden); Jagers, Sverker C. [Goeteborg Univ., Dept. of Polital Science, Goeteborg (Sweden)

    2006-07-01

    This article provides an analysis of the support for public policies from a trust perspective. The empirical focus is on the use of a tax on carbon dioxide (CO{sub 2}), a policy tool aimed at coordinating national emissions targets in Sweden. Among economists and experts in the field of climate policy, a CO{sub 2} tax is viewed as a cost-effective policy. The policy problem is that public support for CO{sub 2} taxes is very low, leaving policy makers with high-cost options. Apart from traditional explanatory variables such as demographic factors, level of education, ideology and self-interest, what can explain this public opposition? Using individual level data, we analyse whether support for increases in the CO{sub 2} tax on gasoline can be explained by citizens' generalized trust in other individuals (who they do not necessarily know) or by their trust in politicians. We find that only the latter measure gains support in a regression analysis. Moreover, when splitting the sample into high-trusting and low-trusting individuals, we find that high-trusting individuals who have access to a car (compared with those without access) are statistically no more likely to resist increases in CO{sub 2} taxes than people without access to a car. Rather, it is individuals with access to a car and who do not trust their politicians who are likely to resist CO{sub 2} taxes. (Author)

  18. Public Health and Politics: Using the Tax Code to Expand Advocacy.

    Science.gov (United States)

    Gorovitz, Eric

    2017-03-01

    Protecting the public's health has always been an inherently political endeavor. The field of public health, however, is conspicuously and persistently absent from sustained, sophisticated engagement in political processes, particularly elections, that determine policy outcomes. This results, in large part, from widespread misunderstanding of rules governing how, and how much, public advocates working in tax-exempt organizations can participate in public policy development. This article briefly summarizes the rules governing public policy engagement by exempt organizations. It then describes different types of exempt organizations, and how they can work together to expand engagement. Next, it identifies several key mechanisms of policy development that public health advocates could influence. Finally, it suggests some methods of applying the tax rules to increase participation in these arenas.

  19. Applying WHO's 'workforce indicators of staffing need' (WISN) method to calculate the health worker requirements for India's maternal and child health service guarantees in Orissa State.

    Science.gov (United States)

    Hagopian, Amy; Mohanty, Manmath K; Das, Abhijit; House, Peter J

    2012-01-01

    In one district of Orissa state, we used the World Health Organization's Workforce Indicators of Staffing Need (WISN) method to calculate the number of health workers required to achieve the maternal and child health 'service guarantees' of India's National Rural Health Mission (NRHM). We measured the difference between this ideal number and current staffing levels. We collected census data, routine health information data and government reports to calculate demand for maternal and child health services. By conducting 54 interviews with physicians and midwives, and six focus groups, we were able to calculate the time required to perform necessary health care tasks. We also interviewed 10 new mothers to cross-check these estimates at a global level and get assessments of quality of care. For 18 service centres of Ganjam District, we found 357 health workers in our six cadre categories, to serve a population of 1.02 million. Total demand for the MCH services guaranteed under India's NRHM outpaced supply for every category of health worker but one. To properly serve the study population, the health workforce supply should be enhanced by 43 additional physicians, 15 nurses and 80 nurse midwives. Those numbers probably under-estimate the need, as they assume away geographic barriers. Our study established time standards in minutes for each MCH activity promised by the NRHM, which could be applied elsewhere in India by government planners and civil society advocates. Our calculations indicate significant numbers of new health workers are required to deliver the services promised by the NRHM.

  20. Gaming of performance measurement in health care: parallels with tax compliance.

    Science.gov (United States)

    Mears, Alex; Webley, Paul

    2010-10-01

    Gaming of performance measurement in health care distorts performance, making it appear better than it is. This can conceal potentially hazardous practice and endanger patients and staff. Research has investigated and categorized this behaviour but as yet has offered little in the way of potential solutions as the drivers are still not well understood. Studies of the psychology of tax behaviour, specifically tax avoidance and evasion, reveal some insights into what the underlying causes are. Looking at health care and tax compliance, seven similarities in response can be detected: negative view of those subject to it; not salient except for specific classes of people; general understanding of the need versus resentment of actuality; cognitive dissonance; moral versus legal grey areas; two levels of objective non-compliance; and four categories of subjective behaviour and attitude. We suggest a model of reaction and compliance for gaming and offer some suggestions as to how this phenomenon might be minimized.

  1. Effects of Medicare payment changes on nursing home staffing and deficiencies.

    Science.gov (United States)

    Konetzka, R Tamara; Yi, Deokhee; Norton, Edward C; Kilpatrick, Kerry E

    2004-06-01

    To investigate the effects of Medicare's Prospective Payment System (PPS) for skilled nursing facilities (SNFs) and associated rate changes on quality of care as represented by staffing ratios and regulatory deficiencies. Online Survey, Certification and Reporting (OSCAR) data from 1996-2000 were linked with Area Resource File (ARF) and Medicare Cost Report data to form a panel dataset. A difference-in-differences model was used to assess effects of the PPS and the BBRA (Balanced Budget Refinement Act) on staffing and deficiencies, a design that allows the separation of the effects of the policies from general trends. Ordinary least squares and negative binomial models were used. The OSCAR and Medicare Cost Report data are self-reported by nursing facilities; ARF data are publicly available. Data were linked by provider ID and county. We find that professional staffing decreased and regulatory deficiencies increased with PPS, and that both effects were mitigated with the BBRA rate increases. The effects appear to increase with the percent of Medicare residents in the facility except, in some cases, at the highest percentage of Medicare. The findings on staffing are statistically significant. The effects on deficiencies, though exhibiting consistent signs and magnitudes with the staffing results, are largely insignificant. Medicare's PPS system and associated rate cuts for SNFs have had a negative effect on staffing and regulatory compliance. Further research is necessary to determine whether these changes are associated with worse outcomes. Findings from this investigation could help guide policy modifications that support the provision of quality nursing home care.

  2. Human Resources Staffing Plan for the Tank Farm Contractor

    International Nuclear Information System (INIS)

    BOSLEY, J.W.

    2000-01-01

    The Human Resources Staffing Plan quantified the equivalent staffing needs required for the Tank Farm Contractor (TFC) and its subcontractors to execute the readiness to proceed baseline between FY 2000-2008. The TFC staffing needs were assessed along with the staffings needs of Fluor Hanford and the privatization contractor. The plan then addressed the staffing needs and recruitment strategies required to execute the baseline

  3. 77 FR 41270 - Health Insurance Premium Tax Credit

    Science.gov (United States)

    2012-07-13

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Parts 1 and 602 [TD 9590] RIN 1545-BJ82 Health Insurance Premium Tax Credit Correction In rule document 2012-12421 appearing on pages 30377-30400 in the issue of Wednesday, May 23, 2012, make the following corrections: 0 1. On page 30385, in the...

  4. Large-scale mHealth professional support for health workers in rural Maharashtra, India.

    Science.gov (United States)

    Hegde, Shailendra Kumar B; Saride, Sriranga Prasad; Kuruganty, Sudha; Banker, Niraja; Patil, Chetan; Phanse, Vishal

    2018-04-01

    Expanding mobile telephony in India has prompted interest in the potential of mobile-telephone health (mHealth) in linking health workers in rural areas with specialist medical advice and other professional services. In 2012, a toll-free helpline offering specialist medical advice to community-based health workers throughout Maharashtra was launched. Calls are handled via a 24 h centre in Pune, staffed by health advisory officers and medical specialists. Health advisory officers handle general queries, which include medical advice via validated algorithms; blood on-call services; grievance issues; and mental health support - the latter calls are transferred to a qualified counsellor. Calls requiring more specialist advice are transferred to the appropriate medical specialist. This paper describes the experience of the first 4 years of this helpline, in terms of the services used, callers, nature of calls, types of queries serviced and lessons learnt. In the first 4 years of the helpline, 669 265 calls were serviced. Of these calls, 453 373 (67.74%) needed medical advice and were handled by health advisory officers. Specialist services were required to address 199 226 (29.77%) calls. Blood-bank-related services accounted for 7919 (1.18%) calls, while 2462 (0.37%) were grievance calls. Counselling for mental health issues accounted for 6285 (0.94%) calls. The large-scale mHealth professional support provided by this helpline in Maharashtra has reached many health workers serving rural communities. Future work is required to explore ways to expand the reach of the helpline further and to measure its effectiveness in improving health outcomes.

  5. Health care joint ventures between tax-exempt organizations and for-profit entities.

    Science.gov (United States)

    Sanders, Michael I

    2005-01-01

    Health care exempt organizations have many options regarding their structure and affiliations with for-profit entities. As long as any joint ventures are carefully structured and the nonprofit retains control over the exempt health care activities, the Internal Revenue Service should not question the structure. However, as outlined above, if the for-profit entity effectively gains control over the activities of the venture, the structure is not likely to be upheld by the IRS or the courts, and either the exempt status of the nonprofit will be denied or revoked, or health care income will be subject to the unrelated business income tax. In summary, the health care industry has been severely impacted by many economic forces, including uncertainty in the area of joint ventures between nonprofits and for-profit health care systems. The uncertainty as to whether the joint venture would negatively impact the nonprofit's tax-exempt status undoubtedly caused many nonprofits to form for-profit subsidiaries and otherwise expanded operations in a for-profit marketplace. Fortunately, with the guidance that is currently available in the form of Revenue Ruling 98-15, Redlands, St. David's, and now Revenue Ruling 2004-51, health care institutions can move forward with properly structured joint ventures with greater confidence that the joint venture will not endanger the tax-exempt status of the nonprofit.

  6. Impact of the Level of State Tax Code Progressivity on Children's Health Outcomes

    Science.gov (United States)

    Granruth, Laura Brierton; Shields, Joseph J.

    2011-01-01

    This research study examines the impact of the level of state tax code progressivity on selected children's health outcomes. Specifically, it examines the degree to which a state's tax code ranking along the progressive-regressive continuum relates to percentage of low birthweight babies, infant and child mortality rates, and percentage of…

  7. Taxing Snack Foods: What to Expect for Diet and Tax Revenues

    OpenAIRE

    Kuchler, Fred; Tegene, Abebayehu; Harris, James Michael

    2004-01-01

    Health researchers and health policy advocates have proposed levying excise taxes on snack foods as a possible way to address the growing prevalence of obesity and overweight in the United States. Some proposals suggest higher prices alone will change consumers' diets. Others claim that change will be possible if earmarked taxes are used to fund an information program. This research examines the potential impact of excise taxes on snack foods, using baseline data from a household survey of fo...

  8. Hospitals with higher nurse staffing had lower odds of readmissions penalties than hospitals with lower staffing.

    Science.gov (United States)

    McHugh, Matthew D; Berez, Julie; Small, Dylan S

    2013-10-01

    The Affordable Care Act's Hospital Readmissions Reduction Program (HRRP) penalizes hospitals based on excess readmission rates among Medicare beneficiaries. The aim of the program is to reduce readmissions while aligning hospitals' financial incentives with payers' and patients' quality goals. Many evidence-based interventions that reduce readmissions, such as discharge preparation, care coordination, and patient education, are grounded in the fundamentals of basic nursing care. Yet inadequate staffing can hinder nurses' efforts to carry out these processes of care. We estimated the effect that nurse staffing had on the likelihood that a hospital was penalized under the HRRP. Hospitals with higher nurse staffing had 25 percent lower odds of being penalized compared to otherwise similar hospitals with lower staffing. Investment in nursing is a potential system-level intervention to reduce readmissions that policy makers and hospital administrators should consider in the new regulatory environment as they examine the quality of care delivered to US hospital patients.

  9. The impact of a sugar-sweetened beverages tax on oral health and costs of dental care in Australia.

    Science.gov (United States)

    Sowa, P Marcin; Keller, Elena; Stormon, Nicole; Lalloo, Ratilal; Ford, Pauline J

    2018-05-22

    Despite a clear causal link between frequent consumption of sugar-sweetened beverages (SSBs) and dental disease, little is known about the implications of a tax on SSBs in the context of oral health. The aim of our study was to estimate the impacts of a SSB tax on the Australian population in the context of oral health outcomes, dental care utilisation and associated costs. We designed a cohort model that accounted for the consequences of the tax through the mechanisms of consumer response to price increase, the effect on oral health due to change in sugar intake, and the implications for dental care use. Our results indicate that in the adult population an ad valorem tax of 20% would lead to a reduction in decayed, missing and filled teeth (DMFT) by 3.9 million units over 10 years, resulting in cost savings of A$666 million. Scenario analyses show that the outcomes are sensitive to the choice of the time horizon, tax rate, price elasticity of demand for SSBs, and the definition of target population. We found that the total and per-person consequences of SSB tax were considerable, both in terms of dental caries (tooth decay) averted and dental care avoided. These results have to be compounded with the implications of SSB tax for other aspects of health and health care, especially in the context of chronic diseases. On the other hand, the improved outcomes have to be weighted against a welfare loss associated with introducing a tax.

  10. An analysis of Malaysia's corporate income tax expenditures and negative income tax expenditures using accounting standards as the benchmark tax base

    OpenAIRE

    Yussof, Salwa Hana

    2017-01-01

    Tax expenditures are government indirect spending, hidden in the tax system, often used to support government’s social and economic objectives. Instead of directly allocating money for a particular objective, the government forgoes tax revenues from those who undertake activities that could achieve the objective. Therefore, tax expenditures should be analysed as government spending programs. Tax expenditure reporting and analysis has been a regular practice among many countries in the worl...

  11. Optimization Of Methodological Support Of Application Tax Benefits In Regions: Practice Of Perm Region

    Directory of Open Access Journals (Sweden)

    Alexandr Ivanovich Tatarkin

    2015-03-01

    Full Text Available In the article, the problem of the methodological process support of regional tax benefits is reviewed. The method of tax benefits assessment, accepted in Perm Region, was chosen as an analysis object because the relatively long period of application of benefits has allowed to build enough statistics base. In the article, the reliability of budget, economic, investment, and social effectiveness assessments of application benefits, based on the Method, is investigated. The suggestions of its perfection are formulated

  12. Nice Guys Finish Last: Are People with Higher Tax Morale Taxed more Heavily?

    OpenAIRE

    Philipp Doerrenberg; Denvil Duncan; Clemens Fuest; Andreas Peichl

    2012-01-01

    This paper is the first to provide evidence of efficient taxation of groups with heterogeneous levels of 'tax morale'. We set up an optimal income tax model where high tax morale implies a high subjective cost of evading taxes. The model predicts that 'nice guys finish last': groups with higher tax morale will be taxed more heavily, simply because taxing them is less costly. Based on unique cross-country micro data and an IV approach to rule out reverse causality, we find empirical support fo...

  13. Avoiding mandatory hospital nurse staffing ratios: an economic commentary.

    Science.gov (United States)

    Buerhaus, Peter I

    2009-01-01

    The imposition of mandatory hospital nurse staffing ratios is among the more visible public policy initiatives affecting the nursing profession. Although the practice is intended to address problems in hospital nurse staffing and quality of patient care, this commentary argues that staffing ratios will lead to negative consequences for nurses involving the equity, efficiency, and costs of producing nursing care in hospitals. Rather than spend time and effort attempting to regulate nurse staffing, this commentary offers alternatives strategies that are directed at fixing the problems that motivate the advocates of staffing ratios.

  14. Worker Sorting, Taxes and Health Insurance Coverage

    OpenAIRE

    Kevin Lang; Hong Kang

    2007-01-01

    We develop a model in which firms hire heterogeneous workers but must offer all workers insurance benefits under similar terms. In equilibrium, some firms offer free health insurance, some require an employee premium payment and some do not offer insurance. Making the employee contribution pre-tax lowers the cost to workers of a given employee premium and encourages more firms to charge. This increases the offer rate, lowers the take-up rate, increases (decreases) coverage among high (low) de...

  15. Tax subsidization of personal assistance services.

    Science.gov (United States)

    Mendelsohn, Steven; Myhill, William N; Morris, Michael

    2012-04-01

    Personal assistance services (PAS) is the term used to describe the range of assistance, services, and supports many people with disabilities and older Americans need to remain in their homes and communities. The Americans with Disabilities Act requires that people with disabilities receive essential services in the communities of their choice rather than in institutional settings. PAS availability often determines whether persons with disabilities become institutionalized or remain in their communities. PAS, however, are not inexpensive or broadly available. Strategies are needed to improve their availability to people with disabilities and the elderly. We sought to analyze 8 provisions of the Internal Revenue Code for their utility to make PAS more affordable and available. The authors conducted a legal analysis of 8 statutory provisions, as interpreted by regulations, court decisions, and other authoritative sources. Each of the tax provisions analyzed covers some PAS expenses incurred by an individual or family. Favorable tax treatment is impacted by the nature and amount of expenses and by the location and conditions of services. The current limitations and complexities of legal interpretations and the fact that many individuals with disabilities are uninformed about these tax provisions present challenges and opportunities. As the need for PAS grows, reform of tax policy is an important complement to health care and long-term services and supports for people with disabilities. To increase utilization of current beneficial tax provisions that subsidize the cost of PAS, individuals with disabilities and tax preparers must become better informed about using these provisions. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Economic and public health impact of 2007-2010 tobacco tax increases in Ukraine.

    Science.gov (United States)

    Ross, Hana; Stoklosa, Michal; Krasovsky, Konstantin

    2012-07-01

    To evaluate the impact of the dynamic 2007-2010 tobacco tax policy in Ukraine on cigarette prices, cigarette consumption, tobacco tax revenue and the tobacco industry's price strategy. Using data on cigarette sales, cigarette prices, income and tobacco control policies, price elasticities of cigarette demand in Ukraine were estimated using two methods. Annual data were used to generate point price elasticity estimates, while monthly data were used in a two-step Engle-Granger procedure. The point price elasticity estimate is data sensitive and ranges from -0.11 to -0.62, centring around -0.32. The regression model estimates a long-run price elasticity of -0.28. Cigarette consumption fell by 13% in 2009 and 15% in 2010 while the tax revenue increased by US$700 million and by US$500 million in 2009 and 2010, respectively, compared to the previous year. Tax increases have changed the tobacco industry's price strategy from one of shielding consumers from the impact of smaller tax hikes in 2007-2008, to one of increasing industry net-of-tax prices, after recent, larger tax increases. The higher real tobacco excise taxes of 2009 and 2010 have significantly reduced tobacco consumption in Ukraine, resulting in encouraging public health and fiscal gains. It will be important for cigarette prices/taxes to keep pace with inflation and income growth for this impact to be sustained.

  17. Benefits of High-Intensity Intensive Care Unit Physician Staffing under the Affordable Care Act

    Directory of Open Access Journals (Sweden)

    Sachin Logani

    2011-01-01

    Full Text Available The Affordable Care Act signed into law by President Obama, with its value-based purchasing program, is designed to link payment to quality processes and outcomes. Treatment of critically ill patients represents nearly 1% of the gross domestic product and 25% of a typical hospital budget. Data suggest that high-intensity staffing patterns in the intensive care unit (ICU are associated with cost savings and improved outcomes. We evaluate the literature investigating the cost-effectiveness and clinical outcomes of high-intensity ICU physician staffing as recommended by The Leapfrog Group (a consortium of companies that purchase health care for their employees and identify ways to overcome barriers to nationwide implementation of these standards. Hospitals that have implemented the Leapfrog initiative have demonstrated reductions in mortality and length of stay and increased cost savings. High-intensity staffing models appear to be an immediate cost-effective way for hospitals to meet the challenges of health care reform.

  18. Development of staffing evaluation principle for advanced main control room and the effect on situation awareness and mental workload

    International Nuclear Information System (INIS)

    Lin, Chiuhsiang Joe; Hsieh, Tsung-Ling; Lin, Shiau-Feng

    2013-01-01

    Highlights: • A staffing evaluation principle was developed for the advanced main control room. • The principle proposed to improve situation awareness and mental workload. • The principle has good validity that was examined by experimental design. - Abstract: Situation awareness and mental workload, both of which influence operator performance in the advanced main control room of a nuclear power plant, can be affected by staffing level. The key goal of staffing is to ensure the proper number of personnel to support plant operations and events. If the staffing level is not adaptive, the operators may have low situation awareness and an excessive mental workload, which lead to human error. Accordingly, this study developed a staffing evaluation principle based on CPM-GOMS modeling for operations in the advanced main control room. A within-subject experiment was designed to examine the validity of the staffing evaluation principle. The results indicated that the situation awareness, mental workload, and operating performance of the staffing level determined by the staffing evaluation principle was significantly better than that of the non-evaluated staffing level; thus, the validity of the staffing evaluation technique is acceptable. The implications of the findings of this study on managerial practice are discussed

  19. Development of staffing evaluation principle for advanced main control room and the effect on situation awareness and mental workload

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Chiuhsiang Joe, E-mail: cjoelin@mail.ntust.edu.tw [Department of Industrial Management, National Taiwan University of Science and Technology, 43, Section 4, Keelung Road, Taipei 10607, Taiwan (China); Hsieh, Tsung-Ling, E-mail: bm1129@gmail.com [Institute of Nuclear Energy Research, 1000, Wenhua Road, Chiaan Village, Lungtan 32546, Taiwan (China); Lin, Shiau-Feng, E-mail: g9602411@cycu.edu.tw [Department of Industrial Engineering, Chung-Yuan Christian University, 200, Chung Pei Road, Chung-Li 32023, Taiwan (China)

    2013-12-15

    Highlights: • A staffing evaluation principle was developed for the advanced main control room. • The principle proposed to improve situation awareness and mental workload. • The principle has good validity that was examined by experimental design. - Abstract: Situation awareness and mental workload, both of which influence operator performance in the advanced main control room of a nuclear power plant, can be affected by staffing level. The key goal of staffing is to ensure the proper number of personnel to support plant operations and events. If the staffing level is not adaptive, the operators may have low situation awareness and an excessive mental workload, which lead to human error. Accordingly, this study developed a staffing evaluation principle based on CPM-GOMS modeling for operations in the advanced main control room. A within-subject experiment was designed to examine the validity of the staffing evaluation principle. The results indicated that the situation awareness, mental workload, and operating performance of the staffing level determined by the staffing evaluation principle was significantly better than that of the non-evaluated staffing level; thus, the validity of the staffing evaluation technique is acceptable. The implications of the findings of this study on managerial practice are discussed.

  20. Hospital nurse staffing and patient mortality, emotional exhaustion, and job dissatisfaction.

    Science.gov (United States)

    Halm, Margo; Peterson, Michelle; Kandels, Mary; Sabo, Julie; Blalock, Miriam; Braden, Rebecca; Gryczman, Anna; Krisko-Hagel, Kathryn; Larson, Dave; Lemay, Diane; Sisler, Bette; Strom, Linda; Topham, Debra

    2005-01-01

    To conduct an investigation similar to a landmark study that investigated the association between nurse-to-patient ratio and patient mortality, failure-to-rescue, emotional exhaustion and job satisfaction of nurses. Cross-sectional analysis of 2709 general, orthopedic, and vascular surgery patients, and 140 staff nurses (42% response rate) caring for these patients in a large Midwestern institution. The main outcome measures were mortality, failure-to-rescue, emotional exhaustion, and job dissatisfaction. Staffing was not a significant predictor of mortality or failure-to-rescue, nor did clinical specialty predict emotional exhaustion or job dissatisfaction. Although these findings reinforce adequate staffing ratios at this institution, programs that support nurses in their daily practice and positively impact job satisfaction need to be explored. The Nursing Research Council not only has heightened awareness of how staffing ratios affect patient and nurse outcomes, but also a broader understanding of how the research process can be used to effectively shape nurse's practice and work environments.

  1. Tax reforms - taxes without tax laws

    OpenAIRE

    Varma, Vijaya Krushna Varma

    2009-01-01

    All Direct and Indirect taxes accompanied by tax laws, accounting, auditing and tax returns, can be abolished if a new tax system called "TOP Tax system" is adopted and implemented by all nations. Ultimate economic reforms will relieve 7 billion people of the world from the cobweb of ambiguous and complex tax structures, plethora of tax laws, mandatory and cumbersome accounting, auditing, tax returns and consequent quagmire of all tax related cases. Taxation, tax collection, tax enforce...

  2. Tax Support of Small Enterprises Activity in Ukraine

    Directory of Open Access Journals (Sweden)

    Pronoza Pavlo V

    2015-03-01

    Full Text Available The purpose of the article is to evaluate the importance of small enterprises for the economic development of Ukraine and determine priorities of their stimulation. The analysis of quantitative indicators of small businesses and their comparison with the average level of all enterprises in Ukraine as a whole allowed evaluating their importance in the development of the country. There has been identified a special role of small enterprises in Ukraine’s economy and confirmed the expediency of using tax regulation instruments aimed at their development. There was identified an insufficient efficiency level of tax regulation of small businesses in Ukraine due to using a simplified system of taxation, accounting and reporting. The basic tools used in the framework of tax regulation of small enterprises activities in international practice have been determined. Additional analysis of performance of small enterprises by types of economic activity on the basis of an integrated assessment permitted to identify priorities of using tax regulation instruments in Ukraine.

  3. Support for School Construction: Blending Sales Tax with Property Tax.

    Science.gov (United States)

    Haney, David W.; Schmidt, Mark

    2002-01-01

    Describes how opinion by North Dakota's attorney general allows school district and city of Jamestown to collaborate in the issuance of bonds for school construction and renovation projects, three-quarters of the revenue for which is raised by a voter-approved city sales tax. (PKP)

  4. Tax-tariff reform with costs of tax administration

    DEFF Research Database (Denmark)

    Munk, Knud Jørgen

    on border taxes to finance its resource requirements. However, the theorem does not hold when taxation is associated with administrative costs. The present paper explores the implications of taking into account the costs of tax administration for optimal taxation and for desirable directions of tax......As is broadly recognized, the straightforward application of the Diamond-Mirrlees (1971) production efficiency theorem implies that when lump-sum taxation is not available, then it is optimal for the government in a small open economy to rely on taxes on the net demand of ouseholds rather than......-tariff reform in countries at different levels of economic development. The paper clarifies the reasons for, and lends support to, the criticism by Stiglitz (2003) of the IMF and the World Bank's recommendation to developing countries to adopt VAT to replace border taxes....

  5. Staffing and job satisfaction: nurses and nursing assistants.

    Science.gov (United States)

    Kalisch, Beatrice; Lee, Kyung Hee

    2014-05-01

    The aim of this study was to examine the relationship between staffing and job satisfaction of registered nurses (RNs) and nursing assistants (NAs). Although a number of previous studies have demonstrated the link between the numbers of patients cared for on the last shift and/or perceptions of staffing adequacy, we could find only one study that utilized a measure of actual staffing (opposed to perceptions of staffing adequacy) and correlated it with job satisfaction of registered nurses. This cross-sectional study included 3523 RNs and 1012 NAs in 131 patient care units. Staff were surveyed to determine job satisfaction and demographic variables. In addition, actual staffing data were collected from each of the study units. Hours per patient day was a significant positive predictor for registered nurse job satisfaction after controlling for covariates. For NAs, a lower skill mix was marginally significant with higher job satisfaction. In addition, the more work experience the NAs reported, the lower their job satisfaction. Adequate staffing levels are essential for RN job satisfaction whereas NA job satisfaction depends on the number of assistive personnel in the mix of nursing staff. Two implications are (1) providing adequate staffing is critical to maintain RN job satisfaction and (2) the NA job needs to be re-engineered to make it a more attractive and satisfying career. © 2012 John Wiley & Sons Ltd.

  6. Improving population health by reducing poverty: New York's Earned Income Tax Credit.

    Science.gov (United States)

    Wicks-Lim, Jeannette; Arno, Peter S

    2017-12-01

    Despite the established relationship between adverse health outcomes and low socioeconomic status, researchers rarely test the link between health improvements and poverty-alleviating economic policies. New research, however, links individual-level health improvements to the Earned Income Tax Credit (EITC), a broad-based income support policy. We build on these findings by examining whether the EITC has ecological, neighborhood-level health effects. We use a difference-in-difference analysis to measure child health outcomes in 90 low- and middle- income neighborhoods before and after the expansion of New York State and New York City's EITC policy between 1997-2010. Our study takes advantage of the relatively exogenous source of income variation supplied by the EITC-legislative changes to EITC policy parameters. This feature minimizes the endogeneity problem in studying the relationship between income and health. Our estimates link a 15-percentage-point increase in EITC benefit rates to a 0.45 percentage-point reduction in the low birthweight rate. We do not observe any measurable link between EITC benefits and prenatal health or asthma-related pediatric hospitalization. The magnitude of the EITC's impact on low birthweight rates suggests ecological effects, and an additional channel through which anti-poverty measures can serve as public health interventions.

  7. Tax evasion, human capital, and productivity-induced tax rate reduction

    Czech Academy of Sciences Publication Activity Database

    Gillman, M.; Kejak, Michal

    2014-01-01

    Roč. 8, č. 1 (2014), s. 42-79 ISSN 1932-8575 Grant - others:UK(CZ) UNCE 204005/2012 Institutional support: PRVOUK-P23 Keywords : tax evasion * human capital * tax rates and tables Subject RIV: AH - Economics Impact factor: 0.600, year: 2014

  8. Impact of Tobacco Taxes and Price Increases in Ukraine, Russia ...

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

    This research will assess how different tobacco taxation scenarios will affect cigarette consumption, smoking prevalence, tobacco excise tax revenues, and tobacco smuggling, all of which directly or indirectly influence public health. The information generated will also support efforts by tobacco control and health NGOs in ...

  9. New law on staffing levels will save lives.

    Science.gov (United States)

    2016-02-17

    Good news about nurse staffing levels can be hard to find, so how fantastic that a protracted campaign in Wales finally paid off last week with the passage of legislation to ensure hospital wards are staffed safely. Next month, the Queen will give royal assent to the Safe Nurse Staffing Levels (Wales) Bill, which will save lives, produce better outcomes and enhance the patient experience of care.

  10. A Case Study of the Philadelphia Sugar-Sweetened Beverage Tax Policymaking Process: Implications for Policy Development and Advocacy.

    Science.gov (United States)

    Purtle, Jonathan; Langellier, Brent; Lê-Scherban, Félice

    Policymakers are increasingly proposing sugar-sweetened beverage (SSB) taxes as an evidence-based strategy to reduce chronic disease risk; and local health departments (LHDs) are well-positioned to play a role in SSB policy development and advocacy. However, most SSB tax proposals fail to become law and limited empiric guidance exists to inform advocacy efforts. In June 2016, Philadelphia, Pennsylvania, passed an SSB tax. To identify features of the Philadelphia SSB tax policymaking process that contributed to the proposal's passage. Qualitative case study. Semistructured interviews were conducted with key informants closely involved with the policymaking process. Interviews were audio-recorded and transcribed. Local news media about the SSB tax proposal were analyzed to triangulate interview findings. Analysis was conducted in NVivo 10 using inductive qualitative content analysis. Philadelphia, Pennsylvania, during the SSB tax policymaking in process. Nine key informants (2 city councilpersons, 4 city agency officials, 1 community-based advocate, 1 news reporter, and 1 researcher). The Philadelphia SSB tax proposal was introduced with the explicit goal of financing universal prekindergarten and deliberately not framed as a health intervention. This framing shifted contentious debates about government involvement in individual behavior toward discussions about how to finance universal prekindergarten, a goal for which broad support existed. The LHD played an important role in communicating research evidence about potential health benefits of the SSB tax proposal at the end of the policymaking process. During local SSB tax policy development processes, LHD officials and other advocates should encourage policymakers to design SSB tax policies so that revenue is directed toward community investments for which broad public support exists. When communicating with policymakers and the public, LHDs should consider emphasizing how SSB tax revenue will be used in addition

  11. Rules regarding the health insurance premium tax credit. Final and temporary regulations.

    Science.gov (United States)

    2014-07-28

    This document contains final and temporary regulations relating to the health insurance premium tax credit enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended by the Medicare and Medicaid Extenders Act of 2010, the Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011, and the Department of Defense and Full-Year Continuing Appropriations Act of 2011 and the 3% Withholding Repeal and Job Creation Act. These regulations affect individuals who enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges) and claim the premium tax credit, and Exchanges that make qualified health plans available to individuals. The text of the temporary regulations in this document also serves as the text of proposed regulations set forth in a notice of proposed rulemaking (REG-104579-13) on this subject in the Proposed Rules section in this issue of the Federal Register.

  12. Effectiveness of tax and price policies in tobacco control.

    Science.gov (United States)

    Chaloupka, Frank J; Straif, Kurt; Leon, Maria E

    2011-05-01

    Over 20 experts on economics, epidemiology, public policy and tobacco control were asked by the International Agency for Research on Cancer (IARC) to evaluate the strength of the available evidence on the effects of tax and price policies to prevent and reduce tobacco use. Draft papers presenting and assessing the evidence on the following topics were developed by the experts in an 8-month period prior to the meeting: tobacco industry pricing strategies and tax related lobbying; tax, price and aggregate demand for tobacco; tax, price and adult tobacco use, use among young people and use among the poor; tax avoidance and tax evasion; and the economic and health impact of tobacco taxation. Subsequently, papers were peer reviewed, revised and resubmitted for final discussion at a 6-day meeting at IARC in Lyon, France, where a consensus evaluation of 18 concluding statements using the pre-established criteria of the IARC Cancer Prevention Handbooks took place. Studies published (or accepted for publication) in the openly available scientific literature were the main source of evidence for the review and evaluation; other types of publications were included when appropriate. In support of 12 of the 18 conclusions, the experts agreed that there was sufficient evidence of effectiveness of increased tobacco excise taxes and prices in reducing overall tobacco consumption and prevalence of tobacco use and improvement of public health, including by preventing initiation and uptake among young people, promoting cessation among current users and lowering consumption among those who continue to use. For the remaining six concluding statements the evidence was strong (four statements) or limited (two statements). The evidence presented and assessed in IARC Handbook volume 14 documents the effectiveness of tax and price policies in the control of tobacco use and improvement of public health.

  13. Tax evasion, human capital, and productivity-induced tax rate reduction

    Czech Academy of Sciences Publication Activity Database

    Gillman, Max; Kejak, Michal

    2014-01-01

    Roč. 8, č. 1 (2014), s. 42-79 ISSN 1932-8575 R&D Projects: GA ČR GA13-34096S Institutional support: RVO:67985998 Keywords : tax evasion * human capital * tax rates and tables Subject RIV: AH - Economics Impact factor: 0.600, year: 2014

  14. Structure and staffing of radiotherapy physics in the UK

    International Nuclear Information System (INIS)

    Thwaites, D I

    1995-01-01

    In 1989 IPSM brought out a policy document on the role of the physical scientist in radiotherapy. At roughly the same time IPSM also produced recommended minimum staffing levels for the medical physics support of radiotherapy, which drew heavily on comprehensive reviews of both physicist and physics technician staffing carried out by the Scottish Radiotherapy Physicists Group in 1980 (updated in 1989). The IPSM figures remain professional recommendations and have not been taken up by any official body. However some of the Scottish figures were included in a SHHD Planning Council Scientific Advisory report and so have some measure of official endorsement. All these figures were derived specifically for the UK situation of essentially regional oncology centres, where generally medium to large radiotherapy departments are the norm, to concentrate equipment, expertise and experience. Thus there are approximately 60 centres for a population of 55 million. In addition the recommendations reflect the typical structure of UK departments, in terms of professional roles and relationships. The current situation regarding physicist and physics technician numbers is reviewed, using evidence from recent surveys. The UK and other recommendations are applied to a number of representative centres and the figures obtained are compared to each other and to the actual staffing levels

  15. Impact of GDP and tax revenue on health care financing: An empirical investigation from Indian states

    OpenAIRE

    Deepak Kumar BEHERA; Umakant DASH

    2017-01-01

    This paper investigates the long run impact of GDP and tax revenue on public health care expenditure using panel FMOLS and DOLS models for sixteen major states of India over the period 1980-2013. This study is more relevant in order to measure the progress in universal health care financing across the states of India because states are heterogeneous in terms of health care spending, associated with low tax bases and low level of GDP growth. The empirical result shows that healt...

  16. Technical basis for staffing levels at nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Shurberg, D.A.; Haber, S.B. [Brookhaven National Lab., Upton, NY (United States); Morisseau, D. [Nuclear Regulatory Commission, Washington, DC (United States)] [and others

    1995-04-01

    The objective of this project is to provide a technical basis for the establishment of criteria for minimum staffing levels of licensed and non-licensed NPP shift personnel. Minimum staffing levels for the purpose of this study, are defined as those necessary for successful accomplishment of all safety and additional functions that must be performed in order for the licensee to meet applicable regulatory requirements. This project involves a multi-faceted approach to the investigation of the issue. Relevant NRC documentation was identified and reviewed. Using the information obtained from this documentation review, a test plan was developed to aid in the collection of further information regarding the adequacy of current shift staffing levels. The test plan addresses three different activities to be conducted to provide information to the NRC for use in the assessment of current minimum staffing levels. The first activity is collection of data related to industry shift staffing practices through site visits to seven nuclear power plants. The second activity is a simulator study, which will use licensed operator crews responding to a simulated event, under two different staffing levels. Finally, workload models will be constructed for both licensed and non-licensed personnel, using a priori knowledge of the simulator scenarios with data resulting from one of the staffing levels studied in the simulator, and the data collected from the site visits. The model will then be validated against the data obtained from the second staffing level studied in the simulator. The validated model can then be used to study the impact of changing staffing-related variables on the plant shift crew`s ability to effectively mitigate an event.

  17. The effect of investor-owned chain acquisitions on hospital expenses and staffing.

    Science.gov (United States)

    Manheim, L M; Shortell, S M; McFall, S

    1989-01-01

    Much concern has been raised about the effect of "corporatization" of health through the expansion of investor-owned hospital chains. One method of expansion is through hospital acquisition. At issue is the question of the effect of acquisitions on expenses and on such patient care inputs as staffing levels. In this article, we examine the effect of acquisition by one investor-owned chain on hospital costs and staffing. Subsequent to acquisition, hospital costs increase and staffing decreases, relative to competitor hospitals. However, since investor-owned hospitals not recently acquired do not have higher cost levels than their competitors, the increase in costs appears to be due to factors associated with the acquisition itself rather than factors associated with being an investor-owned hospital. Under the retrospective payment system in effect at the time, revenues also were higher for acquired hospitals. Under prospective payment, increasing revenues has been more difficult, decreasing acquisition incentives. PMID:2807933

  18. Looking Under the Hood of the Cadillac Tax.

    Science.gov (United States)

    Glied, Sherry; Striar, Adam

    2016-06-01

    One effect of the Affordable Care Act's "Cadillac tax" (now delayed until 2020) is to undo part of the existing federal tax preference for employer-sponsored insurance. The specific features of this tax on high-cost health plans--notably, the inclusion of tax-favored savings vehicles such as health savings accounts (HSAs) in the formula for determining who is subject to the tax--are designed primarily to maximize revenue and minimize coverage disruptions, not to reduce health spending. Thus, at least initially, these savings accounts, rather than enrollee cost-sharing or other plan features, are likely to be affected most by the tax as employers act to limit their HSA contributions. Because high earners are the ones benefiting most from tax-preferred accounts, the high-cost plan tax will probably be more progressive than prior analyses have suggested, while having only a modest impact on total health spending.

  19. Easy Money: Tax Exporting and State Support for Higher Education

    Science.gov (United States)

    Foster, John M.; Fowles, Jacob

    2016-01-01

    There is a substantial literature that assesses the effects of tax-exporting capacities on the tax structures and aggregate spending levels that state governments choose to implement, but no work exists that isolates the effects of state tax exporting on higher education spending. Using state-level data for 1989, 1995, 2002, and 2007, we estimate…

  20. Surcharge tax for tobacco and health promotion: measure for sustainable development

    Directory of Open Access Journals (Sweden)

    May Myat Cho

    2018-03-01

    Southeast Asia Tobacco Control Alliance (SEATCA is working with ASEAN countries on tobacco taxation policy and mechanisms to earmark or surcharge tobacco taxes for tobacco control or health promotion. Experiences and lesson learned from countries will be discussed in this paper.

  1. The Need for Higher Minimum Staffing Standards in U.S. Nursing Homes

    Science.gov (United States)

    Harrington, Charlene; Schnelle, John F.; McGregor, Margaret; Simmons, Sandra F.

    2016-01-01

    Many U.S. nursing homes have serious quality problems, in part, because of inadequate levels of nurse staffing. This commentary focuses on two issues. First, there is a need for higher minimum nurse staffing standards for U.S. nursing homes based on multiple research studies showing a positive relationship between nursing home quality and staffing and the benefits of implementing higher minimum staffing standards. Studies have identified the minimum staffing levels necessary to provide care consistent with the federal regulations, but many U.S. facilities have dangerously low staffing. Second, the barriers to staffing reform are discussed. These include economic concerns about costs and a focus on financial incentives. The enforcement of existing staffing standards has been weak, and strong nursing home industry political opposition has limited efforts to establish higher standards. Researchers should study the ways to improve staffing standards and new payment, regulatory, and political strategies to improve nursing home staffing and quality. PMID:27103819

  2. Tax Administration Systems and Tax Consciousness of Income Tax and Consumption Tax

    OpenAIRE

    横山, 直子

    2015-01-01

    Tax compliance costs of consumption tax are relatively high. Tax compliance costs for self-assessment taxpayers are high, and for withholding income taxpayers, the compliance costs are small. That is to say, characteristics of tax compliance costs for income tax and consumption tax are various. And also characteristics of tax consciousness for income tax and consumption tax are many and various. The features of this paper are to clarify characteristics of tax compliance costs and tax consciou...

  3. Analysis of Hospital Community Benefit Expenditures’ Alignment With Community Health Needs: Evidence From a National Investigation of Tax-Exempt Hospitals

    Science.gov (United States)

    Young, Gary J.; Daniel Lee, Shoou-Yih; Song, Paula H.; Alexander, Jeffrey A.

    2015-01-01

    Objectives. We investigated whether federally tax-exempt hospitals consider community health needs when deciding how much and what types of community benefits to provide. Methods. Using 2009 data from hospital tax filings to the Internal Revenue Service and the 2010 County Health Rankings, we employed both univariate and multivariate analyses to examine the relationship between community health needs and the types and levels of hospitals’ community benefit expenditures. The study sample included 1522 private, tax-exempt hospitals throughout the United States. Results. We found some patterns between community health needs and hospitals’ expenditures on community benefits. Hospitals located in communities with greater health needs spent more as a percentage of their operating budgets on benefits directly related to patient care. By contrast, spending on community health improvement initiatives was unrelated to community health needs. Conclusions. Important opportunities exist for tax-exempt hospitals to improve the alignment between their community benefit activities and the health needs of the community they serve. The Affordable Care Act requirement that hospitals conduct periodic community health needs assessments may be a first step in this direction. PMID:25790412

  4. News Coverage of Sugar-Sweetened Beverage Taxes: Pro- and Antitax Arguments in Public Discourse

    Science.gov (United States)

    Gollust, Sarah E.; Jarlenski, Marian P.; Nathanson, Ashley M.; Barry, Colleen L.

    2013-01-01

    Objectives. We examined news coverage of public debates about large taxes on sugar-sweetened beverages (SSBs) to illuminate how the news media frames the debate and to inform future efforts to promote obesity-related public policy. Methods. We conducted a quantitative content analysis in which we assessed how frequently 30 arguments supporting or opposing SSB taxes appeared in national news media and in news outlets serving jurisdictions where SSB taxes were proposed between January 2009 and June 2011. Results. News coverage included more discrete protax than antitax arguments on average. Supportive arguments about the health consequences and financial benefits of SSB taxes appeared most often. The most frequent opposing arguments focused on how SSB taxes would hurt the economy and how they constituted inappropriate governmental intrusion. Conclusions. News outlets that covered the debate on SSB taxes in their jurisdictions framed the issue in largely favorable ways. However, because these proposals have not gained passage, it is critical for SSB tax advocates to reach audiences not yet persuaded about the merits of this obesity prevention policy. PMID:23597354

  5. A federal tax credit to encourage employers to offer health coverage.

    Science.gov (United States)

    Meyer, J A; Wicks, E K

    2001-01-01

    Many firms that employ low-wage workers cannot afford to offer an employee health plan, and many of the uninsured work for such firms. This article makes the case for an employer tax credit, administered by the Internal Revenue Service, as a way to extend health coverage to uninsured workers and their families. The permanent, fixed-dollar, refundable credit would be available to all low-wage employers (those with average wages of $10 per hour and less), including those already offering coverage. The credit would be graduated depending on average wage: the maximum credit would equal 50% of the cost of a standard benefit package; the minimum would equal 30% of the package. It also would vary by family size and could be used to cover part-time and temporary workers. Participating employers would be required to pay at least 50% of the health insurance premium, proof of which would be shown on firms' tax returns. The paper provides justification for this approach. It closes with a discussion of strengths and weaknesses of this approach and alternative design features.

  6. STAF: A Powerful and Sophisticated CAI System.

    Science.gov (United States)

    Loach, Ken

    1982-01-01

    Describes the STAF (Science Teacher's Authoring Facility) computer-assisted instruction system developed at Leeds University (England), focusing on STAF language and major program features. Although programs for the system emphasize physical chemistry and organic spectroscopy, the system and language are general purpose and can be used in any…

  7. Medicaid payment rates, case-mix reimbursement, and nursing home staffing--1996-2004.

    Science.gov (United States)

    Feng, Zhanlian; Grabowski, David C; Intrator, Orna; Zinn, Jacqueline; Mor, Vincent

    2008-01-01

    We examined the impact of state Medicaid payment rates and case-mix reimbursement on direct care staffing levels in US nursing homes. We used a recent time series of national nursing home data from the Online Survey Certification and Reporting system for 1996-2004, merged with annual state Medicaid payment rates and case-mix reimbursement information. A 5-category response measure of total staffing levels was defined according to expert recommended thresholds, and examined in a multinomial logistic regression model. Facility fixed-effects models were estimated separately for Registered Nurse (RN), Licensed Practical Nurse (LPN), and Certified Nurse Aide (CNA) staffing levels measured as average hours per resident day. Higher Medicaid payment rates were associated with increases in total staffing levels to meet a higher recommended threshold. However, these gains in overall staffing were accompanied by a reduction of RN staffing and an increase in both LPN and CNA staffing levels. Under case-mix reimbursement, the likelihood of nursing homes achieving higher recommended staffing thresholds decreased, as did levels of professional staffing. Independent of the effects of state, market, and facility characteristics, there was a significant downward trend in RN staffing and an upward trend in both LPN and CNA staffing. Although overall staffing may increase in response to more generous Medicaid reimbursement, it may not translate into improvements in the skill mix of staff. Adjusting for reimbursement levels and resident acuity, total staffing has not increased after the implementation of case-mix reimbursement.

  8. Staffing Levels and Inpatient Outcomes at Military Health Care Facilities: A Resource-Based View

    National Research Council Canada - National Science Library

    Yap, Glenn

    2004-01-01

    Using a Resource-Based Theory/View of the firm, this study examined if increased inpatient staffing levels at military hospitals can generate a competitive advantage based on better patient quality outcomes...

  9. The Sugar Tax in Holland

    NARCIS (Netherlands)

    Ajjaji, Fadoua

    2016-01-01

    This inquiry supports the theory of a sugar tax has a positive influence on the sugar consumption of Dutch individuals. Once a tax is implemented, the sugar consumption declines. Furthermore, this study supported the hypothesis claiming that children have a positive influence on their parental sugar

  10. Tax Court allows tax credit for herbs and vitamins, not for massage.

    Science.gov (United States)

    Elliott, Richard

    2002-03-01

    In August 2001, the Tax Court of Canada issued its most recent judgment on the tax deductability of expenses for complementary/alternative therapies. The decision in Pagnotta v Canada is significant for people with HIV/AIDS who use such therapies. It also illustrates how provincial and federal laws regulating health-care practitioners and natural health products have a financial impact on the cost of accessing treatment.

  11. Expanding insurance coverage through tax credits, consumer choice, and market enhancements: the American Medical Association proposal for health insurance reform.

    Science.gov (United States)

    Palmisano, Donald J; Emmons, David W; Wozniak, Gregory D

    2004-05-12

    Recent reports showing an increase in the number of uninsured individuals in the United States have given heightened attention to increasing health insurance coverage. The American Medical Association (AMA) has proposed a system of tax credits for the purchase of individually owned health insurance and enhancements to individual and group health insurance markets as a means of expanding coverage. Individually owned insurance would enable people to maintain coverage without disruption to existing patient-physician relationships, regardless of changes in employers or in work status. The AMA's plan would empower individuals to choose their health plan and give patients and their physicians more control over health care choices. Employers could continue to offer employment-based coverage, but employees would not be limited to the health plans offered by their employer. With a tax credit large enough to make coverage affordable and the ability to choose their own coverage, consumers would dramatically transform the individual and group health insurance markets. Health insurers would respond to the demands of individual consumers and be more cautious about increasing premiums. Insurers would also tailor benefit packages and develop new forms of coverage to better match the preferences of individuals and families. The AMA supports the development of new health insurance markets through legislative and regulatory changes to foster a wider array of high-quality, affordable plans.

  12. Taxing Health Insurance: How Much Is Enough?

    Science.gov (United States)

    1983-09-01

    Chamber of Commerce (1983) for data on differences in coverage by industry.) 1 Some versions of the tax cap would eliminate the ability of employers to deduct premium payments above the tax cap. While this would provide a more immediate stimulus to employers to change the fringe-benefit/wage mixture than the alternative, the long-run incidence would still remain on the employee. Further, since about 25 percent of all workers in the United States are employed either by government or by not-for-profit corporations who do not pay corporate taxes,

  13. Tax Credits and the Use of Medical Care

    OpenAIRE

    Michael Smart; Mark Stabile

    2003-01-01

    Several recent proposals have advocated using the income tax system to collect user fees to help fund the health care system. While there is a considerable amount of research investigating both how individuals respond to tax incentives for employer provided health insurance and on the effects of user fees payable at the point of service on the use of health care services, there is limited evidence on how individuals respond to tax incentives when these are not realized until taxes are paid. T...

  14. Tax incentives for research and development and their use in tax planning

    OpenAIRE

    Pfeiffer, Olena; Spengel, Christoph

    2017-01-01

    This study provides a comprehensive analysis of various aspects of R&D tax incentives. It explains the economic justification behind the state support of research and development and summarizes its main types. In addition, it gives an overview of the existing R&D tax incentives in Europe and provides a thorough review of the empirical literature on the outcomes of fiscal incentives. Furthermore, the Devereux and Griffith model is used to determine the effective tax burden of multinational fir...

  15. Ontario: linking nursing outcomes, workload and staffing decisions in the workplace: the Dashboard Project.

    Science.gov (United States)

    Fram, Nancy; Morgan, Beverley

    2012-03-01

    Research shows that nurses want to provide more input into assessing patient acuity, changes in patient needs and staffing requirements. The Dashboard Project involved the further development and application of an electronic monitoring tool that offers a single source of nursing, patient and organizational information. It is designed to help inform nurse staffing decisions within a hospital setting. The Dashboard access link was installed in computers in eight nursing units within the Hamilton Health Sciences (HHS) network. The Dashboard indicators are populated from existing information/patient databases within the Decision Support Department at HHS. Committees composed of the unit manager, staff nurses, project coordinator, financial controller and an information controller met regularly to review the Dashboard indicators. Participants discussed the ability of the indicators to reflect their patients' needs and the feasibility of using the indicators to inform their clinical staffing plans. Project findings suggest that the Dashboard is a work in progress. Many of the indicators that had originally been incorporated were refined and will continue to be revised based on suggestions from project participants and further testing across HHS. Participants suggested the need for additional data, such as the time that nurses are off the unit (for code blue response, patient transfers and accompanying patients for tests); internal transfers/bed moves to accommodate patient-specific issues and particularly to address infection control issues; deaths and specific unit-centred data in addition to the generic indicators. The collaborative nature of the project enabled staff nurses and management to work together on a matter of high importance to both, providing valuable recommendations for shared nursing and interprofessional planning, further Dashboard development and project management.

  16. District nursing renascent as Wales adopts safe staffing levels.

    Science.gov (United States)

    Labourne, Paul

    2018-05-02

    This article reflects on the history of the NHS in Wales and how this has led to its current structure. How this structure supports integrated working across primary, community and secondary care and how further integration with social care is moving forward and its direct effects on district nursing are explored. This article describes how district nursing is meeting these challenges. Support for district nurses as part of integrated multiprofessional teams is being developed to promote appropriately staffed teams centred on meeting the requirements of people within a designated area and ensuring that home is the best and first place of care.

  17. [Cigarette taxes and demand in Colombia].

    Science.gov (United States)

    Maldonado, Norman; Llorente, Blanca; Deaza, Javier

    2016-10-01

    Estimate price and income elasticities of aggregate demand for cigarettes in Colombia, by controlling for structural market changes since the late 1990s, to identify policy opportunities for taxes that could improve public health and increase tax revenues. Measurement of aggregate demand for cigarettes using gross income reported on value-added tax returns submitted to Colombia's National Tax and Customs Office (DIAN is the acronym in Spanish) by the tobacco product manufacturing industry, subtracting exports. A quarterly time series was obtained for the period 1994-2014. The econometric estimation using two-stage least squares controls for price endogeneity and uses a set of dummy variables to control for structural changes in the market and in its regulation. Demand is, from a statistical standpoint, sensitive to price and to income. Price elasticity of demand is -0.78 and income elasticity is 0.61. Inelastic demand implies that it is possible, through cigarette excise taxes, to meet public health targets and increase revenues simultaneously. The results also suggest that the considerable increase in household income in Colombia in the first decade of the 21st century increased purchasing power, which, lacking an accompanying tax increase, promoted cigarette consumption, with negative effects on public health, and wasted an opportunity to increase tax revenues.

  18. Brown & Smith Communication Solutions: A Staffing System Simulation

    Science.gov (United States)

    Small, Erika E.; Doll, Jessica L.; Bergman, Shawn M.; Heggestad, Eric D.

    2018-01-01

    Developing students' practical skills in strategic staffing and selection within the classroom can be challenging. This article describes a staffing system simulation designed to engage students and develop applied skills in strategic recruiting, assessment, and evaluation of job applicants. Instructors looking for a multifaceted team project…

  19. Health responses to a wealth shock: Evidence from a Swedish tax reform

    OpenAIRE

    Erixson, Oscar

    2014-01-01

    This essay contributes in two ways to the literature on the effects of economic circumstances on health. First, it deals with reverse causality and omitted variable bias by exploiting exogenous variation in inherited wealth generated by the unexpected repeal of the Swedish inheritance tax. Second, it analyzes responses in health outcomes from administrative registers. The results show that increased wealth has limited impacts on objective adult health over a period of six years. This is in li...

  20. Who pays the most cigarette tax in Turkey.

    Science.gov (United States)

    Önder, Zeynep; Yürekli, Ayda A

    2016-01-01

    the most from increases in excise taxes; from a budgetary perspective, as they reduce their smoking consumption significantly, the share of their excise payment in total household expenditures declines. From a health perspective, they are likely to have more health benefits as their consumption reduces. Government revenues are also predicted to increase with increased excise taxes, and the government can allocate a part of these revenue increases on implementing and enforcing other tobacco control measures including cessation support and smoke-free environments. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Food Taxes: A New Holy Grail?

    Directory of Open Access Journals (Sweden)

    Ignaas Devisch

    2013-01-01

    Full Text Available In an effort to reduce the growing prevalence of overweight and obesity, food taxes have been introduced in several European countries, the so-called ‘obesitax’. As yet little evidence is at hand, policy measures are being taken to counterweight the consumption of unhealthy food or the increasing diet-related diseases. Several questions need to be discussed, starting from a general perspective: can food taxes become an appropriate and just policy measure to reduce overweight and obesity and therefore increase consumer’s health? The implementation of an effective and fair food tax is an exercise riddled with uncertainty. Not only is there a need for evidence on the health and economic impact of food taxes, we also have to think about a conceptual and ethical discussion concerning the balance between health imperatives and public health on the one hand, and social and ethical standards on the other hand.

  2. Free Tax Services in Pediatric Clinics.

    Science.gov (United States)

    Marcil, Lucy E; Hole, Michael K; Wenren, Larissa M; Schuler, Megan S; Zuckerman, Barry S; Vinci, Robert J

    2018-05-18

    The earned income tax credit (EITC), refundable monies for America's working poor, is associated with improved child health. Yet, 20% of eligible families do not receive it. We provided free tax preparation services in clinics serving low-income families and assessed use, financial impact, and accuracy. Free tax preparation services ("StreetCred") were available at 4 clinics in Boston in 2016 and 2017. We surveyed a convenience sample of clients ( n = 244) about experiences with StreetCred and previous tax services and of nonparticipants ( n = 100; 69% response rate) and clinic staff ( n = 41; 48% response rate) about acceptability and feasibility. A total of 753 clients received $1 619 650 in federal tax refunds. StreetCred was associated with significant improvement in tax filing rates. Of surveyed clients, 21% were new filers, 47% were new users of free tax preparation, 14% reported new receipt of the EITC, and 21% reported new knowledge of the EITC. StreetCred had high client acceptability; 96% would use StreetCred again. Families with children were significantly more likely to report StreetCred made them feel more connected to their doctor ( P = .02). Clinic staff viewed the program favorably (97% approval). Free tax services in urban clinics are a promising, feasible financial intervention to increase tax filing and refunds, save fees, and link clients to the EITC. With future studies, we will assess scalability and measure impact on health. StreetCred offers an innovative approach to improving child health in primary care settings through a financial intervention. Copyright © 2018 by the American Academy of Pediatrics.

  3. Building alliances in unlikely places: progressive allies and the Tobacco Institute's coalition strategy on cigarette excise taxes.

    Science.gov (United States)

    Campbell, Richard B; Balbach, Edith D

    2009-07-01

    The tobacco industry often utilizes third parties to advance its policy agenda. One such utilization occurred when the industry identified organized labor and progressive groups as potential allies whose advocacy could undermine public support for excise tax increases. To attract such collaboration, the industry framed the issue as one of tax fairness, creating a labor management committee to provide distance from tobacco companies and furthering progressive allies' interests through financial and logistical support. Internal industry documents indicate that this strategic use of ideas, institutions, and interests facilitated the recruitment of leading progressive organizations as allies. By placing excise taxes within a strategic policy nexus that promotes mutual public interest goals, public health advocates may use a similar strategy in forging their own excise tax coalitions.

  4. [The new methods to define the staffing requirements for doctors,nurses and nurses aides: an example of their implementation in an Italian hospital].

    Science.gov (United States)

    Laquintana, Dario; Pazzaglia, Silvia; Demarchi, Antonia

    2017-01-01

    . The new methods to define the staffing requirements for doctors, nurses and nurses aides: an example of their implementation in an Italian hospital. The Italian government, after the transposition of European Union legislation on working hours, made a declaration of commitment to increase the number of staff of the National Health Service (NHS). The method for assessing the staffing needs innovates the old one that dated back a few decades. To implement the method proposed by the Ministry of Health to an Italian hospital and assess its impact on staffing and costs. The model was implemented on all the wards, multiplying the minutes of care expected in 2016, dividing the result by 60 to obtain the hours of care, and further dividing by the number of yearly hours of work of a nurse (1418). Same was done for nurses aides. The minutes of care were related to mean weight of the Diagnosis Related Groups of the ward and the results obtained compared to the actual staffing of nurses and nurses aides. The costs of the differences were calculated. The implementation of the model produced an excess of 23 nurses and a scarcity of 95 nurses aides compared to the actual staffing, with an increase of the costs of € 1.828.562,00. The results obtained and the criticisms received so far show the need of major changes. The data from international studies that associate staffing and patients outcomes and the nurse/patient ratio are macro-indicators already available that may orient choices and investments on the health care professions.

  5. Alcohol Taxes and Birth Outcomes

    Directory of Open Access Journals (Sweden)

    Ning Zhang

    2010-04-01

    Full Text Available This study examines the relationships between alcohol taxation, drinking during pregnancy, and infant health. Merged data from the US Natality Detailed Files, as well as the Behavioral Risk Factor Surveillance System (1985–2002, data regarding state taxes on beer, wine, and liquor, a state- and year-fixed-effect reduced-form regression were used. Results indicate that a one-cent ($0.01 increase in beer taxes decreased the incidence of low-birth-weight by about 1–2 percentage points. The binge drinking participation tax elasticity is −2.5 for beer and wine taxes and −9 for liquor taxes. These results demonstrate the potential intergenerational impact of increasing alcohol taxes.

  6. Fighting Harmful Tax Competition Generated by Offshore Jurisdictions

    Directory of Open Access Journals (Sweden)

    Dan Drosu Saguna

    2015-03-01

    Full Text Available Harmful tax competition is not just tax system, but can also undermine the interests of local communities and the environment. Tax havens are a huge drain of resources from other countries (basic non tax haven to offshore areas. To operate, tax havens are supported economically, politically, and socially by high tax states. Also, by encouraging savings, it boosts investment and capital formation. Because they are low tax jurisdictions, they exert a higher tax on tax rates worldwide.

  7. Interim results of the study of control room crew staffing for advanced passive reactor plants

    International Nuclear Information System (INIS)

    Hallbert, B.P.; Sebok, A.; Haugset, K.

    1996-01-01

    Differences in the ways in which vendors expect the operations staff to interact with advanced passive plants by vendors have led to a need for reconsideration of the minimum shift staffing requirements of licensed Reactor Operators and Senior Reactor Operators contained in current federal regulations (i.e., 10 CFR 50.54(m)). A research project is being carried out to evaluate the impact(s) of advanced passive plant design and staffing of control room crews on operator and team performance. The purpose of the project is to contribute to the understanding of potential safety issues and provide data to support the development of design review guidance. Two factors are being evaluated across a range of plant operating conditions: control room crew staffing; and characteristics of the operating facility itself, whether it employs conventional or advanced, passive features. This paper presents the results of the first phase of the study conducted at the Loviisa nuclear power station earlier this year. Loviisa served as the conventional plant in this study. Data collection from four crews were collected from a series of design basis scenarios, each crew serving in either a normal or minimum staffing configuration. Results of data analyses show that crews participating in the minimum shift staffing configuration experienced significantly higher workload, had lower situation awareness, demonstrated significantly less effective team performance, and performed more poorly as a crew than the crews participating in the normal shift staffing configuration. The baseline data on crew configurations from the conventional plant setting will be compared with similar data to be collected from the advanced plant setting, and a report prepared providing the results of the entire study

  8. The impact of a fat tax: progressive in health, but regressive in income?

    Czech Academy of Sciences Publication Activity Database

    Chudá, T.; Janský, Petr

    2016-01-01

    Roč. 25, č. 4 (2016), s. 445-458 ISSN 1210-0455 Institutional support: RVO:67985998 Keywords : Czech Republic * fat tax * food Subject RIV: AH - Economics Impact factor: 0.710, year: 2016 http://www.vse.cz/pep/569

  9. The relationship of staffing and work environment with implicit rationing of nursing care in Swiss nursing homes--A cross-sectional study.

    Science.gov (United States)

    Zúñiga, Franziska; Ausserhofer, Dietmar; Hamers, Jan P H; Engberg, Sandra; Simon, Michael; Schwendimann, René

    2015-09-01

    Implicit rationing of nursing care refers to the withdrawal of or failure to carry out necessary nursing care activities due to lack of resources, in the literature also described as missed care, omitted care, or nursing care left undone. Under time constraints, nurses give priority to activities related to vital medical needs and the safety of the patient, leaving out documentation, rehabilitation, or emotional support of patients. In nursing homes, little is known about the occurrence of implicit rationing of nursing care and possible contributing factors. The purpose of this study was (1) to describe levels and patterns of self-reported implicit rationing of nursing care in Swiss nursing homes and (2) to explore the relationship between staffing level, turnover, and work environment factors and implicit rationing of nursing care. Cross-sectional, multi-center sub-study of the Swiss Nursing Home Human Resources Project (SHURP). Nursing homes from all three language regions of Switzerland. A random selection of 156 facilities with 402 units and 4307 direct care workers from all educational levels (including 25% registered nurses). We utilized data from established scales to measure implicit rationing of nursing care (Basel Extent of Rationing of Nursing Care), perceptions of leadership ability and staffing resources (Practice Environment Scale of the Nursing Work Index), teamwork and safety climate (Safety Attitudes Questionnaire), and work stressors (Health Professions Stress Inventory). Staffing level and turnover at the unit level were measured with self-developed questions. Multilevel linear regression models were used to explore the proposed relationships. Implicit rationing of nursing care does not occur frequently in Swiss nursing homes. Care workers ration support in activities of daily living, such as eating, drinking, elimination and mobilization less often than documentation of care and the social care of nursing homes residents. Statistically

  10. Staff Assist: A Resource to Improve Nursing Home Quality and Staffing

    Science.gov (United States)

    Castle, Nicholas G.

    2011-01-01

    Purpose: This study describes the creation and use of a web-based resource, designed to help nursing homes implement quality improvements through changes in staffing characteristics. Design and Methods: Information on staffing characteristics (i.e., staffing levels, turnover, stability, and use of agency staff), facility characteristics (e.g.,…

  11. Tax Exemption Issues Facing Academic Health Centers in the Managed Care Environment.

    Science.gov (United States)

    Jones, Darryll K.

    1997-01-01

    Traditional characteristics of academic health centers are outlined, and conflicts with managed care are identified. Operating strategies designed to resolve the conflicts are discussed in light of tax statutes and regulations, Internal Revenue Service interpretations, and case law. Detailed references are included to provide a complete resource…

  12. Cost analysis of nursing home registered nurse staffing times.

    Science.gov (United States)

    Dorr, David A; Horn, Susan D; Smout, Randall J

    2005-05-01

    To examine potential cost savings from decreased adverse resident outcomes versus additional wages of nurses when nursing homes have adequate staffing. A retrospective cost study using differences in adverse outcome rates of pressure ulcers (PUs), urinary tract infections (UTIs), and hospitalizations per resident per day from low staffing and adequate staffing nursing homes. Cost savings from reductions in these events are calculated in dollars and compared with costs of increasing nurse staffing. Eighty-two nursing homes throughout the United States. One thousand three hundred seventy-six frail elderly long-term care residents at risk of PU development. Event rates are from the National Pressure Ulcer Long-Term Care Study. Hospital costs are estimated from Medicare statistics and from charges in the Healthcare Cost and Utilization Project. UTI costs and PU costs are from cost-identification studies. Time horizon is 1 year; perspectives are societal and institutional. Analyses showed an annual net societal benefit of 3,191 dollars per resident per year in a high-risk, long-stay nursing home unit that employs sufficient nurses to achieve 30 to 40 minutes of registered nurse direct care time per resident per day versus nursing homes that have nursing time of less than 10 minutes. Sensitivity analyses revealed a robust set of estimates, with no single or paired elements reaching the cost/benefit equality threshold. Increasing nurse staffing in nursing homes may create significant societal cost savings from reduction in adverse outcomes. Challenges in increasing nurse staffing are discussed.

  13. The effect of physician staffing model on patient outcomes in a medical progressive care unit.

    Science.gov (United States)

    Yoo, E J; Damaghi, N; Shakespeare, W G; Sherman, M S

    2016-04-01

    Although evidence supports the impact of intensivist physician staffing in improving intensive care unit (ICU) outcomes, the optimal coverage for progressive care units (PCU) is unknown. We sought to determine how physician staffing models influence outcomes for intermediate care patients. We conducted a retrospective observational comparison of patients admitted to the medical PCU of an academic hospital during 12-month periods of high-intensity and low-intensity staffing. A total of 318 PCU patients were eligible for inclusion (143 high-intensity and 175 low-intensity). We found that low-intensity patients were more often stepped up from the emergency department and floor, whereas high-intensity patients were ICU transfers (61% vs 42%, P = .001). However, Mortality Probability Model scoring was similar between the 2 groups. In adjusted analysis, there was no association between intensity of staffing and hospital mortality (odds ratio, 0.84; 95% confidence interval, 0.36-1.99; P = .69) or PCU mortality (odds ratio, 0.96; 95% confidence interval, 0.38-2.45; P = .69). There was also no difference in subsequent ICU admission rates or in PCU length of stay. We found no evidence that high-intensity intensivist physician staffing improves outcomes for intermediate care patients. In a strained critical care system, our study raises questions about the role of the intensivist in the graded care options between intensive and conventional ward care. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Development, Validation, and Implementation of a Clinic Nurse Staffing Guideline.

    Science.gov (United States)

    Deeken, Debra Jean; Wakefield, Douglas; Kite, Cora; Linebaugh, Jeanette; Mitchell, Blair; Parkinson, Deidre; Misra, Madhukar

    2017-10-01

    Ensuring that the level of nurse staffing used to care for patients is appropriate to the setting and service intensity is essential for high-quality and cost-effective care. This article describes the development, validation, and implementation of the clinic technical skills permission list developed specifically to guide nurse staffing decisions in physician clinics of an academic medical center. Results and lessons learned in using this staffing guideline are presented.

  15. Nurse staffing patterns and hospital efficiency in the United States.

    Science.gov (United States)

    Bloom, J R; Alexander, J A; Nuchols, B A

    1997-01-01

    The objective of this exploratory study was to assess the effects of four nurse staffing patterns on the efficiency of patient care delivery in the hospital: registered nurses (RNs) from temporary agencies; part-time career RNs; RN rich skill mix; and organizationally experienced RNs. Using Transaction Cost Analysis, four regression models were specified to consider the effect of these staffing plans on personnel and benefit costs and on non-personnel operating costs. A number of additional variables were also included in the models to control for the effect of other organization and environmental determinants of hospital costs. Use of career part-time RNs and experienced staff reduced both personnel and benefit costs, as well as total non-personnel operating costs, while the use of temporary agencies for RNs increased non-personnel operating costs. An RN rich skill mix was not related to either measure of hospital costs. These findings provide partial support of the theory. Implications of our findings for future research on hospital management are discussed.

  16. Influence of design improvements in optimising staffing of NPPs - an Indian experience

    International Nuclear Information System (INIS)

    Bhattacharya, A.S.

    2001-01-01

    Three decades of operating experience in India has led to sustained high performance of NPP's. The staffing modules and policies are standardised. The basic functions of operation, maintenance, technical support and quality assurance are carried out by a team of 727 in-plant persons (for a 2 x 220 MW PHWR station) organised at five levels, for fifty positions in ten job families. The organisational factors that led to optimising of staff are described in the companion paper. This optimisation of manpower is a result of continuous learning - for (i) optimising quantum of workload and (ii) improving productivity. For the first category, design improvements over older Indian NPP's have increased reliability, operability, maintainability and human factors. Few examples: (i) improved man-machine interface in plant controls and on-power refuelling system with operator guidance, logging as well as diagnostic/health monitoring features; (ii) spread out layout for better access and ease of maintenance, separation of plant services for unit-1 from unit-2 and, removal of reactor auxiliaries out to separate buildings; (iii) reduction of maintenance tasks through redesigned equipment and improved condition monitoring means. However, design and procedural improvements also include additional equipment for upgradation of safety measures, e.g. larger number of safety related pumps separate switchyard control room and increased service system equipment. This paper outlines experience of design improvements in optimising staffing and uses a specific case illustration to establish the findings for better use of staff. (author)

  17. Effects of Health-Related Food Taxes and Subsidies on Mortality from Diet-Related Disease in New Zealand: An Econometric-Epidemiologic Modelling Study.

    Science.gov (United States)

    Ni Mhurchu, Cliona; Eyles, Helen; Genc, Murat; Scarborough, Peter; Rayner, Mike; Mizdrak, Anja; Nnoaham, Kelechi; Blakely, Tony

    2015-01-01

    Health-related food taxes and subsidies may promote healthier diets and reduce mortality. Our aim was to estimate the effects of health-related food taxes and subsidies on deaths prevented or postponed (DPP) in New Zealand. A macrosimulation model based on household expenditure data, demand elasticities and population impact fractions for 18 diet-related diseases was used to estimate effects of five tax and subsidy regimens. We used price elasticity values for 24 major commonly consumed food groups in New Zealand, and food expenditure data from national Household Economic Surveys. Changes in mortality from cardiovascular disease, cancer, diabetes and other diet-related diseases were estimated. A 20% subsidy on fruit and vegetables would result in 560 (95% uncertainty interval, 400 to 700) DPP each year (1.9% annual all-cause mortality). A 20% tax on major dietary sources of saturated fat would result in 1,500 (950 to 2,100) DPP (5.0%), and a 20% tax on major dietary sources of sodium would result in 2,000 (1300 to 2,700) DPP (6.8%). Combining taxes on saturated fat and sodium with a fruit and vegetable subsidy would result in 2,400 (1,800 to 3,000) DPP (8.1% mortality annually). A tax on major dietary sources of greenhouse gas emissions would generate 1,200 (750 to 1,700) DPP annually (4.0%). Effects were similar or greater for Maori and low-income households in relative terms. Health-related food taxes and subsidies could improve diets and reduce mortality from diet-related disease in New Zealand. Our study adds to the growing evidence base suggesting food pricing policies should improve population health and reduce inequalities, but there is still much work to be done to improve estimation of health impacts.

  18. Effects of Health-Related Food Taxes and Subsidies on Mortality from Diet-Related Disease in New Zealand: An Econometric-Epidemiologic Modelling Study.

    Directory of Open Access Journals (Sweden)

    Cliona Ni Mhurchu

    Full Text Available Health-related food taxes and subsidies may promote healthier diets and reduce mortality. Our aim was to estimate the effects of health-related food taxes and subsidies on deaths prevented or postponed (DPP in New Zealand.A macrosimulation model based on household expenditure data, demand elasticities and population impact fractions for 18 diet-related diseases was used to estimate effects of five tax and subsidy regimens. We used price elasticity values for 24 major commonly consumed food groups in New Zealand, and food expenditure data from national Household Economic Surveys. Changes in mortality from cardiovascular disease, cancer, diabetes and other diet-related diseases were estimated.A 20% subsidy on fruit and vegetables would result in 560 (95% uncertainty interval, 400 to 700 DPP each year (1.9% annual all-cause mortality. A 20% tax on major dietary sources of saturated fat would result in 1,500 (950 to 2,100 DPP (5.0%, and a 20% tax on major dietary sources of sodium would result in 2,000 (1300 to 2,700 DPP (6.8%. Combining taxes on saturated fat and sodium with a fruit and vegetable subsidy would result in 2,400 (1,800 to 3,000 DPP (8.1% mortality annually. A tax on major dietary sources of greenhouse gas emissions would generate 1,200 (750 to 1,700 DPP annually (4.0%. Effects were similar or greater for Maori and low-income households in relative terms.Health-related food taxes and subsidies could improve diets and reduce mortality from diet-related disease in New Zealand. Our study adds to the growing evidence base suggesting food pricing policies should improve population health and reduce inequalities, but there is still much work to be done to improve estimation of health impacts.

  19. Enhancing the Alberta Tax Advantage with a Harmonized Sales Tax

    Directory of Open Access Journals (Sweden)

    Philip Bazel

    2013-09-01

    income tax from 10 to 8.43 per cent, reducing taxes on investment. An HST could also bring in an estimated $800 million in additional annual revenue from tourists and visitors, and would likely entitle the province to a $1.3 billion HST transition payment from the federal government. If the government can convince Albertans that the sales tax would be revenue neutral, and can promise simultaneous significant tax cuts to personal incomes, as well as corporate tax reductions that will enhance Alberta’s competitiveness, then winning public support is possible. The task of persuading the public must fall to bold politicians. But if provincial legislators truly value tax fairness, competitiveness, and the future fiscal stability of the province, they have a duty to convince voters that an HST is the right choice for Alberta.

  20. Improving Staffing and Nurse Engagement in a Neuroscience Intermediate Unit.

    Science.gov (United States)

    Nadolski, Charles; Britt, Pheraby; Ramos, Leah C

    2017-06-01

    The neuroscience intermediate unit is a 23-bed unit that was initially staffed with a nurse-to-patient ratio of 1:4 to 1:5. In time, the unit's capacity to care for the exceeding number of progressively acute patients fell short of the desired goals in the staff affecting the nurse satisfaction. The clinical nurses desired a lower nurse-patient ratio. The purpose of this project was to justify a staffing increase through a return on investment and increased quality metrics. This initiative used mixed methodology to determine the ideal staffing for a neuroscience intermediate unit. The quantitative section focused on a review of the acuity of the patients. The qualitative section was based on descriptive interviews with University Healthcare Consortium nurse managers from similar units. The study reviewed the acuity of 9,832 patient days to determine the accurate acuity of neuroscience intermediate unit patients. Nurse managers at 12 University Healthcare Consortium hospitals and 8 units at the Medical University of South Carolina were contacted to compare staffing levels. The increase in nurse staffing contributed to an increase in many quality metrics. There were an 80% decrease in controllable nurse turnover and a 75% reduction in falls with injury after the lowered nurse-patient ratio. These 2 metrics established a return on investment for the staffing increase. In addition, the staffing satisfaction question on the Press Ganey employee engagement survey increased from 2.44 in 2013 to 3.72 in 2015 in response to the advocacy of the bedside nurses.

  1. Effects of policy characteristics and justifications on acceptance of a gasoline tax increase

    International Nuclear Information System (INIS)

    Kaplowitz, Stan A.; McCright, Aaron M.

    2015-01-01

    Many economists argue that increasing the gasoline tax is an effective way to reduce fuel consumption. Yet, public support for such a tax increase has been rather low among US residents. We performed eight survey experiments (total N approximately 3000) to examine how selected policy characteristics and persuasive messages influence support for a gasoline tax increase. Several policy characteristics significantly increased support for a gasoline tax increase. Having the increase phased in over five years modestly increased support. Compared with giving the extra revenue to the US Treasury’s General Fund, both refunding the extra revenue equally to all American families and having this revenue used for energy efficient transportation strongly increased support. Support for a gasoline tax increase was not affected by the nature of the mechanism to achieve revenue neutrality. Most people supported a 20 cent per gallon tax increase to repair roads and bridges. Explaining how the gasoline tax increase would reduce fuel consumption slightly increased support for a gasoline tax increase, but neither being informed of the high gasoline prices in other advanced industrial countries nor the actual pump price of gasoline at the time of the experiment influenced support for a gasoline tax increase. - Highlights: • Phasing in the tax increase modestly raised support. • Making the tax increase revenue-neutral increased support. • Using the extra revenue for energy efficiency increased support. • Information on high gasoline prices elsewhere did not influence support. • Variation in actual fuel prices did not influence support.

  2. Nurse dose: linking staffing variables to adverse patient outcomes.

    Science.gov (United States)

    Manojlovich, Milisa; Sidani, Souraya; Covell, Christine L; Antonakos, Cathy L

    2011-01-01

    Inconsistent findings in more than 100 studies have made it difficult to explain how variation in nurse staffing affects patient outcomes. Nurse dose, defined as the level of nurses required to provide patient care in hospital settings, draws on variables used in staffing studies to describe the influence of many staffing variables on outcomes. The aim of this study was to examine the construct validity of nurse dose by determining its association with methicillin-resistant Staphylococcus aureus (MRSA) infections and reported patient falls on a sample of inpatient adult acute care units. Staffing data came from 26 units in Ontario, Canada, and Michigan. Financial and human resource data were data sources for staffing variables. Sources of data for MRSA came from infection control departments. Incident reports were the data source for patient falls. Data analysis consisted of bivariate correlations and Poisson regression. Bivariate correlations revealed that nurse dose attributes (active ingredient and intensity) were associated significantly with both outcomes. Active ingredient (education, experience, skill mix) and intensity (full-time employees, registered nurse [RN]:patient ratio, RN hours per patient day) were significant predictors of MRSA. Coefficients for both attributes were negative and almost identical. Both attributes were significant predictors of reported patient falls, and coefficients were again negative, but coefficient sizes differed. By conceptualizing nurse and staffing variables (education, experience, skill mix, full-time employees, RN:patient ratio, RN hours per patient day) as attributes of nurse dose and by including these in the same analysis, it is possible to determine their relative influence on MRSA infections and reported patient falls.

  3. Enacting tobacco taxes by direct popular vote in the United States: lessons from 20 years of experience.

    Science.gov (United States)

    Lum, K L; Barnes, R L; Glantz, S A

    2009-10-01

    Tobacco tax increases reduce tobacco use, can provide funds for tobacco prevention and enjoy broad public support. Because of tobacco industry influence in legislatures, US public health advocates have shifted the venue for tobacco tax policymaking to direct popular vote 22 times since 1988. We combined case studies of individual state campaigns with tobacco industry documents to identify strategies related to outcome. The tobacco industry developed a voter segmentation model to determine which tobacco tax increases it could defeat. Two industry arguments arising from this model often were raised in losing campaigns-the tax increase did not dedicate enough to tobacco control and hospitals and health maintenance organisations would profit. The industry effectively influenced early voters. Success was associated with building a strong base of public support before the campaign, dedicating sufficient funds to tobacco control, avoiding proposals largely devoted to financing hospitals and other medical service providers, effectively engaging grassroots and framing the campaign with clear justifications for cigarette tax increases. Tobacco tax ballot measures commonly allocated substantial funds to medical services; tobacco companies are becoming more successful in making this use of funds an issue. Proponents' campaigns should be timed to account for the trend to voting well before election day. Ballot measures to increase tobacco taxes with a substantial fraction of the money devoted to tobacco control activities will probably fare better than ones that give priority to funding medical services.

  4. Dynamic Staffing and Rescheduling in Software Project Management: A Hybrid Approach.

    Directory of Open Access Journals (Sweden)

    Yujia Ge

    Full Text Available Resource allocation could be influenced by various dynamic elements, such as the skills of engineers and the growth of skills, which requires managers to find an effective and efficient tool to support their staffing decision-making processes. Rescheduling happens commonly and frequently during the project execution. Control options have to be made when new resources are added or tasks are changed. In this paper we propose a software project staffing model considering dynamic elements of staff productivity with a Genetic Algorithm (GA and Hill Climbing (HC based optimizer. Since a newly generated reschedule dramatically different from the initial schedule could cause an obvious shifting cost increase, our rescheduling strategies consider both efficiency and stability. The results of real world case studies and extensive simulation experiments show that our proposed method is effective and could achieve comparable performance to other heuristic algorithms in most cases.

  5. KNOWLEDGE IS POWER. IMPROVING TAX COMPLIANCE BY MEANS OF BOOSTING TAX LITERACY

    Directory of Open Access Journals (Sweden)

    Nichita Ramona-Anca

    2015-07-01

    Full Text Available Because empirical investigations entailing classical tax evasion models often reported consistent deviations from perfect rationality, social scientists interested in tax behavior have extended their area of research by focusing on compliance determinants outside the economic spectrum (i.e., tax rate, audit rate, penalty rate, income. Consequently, a manifold of variables from psychology (attitudes, norms, perceptions, sociology (education, gender or political science (fiscal policy, tax law complexity, voting were taken into account as determinants of taxpayers’ decisions. In addition, behavioral models like the Australian Taxation Office compliance model, New Zealand Inland Revenue compliance model or the “slippery slope” framework have incorporated such variables. Recent empirical developments have indicated that tax literacy can be counted as a significant determinant of tax compliance. Forasmuch compliance strategies exclusively grounded on coercion are rather costly (high monitoring outlays, large staff employed in the monitoring process, etc., generally yield short-term outcomes and may attract the resistance of otherwise honest taxpayers, authorities worldwide have begun searching for the adequate combination between cooperation and coercion, in which the emphasis on the former should prevail. State budgets are better off when authorities enact compliance strategies extensively built on cooperation, for they generate long-term results, require fewer outlays and secure the support of most honest taxpayers. The current paper draws on the effects of tax literacy (i.e., the level of tax knowledge on taxpayers’ behavior, highlighting miscellaneous strategies employed by national tax authorities around the world. As a general trend, increasing tax literacy among very young and soon-to-be taxpayers is preferred by several tax authorities, because potential contributors have to be accustomed to the requirements of tax systems before

  6. Do Taxes Affect Corporate Financing Decisions?

    OpenAIRE

    MacKie-Mason, Jeffrey K

    1990-01-01

    This paper provides clear evidence of substantial tax effects on the choice between issuing debt or equity; most studies fail to find significant effects. The relationship between tax shields and debt policy is clarified. Other papers miss the fact that most tax shields have a negligible effect on the marginal tax rate for most firms. New predictions are strongly supported by an empirical analysis; the method is to study incremental financing decisions using discrete choice analysis. Previous...

  7. Wage, Work Environment, and Staffing: Effects on Nurse Outcomes

    Science.gov (United States)

    McHugh, Matthew D.; Ma, Chenjuan

    2015-01-01

    Research has shown that hospitals with better nurse staffing and work environments have better nurse outcomes—less burnout, job dissatisfaction, and intention to leave the job. Many studies, however, have not accounted for wage effects, which may confound findings. By using a secondary analysis with cross-sectional administrative data and a four-state survey of nurses, we investigated how wage, work environment, and staffing were associated with nurse outcomes. Logistic regression models, with and without wage, were used to estimate the effects of work environment and staffing on burnout, job dissatisfaction, and intent to leave. We discovered that wage was associated with job dissatisfaction and intent to leave but had little influence on burnout, while work environment and average patient-to-nurse ratio still have considerable effects on nurse outcomes. Wage is important for good nurse outcomes, but it does not diminish the significant influence of work environment and staffing on nurse outcomes. PMID:25121923

  8. Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit. Final regulations.

    Science.gov (United States)

    2015-12-18

    This document contains final regulations on the health insurance premium tax credit enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended by the Medicare and Medicaid Extenders Act of 2010, the Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011, and the Department of Defense and Full-Year Continuing Appropriations Act, 2011. These final regulations affect individuals who enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges, sometimes called Marketplaces) and claim the health insurance premium tax credit, and Exchanges that make qualified health plans available to individuals and employers.

  9. The Benefit Implications of Recent Trends in Flexible Staffing Arrangements. Staff Working Paper.

    Science.gov (United States)

    Houseman, Susan N.

    Workers in flexible staffing arrangementsincluding temporary agency, direct-hire temporary, on-call, and contract workersare much less likely than regular, direct-hire employees to be covered by laws mandating or regulating workplace benefits. They are also much less likely to receive pension, health insurance, and other benefits on the job.…

  10. Taxes and Bribes in Uganda

    Science.gov (United States)

    Jagger, Pamela; Shively, Gerald

    2016-01-01

    Using data from 433 firms operating along Uganda’s charcoal and timber supply chains we investigate patterns of bribe payment and tax collection between supply chain actors and government officials responsible for collecting taxes and fees. We examine the factors associated with the presence and magnitude of bribe and tax payments using a series of bivariate probit and Tobit regression models. We find empirical support for a number of hypotheses related to payments, highlighting the role of queuing, capital-at-risk, favouritism, networks, and role in the supply chain. We also find that taxes crowd-in bribery in the charcoal market. PMID:27274568

  11. Taxes and Bribes in Uganda.

    Science.gov (United States)

    Jagger, Pamela; Shively, Gerald

    Using data from 433 firms operating along Uganda's charcoal and timber supply chains we investigate patterns of bribe payment and tax collection between supply chain actors and government officials responsible for collecting taxes and fees. We examine the factors associated with the presence and magnitude of bribe and tax payments using a series of bivariate probit and Tobit regression models. We find empirical support for a number of hypotheses related to payments, highlighting the role of queuing, capital-at-risk, favouritism, networks, and role in the supply chain. We also find that taxes crowd-in bribery in the charcoal market.

  12. Property taxes and economic development. An approach to the relationship between property taxes and the investment of Antioquia's municipalities

    Directory of Open Access Journals (Sweden)

    Santiago Tobón Zapata

    2013-06-01

    Full Text Available This paper discusses the relationship between the levels of investment in health and education made by the municipalities and the collection of property taxes. A data panel methodology was used with a sample of 97 municipalities in the department of Antioquia (Colombia for the period 2000 - 2008. According to the results, it is possible to conclude that there is no relationship between the levels of autonomous investment in education and the collection of property taxes. On the other hand, in relation to health investments, a negative relationship was found between property tax collection and autonomous investment in health. Finally, in addition to the initial scope proposed, a positive relationship was shown between the collection of property taxes and investments in the development of roads and infrastructure.

  13. How to Set up an Effective Food Tax? Comment on "Food Taxes: A New Holy Grail?".

    Science.gov (United States)

    Bonnet, Céline

    2013-09-01

    Whereas public information campaigns have failed to reverse the rising trend in obesity, economists support food taxes as they suggest they can force individuals to change their eating behavior and make the agro-food industry think more about healthy food products. Excise taxes based on the unhealthy nutrient content would be more effective since they impact more on unhealthy food products than VAT (value-added-tax) taxes. Taxes based only on junk food products would avoid perverse effects on healthy nutrient. However, as eating behavior of consumers is complex, a modeling analysis would allow to assess unexpected effects on other unhealthy nutrients or products.

  14. Public opinion regarding earmarked cigarette tax in Taiwan

    Directory of Open Access Journals (Sweden)

    Yang Chung-Lin

    2003-12-01

    Full Text Available Abstract Background Cigarette taxation has been perceived by academics and policy-makers as one of the most effective ways of reducing the use of cigarettes. On January 1 2002, the Taiwan government imposed a New Taiwan (NT $5 per pack tax earmarked for the purpose of tobacco control. This study uses a survey collected prior to taxation to assess public attitudes toward cigarette taxation, public beliefs about the effectiveness of cigarette taxation at reducing cigarette use and public opinions about the allocation of this tax revenue. Methods Data were drawn from a national face-to-face interview on cigarette consumption in 2000. A total of 3,279 adults were aged 18 to 64 years; 49.9% of whom were male and 50.1% female, and with a smoking prevalence of 49.1% and 4.1%, respectively. The attitudes toward cigarette tax were analysed using multi-logit regressions. We analysed by logistic regression the potential changes in smoking behaviour that smokers might make in response to the five NT (New Taiwan dollar earmarked tax on cigarettes per pack. We summarized public opinions about the allocation of earmarked tax revenue using descriptive statistics. Results Current smokers (OR = 0.34 and former smokers (OR = 0.68 were less likely to support the cigarette tax than non-smokers. A favourable attitude toward the tax was positively associated with personal monthly income, especially among females. Among male smokers, the possibility of reducing/quitting smoking in response to the five-NT-dollar tax was negatively associated with the monthly expense for smoking. The two most frequently-suggested areas to receive money from the revenue collected from the earmarked tax were health education and cancer subsidy. Conclusions Smoking status and economic factors determine the attitude and potential responses of people toward the cigarette tax. Taiwan's five NT-dollar earmarked tax for cigarettes may have only a limited effect upon the reduction in cigarette

  15. The Danish tax on saturated fat

    DEFF Research Database (Denmark)

    Vallgårda, Signild; Holm, Lotte; Jensen, Jørgen Dejgård

    2015-01-01

    arguments and themes involved in the debates surrounding the introduction and the repeal. SUBJECTS/METHODS: An analysis of parliamentary debates, expert reports and media coverage; key informant interviews; and a review of studies about the effects of the tax on consumer behaviour. RESULTS: A tax......BACKGROUND/OBJECTIVES: Health promoters have repeatedly proposed using economic policy tools, taxes and subsidies, as a means of changing consumer behaviour. As the first country in the world, Denmark introduced a tax on saturated fat in 2011. It was repealed in 2012. In this paper, we present...... indicates that the tax was effective in changing consumer behaviour....

  16. Rostering from staffing levels: a branch-and-price approach

    NARCIS (Netherlands)

    van der Veen, Egbert; Veltman, Bart

    Many rostering methods first create shifts from some given staffing levels, and after that create rosters from the set of created shifts. Although such a method has some nice properties, it also has some bad ones. In this paper we outline a method that creates rosters directly from staffing levels.

  17. Identifying nurse staffing research in Medline: development and testing of empirically derived search strategies with the PubMed interface.

    Science.gov (United States)

    Simon, Michael; Hausner, Elke; Klaus, Susan F; Dunton, Nancy E

    2010-08-23

    The identification of health services research in databases such as PubMed/Medline is a cumbersome task. This task becomes even more difficult if the field of interest involves the use of diverse methods and data sources, as is the case with nurse staffing research. This type of research investigates the association between nurse staffing parameters and nursing and patient outcomes. A comprehensively developed search strategy may help identify nurse staffing research in PubMed/Medline. A set of relevant references in PubMed/Medline was identified by means of three systematic reviews. This development set was used to detect candidate free-text and MeSH terms. The frequency of these terms was compared to a random sample from PubMed/Medline in order to identify terms specific to nurse staffing research, which were then used to develop a sensitive, precise and balanced search strategy. To determine their precision, the newly developed search strategies were tested against a) the pool of relevant references extracted from the systematic reviews, b) a reference set identified from an electronic journal screening, and c) a sample from PubMed/Medline. Finally, all newly developed strategies were compared to PubMed's Health Services Research Queries (PubMed's HSR Queries). The sensitivities of the newly developed search strategies were almost 100% in all of the three test sets applied; precision ranged from 6.1% to 32.0%. PubMed's HSR queries were less sensitive (83.3% to 88.2%) than the new search strategies. Only minor differences in precision were found (5.0% to 32.0%). As with other literature on health services research, nurse staffing studies are difficult to identify in PubMed/Medline. Depending on the purpose of the search, researchers can choose between high sensitivity and retrieval of a large number of references or high precision, i.e. and an increased risk of missing relevant references, respectively. More standardized terminology (e.g. by consistent use of the

  18. Taxes and Bribes in Uganda

    OpenAIRE

    Jagger, Pamela; Shively, Gerald

    2014-01-01

    Using data from 433 firms operating along Uganda’s charcoal and timber supply chains we investigate patterns of bribe payment and tax collection between supply chain actors and government officials responsible for collecting taxes and fees. We examine the factors associated with the presence and magnitude of bribe and tax payments using a series of bivariate probit and Tobit regression models. We find empirical support for a number of hypotheses related to payments, highlighting the role of q...

  19. TAX SMOOTHING: TESTS ON INDONESIAN DATA

    Directory of Open Access Journals (Sweden)

    Rudi Kurniawan

    2011-01-01

    Full Text Available This paper contributes to the literature of public debt management by testing for tax smoothing behaviour in Indonesia. Tax smoothing means that the government smooths the tax rate across all future time periods to minimize the distortionary costs of taxation over time for a given path of government spending. In a stochastic economy with an incomplete bond market, tax smoothing implies that the tax rate approximates a random walk and changes in the tax rate are nearly unpredictable. For that purpose, two tests were performed. First, random walk behaviour of the tax rate was examined by undertaking unit root tests. The null hypothesis of unit root cannot be rejected, indicating that the tax rate is nonstationary and, hence, it follows a random walk. Second, the predictability of the tax rate was examined by regressing changes in the tax rate on its own lagged values and also on lagged values of changes in the goverment expenditure ratio, and growth of real output. They are found to be not significant in predicting changes in the tax rate. Taken together, the present evidence seems to be consistent with the tax smoothing, therefore provides support to this theory.

  20. Mining routinely collected acute data to reveal non-linear relationships between nurse staffing levels and outcomes.

    Science.gov (United States)

    Leary, Alison; Cook, Rob; Jones, Sarahjane; Smith, Judith; Gough, Malcolm; Maxwell, Elaine; Punshon, Geoffrey; Radford, Mark

    2016-12-16

    Nursing is a safety critical activity but not easily quantified. This makes the building of predictive staffing models a challenge. The aim of this study was to determine if relationships between registered and non-registered nurse staffing levels and clinical outcomes could be discovered through the mining of routinely collected clinical data. The secondary aim was to examine the feasibility and develop the use of 'big data' techniques commonly used in industry for this area of healthcare and examine future uses. The data were obtained from 1 large acute National Health Service hospital trust in England. Routinely collected physiological, signs and symptom data from a clinical database were extracted, imported and mined alongside a bespoke staffing and outcomes database using Mathmatica V.10. The physiological data consisted of 120 million patient entries over 6 years, the bespoke database consisted of 9 years of daily data on staffing levels and safety factors such as falls. To discover patterns in these data or non-linear relationships that would contribute to modelling. To examine feasibility of this technique in this field. After mining, 40 correlations (pdata (such as the presence or absence of nausea) and staffing factors. Several inter-related factors demonstrated step changes where registered nurse availability appeared to relate to physiological parameters or outcomes such as falls and the management of symptoms. Data extraction proved challenging as some commercial databases were not built for extraction of the massive data sets they contain. The relationship between staffing and outcomes appears to exist. It appears to be non-linear but calculable and a data-driven model appears possible. These findings could be used to build an initial mathematical model for acute staffing which could be further tested. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. Would Tax Evasion and Tax Avoidance Undermine a National Retail Sales Tax?

    OpenAIRE

    Murray, Matthew N.

    1997-01-01

    Argues that shifting to an indirect tax system (a national sales tax) will not necessarily reduce tax avoidance and tax evasion behavior by businesses and individuals, particularly if the tax rate is set high to maintain revenue neutrality. Lack of experience in administering a high-rate, indirect tax system precludes definitive statements regarding the likely extent of tax base erosion under a national sales tax.

  2. Staffing decision processes and issues: Case studies of seven US Nuclear Power Plants

    International Nuclear Information System (INIS)

    Melber, B.; Roussel, A.; Baker, K.; Durbin, N.; Hunt, P.; Hauth, J.; Forslund, C.; Terrill, E.; Gore, B.

    1994-03-01

    The objective of this report is to identify how decisions are made regarding staffing levels and positions for a sample of U.S. nuclear power plants. In this report, a framework is provided for understanding the major forces driving staffing and the implications of staffing decisions for plant safety. The focus of this report is on driving forces that have led to changes in staffing levels and to the establishment of new positions between the mid-1980s and the early 1990s. Processes used at utilities and nuclear power plants to make and implement these staffing decisions are also discussed in the report. While general trends affecting the plant as a whole are presented, the major emphasis of this report is on staffing changes and practices in the operations department, including the operations shift crew. The findings in this report are based on interviews conducted at seven nuclear power plants and their parent utilities. A discussion of the key findings is followed by a summary of the implications of staffing issues for plant safety

  3. Using search query surveillance to monitor tax avoidance and smoking cessation following the United States' 2009 "SCHIP" cigarette tax increase.

    Science.gov (United States)

    Ayers, John W; Ribisl, Kurt; Brownstein, John S

    2011-03-16

    Smokers can use the web to continue or quit their habit. Online vendors sell reduced or tax-free cigarettes lowering smoking costs, while health advocates use the web to promote cessation. We examined how smokers' tax avoidance and smoking cessation Internet search queries were motivated by the United States' (US) 2009 State Children's Health Insurance Program (SCHIP) federal cigarette excise tax increase and two other state specific tax increases. Google keyword searches among residents in a taxed geography (US or US state) were compared to an untaxed geography (Canada) for two years around each tax increase. Search data were normalized to a relative search volume (RSV) scale, where the highest search proportion was labeled 100 with lesser proportions scaled by how they relatively compared to the highest proportion. Changes in RSV were estimated by comparing means during and after the tax increase to means before the tax increase, across taxed and untaxed geographies. The SCHIP tax was associated with an 11.8% (95% confidence interval [95%CI], 5.7 to 17.9; ptax levels in Canada during the months after the tax. Tax avoidance searches increased 27.9% (95%CI, 15.9 to 39.9; ptax compared to Canada, respectively, suggesting avoidance is the more pronounced and durable response. Trends were similar for state-specific tax increases but suggest strong interactive processes across taxes. When the SCHIP tax followed Florida's tax, versus not, it promoted more cessation and avoidance searches. Efforts to combat tax avoidance and increase cessation may be enhanced by using interventions targeted and tailored to smokers' searches. Search query surveillance is a valuable real-time, free and public method, that may be generalized to other behavioral, biological, informational or psychological outcomes manifested online.

  4. Tax avoidance, tax evasion, and tax flight: Do legal differences matter?

    OpenAIRE

    Schneider, Friedrich; Kirchler, Erich; Maciejovsky, Boris

    2001-01-01

    Although from an economic point of view, legal considerations apart, tax avoidance, tax evasion and tax flight have similar effects, namely a reduction of revenue yields, and are based on the same desire to reduce the tax burden, it is likely that individuals perceive them as different and as unequally fair. Overall, 252 fiscal officers, business students, business lawyers, and entrepreneurs produced spontaneous associations to a scenario either describing tax avoidance, tax evasion, or tax f...

  5. Tax Compliance Inventory: TAX-I Voluntary tax compliance, enforced tax compliance, tax avoidance, and tax evasion

    Science.gov (United States)

    Kirchler, Erich; Wahl, Ingrid

    2010-01-01

    Surveys on tax compliance and non-compliance often rely on ad hoc formulated items which lack standardization and empirical validation. We present an inventory to assess tax compliance and distinguish between different forms of compliance and non-compliance: voluntary versus enforced compliance, tax avoidance, and tax evasion. First, items to measure voluntary and enforced compliance, avoidance, and evasion were drawn up (collected from past research and newly developed), and tested empirically with the aim of producing four validated scales with a clear factorial structure. Second, findings from the first analyses were replicated and extended to validation on the basis of motivational postures. A standardized inventory is provided which can be used in surveys in order to collect data which are comparable across research focusing on self-reports. The inventory can be used in either of two ways: either in its entirety, or by applying the single scales independently, allowing an economical and fast assessment of different facets of tax compliance. PMID:20502612

  6. Tax Compliance Inventory: TAX-I Voluntary tax compliance, enforced tax compliance, tax avoidance, and tax evasion.

    Science.gov (United States)

    Kirchler, Erich; Wahl, Ingrid

    2010-06-01

    Surveys on tax compliance and non-compliance often rely on ad hoc formulated items which lack standardization and empirical validation. We present an inventory to assess tax compliance and distinguish between different forms of compliance and non-compliance: voluntary versus enforced compliance, tax avoidance, and tax evasion. First, items to measure voluntary and enforced compliance, avoidance, and evasion were drawn up (collected from past research and newly developed), and tested empirically with the aim of producing four validated scales with a clear factorial structure. Second, findings from the first analyses were replicated and extended to validation on the basis of motivational postures. A standardized inventory is provided which can be used in surveys in order to collect data which are comparable across research focusing on self-reports. The inventory can be used in either of two ways: either in its entirety, or by applying the single scales independently, allowing an economical and fast assessment of different facets of tax compliance.

  7. Fabulous award for staffing app.

    Science.gov (United States)

    2015-12-02

    A safe staffing app giving up-to-date information on the number of nurses on the wards at Nottingham University Hospitals NHS Trust scooped top prize at the inaugural Academy of Fabulous NHS Stuffawards in London last week.

  8. Modelling the impact of raising tobacco taxes on public health and finance.

    Science.gov (United States)

    Goodchild, Mark; Perucic, Anne-Marie; Nargis, Nigar

    2016-04-01

    To investigate the potential for tobacco tax to contribute to the 2030 agenda for sustainable development by reducing tobacco use, saving lives and generating tax revenues. A model of the global cigarette market in 2014--developed using data for 181 countries--was used to quantify the impact of raising cigarette excise in each country by one international dollar (I$) per 20-cigarette pack. All currencies were converted into I$ using purchasing power parity exchange rates. The results were summarized by income group and region. According to our model, the tax increase would lead the mean retail price of cigarettes to increase by 42%--from 3.20 to 4.55 I$ per 20-cigarette pack. The prevalence of daily smoking would fall by 9%--from 14.1% to 12.9% of adults--resulting in 66 million fewer smokers and 15 million fewer smoking-attributable deaths among the adults who were alive in 2014. Cigarette excise revenue would increase by 47%--from 402 billion to 593 billion I$--giving an extra 190 billion I$s in revenue. This, in turn, could help create the fiscal space required to finance development priorities. For example, if the extra revenue was allocated to health budgets, public expenditure on health could increase by 4% globally. Tobacco taxation can prevent millions of smoking-attributable deaths throughout the world and contribute to achieving the sustainable development goals. There is also potential for tobacco taxation to create the fiscal space needed to finance development, particularly in low- and middle-income countries.

  9. Assessment of activities performed by clinical nurse practitioners and implications for staffing and patient care at primary health care level in South Africa

    Directory of Open Access Journals (Sweden)

    Jude Igumbor

    2016-03-01

    Full Text Available Background: The shortage of nurses in public healthcare facilities in South Africa is well documented; finding creative solutions to this problem remains a priority. Objective: This study sought to establish the amount of time that clinical nurse practitioners (CNPs in one district of the Western Cape spend on clinical services and the implications for staffing and skills mix in order to deliver quality patient care. Methods: A descriptive cross-sectional study was conducted across 15 purposively selected clinics providing primary health services in 5 sub-districts. The frequency of activities and time CNPs spent on each activity in fixed and mobile clinics were recorded. Time spent on activities and health facility staff profiles were correlated and predictors of the total time spent by CNPs with patients were identified. Results: The time spent on clinical activities was associated with the number of CNPs in the facilities. CNPs in fixed clinics spent a median time of about 13 minutes with each patient whereas CNPs in mobile clinics spent 3 minutes. Fixed-clinic CNPs also spent more time on their non-core functions than their core functions, more time with patients, and saw fewer patients compared to mobile-clinic CNPs. Conclusions: The findings give insight into the time CNPs in rural fixed and mobile clinics spend with their patients, and how patient caseload may affect consultation times. Two promising strategies were identified – task shifting and adjustments in health workerd eployment – as ways to address staffing and skills mix, which skills mix creates the potential for using healthcare workers fully whilst enhancing the long-term health of these rural communities.

  10. Modelled health benefits of a sugar-sweetened beverage tax across different socioeconomic groups in Australia: A cost-effectiveness and equity analysis.

    Science.gov (United States)

    Lal, Anita; Mantilla-Herrera, Ana Maria; Veerman, Lennert; Backholer, Kathryn; Sacks, Gary; Moodie, Marjory; Siahpush, Mohammad; Carter, Rob; Peeters, Anna

    2017-06-01

    A sugar-sweetened beverage (SSB) tax in Mexico has been effective in reducing consumption of SSBs, with larger decreases for low-income households. The health and financial effects across socioeconomic groups are important considerations for policy-makers. From a societal perspective, we assessed the potential cost-effectiveness, health gains, and financial impacts by socioeconomic position (SEP) of a 20% SSB tax for Australia. Australia-specific price elasticities were used to predict decreases in SSB consumption for each Socio-Economic Indexes for Areas (SEIFA) quintile. Changes in body mass index (BMI) were based on SSB consumption, BMI from the Australian Health Survey 2011-12, and energy balance equations. Markov cohort models were used to estimate the health impact for the Australian population, taking into account obesity-related diseases. Health-adjusted life years (HALYs) gained, healthcare costs saved, and out-of-pocket costs were estimated for each SEIFA quintile. Loss of economic welfare was calculated as the amount of deadweight loss in excess of taxation revenue. A 20% SSB tax would lead to HALY gains of 175,300 (95% CI: 68,700; 277,800) and healthcare cost savings of AU$1,733 million (m) (95% CI: $650m; $2,744m) over the lifetime of the population, with 49.5% of the total health gains accruing to the 2 lowest quintiles. We estimated the increase in annual expenditure on SSBs to be AU$35.40/capita (0.54% of expenditure on food and non-alcoholic drinks) in the lowest SEIFA quintile, a difference of AU$3.80/capita (0.32%) compared to the highest quintile. Annual tax revenue was estimated at AU$642.9m (95% CI: $348.2m; $1,117.2m). The main limitations of this study, as with all simulation models, is that the results represent only the best estimate of a potential effect in the absence of stronger direct evidence. This study demonstrates that from a 20% tax on SSBs, the most HALYs gained and healthcare costs saved would accrue to the most disadvantaged

  11. Modelled health benefits of a sugar-sweetened beverage tax across different socioeconomic groups in Australia: A cost-effectiveness and equity analysis

    Science.gov (United States)

    Mantilla-Herrera, Ana Maria; Veerman, Lennert; Backholer, Kathryn; Moodie, Marjory; Siahpush, Mohammad; Carter, Rob; Peeters, Anna

    2017-01-01

    Background A sugar-sweetened beverage (SSB) tax in Mexico has been effective in reducing consumption of SSBs, with larger decreases for low-income households. The health and financial effects across socioeconomic groups are important considerations for policy-makers. From a societal perspective, we assessed the potential cost-effectiveness, health gains, and financial impacts by socioeconomic position (SEP) of a 20% SSB tax for Australia. Methods and findings Australia-specific price elasticities were used to predict decreases in SSB consumption for each Socio-Economic Indexes for Areas (SEIFA) quintile. Changes in body mass index (BMI) were based on SSB consumption, BMI from the Australian Health Survey 2011–12, and energy balance equations. Markov cohort models were used to estimate the health impact for the Australian population, taking into account obesity-related diseases. Health-adjusted life years (HALYs) gained, healthcare costs saved, and out-of-pocket costs were estimated for each SEIFA quintile. Loss of economic welfare was calculated as the amount of deadweight loss in excess of taxation revenue. A 20% SSB tax would lead to HALY gains of 175,300 (95% CI: 68,700; 277,800) and healthcare cost savings of AU$1,733 million (m) (95% CI: $650m; $2,744m) over the lifetime of the population, with 49.5% of the total health gains accruing to the 2 lowest quintiles. We estimated the increase in annual expenditure on SSBs to be AU$35.40/capita (0.54% of expenditure on food and non-alcoholic drinks) in the lowest SEIFA quintile, a difference of AU$3.80/capita (0.32%) compared to the highest quintile. Annual tax revenue was estimated at AU$642.9m (95% CI: $348.2m; $1,117.2m). The main limitations of this study, as with all simulation models, is that the results represent only the best estimate of a potential effect in the absence of stronger direct evidence. Conclusions This study demonstrates that from a 20% tax on SSBs, the most HALYs gained and healthcare costs

  12. The relationship of California's Medicaid reimbursement system to nurse staffing levels.

    Science.gov (United States)

    Mukamel, Dana B; Kang, Taewoon; Collier, Eric; Harrington, Charlene

    2012-10-01

    Policy initiatives at the Federal and state level are aimed at increasing staffing in nursing homes. These include direct staffing standards, public reporting, and financial incentives. To examine the impact of California's Medicaid reimbursement for nursing homes which includes incentives directed at staffing. Two-stage limited-information maximum-likelihood regressions were used to model the relationship between staffing [registered nurses (RNs), licensed practical nurses, and certified nursing assistants hours per resident day] and the Medicaid payment rate, accounting for the specific structure of the payment system, endogeneity of payment and case-mix, and controlling for facility and market characteristics. A total of 927 California free-standing nursing homes in 2006. The model included facility characteristics (case-mix, size, ownership, and chain affiliation), market competition and excess demand, labor supply and wages, unemployment, and female employment. The instrumental variable for Medicaid reimbursement was the peer group payment rate for 7 geographical market areas, and the instrumental variables for resident case-mix were the average county revenues for professional therapy establishments and the percent of county population aged 65 and over. Consistent with the rate incentives and rational expectation behavior, expected nursing home reimbursement rates in 2008 were associated with increased RN staffing levels in 2006 but had no relationship with licensed practical nurse and certified nursing assistant staffing. The effect was estimated at 2 minutes per $10 increase in rate. The incentives in the Medicaid system impacted only RN staffing suggesting the need to improve the state's rate setting methodology.

  13. Outcomes and Costs of Community Living: Semi-Independent Living and Fully Staffed Group Homes

    Science.gov (United States)

    Felce, David; Perry, Jonathan; Romeo, Renee; Robertson, Janet; Meek, Andrea; Emerson, Eric; Knapp, Martin

    2008-01-01

    In a matched-groups design, costs and quality of life outcomes for adults with intellectual disabilities with relatively low support needs were compared between those in fully staffed group homes (n = 35) and in semi-independent living (n = 35). Data were collected on participant characteristics, setting organization, various lifestyle outcomes,…

  14. The Association of Team-Specific Workload and Staffing with Odds of Burnout Among VA Primary Care Team Members.

    Science.gov (United States)

    Helfrich, Christian D; Simonetti, Joseph A; Clinton, Walter L; Wood, Gordon B; Taylor, Leslie; Schectman, Gordon; Stark, Richard; Rubenstein, Lisa V; Fihn, Stephan D; Nelson, Karin M

    2017-07-01

    Work-related burnout is common in primary care and is associated with worse patient safety, patient satisfaction, and employee mental health. Workload, staffing stability, and team completeness may be drivers of burnout. However, few studies have assessed these associations at the team level, and fewer still include members of the team beyond physicians. To study the associations of burnout among primary care providers (PCPs), nurse care managers, clinical associates (MAs, LPNs), and administrative clerks with the staffing and workload on their teams. We conducted an individual-level cross-sectional analysis of survey and administrative data in 2014. Primary care personnel at VA clinics responding to a national survey. Burnout was measured with a validated single-item survey measure dichotomized to indicate the presence of burnout. The independent variables were survey measures of team staffing (having a fully staffed team, serving on multiple teams, and turnover on the team), and workload both from survey items (working extended hours), and administrative data (patient panel overcapacity and average panel comorbidity). There were 4610 respondents (estimated response rate of 20.9%). The overall prevalence of burnout was 41%. In adjusted analyses, the strongest associations with burnout were having a fully staffed team (odds ratio [OR] = 0.55, 95% CI 0.47-0.65), having turnover on the team (OR = 1.67, 95% CI 1.43-1.94), and having patient panel overcapacity (OR = 1.19, 95% CI 1.01-1.40). The observed burnout prevalence was 30.1% lower (28.5% vs. 58.6%) for respondents working on fully staffed teams with no turnover and caring for a panel within capacity, relative to respondents in the inverse condition. Complete team staffing, turnover among team members, and panel overcapacity had strong, cumulative associations with burnout. Further research is needed to understand whether improvements in these factors would lower burnout.

  15. Taxing Junk Food to Counter Obesity

    Science.gov (United States)

    Franck, Caroline; Grandi, Sonia M.

    2013-01-01

    We examined the advantages and disadvantages of implementing a junk food tax as an intervention to counter increasing obesity in North America. Small excise taxes are likely to yield substantial revenue but are unlikely to affect obesity rates. High excise taxes are likely to have a direct impact on weight in at-risk populations but are less likely to be politically palatable or sustainable. Ultimately, the effectiveness of earmarked health programs and subsidies is likely to be a key determinant of tax success in the fight against obesity. PMID:24028245

  16. Taxing junk food to counter obesity.

    Science.gov (United States)

    Franck, Caroline; Grandi, Sonia M; Eisenberg, Mark J

    2013-11-01

    We examined the advantages and disadvantages of implementing a junk food tax as an intervention to counter increasing obesity in North America. Small excise taxes are likely to yield substantial revenue but are unlikely to affect obesity rates. High excise taxes are likely to have a direct impact on weight in at-risk populations but are less likely to be politically palatable or sustainable. Ultimately, the effectiveness of earmarked health programs and subsidies is likely to be a key determinant of tax success in the fight against obesity.

  17. The rise and fall of the world's first fat tax.

    Science.gov (United States)

    Bødker, Malene; Pisinger, Charlotta; Toft, Ulla; Jørgensen, Torben

    2015-06-01

    In 2011, Denmark introduced the world's first tax on saturated fat, but only 15 months later the fat tax was abolished. The aim of this article is to investigate the political processes surrounding the implementation and rapid abolition of the fat tax. Our findings suggest that industry and trade associations were heavily involved in the political process of formulating the fat tax. Industry representatives used certain tactics to oppose the fat tax: threatening lawsuits, predicting welfare losses, casting doubt on evidence, diverting focus and requesting postponement. After the fat tax was implemented, the food industry continued their opposition through intensified lobbyism and juridical actions at EU level. However, other factors seem to have contributed to the fall of the fat tax. The tax received criticism for being poorly designed and gradually lost popularity among health professionals, politicians and the public. In the end, the fat tax was abolished for financial reasons. This study demonstrates how politicians considered the fat tax as a funding source rather than a public health initiative, which resulted in significant shortcomings. Furthermore, we demonstrate that the massive influence by industry stakeholders was not balanced with inputs from public health professionals, who should assume a more proactive role in policy-making. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. The nuclear tax and you

    International Nuclear Information System (INIS)

    Harper, Mike

    1990-01-01

    Area Electricity Boards in the United Kingdom are required to contract for a specified amount of non-fossil fuel electricity. This is known as the Non-Fossil Fuel Obligation (NFFO). The Boards are able to recoup the additional costs of such purchases by charging the difference to their customers on a pro rata basis. Although the tax is raised for all non-fossil fuel sources, which includes most renewable energy schemes the majority of it will be used to support nuclear power. Initially the total non-nuclear component is expected to be 300 MW, rising to 800 MW by 1998 as more renewables come on stream. This compares to an initial total for nuclear power of 8,548 MW, decreasing to 7714 MW in 1998 as older capacity gets taken off. This clearly shows that the tax is nuclear based and justifies the epithet the Nuclear Tax. Friends of the Earth is launching a campaign to ensure that everyone who pays the Nuclear Tax is aware how much it is, and what it is going to support, and to show why this money is being wasted, when it should be directed to the fuller support of renewables or to the promotion of energy efficiency and energy conservation. (author)

  19. Using Search Query Surveillance to Monitor Tax Avoidance and Smoking Cessation following the United States' 2009 “SCHIP” Cigarette Tax Increase

    Science.gov (United States)

    Ayers, John W.; Ribisl, Kurt; Brownstein, John S.

    2011-01-01

    Smokers can use the web to continue or quit their habit. Online vendors sell reduced or tax-free cigarettes lowering smoking costs, while health advocates use the web to promote cessation. We examined how smokers' tax avoidance and smoking cessation Internet search queries were motivated by the United States' (US) 2009 State Children's Health Insurance Program (SCHIP) federal cigarette excise tax increase and two other state specific tax increases. Google keyword searches among residents in a taxed geography (US or US state) were compared to an untaxed geography (Canada) for two years around each tax increase. Search data were normalized to a relative search volume (RSV) scale, where the highest search proportion was labeled 100 with lesser proportions scaled by how they relatively compared to the highest proportion. Changes in RSV were estimated by comparing means during and after the tax increase to means before the tax increase, across taxed and untaxed geographies. The SCHIP tax was associated with an 11.8% (95% confidence interval [95%CI], 5.7 to 17.9; ptax levels in Canada during the months after the tax. Tax avoidance searches increased 27.9% (95%CI, 15.9 to 39.9; ptax compared to Canada, respectively, suggesting avoidance is the more pronounced and durable response. Trends were similar for state-specific tax increases but suggest strong interactive processes across taxes. When the SCHIP tax followed Florida's tax, versus not, it promoted more cessation and avoidance searches. Efforts to combat tax avoidance and increase cessation may be enhanced by using interventions targeted and tailored to smokers' searches. Search query surveillance is a valuable real-time, free and public method, that may be generalized to other behavioral, biological, informational or psychological outcomes manifested online. PMID:21436883

  20. Tax Unit Boundaries

    Data.gov (United States)

    Kansas Data Access and Support Center — The Statewide GIS Tax Unit boundary file was created through a collaborative partnership between the State of Kansas Department of Revenue Property Valuation...

  1. ISSUES CONCERNING THE ROLE OF PROMOTION FOR TAX AUTHORITIES

    OpenAIRE

    Carmen Comaniciu; Liliana Bunescu

    2012-01-01

    Tax administration having as general objectives fighting against tax evasion, business support, modernization and improvement of procedures, prevention of tax evasion during collection, improving the collection of budgetary debts wants to be a modern administration that rely on principles of efficiency, transparency and responsibility. How the objectives of tax administration are known? Does everyone understand the objectives of tax administration? Do taxpayers know that major strategic orien...

  2. IS THE VALUE ADDED TAX A SUPERIOR SALES TAX IN ALL SALES TAXES?

    Directory of Open Access Journals (Sweden)

    MUSTAFA ALİ SARILI

    2013-05-01

    Full Text Available Value Added Tax (VAT is a tax imposed on the value added to a product at each stage of the production and distribution process. Value added is never taxed twice under VAT and thus cascading (tax on tax effects do not occur. It is a single tax on goods and services but the tax is collected multiple stages. At each of these stages, the amount of tax payable is computed by subtracting the tax previously paid on purchases from the tax charged on sales by the traders for each taxation period. In last three decades, VAT, a relatively new and better commodity taxation, has been introduced in many countries. It has replaced different types of sales taxes in such countries. This article attempts to evaluate VAT by comparing with other sales taxes.

  3. Tax penalties in SME tax compliance

    Directory of Open Access Journals (Sweden)

    Artur Swistak

    2016-03-01

    Full Text Available Small business tax compliance requires special attention. On the one hand small businesses are often incapable of rigorously fulfilling their tax obligations, more vulnerable to external risks and tempted to exploit opportunities to be non-compliant. On the other hand, unlike larger businesses, they are usually sole proprietors or owner-operated businesses, hence highly responsive to personal, social, cognitive and emotional factors. These attributes pave the way to a better use of measures designed to influence their behavior and choices. This paper discusses the role and effectiveness of tax penalties in enhancing tax compliance in small businesses. It argues that tax penalties, although indispensable for tax enforcement, may not be a first-choice tool in ensuring tax compliance. Too punitive a tax regime is an important barrier to business formalization and increasing severity of tax penalties does not produce the intended results. To be effective, tax penalties should deter and motivate taxpayers rather than exert repressive measures against them.

  4. The Tax Burden on Tobacco Volume 51, 1970-2016

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1970-2016. Orzechowski and Walker. Tax Burden on Tobacco. Tax burden data was obtained from the annual compendium on tobacco revenue and industry statistics, The Tax...

  5. Energy taxes, environment and competitiveness

    International Nuclear Information System (INIS)

    Munksgaard, J.; Gaern Hansen, L.; Bech-Ravn, C.; Ramskov, J.L.

    2006-11-01

    Economic theory about foreign trade and competition as well as empirical studies of relevance are not making evident that industries in general should pay lower environmental taxes than other kind of consumers. Consequently, economic theory cannot justify the present Danish energy tax regime where households are required to pay high energy taxes whereas industries are allowed to pay low energy taxes. On the contrary, it is more likely that reduced industry taxes will result in reduced welfare to society, lower income and lower employment as compared to a scenario of equal energy taxes. Theory can justify, however, a stepwise introduction of green taxes in order to make industries and markets adapt to the new regulatory framework. Moreover, some theoretical contributions argue that under certain circumstances one could point to a need for protecting certain kinds of industries (e.g. industries employing unskilled labour), but an exclusive tax reduction given to all industries is not supported by economic theory. By using the GTAP model we have calculated the welfare effect of levelling Danish energy taxes so households and industries have to pay equal energy taxes. The GTAP model has a good and international reputation for being designed to analyse international trade and competitiveness. We find that levelling the Danish energy taxes will increase welfare in Denmark by 1.3% equivalent to DKK 8 billion. The Danish energy tax reform, however, will cause an increase in CO 2 emissions in neighbouring countries. The calculation does not consider the influence of the EU market for tradable CO 2 permits introduced as from January 2005. (au)

  6. The relation between cigarette taxes and older adult smoking in Zhejiang and Gansu: what happened following the 2009 Chinese Tax adjustments?

    Science.gov (United States)

    Wang, Qing

    2017-04-04

    In May 2009, the Chinese government raised cigarette excise tax rates and adjusted standards for Grade A cigarettes and Grade B cigarettes. The present study aimed to examine the effects of the tax adjustments in 2009 on smoking behaviors and health outcomes among smokers aged above 45. Data from the 2008 and 2012 China Health and Retirement Longitudinal Study of Zhejiang and Gansu provinces were used to estimate the influence of tax increase on the number of cigarettes smoked daily and health capital. The sample included 706 smokers who were 45 years old and older at the time of data collection in 2008. The sample group was surveyed again in 2012. The final sample size was 1366. Logit model was applied. Cigarette tax adjustment in 2009 resulted in the decrease in the likelihood of smoking 0-10 cigarettes per day by 1.06%; the increase in the likelihood of those smoking 11-20 cigarettes per day by 0.44%; and, those smoking 20 cigarettes or more by 0.63%; the decrease in the likelihood of good health by 0.47%; the increase in the prevalence of chronic disease by 1.34%. The smoke tax adjustment in 2009 worsened individual unhealthy smoking behaviors and health outcomes. The proposed cigarette tax levied at the retail level can reduce the State Tobacco Monopoly Administration's control overall and each price and increase the influence of the market on cigarette consumption in China.

  7. Does daily nurse staffing match ward workload variability? Three hospitals' experiences.

    Science.gov (United States)

    Gabbay, Uri; Bukchin, Michael

    2009-01-01

    Nurse shortage and rising healthcare resource burdens mean that appropriate workforce use is imperative. This paper aims to evaluate whether daily nursing staffing meets ward workload needs. Nurse attendance and daily nurses' workload capacity in three hospitals were evaluated. Statistical process control was used to evaluate intra-ward nurse workload capacity and day-to-day variations. Statistical process control is a statistics-based method for process monitoring that uses charts with predefined target measure and control limits. Standardization was performed for inter-ward analysis by converting ward-specific crude measures to ward-specific relative measures by dividing observed/expected. Two charts: acceptable and tolerable daily nurse workload intensity, were defined. Appropriate staffing indicators were defined as those exceeding predefined rates within acceptable and tolerable limits (50 percent and 80 percent respectively). A total of 42 percent of the overall days fell within acceptable control limits and 71 percent within tolerable control limits. Appropriate staffing indicators were met in only 33 percent of wards regarding acceptable nurse workload intensity and in only 45 percent of wards regarding tolerable workloads. The study work did not differentiate crude nurse attendance and it did not take into account patient severity since crude bed occupancy was used. Double statistical process control charts and certain staffing indicators were used, which is open to debate. Wards that met appropriate staffing indicators prove the method's feasibility. Wards that did not meet appropriate staffing indicators prove the importance and the need for process evaluations and monitoring. Methods presented for monitoring daily staffing appropriateness are simple to implement either for intra-ward day-to-day variation by using nurse workload capacity statistical process control charts or for inter-ward evaluation using standardized measure of nurse workload intensity

  8. TAX COSTS AND CORPORATION DIVIDEND POLICY: Evidence from the 1986 U.S. Tax Reform Acts

    Directory of Open Access Journals (Sweden)

    Siddharta Utama

    2003-02-01

    shareholders with long investment horizons because the tax cost saved from decreasing dividend payout ratios is an increasing function of shareholders’ investment horizon. The empirical tests support the hypothesis and show a negative relationship between the change in incremental tax costs and the change in dividend payout ratios for firms with long average investment horizons.

  9. Tax Efficiency vs. Tax Equity – Points of View regarding Tax Optimum

    Directory of Open Access Journals (Sweden)

    Stela Aurelia Toader

    2011-10-01

    Full Text Available Objectives. Starting from the idea that tax equity requirements, administration costs and the tendency towards tax evasion determine the design of tax systems, it is important to identify a satisfactory efficiency/equity deal in order to build a tax system as close to optimum requirements as possible. Prior Work Previous studies proved that an optimum tax system is that through which it will be collected a level of tax revenues which will satisfy budgetary demands, while losing only a minimum ‘amount’ of welfare. In what degree the Romanian tax system meets these requirements? Approach We envisage analyzing the possibilities of improving Romanian tax system as to come nearest to optimum requirements. Results We can conclude fiscal system can uphold important improvements in what assuring tax equity is concerned, resulting in raising the degree of free conformation in the field of tax payment and, implicitly, the degree of tax efficiency. Implications Knowing to what extent it can be acted upon in the direction of finding that satisfactory efficiency/equity deal may allow oneself to identify the blueprint of a tax system in which the loss of welfare is kept down to minimum. Value For the Romanian institutions empowered to impose taxes, the knowledge of the possibilities of making the tax system more efficient can be important while aiming at reducing the level of evasion phenomenon.

  10. How to Set up an Effective Food Tax?; Comment on “Food Taxes: A New Holy Grail?”

    Directory of Open Access Journals (Sweden)

    Céline Bonnet

    2013-01-01

    Full Text Available Whereas public information campaigns have failed to reverse the rising trend in obesity, economists support food taxes as they suggest they can force individuals to change their eating behavior and make the agro-food industry think more about healthy food products. Excise taxes based on the unhealthy nutrient content would be more effective since they impact more on unhealthy food products than VAT (value-added-tax taxes. Taxes based only on junk food products would avoid perverse effects on healthy nutrient. However, as eating behavior of consumers is complex, a modeling analysis would allow to assess unexpected effects on other unhealthy nutrients or products.

  11. Modelling the impact of raising tobacco taxes on public health and finance

    Science.gov (United States)

    Perucic, Anne-Marie; Nargis, Nigar

    2016-01-01

    Abstract Objective To investigate the potential for tobacco tax to contribute to the 2030 agenda for sustainable development by reducing tobacco use, saving lives and generating tax revenues. Methods A model of the global cigarette market in 2014 – developed using data for 181 countries – was used to quantify the impact of raising cigarette excise in each country by one international dollar (I$) per 20-cigarette pack. All currencies were converted into I$ using purchasing power parity exchange rates. The results were summarized by income group and region. Findings According to our model, the tax increase would lead the mean retail price of cigarettes to increase by 42% – from 3.20 to 4.55 I$ per 20-cigarette pack. The prevalence of daily smoking would fall by 9% – from 14.1% to 12.9% of adults – resulting in 66 million fewer smokers and 15 million fewer smoking-attributable deaths among the adults who were alive in 2014. Cigarette excise revenue would increase by 47% – from 402 billion to 593 billion I$ – giving an extra 190 billion I$s in revenue. This, in turn, could help create the fiscal space required to finance development priorities. For example, if the extra revenue was allocated to health budgets, public expenditure on health could increase by 4% globally. Conclusion Tobacco taxation can prevent millions of smoking-attributable deaths throughout the world and contribute to achieving the sustainable development goals. There is also potential for tobacco taxation to create the fiscal space needed to finance development, particularly in low- and middle-income countries. PMID:27034518

  12. Modify Federal Tax Code to Create Incentives for Individuals to Obtain Coverage.

    Science.gov (United States)

    McGlynn, Elizabeth A

    2011-01-01

    This article explores how a refundable tax credit to offset the cost of health insurance premiums would affect health system performance along nine dimensions. A refundable tax credit would produce a slight gain in health as measured by life expectancy; 2.3 to 10 million people would become newly insured under this policy change. It is uncertain how the policy would affect waste or patient experience. Refundable tax credits would have no discernable effect on total health care spending, overall consumer financial risk, reliability of care, or health system capacity. Implementing refundable tax credits would be relatively easy.

  13. The relation between cigarette taxes and older adult smoking in Zhejiang and Gansu: what happened following the 2009 Chinese Tax adjustments?

    OpenAIRE

    Wang, Qing

    2017-01-01

    Background In May 2009, the Chinese government raised cigarette excise tax rates and adjusted standards for Grade A cigarettes and Grade B cigarettes. The present study aimed to examine the effects of the tax adjustments in 2009 on smoking behaviors and health outcomes among smokers aged above 45. Methods Data from the 2008 and 2012 China Health and Retirement Longitudinal Study of Zhejiang and Gansu provinces were used to estimate the influence of tax increase on the number of cigarettes smo...

  14. Revenue stream: How state taxes fund public services, amenities

    OpenAIRE

    Brye Steeves

    2009-01-01

    Each state has a portfolio with a varying assortment of revenue sources, such as income tax and sales tax, which are affected by the health of the economy. In down times, services get cut or taxes are raised.

  15. Sugar Price Supports and Taxation

    Science.gov (United States)

    Dilk, Abby; Savaiano, Dennis A.

    2017-01-01

    Domestic US sugar production has been protected by government policy for the past 82 years, resulting in elevated domestic prices and an estimated annual (2013) $1.4 billion dollar “tax” on consumers. These elevated prices and the simultaneous federal support for domestic corn production have ensured a strong market for high-fructose corn syrup. Americans have dramatically increased their consumption of caloric sweeteners during the same period. Consumption of “empty” calories (ie, foods with low-nutrient/high-caloric density)—sugar and high-fructose corn syrup being the primary sources—is considered by most public health experts to be a key contributing factor to the rise in obesity. There have been substantial efforts to tax sugar-sweetened beverages (SSBs) to both reduce consumption and provide a source of funds for nutrition education, thereby emulating the tobacco tax model. Volume-based SSB taxes levy the tax rate per ounce of liquid, where some are only imposed on beverages with added sugar content exceeding a set threshold. Nonetheless, volume-based taxes have significant limitations in encouraging consumers to reduce their caloric intake due to a lack of transparency at the point of purchase. Thus, it is hypothesized that point-of-purchase, nutrient-specific excise taxes on SSBs would be more effective at reducing sugar consumption. However, all SSB taxes are limited by the possibility that consumers may compensate their decreased intake from SSBs with other high-calorie junk foods. Furthermore, there are no existing studies to provide evidence on how SSB taxes will impact obesity rates in the long term. The paradox of sugar prices is that Americans have paid higher prices for sugar to protect domestic production for more than 80 years, and now, Americans are being asked to pay even more to promote public health. The effective use of sugar taxes should be considered based on their merits in reducing sugar consumption and making available a new

  16. The Untapped Power of Soda Taxes: Incentivizing Consumers, Generating Revenue, and Altering Corporate Behavior

    Directory of Open Access Journals (Sweden)

    Sarah A. Roache

    2017-09-01

    Full Text Available Globally, soda taxes are gaining momentum as powerful interventions to discourage sugar consumption and thereby reduce the growing burden of obesity and non-communicable diseases (NCDs. Evidence from early adopters including Mexico and Berkeley, California, confirms that soda taxes can disincentivize consumption through price increases and raise revenue to support government programs. The United Kingdom’s new graduated levy on sweetened beverages is yielding yet another powerful impact: soda manufacturers are reformulating their beverages to significantly reduce the sugar content. Product reformulation – whether incentivized or mandatory – helps reduce overconsumption of sugars at the societal level, moving away from the long-standing notion of individual responsibility in favor of collective strategies to promote health. But as a matter of health equity, soda product reformulation should occur globally, especially in low- and middleincome countries (LMICs, which are increasingly targeted as emerging markets for soda and junk food and are disproportionately impacted by NCDs. As global momentum for sugar reduction increases, governments and public health advocates should harness the power of soda taxes to tackle the economic, social, and informational drivers of soda consumption, driving improvements in food environments and the public’s health.

  17. Tax credits and purchasing pools: will this marriage work?

    Science.gov (United States)

    Trude, S; Ginsburg, P B

    2001-04-01

    Bipartisan interest is growing in Congress for using federal tax credits to help low-income families buy health insurance. Regardless of the approach taken, tax credit policies must address risk selection issues to ensure coverage for the chronically ill. Proposals that link tax credits to purchasing pools would avoid risk selection by grouping risks similar to the way large employers do. Voluntary purchasing pools have had only limited success, however. This Issue Brief discusses linking tax credits to purchasing pools. It uses information from the Center for Studying Health System Change's (HSC) site visits to 12 communities as well as other research to assess the role of purchasing pools nationwide and the key issues and implications of linking tax credits and pools.

  18. Tax Havens: International Tax Avoidance and Evasion

    OpenAIRE

    Gravelle, Jane G.

    2009-01-01

    The federal government loses both individual and corporate income tax revenue from the shifting of profits and income into low-tax countries, often referred to as tax havens. Tax havens are located around the world with concentrations in the Caribbean and Europe. Corporate profit shifting may cost up to $60 billion in revenue and remedies are likely to involve tax law changes. Individual income tax losses more often arise from tax evasion, and are facilitated by the lack of information report...

  19. Revenue and Health Impacts of Restructuring Tobacco Excise Tax ...

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

    A proposed law in the Philippines to increase the excise tax on tobacco by ... developing countries to reduce demand for tobacco through price and tax measures. Southeast Asian countries are struggling with how to implement the main provisions of the Convention. ... Far East Asia, Philippines, Central Asia, South Asia ...

  20. TAX RESEARCH Financial Accounting versus Tax Accounting - Tax Rules’ Impact on Investment Decisions

    OpenAIRE

    Dr.Sc. Skender Ahmeti; Dr.Sc. Muhamet Aliu; MSc. Alban Elshani; Yllka Ahmeti

    2014-01-01

    This paper provides guidance for all those interested in research related to tax. In the study are included three main areas dealing with taxes and about taxes: (1) the role of information in corporation tax expenditures under the rules and laws of the country against financial statements according to international accounting standards, (2) case study PTK; how much effective tax and tax on extra profit has it paid (3) the impact of tax rules on investment decisions - the reasons and profits o...

  1. Concept of Tax Advising Within Tax Optimization

    OpenAIRE

    Svitlana Bychkova; Makarova Nadiya

    2013-01-01

    Tax advising is strictly individual service requiring knowledge in the fields of law, tax and accounting. Tax advising includes not only advising on taxation models depending on the economic entity type of activity, but it also deals with issues of tax optimization. In the article the authors have offered their views on the concept of tax consulting in the area of tax optimization (tax planning). The subject matter has been a set of the most rational and important settings that allow you to u...

  2. The three hurdles of tax planning: How business context, aims of tax planning, and tax manager power affect tax

    OpenAIRE

    Feller, Anna; Schanz, Deborah

    2014-01-01

    The question of why some companies pay more taxes than others is a widely investigated topic of interest. One of the famous suspect explanations is a phenomenon called tax avoidance. We develop a holistic theoretical concept of influences on corporate tax planning through a series of 19 in-depth German tax expert interviews. Our findings show that three distinct hurdles in the tax planning process can explain different levels of tax expense across companies. Those three hurdles are which tax ...

  3. Does More Progressive Tax Make Tax Discipline Weaker?

    OpenAIRE

    Tatiana Damjanovic

    2005-01-01

    This paper investigates the relationship between the disparity in tax base and tax collection. I address the tax collection problem with traditional industrial organization approach. Thus, I model the "tax minimization" industry where the supplier helps taxpayers to avoid their tax liability. I find that lower income inequality as well as a less progressive tax code may result in a smaller number of tax payers committing to their tax duties. Finally, I question the reduction in the highest ta...

  4. Fiscal and tax policy support for energy efficiency retrofit for existing residential buildings in China's northern heating region

    International Nuclear Information System (INIS)

    Li Dongyan

    2009-01-01

    Energy efficiency retrofit for existing residential buildings (EERERB) in China's northern heating region is an important component of the national energy strategy. The main content and related subject in EERERB performance is the basis of understanding and developing targeted policies. So, this paper designed the content system of EERERB. And then, provided a cost-benefit analysis on related subjects, assessed the government's function in EERERB, and come to the conclusion that the Chinese government should increase fiscal fund investment and implement more fiscal and tax incentive policies. Moreover, in view of China's current policy, which lacks long-term mechanism and flexibility, this paper proposed specific policy recommendations, including clarifying the government's corresponding responsibilities at all levels and increasing the intensity of the central government's transfer payments. It further proposed targeted financial and tax policies for supporting and encouraging heating enterprises and owners, as well as policies to cultivate energy-saving service markets and to support the ESCO.

  5. Staffing, overtime, and shift scheduling project

    International Nuclear Information System (INIS)

    Lewis, P.M.

    1989-01-01

    Recent events at the Peach Bottom nuclear power plant have demonstrated the need to establish a quantifiable basis for assessing the safety significance of long work hours on nuclear power plant operators. The incidents at TMI-2, Chernobyl, and Bhopal, which all occurred during the late evening/night shift, further highlight the importance of the relationship between shift scheduling and performance. The objective of this project is to estimate, using statistical analysis on data from the nuclear industry, the effects on safety of staffing levels, overtime, and shift scheduling for operators and maintenance personnel. Regarding staffing levels, the Nuclear Regulatory Commission (NRC) currently has no explicit regulation concerning the minimum acceptable levels of staffing in a plant that has an operating license. The NRC has no systematic method for collecting data on the number of licensed operators on the operating crews. In 1982 the NRC recommended that plants write into their technical specifications a model policy on overtime. Currently, 77 nuclear power plant units have the model policy or a modification of it written into their technical specifications; 33 units have no policy on overtime. The model policy sets limits on overtime for safety related personnel, although these limits can be exceeded with plant manger approval. The US nuclear power industry has three types of shift schedules: (1) forward-rotating 8-hour/day shift schedules, (2) backward-rotating 8-hour/day schedules, and (3) 12-hour/day schedules

  6. Running Head: Evaluation of Contract Versus VA-Staffed CBOCs. Evaluating Contract versus VA-Staffed Community Based Outpatient Clinics (CBOCs) Using Patient Satisfaction and Access Measures in the Veterans Health Administration

    Science.gov (United States)

    2009-06-01

    staffed CBOC, with dependent variables adjusting for SHEP scores and case mix factors. The equation for the null hypothesis is Hho = In (estimated...that the model can be further improved through combining several of the satisfaction scores. The equation for the null hypothesis is that Hho = In

  7. Extension Staffing Models to Serve 4-H Clientele in Changing Times

    Directory of Open Access Journals (Sweden)

    Donna R. Gillespie

    2010-03-01

    Full Text Available In response to budget cuts in 2002, 4-H staffing models were restructured. The response by University of Idaho Extension was intended to continue meeting the needs of Idaho’s citizens with fewer UI Extension faculty. This staffing reorganization led to the formation of the District III 4-H Team who united to bring stronger 4-H programs to south central Idaho and expand programs to underserved audiences. Information from surveys and interviews over the past seven years reflects the effectiveness, challenges and successes of the District III 4-H Team. In Making the Best Better: 4-H Staffing Patterns and Trends in the Largest Professional Network in the Nation (2007, author Kirk A. Astroth notes a nationwide change in 4-H leadership at the county level from 4-H faculty to program assistants or coordinators. The information gathered in our research may help other states determine staffing models to meet the needs of clientele in these changing times.

  8. Radiotherapy staffing in the European countries

    DEFF Research Database (Denmark)

    Lievens, Yolande; Defourny, Noémie; Coffey, Mary

    2014-01-01

    includes a detailed analysis of radiotherapy staffing (questionnaire items 47-60), analysed in relation to the annual number of treatment courses and the socio-economic status of the countries. The analysis was conducted between February and July 2014, and is based on validated responses from 24 of the 40...... of countries can be distinguished on the basis of available personnel resources and socio-economic status. CONCLUSIONS: The average personnel figures in Europe are now consistent with, or even more favourable than the QUARTS recommendations, probably reflecting a combination of better availability as such......, in parallel with the current use of more complex treatments than a decade ago. A considerable variation in available personnel and delivered courses per year however persists among the highest and lowest staffing levels. This not only reflects the variation in cancer incidence and socio-economic determinants...

  9. Not so sweet refrain: sugar-sweetened beverage taxes, industry opposition and harnessing the lessons learned from tobacco control legal challenges.

    Science.gov (United States)

    George, Anita

    2018-05-21

    As a growing number of countries implement, or announce plans to introduce, a sugar-sweetened beverage (SSB) tax, this paper explores the public health rationale for such a tax and provides an overview of the international normative and policy instruments supporting the introduction of fiscal measures on sugary drinks. After examining parallels between the legal arguments raised by the food and beverage industry in opposition to SSB taxes and those raised by the tobacco industry in response to tobacco control measures, this paper draws four key lessons that will assist countries to design effective and robust SSB tax measures and counter food and beverage industry opposition: regulatory distinctions in tax coverage should be based on bona fide, evidence-based reasoning; evidence-based measures need to be tailored to a country's public health objectives as part of a comprehensive strategy to address unhealthy diet consumption; procedural requirements and due process should be observed in the drafting and implementation of the measure; and regulatory space exists within domestic constitutions, laws and international trade and investment agreements recognising the sovereign right of states to regulate in the interests of public health.

  10. The Implications of Flexible Staffing Arrangements for Job Stability

    OpenAIRE

    Houseman, Susan N.; Polivka, Anne E.

    1999-01-01

    In this paper, we examine the job stability of workers in a wide range of flexible staffing arrangements: agency temporary, direct-hire temporary, on-call, contract company, independent contractor, and regular part-time work. We draw upon two data sources in our analysis. The first is a nationwide survey of employers on their use of flexible staffing arrangements conducted by the Upjohn Institute for Employment Research. This survey provides evidence on why employers use various types of flex...

  11. Can voter-approved tax levies provide fiscal advantages and stability for local public health agencies?

    Science.gov (United States)

    Schmalzried, Hans D; Fallon, L Fleming

    2013-01-01

    Major funding cuts have occurred throughout the United States public health system during the past several years. Funding for local public health agency (LPHA) services and programs is obtained through a patchwork of sources that vary both within and among states. Even though local city and county sources provide a significant proportion of funding for LPHAs, information available in the literature about these revenues is sparse and is not clearly described. This study focused on a single specific revenue stream included in the local sources (local city and county) category: funds voted on directly by the public. The primary purpose of this study was to examine whether this type of funding source provided fiscal advantages for LPHAs. Specifically, we wanted to see how sensitive levy votes were to changing general economic conditions. A questionnaire to collect LPHA levy data was developed, approved, and mailed to county boards of elections in Ohio (n = 88). Elections officials were asked to provide voting results for all LPHA levy ballot attempts since 1994 regardless of outcome. In the study period (1994 through 2011), 250 LPHA property tax levies were placed on election ballots in Ohio. LPHAs were successful in 155 (62.0%) and unsuccessful in 95 (38.0%) attempts. Over the 18-year period, the most noteworthy outcome was a 94.6% pass rate for renewal levies. Our study demonstrated that voter-approved tax levies provide some fiscal advantages for LPHAs: higher per capita revenues than those who have to rely on other sources of income and predictable revenue streams. This translates into more funds being available for public health programs and services. Property tax levies allow citizens to make direct investments in their local health departments.

  12. The impact of managed care penetration and hospital quality on efficiency in hospital staffing.

    Science.gov (United States)

    Mobley, Lee R; Magnussen, Jon

    2002-01-01

    The state of California has recently mandated minimum nurse-staffing ratios, raising concerns about possible affects on hospital efficiency. In this study, we examine how market factors and quality were related to staffing levels in California hospitals in 1995 (prior to implementation of the new law). We are particularly interested in the affect of managed care penetration on this aspect of hospital efficiency because the call to legislative action was predicated on fears that hospitals were reducing staffing below optimal levels in response to managed care pressures. We derive a unique measure of excess staffing in hospitals based on a data envelopment analysis (DEA) production function model, which explicitly includes ancillary care among the inputs and outputs. This careful specification of production is important because ancillary care use has risen relative to daily hospital services, with the spread of managed care and advances in medical technology. We find that market share (adjusted for size) and market concentration are the major determinants of excess staffing while managed care penetration is insignificant. We also find that poor quality (outcomes worse than expected) is associated with less efficient staffing. These findings suggest that the larger, more efficient urban hospitals will be penalized more heavily under binding staffing ratios than smaller, less-urban hospitals.

  13. The effects of the Danish saturated fat tax on food and nutrient intake and modelled health outcomes

    DEFF Research Database (Denmark)

    Smed, Sinne; Scarborough, P.; Rayner, M.

    2016-01-01

    Integrated ModEl)) to estimate the effect of these changes on non-communicable diseases (NCDs) and mortality. Results: The tax resulted in a 4.0% reduction in saturated fat intake. Vegetable consumption increased, and salt consumption increased for most individuals, except younger females. We find a modelled......Background/Objective: The World Health Organisation recommends governments to consider the use of fiscal policies to promote healthy eating. However, there is very limited evidence of the effect of food taxation in a real-life setting, as most evidence is based on simulation studies. The objective...... reduction in mortality with 123 lives saved annually, 76 of them below 75 years equal to 0.4% of all deaths from NCDs. Conclusions: Modelling the effect of the changes in diet on health outcomes suggests that the saturated fat tax made a positive, but minor, contribution to public health in Denmark....

  14. Studying the consumption and health outcomes of fiscal interventions (taxes and subsidies) on food and beverages in countries of different income classifications; a systematic review.

    Science.gov (United States)

    Alagiyawanna, Amaap; Townsend, Nick; Mytton, Oli; Scarborough, Pete; Roberts, Nia; Rayner, Mike

    2015-09-14

    Governments use fiscal interventions (FIs) on food and beverages to encourage healthy food behaviour and positive health outcomes. The objective of this review was to study the behavioural and health outcomes of implemented food and beverage FIs in the form of taxes and subsidies in countries of different income classifications. The present systematic review was conducted in accordance with Cochrane protocols. The search was carried out on academic and grey literature in English, for studies conducted in different countries on implemented FIs on food and non-alcoholic beverages and health outcomes, with a special focus on the income of those countries. Eighteen studies met the inclusion criteria and 14 were from peer- reviewed journals. Thirteen studies came from high-income (HI) countries, four from upper middle-income (UMI) countries and only one came from a lower middle-income (LMI) country. There were no studies from lower-income (LI) countries. Of these 18 studies; nine focused on taxes, all of which were from HI countries. Evidence suggests that FIs on foods can influence consumption of taxed and subsidized foods and consequently have the potential to improve health. Although this review supports previous findings that FIs can have an impact on healthy food consumption, it also highlights the lack of evidence available from UMI, LMI and LI countries on such interventions. Therefore, evidence from HI countries may not be directly applicable to middle-income and LI countries. Similar research conducted in middle and low income countries will be beneficial in advocating policy makers on the effectiveness of FIs in countering the growing issues of non-communicable diseases in these countries.

  15. Tax_Units_2011_Final

    Data.gov (United States)

    Kansas Data Access and Support Center — The Statewide GIS Tax Unit boundary file was created through a collaborative partnership between the State of Kansas Department of Revenue Property Valuation...

  16. Tobacco product prices before and after a statewide tobacco tax increase.

    Science.gov (United States)

    Brock, Betsy; Choi, Kelvin; Boyle, Raymond G; Moilanen, Molly; Schillo, Barbara A

    2016-03-01

    In 2013, the State of Minnesota Legislature passed a tobacco tax increase that increased the combined cigarette excise and sales tax by US$1.75 (from US$1.60 to US$3.35) and increased the tax on non-cigarette tobacco products from 70% to 95% of the wholesale price. The current study explores the change in tobacco prices in retail locations and whether the tax increase was fully passed to consumers. An observational study of tobacco retail prices was performed in a sample of 61 convenience stores in Minnesota, North Dakota, South Dakota and Wisconsin. Six rounds of data were collected between May 2013 and January 2014. In each round, purchases were made at the same stores for the same four tobacco products (Camel Blue cigarettes, Marlboro Gold cigarettes, Grizzly Wintergreen moist smokeless tobacco and Copenhagen Wintergreen moist smokeless tobacco). For all studied tobacco products, prices in Minnesota increased significantly after the tax increase (Round 1-Round 6). After controlling for price changes in neighbouring states, the average price difference in Minnesota for the two cigarette brands increased by US$1.89 and US$1.81, which are both more than the US$1.75 tax increase. For moist smokeless, the average price difference increased by US$0.90 and US$0.94. Significant price changes were not observed in the comparison states. After the introduction of the minimum moist smokeless tax, a significantly higher proportion of Minnesota stores offered price promotions on smokeless tobacco. A large tobacco tax resulted in an average retail cigarette price exceeding the tax, suggesting the industry over-shifted the cigarette tax increase to consumers in Minnesota. The findings support the known public health benefit of tobacco tax increases while highlighting the need for additional information about how, or if, tobacco companies use price promotions to blunt the impact of tax increases. Published by the BMJ Publishing Group Limited. For permission to use (where not

  17. Deferred Tax Assets and Deferred Tax Expense Against Tax Planning Profit Management

    Directory of Open Access Journals (Sweden)

    Warsono

    2017-09-01

    Full Text Available The purpose of this study is to examine the probability of earnings management performed by Property and Real Estate companies listed in Indonesia Stock Exchange (BEI in the period 2011-2015. How to do the management to influence the accounting numbers can be either profit management through deferred tax assets, deferred tax expense and tax planning in the financial statements. This paper examines the effect of deferred tax assets deferred tax burden, and tax planning to earnings management conducted by the company. Data of the research is to use secondary data from company financial statements that were downloaded from the official website of Indonesia Stock Exchange. Using sampling technique is performed by purposive sampling. The study population is the Property and Real Estate companies listed in Indonesia Stock Exchange in the period 2011-2015. The study take sample as many as 34 companies Property and Real Estate in the Stock Exchange in 2011-2015. Hypothesis testing uses multiple regressions with SPSS software version 22. The result shows that the Deferred Tax Assets positive and significant effect on earnings management; while deferred tax expense and tax planning significant negative effect on earnings management.

  18. Canada's gas taxes = highway robbery

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-05-01

    This report was prepared for the second annual 'gas honesty day' (May 18, 2000) in an effort to draw attention to the frustration of Canadian taxpayers with gasoline retailers and the petroleum industry for the inordinately and unjustifiably high prices for gasoline at the pump. The report points out that the public outcry is, in fact, misdirected since the largest profiteers at the pumps, the federal government, remains largely unscathed. It is alleged in the report that gas taxes are tantamount to highway robbery. Ostensibly collected for road construction and maintenance, of the almost $ 5 billion collected in 1999, only a paltry $ 194 million was returned to the provinces for roadway and highway spending. The 10-year average of federal returns to the the provinces from tax on gasoline is a meager 4.7 per cent, which fell even further to 4.1 per cent in 1998-1999. Gasoline tax revenues continue to climb, while government commitment to real roadway and highway spending continues to decline. This document attempts to shed some light on the pricing structure for gasoline. Without defending or explaining the non-tax portion of the pump price charged by Canada's oil companies, which is a task for the oil companies to undertake, the document makes a concerted effort to raise public awareness and focus public attention on government's involvement, namely that gas taxes represent on average about 50 per cent of the pump price and that the majority of the taxes collected are not put back into road and highway improvements. The Canadian Taxpayers Federation, authors of this report, expect that by focusing debate on the issue of gasoline taxes a broad support for a lowering of the overall tax burden on motorists will result. Among other things, the CTF advocates reduction of federal and provincial fuel taxes to levels commensurate with highway funding; dedication of fuel tax revenues to highway construction and maintenance; elimination of the sales and goods

  19. TAX OPTIMIZATION, TAX AVOIDANCE OR TAX EVASION? CONTRIBUTIONS TO THE OFFSHORE COMPANIES’ LEGAL BACKGROUND

    OpenAIRE

    Eva ERDÕS

    2010-01-01

    Is it a legal or illegal activity to give money to establish offshore firms? What is the offshore practice is it a method of tax optimization, tax minimization or is it a harmful activity, which means tax avoidance or tax evasion. This question is very important in the European Union’s tax law system, because the EU tax law is against the harmful tax competition. Some member states’ legal system is permitted to use offshore companies’ rules, but in the European Union it is prohibited to estab...

  20. TOP TAX SYSTEM - A common tax system for all nations

    OpenAIRE

    VIJAYA KRUSHNA VARMA

    2011-01-01

    TOP Tax system is a new tax system which can be used as a common tax system for all nations. This new tax system will be without present tax system’s all Direct and Indirect taxes accompanied by tax laws, tax exemptions, multiple tax collection departments to relieve 7 billion people of the world from the cobweb of ambiguous and complex tax structures, plethora of tax laws, mandatory and cumbersome accounting, auditing, tax returns and consequent quagmire of all tax related cases. Taxation, t...

  1. Tax Arbitrage by Colleges and Universities. A CBO Study

    Science.gov (United States)

    Congressional Budget Office, 2010

    2010-01-01

    Colleges and universities enjoy a variety of federal tax preferences that are designed to support a broader public purpose--the advancement of higher education and research. Not only are institutions of higher learning exempt from paying federal income taxes, they also are eligible to receive tax deductible charitable contributions and allowed to…

  2. A time series analysis of presentations to Queensland health facilities for alcohol-related conditions, following the increase in 'alcopops' tax.

    Science.gov (United States)

    Kisely, Steve; Crowe, Elizabeth; Lawrence, David; White, Angela; Connor, Jason

    2013-08-01

    In response to concerns about the health consequences of high-risk drinking by young people, the Australian Government increased the tax on pre-mixed alcoholic beverages ('alcopops') favoured by this demographic. We measured changes in admissions for alcohol-related harm to health throughout Queensland, before and after the tax increase in April 2008. We used data from the Queensland Trauma Register, Hospitals Admitted Patients Data Collection, and the Emergency Department Information System to calculate alcohol-related admission rates per 100,000 people, for 15 - 29 year-olds. We analysed data over 3 years (April 2006 - April 2009), using interrupted time-series analyses. This covered 2 years before, and 1 year after, the tax increase. We investigated both mental and behavioural consequences (via F10 codes), and intentional/unintentional injuries (S and T codes). We fitted an auto-regressive integrated moving average (ARIMA) model, to test for any changes following the increased tax. There was no decrease in alcohol-related admissions in 15 - 29 year-olds. We found similar results for males and females, as well as definitions of alcohol-related harms that were narrow (F10 codes only) and broad (F10, S and T codes). The increased tax on 'alcopops' was not associated with any reduction in hospital admissions for alcohol-related harms in Queensland 15 - 29 year-olds.

  3. A note on the neutrality of profit taxes with tax evasion and tax avoidance

    OpenAIRE

    Che-chiang Huang; Horn-in Kuo

    2014-01-01

    Traditional literature exploring the relationship between production and tax evasion ignores the impact of other activities on these two decisions. This paper incorporates firms' tax avoidance activities into the model of tax evasion. In contrast to conventional results, we find that profit tax is not necessarily neutral. In addition, the independency or separability of tax evasion and production decisions may not hold either whenever tax avoidance is present.

  4. Fiscal incentives, behavior change and health promotion: what place in the health-in-all-policies toolkit?

    Science.gov (United States)

    Sassi, Franco; Belloni, Annalisa

    2014-06-01

    Taxes, subsidies and welfare benefits may provide financial incentives to encourage healthy behaviors or discourage less healthy ones. Historically, taxes have been used in many countries to deter behaviors like tobacco smoking or harmful alcohol use. More recently, an increasing number of governments have sought to expand the scope for the use of fiscal measures in health promotion to foods and beverages high in fat, salt or sugar. A strong public health rationale, supported by a growing body of evidence of the health impacts of taxes and other fiscal measures, adds to the more traditional rationale for the use of commodity taxes, which hinges on their revenue-generating potential and their ability to address the costs imposed by consumers of health-related commodities on other individuals. Despite limitations in the existing evidence base, reviewed in this paper, taxes have been shown to generate significant health gains when applied to tobacco products and alcoholic beverages. In the case of foods and non-alcoholic beverages, the effects tend to build up over time and are stronger in people with lower socio-economic status. However, a number of potentially undesirable effects suggest that governments should exercise caution in planning and implementing taxes on health-related commodities. In particular, commodity taxes are generally regressive, and this is especially the case for taxes on tobacco, foods and non-alcoholic beverages, although the actual size of the tax burden involved is relatively modest. In addition, taxes may negatively impact on economic efficiency and social welfare, and may incentivize illicit activities. © OECD (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Pre-hospital critical care by anaesthesiologist-staffed pre-hospital services in Scandinavia

    DEFF Research Database (Denmark)

    Krüger, A J; Lossius, H M; Mikkelsen, S

    2013-01-01

    All Scandinavian countries provide anaesthesiologist-staffed pre-hospital services. Little is known of the incidence of critical illness or injury attended by these services. We aimed to investigate anaesthesiologist-staffed pre-hospital services in Scandinavia with special emphasis on incidence...

  6. Counseling, Psychological, and Social Services Staffing: Policies in U.S. School Districts.

    Science.gov (United States)

    Brener, Nancy; Demissie, Zewditu

    2018-06-01

    Schools are in a unique position to meet the mental and behavioral health needs of children and adolescents because approximately 95% of young people aged 7-17 years attend school. Little is known, however, about policies related to counseling, psychological, and social services staffing in school districts. This study analyzed the prevalence of such policies in public school districts in the U.S. Data from four cycles (2000, 2006, 2012, and 2016) of the School Health Policies and Practices Study, a national survey periodically conducted to assess policies and practices for ten components of school health, were analyzed in 2017. The survey collected data related to counseling, psychological, and social services among nationally representative samples of school districts using online or mailed questionnaires. Sampled districts identified respondents responsible for or most knowledgeable about the content of each questionnaire. The percentage of districts with a district-level counseling, psychological, and social services coordinator increased significantly from 62.6% in 2000 to 79.5% in 2016. In 2016, 56.3% of districts required each school to have someone to coordinate counseling, psychological, and social services at the school. Fewer districts required schools at each level to have a specified ratio of counselors to students (16.2% for elementary schools, 16.8% for middle schools, and 19.8% for high schools), and the percentage of districts with these requirements has decreased significantly since 2012. Increases in the prevalence of district-level staffing policies could help increase the quantity and quality of counseling, psychological, and social services staff in schools nationwide, which in turn could improve mental and behavioral health outcomes for students. This article is part of a supplement entitled The Behavioral Health Workforce: Planning, Practice, and Preparation, which is sponsored by the Substance Abuse and Mental Health Services Administration

  7. THE TAX CONTROL AS A COMPONENT OF TAX ADMINISTRATION

    Directory of Open Access Journals (Sweden)

    Olga Zhuk

    2017-03-01

    Full Text Available In the article the features of tax control in the system of taxes administration were investigated. The basic approaches to the determination of tax control were defined. Principles of tax control that must be kept were defined and it will ensure efficiency and effectiveness of tax control. Basic forms of tax control were characterized. An advantages of horizontal monitoring that is one of the form of tax controls were directed. Key words: tax control, tax control forms, horizontal monitoring, documentaries, desk and actual checks.

  8. Does a higher income have positive health effects? Using the earned income tax credit to explore the income-health gradient.

    Science.gov (United States)

    Larrimore, Jeff

    2011-12-01

    The existence of a positive relationship between income and morbidity has been well documented in the literature. But it is unclear whether the relationship is positive because increased income allows individuals to purchase more health inputs that improve their health, because healthy individuals are more productive and thus can earn higher wages in the labor market, or because a third factor is improving health and increasing income. This article explores whether increases in income improve the health of the low-income population. Because health status may affect income, this article uses an "instrumental variable" strategy that considers income variations over seventeen years of changes in the generosity of state and federal Earned Income Tax Credits (EITC, a measure that should be exogenous to health status). I measured health status using both the self-reported health status and the functional limitations indicated on the Survey of Income and Program Participation (SIPP), as well as the self-reported health status indicated on the March Current Population Survey (CPS). I found only limited support for the theory that the relationship between income and morbidity is derived from shifts in income. Although I did observe a correlation between income and self-reported health, I found no evidence that increases in income significantly improve self-reported health statuses. In addition, while increases in income appear to reduce the prevalence of hearing limitations when using corrective measures, these increases did not have a significant effect on most of the other functional limitations considered here. These findings suggest that the ability to improve short-term health outcomes through public transfer payments may be limited. However, the lifetime effects on the health of people with higher incomes would still be a valuable avenue for future research. © 2011 Milbank Memorial Fund.

  9. Does a Higher Income Have Positive Health Effects? Using the Earned Income Tax Credit to Explore the Income-Health Gradient

    Science.gov (United States)

    Larrimore, Jeff

    2011-01-01

    Context The existence of a positive relationship between income and morbidity has been well documented in the literature. But it is unclear whether the relationship is positive because increased income allows individuals to purchase more health inputs that improve their health, because healthy individuals are more productive and thus can earn higher wages in the labor market, or because a third factor is improving health and increasing income. This article explores whether increases in income improve the health of the low-income population. Methods Because health status may affect income, this article uses an “instrumental variable” strategy that considers income variations over seventeen years of changes in the generosity of state and federal Earned Income Tax Credits (EITC, a measure that should be exogenous to health status). I measured health status using both the self-reported health status and the functional limitations indicated on the Survey of Income and Program Participation (SIPP), as well as the self-reported health status indicated on the March Current Population Survey (CPS). Findings I found only limited support for the theory that the relationship between income and morbidity is derived from shifts in income. Although I did observe a correlation between income and self-reported health, I found no evidence that increases in income significantly improve self-reported health statuses. In addition, while increases in income appear to reduce the prevalence of hearing limitations when using corrective measures, these increases did not have a significant effect on most of the other functional limitations considered here. Conclusions These findings suggest that the ability to improve short-term health outcomes through public transfer payments may be limited. However, the lifetime effects on the health of people with higher incomes would still be a valuable avenue for future research. PMID:22188352

  10. Tax on sugar sweetened beverages in Spain.

    Science.gov (United States)

    Ortún, Vicente; G López-Valcárcel, Beatriz; Pinilla, Jaime

    2016-10-13

    This article provides a critical review about the challenges that taxes on sugary drinks as an instrument of health policy must face to reverse the trend of the current epidemics of obesity. We analyzed the experiences of the leading countries, particularly Mexico, and reflect on the counterweight exerted by the industry against obesity policies, and on the power of lobbyists. Those tax policies for public health have to overcome the enormous strength of the industry, which is exerted in several-science and research, brand reputation, influence on regulators-levels. We suggest that a specific tax on sugary drinks has enough potential to reduce noncommunicable diseases and risk -diabetes, Hypertriglyceridemia, hyperholesterolemia LDL, hypertension- via reduced consumption thanks to the high price elasticity of those drinks. Furthermore, the effects are amplified even in the medium term, once established new habits to healthier eating. These taxes could encourage business innovation without inflicting costs of lost jobs and contribute to reducing the social gradient in obesity.

  11. Bureaucratic Tax-Seeking: The Danish Waste Tax

    OpenAIRE

    Christoffersen, Henrik; Svendsen, Gert Tinggaard

    2000-01-01

    Two main results in traditional tax theory states the following. First, general taxes minimize the welfare loss from changed relative prices. Second, because the total public budget tends to exceed the optimal size, a leader (here named 'troop leader') is needed in the budget process to prevent over-taxation. Nevertheless, differentiated taxes initiated by individual ministries generate a still larger proportion of total tax revenue, in particular under cover of taxing externalities such as e...

  12. The Impact of Tax Incentives on Research and Development

    Directory of Open Access Journals (Sweden)

    Petr Svoboda

    2017-01-01

    Full Text Available The goal of this article is to analyze the impact of tax incentives on research and development and compare its effectiveness to direct government support of research and development. The analysis is based on regression analysis, which compares effect of tax incentives for research and development and direct government support (as percentage of GDP in 28 countries of OECD in 2013 on innovative effectiveness of these countries measured by number of registered triadic patent families per billion GDP in the same year. Results suggest that tax incentives are more effective form of research and development support than direct government funding. Research also revealed interesting case of Switzerland’s research and development performance backed by almost none government support, which should be subject to future study.

  13. Nursing teamwork, staff characteristics, work schedules, and staffing.

    Science.gov (United States)

    Kalisch, Beatrice J; Lee, Hyunhwa

    2009-01-01

    This study aimed to explore whether and how staff characteristics, staffing, and scheduling variables are associated with the level of teamwork in nursing staff on acute care hospital patient units. This was a cross-sectional study with a sample of 1,758 nursing staff members from two different hospitals on 38 patient care units who completed the Nursing Teamwork Survey in 2008. This study focused on nursing teams who are stationed on a particular patient care unit (as opposed to visitors to the units). The return rate was 56.9%. The sample was made up of 77.4% nurses (registered nurses and licensed practical nurses), 11.9% assistive personnel, and 7.9% unit secretaries. Teamwork varied by unit and service type, with the highest scores occurring in pediatrics and maternity and the lowest scores on the medical-surgical and emergency units. Staff with less than 6 months of experience, those working 8- or 10-hour shifts (as opposed to 12 hours or a combination of 8 and 12 hours), part-time staff (as opposed to full time), and those working on night shift had higher teamwork scores. The higher teamwork scores were also associated with no or little overtime. The higher perception of the adequacy of staffing and the fewer patients cared for on a previous shift, the higher the teamwork scores. There is a relationship between selected staff characteristics, aspects of work schedules, staffing, and teamwork. Nursing staff want to work where teamwork is high, and perceptions of good staffing lead to higher teamwork. Higher teamwork scores correlated with those who worked less overtime.

  14. Integrating ICT Skills and Tax Software in Tax Education: A Survey of Malaysian Tax Practitioners' Perspectives

    Science.gov (United States)

    Ling, Lai Ming; Nawawi, Nurul Hidayah Ahamad

    2010-01-01

    Purpose: This study aims to examine the ICT skills needed by a fresh accounting graduate when first joining a tax firm; to find out usage of electronic tax (e-tax) applications in tax practice; to assess the rating of senior tax practitioners on fresh graduates' ICT and e-tax applications skills; and to solicit tax practitioners' opinion regarding…

  15. Bureaucratic Tax-Seeking: The Danish Waste Tax

    DEFF Research Database (Denmark)

    Christoffersen, Henrik; Svendsen, Gert Tinggaard

    2000-01-01

    Two main results in traditional tax theory states the following. First, general taxes minimize the welfare loss from changed relative prices. Second, because the total public budget tends to exceed the optimal size, a leader (here named 'troop leader') is needed in the budget process to prevent...... over-taxation. Nevertheless, differentiated taxes initiated by individual ministries generate a still larger proportion of total tax revenue, in particular under cover of taxing externalities such as environmental pollution. We suggest that this situation leads to over-taxation for two reasons. First......, the absence of a strong and fully informed troop leader prevents rational coordination of collective action. Second, budget maximization leads to overwhelming fiscal pressure because bureaucracies are competing about resources just like fishermen or hunters (here named 'bureaucratic tax-seeking'). Taxing...

  16. INCREASE TAX BASE AS INDICATOR OF SUSTAINABLE DEVELOPMENT COMPANIES

    Directory of Open Access Journals (Sweden)

    V. Iu. Padalkin

    2014-01-01

    Full Text Available Summary. The article analyzed the tax burden as an indicator of growth of production and security of financial activity of working capital. The most important duty of the enterprise - the taxpayer in accordance with paragraph 1 of art. 3 of the Tax Code of the Russian Federation is the responsibility to pay the legally established taxes and fees. However, according to article 45 of the Tax Code to claim 1 tax liability must be carried out within the period prescribed by law. Under the tax in accordance with paragraph 1 of article 8 of the Tax Code is understood mandatory, individually gratuitous payment collected from organizations and individuals in the form of alienation of their right to property, economic or operational management of funds for financial support of the state and (or municipalities. Tax regulation - measures the indirect impact on the economy of the state, economic and social processes by changing the types of taxes, tax rates, tax incentives to establish, reduce or increase the overall level of tax payments to the budget. So, tax cuts can stimulate production, and raising taxes - to restrain or even suppress some activities.

  17. A Stochastic After-Taxes Optimisation Model to Support Distribution Network Strategies

    DEFF Research Database (Denmark)

    Fernandes, Rui; Hvolby, Hans-Henrik; Gouveia, Borges

    2012-01-01

    The paper proposes a stochastic model to integrate tax issues into strategic distribution network decisions. Specifically, this study will explore the role of distribution models in business profitability, and how to use the network design to deliver additional bottom-line results, using...... distribution centres located in different countries. The challenge is also to reveal how financial and tax knowledge can help logistic leaders improving the value to their companies under global solutions and sources of business net profitability in a dynamic environment. In particular, based on inventory...

  18. Globalization, Tax Competition and Tax Burden İn Turkey

    Directory of Open Access Journals (Sweden)

    Veli KARGI

    2016-07-01

    Full Text Available 1990’s world was quite different from the world of 1950’s. Especially in the last twenty years, the increasing involvement of Japan in the world economy since the 1990s, in addition to the dominance of globalization and market economy throughout the world, the rapid spread of information resulting from the developments in IT-technology and the international competition emerging in the field of technology have all led to some significant developments in the world economy. Reduction of high mobility income and corporate tax rates due to tax competition may cause an unjust distribution of the tax burden. The fact that indirect taxation constitutes about 70% of the tax revenues obtained in Turkey can be taken as an indication of the unfairness in the distribution of tax burden in Turkey. In this study, following a definition of globalization and tax competition, classification of tax competition, reasons for increasing tax competition, benefits and losses of tax competition are explained, and changes introduced by various countries in their tax systems due to tax competition, the distribution of tax burden resulting from tax competition in Turkey and the effectiveness of the new income tax law in Turkey in terms of tax competition are analyzed.

  19. The effects of nurse staffing on hospital financial performance: competitive versus less competitive markets.

    Science.gov (United States)

    Everhart, Damian; Neff, Donna; Al-Amin, Mona; Nogle, June; Weech-Maldonado, Robert

    2013-01-01

    Hospitals facing financial uncertainty have sought to reduce nurse staffing as a way to increase profitability. However, nurse staffing has been found to be important in terms of quality of patient care and nursing-related outcomes. Nurse staffing can provide a competitive advantage to hospitals and as a result of better financial performance, particularly in more competitive markets. In this study, we build on the Resource-Based View of the Firm to determine the effect of nurse staffing on total profit margin in more competitive and less competitive hospital markets in Florida. By combining a Florida statewide nursing survey with the American Hospital Association Annual Survey and the Area Resource File, three separate multivariate linear regression models were conducted to determine the effect of nurse staffing on financial performance while accounting for market competitiveness. The analysis was limited to acute care hospitals. Nurse staffing levels had a positive association with financial performance (β = 3.3, p = .02) in competitive hospital markets, but no significant association was found in less competitive hospital markets. Hospitals in more competitive hospital markets should reconsider reducing nursing staff, as these cost-cutting measures may be inefficient and negatively affect financial performance.

  20. Simulating the impact on health of internalising the cost of carbon in food prices combined with a tax on sugar-sweetened beverages.

    Science.gov (United States)

    Briggs, Adam D M; Kehlbacher, Ariane; Tiffin, Richard; Scarborough, Peter

    2016-02-03

    Rising greenhouse gas emissions (GHGEs) have implications for health and up to 30 % of emissions globally are thought to arise from agriculture. Synergies exist between diets low in GHGEs and health however some foods have the opposite relationship, such as sugar production being a relatively low source of GHGEs. In order to address this and to further characterise a healthy sustainable diet, we model the effect on UK non-communicable disease mortality and GHGEs of internalising the social cost of carbon into the price of food alongside a 20 % tax on sugar sweetened beverages (SSBs). Developing previously published work, we simulate four tax scenarios: (A) a GHGEs tax of £2.86/tonne of CO2 equivalents (tCO2e)/100 g product on all products with emissions greater than the mean across all food groups (0.36 kgCO2e/100 g); (B) scenario A but with subsidies on foods with emissions lower than 0.36 kgCO2e/100 g such that the effect is revenue neutral; (C) scenario A but with a 20 % sales tax on SSBs; (D) scenario B but with a 20 % sales tax on SSBs. An almost ideal demand system is used to estimate price elasticities and a comparative risk assessment model is used to estimate changes to non-communicable disease mortality. We estimate that scenario A would lead to 300 deaths delayed or averted, 18,900 ktCO2e fewer GHGEs, and £3.0 billion tax revenue; scenario B, 90 deaths delayed or averted and 17,100 ktCO2e fewer GHGEs; scenario C, 1,200 deaths delayed or averted, 18,500 ktCO2e fewer GHGEs, and £3.4 billion revenue; and scenario D, 2,000 deaths delayed or averted and 16,500 ktCO2e fewer GHGEs. Deaths averted are mainly due to increased fibre and reduced fat consumption; a SSB tax reduces SSB and sugar consumption. Incorporating the social cost of carbon into the price of food has the potential to improve health, reduce GHGEs, and raise revenue. The simple addition of a tax on SSBs can mitigate negative health consequences arising from sugar being low in GHGEs. Further

  1. A comparison of current Naval Facilities Engineering Command field office staffing methods, state staffing methods and the construction industry institutes owner contractor work structure

    OpenAIRE

    Monreal, Michael

    2001-01-01

    CIVINS (Civilian Institutions) Thesis document This report was generated by accepting a report topic contained in a list of topics on the Civil Engineer Corps Graduate School Information web page. The topic request and description is noted as follows: Topic. How to Measure Staffing Requirements in ROICC offices and Other Acquisition Functions with a description. Description: We base current staffing requirements on history and only adjust from what we have used in the past years. It is sus...

  2. TAX RESEARCH Financial Accounting versus Tax Accounting - Tax Rules’ Impact on Investment Decisions

    Directory of Open Access Journals (Sweden)

    Dr.Sc. Skender Ahmeti

    2014-02-01

    Full Text Available This paper provides guidance for all those interested in research related to tax. In the study are included three main areas dealing with taxes and about taxes: (1 the role of information in corporation tax expenditures under the rules and laws of the country against financial statements according to international accounting standards, (2 case study PTK; how much effective tax and tax on extra profit has it paid (3 the impact of tax rules on investment decisions - the reasons and profits of the company and the host country. We will try to summarize here the three areas of study and come to some conclusions on how to deal with fiscal policy in Kosovo. In addition, we will offer our opinion on some interesting and important questions for future research.

  3. Capital Income Tax Coordination and the Income Tax Mix

    DEFF Research Database (Denmark)

    Huizinga, Harry; Nielsen, Søren Bo

    2005-01-01

    in the mix of capital and labor taxes brought on by capital income tax coordination can potentially be welfare reducing. This reflects that in a non-cooperative equilibrium capital income taxes may be more distorting from an international perspective than are labor income taxes. Simulations with a simple...... model calibrated to EU public finance data suggest that countries indeed lower their labor taxes in response to higher coordinated capital income taxes. The overall welfare effects of capital income tax coordination, however, are estimated to remain positive.JEL Classification: F20, H87......Europe has seen several proposals for tax coordination only in the area of capital income taxation, leaving countries free to adjust their labor taxes. The expectation is that highercapital income tax revenues would cause countries to reduce their labor taxes. This paper shows that such changes...

  4. Implications of the 2017 Tax Cuts and Jobs Act for Public Health.

    Science.gov (United States)

    Glied, Sherry

    2018-03-22

    The recently passed Tax Cuts and Jobs Act will reduce total federal revenues by about 4% between 2018 and 2027. The law makes multiple changes to the taxation of individuals and corporations. It also repeals the Affordable Care Act's (ACA's) individual mandate penalties, which will erase some of the gains in insurance coverage achieved since implementation of the ACA's coverage expansions. The resulting increases in rates of uninsurance will likely lead to increased uncompensated care and deflect hospitals and health departments from addressing other prevention and public health needs. In addition, the law is expected to lead to substantial increases in the federal debt and, consequently, to calls for reductions in spending on entitlement programs, particularly Medicare, and on discretionary programs, including public health. Many other provisions of the law could also have second-order effects on public health. (Am J Public Health. Published online ahead of print March 22, 2018: e1-e3. doi:10.2105/AJPH.2018.304388).

  5. The Effects of Tax Competition when Politicians Create Rents to Buy Political Support

    DEFF Research Database (Denmark)

    Eggert, Wolfgang; Sørensen, Peter Birch

    We set up a probabilistic voting model to explore the hypothesis that tax competition improves public sector efficiency and social welfare. In the absence of tax base mobility, distortions in the political process induce vote-maximising politicians to create rents to public sector employees...

  6. The effects of tax competition when politicians create rents to buy political support

    DEFF Research Database (Denmark)

    Eggert, Wolfgang; Sørensen, Peter Birch

    2008-01-01

    We set up a probabilistic voting model to explore the hypothesis that tax competition improves public sector efficiency and social welfare. In the absence of tax base mobility, distortions in the political process induce vote-maximising politicians to create rents to public sector employees...

  7. A Study of Japanese Consumption Tax System : Mainly on Multiple Tax Rates and Input Tax Credit Methods

    OpenAIRE

    栗原, 克文

    2007-01-01

    One of the most important discussions on Japanese tax system reform includes how consumption tax (Value-added tax) system ought to be. Facing issues like depopulation, aging society and large budget deficit, consumption tax can be an effective source of revenue to secure social security. This article mainly focuses on multiple tax rates and input tax credit methods of Japanese consumption tax system. Because of regressive nature of consumption tax, tax rate reduction, exemption on foodstuffs ...

  8. Pollution taxes - where are we heading?

    International Nuclear Information System (INIS)

    Ritter, W.

    1996-01-01

    Reshaping the system of taxation towards ecologic objectives by introduction of new, environment-oriented taxes affecting industrial production factors would adversely affect the ecologic and economic progress and in the end would give advocates of this policy the lie. Approaches for amendment of the tax system more strongly implementing environmental policy objectives should rather be based on legal incentives given by the system of taxation for enhanced investments and innovation, as well as pinpointed tax benefits, than on new taxes skimming off the financial means required for investments and innovation. Inudstry has been playing a positive and active part in the efforts for enhanced protection of the environment. Industry's self-commitment programme for greenhouse gas abatement has meant an important step forward. It is now up to the legislator to open up new room for action in support of environmental policy goals, instead of barring the road by new taxes. (orig.) [de

  9. Exchange of Information in Tax Matters

    Directory of Open Access Journals (Sweden)

    Paweł Szwajdler

    2017-01-01

    Full Text Available The main aim of this paper is to present issues related to exchange of tax information. The author focuses on models of exchange of information and boundaries of obligations in reference to above-mentioned problems. Automatic exchange of information, spontaneous exchange of information and exchange of information on request are analysed in this work on the base of OECD Convention on Mutual Administrative Assistance in Tax Matters, Council Directive 2011/16 and OECD Model Agreement on Exchange of Information in Tax Matters. In the summary, it was showed that the most efficient method of exchange of tax information is automatic exchange of information. Furthermore, it was stated that exchange on request can be related to negative phenomenon such as fishing expedition. Spontaneous exchange of information is thought to play only supportive role.  The author also considers that boundaries of exchange of information in tax matters were regulated so as to protect jeopardised raison d’ État.

  10. Comparison of nurse staffing based on changes in unit-level workload associated with patient churn.

    Science.gov (United States)

    Hughes, Ronda G; Bobay, Kathleen L; Jolly, Nicholas A; Suby, Chrysmarie

    2015-04-01

    This analysis compares the staffing implications of three measures of nurse staffing requirements: midnight census, turnover adjustment based on length of stay, and volume of admissions, discharges and transfers. Midnight census is commonly used to determine registered nurse staffing. Unit-level workload increases with patient churn, the movement of patients in and out of the nursing unit. Failure to account for patient churn in staffing allocation impacts nurse workload and may result in adverse patient outcomes. Secondary data analysis of unit-level data from 32 hospitals, where nursing units are grouped into three unit-type categories: intensive care, intermediate care, and medical surgical. Midnight census alone did not account adequately for registered nurse workload intensity associated with patient churn. On average, units were staffed with a mixture of registered nurses and other nursing staff not always to budgeted levels. Adjusting for patient churn increases nurse staffing across all units and shifts. Use of the discharges and transfers adjustment to midnight census may be useful in adjusting RN staffing on a shift basis to account for patient churn. Nurse managers should understand the implications to nurse workload of various methods of calculating registered nurse staff requirements. © 2013 John Wiley & Sons Ltd.

  11. Improvements in nuclear plant staffing resulting from the AP600 design programme

    International Nuclear Information System (INIS)

    Mycoff, C.

    2001-01-01

    The staffing for a single-unit AP600 is estimated to require a staff for operation and maintenance about 32% smaller than current generation power plants of similar size. These staffing reductions are driven primarily by various features incorporated into the AP600 plant design. (author)

  12. Alcohol consumption and Tax Differentials Between Beer, Wine and Spirits

    OpenAIRE

    Henry Saffer

    1989-01-01

    Several public health interest groups in the United States have recently called for equalization of the federal tax on a unit of alcohol in beer, in wine and in spirits. This paper provides some new empirical evidence of what effect alcohol tax differentials have on total alcohol consumption. The data indicate that the greatest decrease in alcohol consumption results from an increase in spirits taxes, followed by beer taxes and then wine taxes. This suggests that the existing generally accept...

  13. Leadership, staffing and quality of care in nursing homes

    Science.gov (United States)

    2011-01-01

    Background Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care. Methods A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively. Results Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (r = 0.78). Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff. Conclusions Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses and quality of care is

  14. Leadership, staffing and quality of care in nursing homes

    Directory of Open Access Journals (Sweden)

    Havig Anders

    2011-11-01

    Full Text Available Abstract Background Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care. Methods A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively. Results Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (r = 0.78. Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff. Conclusions Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses

  15. MACROECONMIC TENDENCIES OF ENVIRONMENTAL TAXES IN

    Directory of Open Access Journals (Sweden)

    Cristea Anca

    2011-12-01

    Full Text Available Reforms of environmental taxes in EU member states began to consolidate a strategic conceptual basis since the early '90s, when it was launched the idea of changing the tax burden from the tax factor of production, work to the environmental factors and use of environmental unfriendly activities and goods. The theoretical support of this view is represented by the corrective taxes Pigou situation justifying the optimal level of activity of producing goods and services from a social perspective, the collection of taxes imposed by the state of polluters, depending on the amount of damage and damage to third parties, the principle of 'polluter pays'. Despite the green fees start reforms of the EU member countries and their levels are not increased in recent years as a share of GDP. In the EU-27, 2008, revenues from environmental taxes represented a rate of about 2.8% of GDP and 6.1% of total revenues compared to 2.9% and 7.0% record share of GDP in 1999. Effects of environmental taxes on eco-efficiency must be seen not only in terms of their size or budget as income tax to GDP ratio, but also as a positive economic and social impact generated by larger beneficial effects of reducing pollution and preserving the quality natural resources and environmental factors.

  16. Different Tax Systems among Nations and International Tax Avoidance

    OpenAIRE

    栗原, 克文

    2008-01-01

    As economic globalization proceeds, tax policies of one nation influence others more and greater pressures are imposed on tax systems and tax administrations.The possibility of tax avoidance will expand if cross-border transactions are abused.Specifically, tax system differentials among countries increase the opportunity for tax avoidance.Under some tax avoidance schemes, foreign entities which have no or little economic substance are used to create artificial losses, so that they can minimiz...

  17. Using payroll deduction to shelter individual health insurance from income tax.

    Science.gov (United States)

    Hall, Mark A; Hager, Christie L; Orentlicher, David

    2011-02-01

    To assess the impact of state laws requiring or encouraging employers to establish "section 125" cafeteria plans that shelter employees' premium contributions from tax. Available descriptive statistics, 65 key-informant interviews, and relevant documents in study states and nationally, 2008-2009. Case studies were conducted in Indiana, Massachusetts, and Missouri--three states adopting laws in 2007. Descriptive quantitative information came from insurers, regulators, and surveys of employers. In each state, 15-17 semistructured but open-ended interviews were conducted with insurance agents, insurers, government officials, and third-party administration firms, and 29 informed sources were interviewed from a national perspective or other states. Key informants were selected based on their known or reported experience, in a "snowball" fashion until saturation was reached. Interview notes were coded for systematic analysis. Finally, relevant rulings, brochures, instructions, marketing materials, and other documents were collected and analyzed. Despite the potential for substantial cost savings, use of section 125 plans to purchase individual insurance remained low in these states after 1 or 2 years. Absent a mandate, few employers were strongly motivated to offer these plans in order to retain an adequate workforce, and uncertainty about federal legality deterred doing so. For smaller employers, benefits to owners did not outweigh administrative complexities. Nevertheless, few downsides were found to states mandating or encouraging these plans. In particular, there is little evidence that many employers dropped group coverage as a result. Section 125 plans remain a limited tool for states to reduce the inequitable tax treatment of individually purchased insurance, but a complete remedy requires reform of federal tax law. © Health Research and Educational Trust.

  18. New tax law hobbles tax-exempt hospitals.

    Science.gov (United States)

    Goldblatt, S J

    1982-03-01

    The Economic Recovery Tax Act of 1981 left tax-exempt hospitals at a significant disadvantage in the competition for capital. Although the new law's accelerated depreciation schedules and liberalized investment tax credits contain some marginal benefits for tax-exempt hospitals, these benefits are probably more than offset by the impact of the law on charitable giving.

  19. Union Women, the Tobacco Industry, and Excise Taxes

    Science.gov (United States)

    Balbach, Edith D.; Campbell, Richard B.

    2009-01-01

    Between 1987 and 1997, the tobacco industry used the issue of cigarette excise tax increases to create a political partnership with the Coalition of Labor Union Women (CLUW), a group representing female trade unionists in the U.S. This paper documents how the industry created this relationship and the lessons tobacco-control advocates can learn from the industry’s example, in order to mitigate possible unintended consequences of advocating excise tax increases In 1998, under the terms of the Master Settlement Agreement, the tobacco industry began making documents produced in litigation available publicly. Currently, approximately 50 million pages are available online, including substantial documentation of the industry–CLUW relationship. For this study, a comprehensive search of these documents was conducted. The tobacco industry encouraged CLUW’s opposition to excise tax increases by emphasizing the economic regressivity of these taxes, discussing excise taxes generically to deflect attention from cigarettes, and encouraging opposition to earmarking cigarette taxes to pay for specific programs. In addition, CLUW received at least $221,500 in financial support between 1987 and 1997 and in-kind support for its conferences, membership materials, and other services. Excise tax increases, if pursued without considering the impacts they may have on low-SES populations, may have unintended consequences. In this case, such proposals may have helped to create a relationship between CLUW and the tobacco industry. Because excise taxes are endorsed in the Framework Convention on Tobacco Control, tobacco-control advocates must understand how to build relationships with low-SES populations and mitigate potential alliances with the tobacco industry. PMID:19591750

  20. The public health benefit of increasing tobacco taxes in New York State.

    Science.gov (United States)

    Cummings, K M; Sciandra, R

    1990-04-01

    The 1989-1990 New York State budget increased the tax on a package of cigarettes from 21 to 33 cents. In this paper we estimate the impact of this tax increase on smoking prevalence and smoking-induced deaths in New York State. Findings show that 115,967 New Yorkers will be encouraged to quit or not start smoking as a result of the increased cigarette tax. The reduced prevalence of smoking attributed to the tax will result in the avoidance of approximately 28,992 premature smoking-induced deaths over the next generation.

  1. From tax evasion to tax planning

    OpenAIRE

    Bourgain, Arnaud; Pieretti, Patrice; Zanaj, Skerdilajda

    2013-01-01

    The aim of this paper is to analyze within a simple model how a re- moval of bank secrecy can impact tax revenues and banks' profitability assuming that offshore centers are able to offer sophisticated but legal or not easily detectable tax planning. Two alternative regimes are considered. A first in which there is strict bank secrecy and a second where there is international information exchange for tax purposes. We show in particular that sharing tax information with onshore coun- tries can...

  2. Determining Nurse Aide Staffing Requirements to Provide Care Based on Resident Workload: A Discrete Event Simulation Model.

    Science.gov (United States)

    Schnelle, John F; Schroyer, L Dale; Saraf, Avantika A; Simmons, Sandra F

    2016-11-01

    Nursing aides provide most of the labor-intensive activities of daily living (ADL) care to nursing home (NH) residents. Currently, most NHs do not determine nurse aide staffing requirements based on the time to provide ADL care for their unique resident population. The lack of an objective method to determine nurse aide staffing requirements suggests that many NHs could be understaffed in their capacity to provide consistent ADL care to all residents in need. Discrete event simulation (DES) mathematically models key work parameters (eg, time to provide an episode of care and available staff) to predict the ability of the work setting to provide care over time and offers an objective method to determine nurse aide staffing needs in NHs. This study had 2 primary objectives: (1) to describe the relationship between ADL workload and the level of nurse aide staffing reported by NHs; and, (2) to use a DES model to determine the relationship between ADL workload and nurse aide staffing necessary for consistent, timely ADL care. Minimum Data Set data related to the level of dependency on staff for ADL care for residents in over 13,500 NHs nationwide were converted into 7 workload categories that captured 98% of all residents. In addition, data related to the time to provide care for the ADLs within each workload category was used to calculate a workload score for each facility. The correlation between workload and reported nurse aide staffing levels was calculated to determine the association between staffing reported by NHs and workload. Simulations to project staffing requirements necessary to provide ADL care were then conducted for 65 different workload scenarios, which included 13 different nurse aide staffing levels (ranging from 1.6 to 4.0 total hours per resident day) and 5 different workload percentiles (ranging from the 5th to the 95th percentile). The purpose of the simulation model was to determine the staffing necessary to provide care within each workload

  3. Tax Law

    NARCIS (Netherlands)

    Schaper, Marcel; Hage, Jaap; Waltermann, Antonia; Akkermans, Bram

    2017-01-01

    Taxes are compulsory, unrequited payments to government. This chapter discusses the goals of taxation and provides an introduction to the most important taxes: taxes on income, taxes on goods and services, and taxes on property. Furthermore, the chapter offers insights to procedural issues of

  4. Staffing and training experience at the Bilibino nuclear power plant

    International Nuclear Information System (INIS)

    Tukhvetov, F.

    2001-01-01

    Bilibino NPP has four 12 MW(e) water cooled graphite moderated channel reactors. The plant has been in operation since 1973 in conditions of isolated local energy system in a remote area with extreme climatic conditions. The plant accounts for almost 70 per cent of energy produced in the region, it also provides heating to the regional centre. The plant's organisational structure is on the whole consistent with the standard structure of other NPPs of ex-USSR. At the same time there are some specific features due to high cost of personnel in the prime cost of the generated energy. As a result a need arises to broaden the task of catering for each worker and, therefore, to extend and increase the level of training. The number of high-quality personnel is on the increase. A method of step-by-step training is widely used at all work areas for training operations personnel. At the end of each step a worker is engaged in independent activities at this work area. When a plant is located in a remote area efficient and effective maintenance becomes highly instrumental. The engineering and design support on the part of the utility and equipment manufacturer begins to play a greater role. Activities to optimise the plant organisational structure were mostly characterised by merging of subdivisions and by some change in the proportion of different categories of personnel. It would be an optimum decision to put all supporting services, namely, logistics, book-keeping and staffing departments, within the utility's authority. Operations experience of the Bilibino plant will certainly be valuable for projection, location choice and staffing of plants with small and medium reactors. (author)

  5. Regional features of the individual income tax

    Directory of Open Access Journals (Sweden)

    L. V. Demina

    2016-01-01

    Full Text Available Tax on income of physical persons according to the method of establishing refers to federal taxes, however, is the establishment of a regional peculiarities. Currently, in accordance with the distribution of taxes between the budgets of the order, the share of this tax in the regional budgets is directly dependent on the level and income level received by the population, to carry on activity in a particular area of the country. The article discusses the possibility of impact on the taxation of income of different categories of individuals from the regions. Since the tax on personal income has expressed toms-social orientation, in the Tax Code of the Russian Federation provided for the regions eligible for the establishment of a number of benefits for certain categories of taxpayers. This article describes the possible impact on the taxation of income of different categories of individuals from the regions by establishing incentives. The issues of granting tariff preferences income owners of private farms on the example of the Moscow region. An important social task of the state related to the support of family and birth rate increase, which is be implemented in the Russian Federation in the framework of the tax on personal income, is exemption from personal income tax funds regional maternal (family capital. The regional legislation can be traced virtually the same position on the determination of the number of children in the case of birth (adoption of which the inhabitants of the region there is a right to additional measures of state support and tax benefits. The data on the size of the analysis of the results of the regional maternity capital and the terms of its provision. We describe the benefits that the regions were able to provide 2016 individuals - payers of personal income tax on income from the sale of real estate. We consider the benefits that are currently install or may be establish by laws of subjects of federation in the

  6. STAFFING DALAM ALQURAN DAN HADIS DITINJAU DARI MANAJEMEN PENDIDIKAN

    Directory of Open Access Journals (Sweden)

    Tuti Andriani

    2016-08-01

    Full Text Available Staffing in an organization can be defined as a series of processes and efforts to acquire, develop, motivate, and evaluate the overall human resources. It is required within the organization in achieving its goals. In staffing, putting a person in a work should be in accordance with his capabilities and expertise so that all are expected to be achieved. Job placement principle is the principle of humanity, democracy, the right man on the right place, equal pay for equal work, unity of direction, the principle of unity of purpose, unity of command, Efficiency and Productivity Work. The concept is the placement, promotion, transfer and demotion. Staffing in the Qur'an and Hadith seen from education management is an employee must complete properly, responsibility, trust, has the capability and expertise, serve, work ethic, strong and trustworthy, honest, sincere, true and trustful, physical and mental strength, and high manners. Professionalism in view of sharia is characterized by three things, namely ahliyah (expertise, himmatul 'charity (high work ethic, trustworthy (reliable.

  7. Early home-supported discharge after stroke

    DEFF Research Database (Denmark)

    Langhorne, P.; Jepsen, Birgitte G.; Larsen, Torben

    2014-01-01

    benefit most are likely to have moderate stroke severity and may be able to cooperate with rehabilitation in the home setting. Staffing requirements will vary according to several factors. These will include (a) the severity and complexity of stroke impairments, (b) the current level of community support......This report is a brief practical problem-based guide to support clinical management in the implementation of early home-supported discharge as an integrated part of stroke care. However, it is clear that skilled members of a multidisciplinary team are needed and they need to work in a coordinated......, (c) the duration of rehabilitation input, and (d) the rehabilitation targets planned. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins....

  8. The Effects of Nurse Staffing on Hospital Financial Performance: Competitive Versus Less Competitive Markets

    Science.gov (United States)

    Everhart, Damian; Neff, Donna; Al-Amin, Mona; Nogle, June; Weech-Maldonado, Robert

    2013-01-01

    Background Hospitals facing financial uncertainty have sought to reduce nurse staffing as a way to increase profitability. However, nurse staffing has been found to be important in terms of quality of patient care and nursing related outcomes. Nurse staffing can provide a competitive advantage to hospitals and as a result better financial performance, particularly in more competitive markets Purpose In this study we build on the Resource-Based View of the Firm to determine the effect of nurse staffing on total profit margin in more competitive and less competitive hospital markets in Florida. Methodology/Approach By combining a Florida statewide nursing survey with the American Hospital Association Annual Survey and the Area Resource File, three separate multivariate linear regression models were conducted to determine the effect of nurse staffing on financial performance while accounting for market competitiveness. The analysis was limited to acute care hospitals. Findings Nurse staffing levels had a positive association with financial performance (β=3.3; p=0.02) in competitive hospital markets, but no significant association was found in less competitive hospital markets. Practice Implications Hospitals in more competitive hospital markets should reconsider reducing nursing staff, as these cost cutting measures may be inefficient and negatively affect financial performance. PMID:22543824

  9. Impact of the application of the Value Added Tax to imaging tests on out-of-pocket health expenses of households in Chile.

    Science.gov (United States)

    Cuadrado, Cristóbal; Silva-Illanes, Nicolás

    2015-12-09

    Out-of-pocket healthcare expense represents a challenge for health systems for it constitutes a barrier to health care, impacting the equality of access to healthcare systems, something particularly important in the Chilean health system. In this context, the Government recently raised the possibility of incorporating a tax on imaging tests, creating debate over its potential consequences. To explore the impact on household out-of-pocket healthcare expense by the implementation of a value added tax to imaging tests in Chile. Cross-sectional study using data of household expenditures from the VII Household Budget Survey. Out-of-pocket healthcare expense and catastrophic household expenses are calculated comparing two scenarios, with and without the inclusion of the proposed tax. Analyses are presented by income deciles to explore the differential equality impact. 42.8% of diagnostic test expense on household corresponds to imaging studies. Under a scenario of tax implementation, a relative increase of 1.1% of out-of-pocket expenses and 2.2% of catastrophic household expenses is observed. The groups that suffer the greatest impact are those with lower income levels, concentrating in the first fifth deciles. We conclude that, although the increase in the average out-of- pocket spending is moderate, this policy may involve a significant increase in the catastrophic expense of the population with the lowest incomes, thereby increasing health inequalities. Considering the challenges of health system financing in Chile, it appears that such fiscal policy would only worsen the possibility of moving towards lower levels of out-of-pocket of household expenses.

  10. Public health systems under attack in Canada: Evidence on public health system performance challenges arbitrary reform.

    Science.gov (United States)

    Guyon, Ak'ingabe; Perreault, Robert

    2016-10-20

    Public health is currently being weakened in several Canadian jurisdictions. Unprecedented and arbitrary cuts to the public health budget in Quebec in 2015 were a striking example of this. In order to support public health leaders and citizens in their capacity to advocate for evidence-informed public health reforms, we propose a knowledge synthesis of elements of public health systems that are significantly associated with improved performance. Research consistently and significantly associates four elements of public health systems with improved productivity: 1) increased financial resources, 2) increased staffing per capita, 3) population size between 50,000 and 500,000, and 4) specific evidence-based organizational and administrative features. Furthermore, increased financial resources and increased staffing per capita are significantly associated with improved population health outcomes. We contend that any effort at optimization of public health systems should at least be guided by these four evidence-informed factors. Canada already has existing capacity in carrying out public health systems and services research. Further advancement of our academic and professional expertise on public health systems will allow Canadian public health jurisdictions to be inspired by the best public health models and become stronger advocates for public health's resources, interventions and outcomes when they need to be celebrated or defended.

  11. 77 FR 40638 - Syniverse Technologies, Inc., Including On-Site Leased Workers From Insight Global Stone Staffing...

    Science.gov (United States)

    2012-07-10

    ..., Inc., Including On-Site Leased Workers From Insight Global Stone Staffing, and Randstad Formerly Known..., Massachusetts, including on-site leased workers from Insight Global, Stone Staffing, Randstad formerly known as... Insight Global, Stone Staffing, Randstad, formerly known as Sapphire Technologies, were employed on-site...

  12. Redistributive Effects of Income Tax Rates and Tax Base 1984-2009: Evidence from Japanese Tax Reforms

    OpenAIRE

    Miyazaki, Takeshi; Kitamura, Yukinobu

    2014-01-01

    The primary objective of this paper is to examine how and to what extent changes in income tax rates and income tax deductions affect income inequality from longitudinal perspectives, by using microdata from Japanese individuals and households. The findings of this paper could shed light on the effects of tax rates and tax deduction on tax progressivity. First, redistributive effects of the Japanese income tax are likely to decline for the period 1984-2009. Second, the income tax reforms, i.e...

  13. Excise Tax Avoidance: The Case of State Cigarette Taxes

    Science.gov (United States)

    DeCicca, Philip; Kenkel, Donald; Liu, Feng

    2013-01-01

    We conduct an applied welfare economics analysis of cigarette tax avoidance. We develop an extension of the standard formula for the optimal Pigouvian corrective tax to incorporate the possibility that consumers avoid the tax by making purchases in nearby lower-tax jurisdictions. To provide a key parameter for our formula, we estimate a structural endogenous switching regression model of border-crossing and cigarette prices. In illustrative calculations, we find that for many states, after taking into account tax avoidance the optimal tax is at least 20 percent smaller than the standard Pigouvian tax that simply internalizes external costs. Our empirical estimate that tax avoidance strongly responds to the price differential is the main reason for this result. We also use our results to examine the benefits of replacing avoidable state excise taxes with a harder-to-avoid federal excise tax on cigarettes. PMID:24140760

  14. Excise tax avoidance: the case of state cigarette taxes.

    Science.gov (United States)

    DeCicca, Philip; Kenkel, Donald; Liu, Feng

    2013-12-01

    We conduct an applied welfare economics analysis of cigarette tax avoidance. We develop an extension of the standard formula for the optimal Pigouvian corrective tax to incorporate the possibility that consumers avoid the tax by making purchases in nearby lower tax jurisdictions. To provide a key parameter for our formula, we estimate a structural endogenous switching regression model of border-crossing and cigarette prices. In illustrative calculations, we find that for many states, after taking into account tax avoidance the optimal tax is at least 20% smaller than the standard Pigouvian tax that simply internalizes external costs. Our empirical estimate that tax avoidance strongly responds to the price differential is the main reason for this result. We also use our results to examine the benefits of replacing avoidable state excise taxes with a harder-to-avoid federal excise tax on cigarettes. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. Staffing to Maximize Profit for Call Centers with Impatient and Repeat-Calling Customers

    Directory of Open Access Journals (Sweden)

    Jun Gong

    2015-01-01

    Full Text Available Motivated by call center practice, we study the optimal staffing of many-server queues with impatient and repeat-calling customers. A call center is modeled as an M/M/s+M queue, which is developed to a behavioral queuing model in which customers come and go based on their satisfaction with waiting time. We explicitly take into account customer repeat behavior, which implies that satisfied customers might return and have an impact on the arrival rate. Optimality is defined as the number of agents that maximize revenues net of staffing costs, and we account for the characteristic that revenues are a direct function of staffing. Finally, we use numerical experiments to make certain comparisons with traditional models that do not consider customer repeat behavior. Furthermore, we indicate how managers might allocate staffing optimally with various customer behavior mechanisms.

  16. Does an Uncertain Tax System Encourage "Aggressive Tax Planning"?

    OpenAIRE

    James Alm

    2014-01-01

    "Aggressive tax planning" (ATP) is typically characterized as a tax scheme that reduces the effective tax rate of a particular type of income to a level below the one sought by fiscal policy for this income. One motivation often suggested for its use is the uncertainty in tax liabilities introduced by a complicated and ever changing tax system. In this paper, I examine the impact of an uncertainty on the use of such tax schemes; by implication, I also examine how a simpler and more stable tax...

  17. Dividends and Taxes: Evidence on Tax-Reduction Strategies.

    OpenAIRE

    Chaplinsky, Susan; Seyhun, H Nejat

    1990-01-01

    This article investigates two aspects of dividend tax avoidance not addressed by prior research. First, it examines the aggregate dividend tax savings provided to individuals through tax-exempt and tax-deferred accumulators. Using the Internal Revenue Service Individual Income Tax Model, it then proceeds to determine whether specific provisions of the Internal Revenue Code, such as the preferential treatment of capital gains, the investment-interest limitation, and the $100 dividend exclusion...

  18. The impact of HMO penetration on the relationship between nurse staffing and quality.

    Science.gov (United States)

    Mark, Barbara A; Harless, David W; McCue, Michael

    2005-07-01

    While there are a number of studies examining the relationship between nurse staffing and quality, none has examined structural differences in the relationship between nurse staffing and quality contingent upon the level of managed care penetration. We used administrative data, and a dynamic panel data model to examine this relationship in a panel of 422 acute care hospitals from 1990 to 1995. We found that there were significant differences in the relationship between nurse staffing and both mortality and length of stay depending upon the level of HMO penetration in the hospital's market.

  19. Health Care Delivery.

    Science.gov (United States)

    Starfield, Barbara

    1987-01-01

    The article reviews emerging health care delivery options for handicapped children. Cost structures, quality of care, and future prospects are considered for Health Maintenance Organizations, Preferred Provider Organizations, Tax Supported Direct Service Programs, Hospital-Based Services, and Ambulatory Care Organizations. (Author/DB)

  20. Is the "alcopops" tax working? Probably yes but there is a bigger picture.

    Science.gov (United States)

    Skov, Steven J; Chikritzhs, Tanya N; Kypri, Kypros; Miller, Peter G; Hall, Wayne D; Daube, Michael M; Moodie, A Rob

    2011-07-18

    The Australian Government's decision to raise taxes on ready-to-drink spirit-based beverages (RTDs; "alcopops") in 2008 caused great controversy. Interest groups have selectively cited evidence to support their points of view. The alcohol industry cited Victorian data from the Australian Secondary Students' Alcohol and Drug Survey (ASSADS) as evidence that the tax had failed, but closer examination of the data suggests that fewer students are drinking, and fewer are drinking at risky or high-risk levels. Excise data from the first full year after the tax came into effect showed a more than 30% reduction in RTD sales and a 1.5% reduction in total pure alcohol sold in Australia. Although understanding the impact of the alcopops tax will require critical analysis of a range of evidence, sales and ASSADS data suggest that the tax has resulted in reduced consumption of RTDs and total alcohol. The most effective and cost-effective measures for reducing consumption and harm are a comprehensive graduated volumetric alcohol taxation system, a minimum price per standard drink, and special measures for particular products that may cause disproportionate harm. While welcoming the alcopops tax, public health advocates have consistently argued for a comprehensive package of reform that covers pricing, availability and promotion of alcohol, as well as education and treatment services.

  1. [Impact of Increased Supply of Newly Licensed Nurses on Hospital Nurse Staffing and Policy Implications].

    Science.gov (United States)

    Kim, Yunmi; You, Sunju; Kim, Jinhyun

    2017-12-01

    This study aimed to analyze the impact of increasing the supply of newly licensed nurses on improving the hospital nurse staffing grades for the period of 2009~2014. Using public administrative data, we analyzed the effect of newly licensed nurses on staffing in 1,594 hospitals using Generalized Estimating Equation (GEE) ordered logistic regression, and of supply variation on improving staffing grades in 1,042 hospitals using GEE logistic regression. An increase of one newly licensed nurse per 100 beds in general units had significantly lower odds of improving staffing grades (grades 6~0 vs. 7) (odds ratio=0.95, p=.005). The supply of newly licensed nurses increased by 32% from 2009 to 2014, and proportion of hospitals whose staffing grade had improved, not changed, and worsened was 19.1%, 70.1%, and 10.8% respectively. Compared to 2009, the supply variation of newly licensed nurses in 2014 was not significantly related to the increased odds of improving staffing grades in the region (OR=1.02, p=.870). To achieve a balance in the regional supply and demand for hospital nurses, compliance with nurse staffing legislation and revisions in the nursing fee differentiation policy are needed. Rather than relying on increasing nurse supply, retention policies for new graduate nurses are required to build and sustain competent nurse workforce in the future. © 2017 Korean Society of Nursing Science

  2. 77 FR 63872 - Alternative Management Resources, Inc., Doepker Group, Inc., D.B.A. Time Staffing, Inc...

    Science.gov (United States)

    2012-10-17

    ... Resources, Inc., Doepker Group, Inc., D.B.A. Time Staffing, Inc., Personnel Management Group, Inc...., Doepker Group, Inc., D.B.A. Time Staffing, Inc., Personnel Management Group, Inc., Select Staffing, and... follows: ''All workers of Alternative Management Resources, Inc., Doepker Group, Inc., D.B.A. Time...

  3. Banking deregulation and corporate tax avoidance

    Directory of Open Access Journals (Sweden)

    Bill B. Francis

    2017-06-01

    Full Text Available We investigate whether tax avoidance substitutes for external financing. We exploit interstate banking deregulation as a quasi-external shock to examine whether firms engage in less tax avoidance after banking deregulation, because of cheaper and easier access to credit from banks. We find no empirical evidence to support this substitutive relation, even for firms with higher financial constraints or firms with higher external financing dependence.

  4. Gender differences in public perceptions on National Health Insurance

    African Journals Online (AJOL)

    through removing financial barriers to health services.2-4. The .... services were free. Support for NHI was stronger among females than males (Table 2): a higher proportion of females than males preferred NHI to holding down taxes (76.1% v. 70.0%), and .... NHI tax may have little impact on the demand for private health ...

  5. CEO Power, Corporate Tax Avoidance and Tax Aggressiveness

    OpenAIRE

    GATOT SOEPRIYANTO

    2017-01-01

    My thesis investigates the association between CEO power, corporate tax avoidance and tax aggressiveness, using two organizational theory perspectives: self-interest and stewardship. I find that a powerful CEO engages in less corporate tax avoidance activities, which lends credence to the risk minimization motive of the stewardship perspective. My findings on the association between CEO power and tax aggressiveness show that powerful CEOs avoid risky tax avoidance strategies that expose a fir...

  6. Contribution retribution. Health system, CEO must pay excise taxes after pressuring workers to help fund state association's PAC through payroll deductions.

    Science.gov (United States)

    Taylor, Mark

    2004-11-22

    The IRS wants not-for-profit health systems to remember to keep their distance from politics--it's taxing the payroll contributions at one system that went to a state hospital association's PAC. Kenneth Robbins, left, says hospitals should always be conscious of activities that could jeopardize their tax-exempt status. "It's an issue we've been concerned with as long as I can remember," he says.

  7. Public willingness to pay for a US carbon tax and preferences for spending the revenue

    Science.gov (United States)

    Kotchen, Matthew J.; Turk, Zachary M.; Leiserowitz, Anthony A.

    2017-09-01

    We provide evidence from a nationally representative survey on Americans’ willingness to pay (WTP) for a carbon tax, and public preferences for how potential carbon-tax revenue should be spent. The average WTP for a tax on fossil fuels that increases household energy bills is US177 per year. This translates into an average WTP of 14% more on average for households across the United States, where energy costs differ significantly across states. Regarding the tax revenues, Americans are most in support of using the money to invest in clean energy and infrastructure. There is relatively less support for reducing income or payroll taxes, returning dividends to households, and other expenditure categories. Finally, Americans support using the tax revenues to assist displaced workers in the coal industry enough to compensate each miner nearly US146 000 upon passage of a carbon tax.

  8. Tax Planning Implementation on Income Tax, Article 23 as A Legal Effort To Minimize Tax Expense Payable

    Directory of Open Access Journals (Sweden)

    Achmad Daengs GS

    2017-03-01

    Full Text Available An effort to minimize tax burden can be done in various ways start from inside the scope of taxation regulation to violate the taxation regulation. This research focuses on related Laws with the efforts to minimize Income tax. In general tax planning referred to engineered the business process and tax payer transaction. The aim is tax payable in minimal number but under taxation regulation scope. The outline of this study focus on planning effort of Tax Income Article 23 to minimize tax expense payable run in PT. TRIPERKASA AMININDAH Surabaya. Tax planning that done in this company refer to provision  in accordance with  Directorate General of Tax Decision Number : Kep-305/PJ/2001 on the estimates of nett income. Tax planning had done by this company in addition to refer the regulation also based on the condition of this company which experiencing poor performance. Then the aim that will be reached from that tax planning to reach minimal expense over the Income Tax Article 23 it can be done with gross up method. From the analysis result on the alternative it can draw a conclusion that PT. TRIPERKASA AMININDAH  Surabaya  has made adjustments on the regulation above, calculation of Income Tax Article 23 with gross up method in fact be able to saving the tax then suitable with the tax planning aim that is effort to minimize tax expense payable.

  9. Tax_Unit_Certification_Final_2012

    Data.gov (United States)

    Kansas Data Access and Support Center — The Statewide GIS Tax Unit boundary file was created through a collaborative partnership between the State of Kansas Department of Revenue Property Valuation...

  10. Tax_Units_Certification_2013_0301

    Data.gov (United States)

    Kansas Data Access and Support Center — The Statewide GIS Tax Unit boundary file was created through a collaborative partnership between the State of Kansas Department of Revenue Property Valuation...

  11. The “Cadillac Tax” on Health Benefits in the United States Will Hit the Middle Class Hardest: Refuting the Myth That Health Benefit Tax Subsidies Are Regressive.

    Science.gov (United States)

    Woolhandler, Steffie; Himmelstein, David U

    2016-01-01

    U.S. employment-based health benefits are exempt from income and payroll taxes, an exemption that provided tax subsidies of $326.2 billion in 2015. Both liberal and conservative economists have denounced these subsidies as “regressive” and lauded a provision of the Affordable Care Act—the Cadillac Tax—that would curtail them. The claim that the subsidies are regressive rests on estimates showing that the affluent receive the largest subsidies in absolute dollars. But this claim ignores the standard definition of regressivity, which is based on the share of income paid by the wealthy versus the poor, rather than on dollar amounts. In this study, we calculate the value of tax subsidies in 2009 as a share of income for each income quintile and for the wealthiest Americans. In absolute dollars, tax subsidies were highest for families between the 80th and 95th percentiles of family income and lowest for the poorest 20%. However, as shares of income, subsidies were largest for the middle and fourth income quintiles and smallest for the wealthiest 0.5% of Americans. We conclude that the tax subsidy to employment-based insurance is neither markedly regressive, nor progressive. The Cadillac Tax will disproportionately harm families with (2009) incomes between $38,550 and $100,000, while sparing the wealthy.

  12. Staffing the Global Organization: "Cultural Nomads"

    Science.gov (United States)

    McPhail, Ruth; Fisher, Ron; Harvey, Michael; Moeller, Miriam

    2012-01-01

    This article explores the evolution of international staffing in an increasingly globalized and hypercompetitive marketplace. As the issue of staff retention becomes critical in global organizations, it is important to understand the types of managers that may be on or assigned to overseas assignments. The purpose of this article is to present a…

  13. Entrepreneur's Choice of Tax Base: Earned or Capital Income?

    OpenAIRE

    Jouko Ylä-Liedenpohja

    2002-01-01

    The determination of the entrepreneur’s tax burden in the dual income tax system is studied. The dual system taxes income from capital at a flat rate, but earned income at progressive rates. The media view claims the entrepreneur to be able to take his pay as favourably taxed income from capital. It is shown not to be supported by the recent data nor by deductive analysis in case of start-ups when (i) proper opportunity costs of the outside employment option and (ii) the financial capital tie...

  14. Sugary beverage tax policy: lessons learned from tobacco.

    Science.gov (United States)

    Pomeranz, Jennifer L

    2014-03-01

    Excise taxes on sugary beverages have been proposed as a method to replicate the public health success of tobacco control and to generate revenue. As policymakers increase efforts to pass sugary beverage taxes, they can anticipate that manufacturers will emulate the strategies employed by tobacco companies in their attempts to counteract the impact of such taxes. Policymakers should therefore consider 2 complementary laws-minimum price laws and prohibitions on coupons and discounting-to accomplish the intended price increase.

  15. The Politics of Local Tax Policy-Making in Poland

    Directory of Open Access Journals (Sweden)

    Swianiewicz Paweł

    2016-06-01

    To what extent is tax policy an important item of the local political agenda in Polish municipalities ? Is it a subject of intense debates at city hall and local councils or is it accepted as a routine exercise ? The results suggest that the issues related to local taxes play a relatively marginal role compared to issues such as the location of major investments. However, the importance of taxes in local debates increases in those local communities in which the tax yields collected are larger and in the case of those taxes which are paid by a wider group of tax payers.Who governs in local tax-policy-making ? According to local provisions the proposal of tax resolution is submitted by the mayor, and the local council makes the final decision. But empirical findings suggest that the practice follows the “strong mayor” model, in which the local political leader, supporter by his staff of the financial department, is more influential than the councilors.

  16. Development of Staffing Patterns in Six New Medical Schools Established 1952-1960.

    Science.gov (United States)

    National Institutes of Health (DHEW), Bethesda, MD. Resources Analysis Branch.

    This summary report of staffing patterns in 6 medical schools established between 1952 and 1960 is the first phase of a proposed study of biomedical staffing requirements in institutions of higher education, 1965-1975. The 6 schools are: the University of Miami, Albert Einstein College of medicine at Yeshiva University, the University of Florida,…

  17. Worthy Work, Unlivable Wages: The National Child Care Staffing Study, 1988-1997.

    Science.gov (United States)

    Whitebook, Marcy; Howes, Carollee; Phillips, Deborah

    In 1988, the National Child Care Staffing Study first gathered information on staffing and quality from a sample of child care centers in five metropolitan areas--Atlanta, Boston, Detroit, Phoenix, and Seattle--and returned for updated information in 1992. In 1997, directors of the original sample of centers still in operation were contacted again…

  18. The relationship between alcohol taxes and binge drinking: evaluating new tax measures incorporating multiple tax and beverage types.

    Science.gov (United States)

    Xuan, Ziming; Chaloupka, Frank J; Blanchette, Jason G; Nguyen, Thien H; Heeren, Timothy C; Nelson, Toben F; Naimi, Timothy S

    2015-03-01

    U.S. studies contribute heavily to the literature about the tax elasticity of demand for alcohol, and most U.S. studies have relied upon specific excise (volume-based) taxes for beer as a proxy for alcohol taxes. The purpose of this paper was to compare this conventional alcohol tax measure with more comprehensive tax measures (incorporating multiple tax and beverage types) in analyses of the relationship between alcohol taxes and adult binge drinking prevalence in U.S. states. Data on U.S. state excise, ad valorem and sales taxes from 2001 to 2010 were obtained from the Alcohol Policy Information System and other sources. For 510 state-year strata, we developed a series of weighted tax-per-drink measures that incorporated various combinations of tax and beverage types, and related these measures to state-level adult binge drinking prevalence data from the Behavioral Risk Factor Surveillance System surveys. In analyses pooled across all years, models using the combined tax measure explained approximately 20% of state binge drinking prevalence, and documented more negative tax elasticity (-0.09, P = 0.02 versus -0.005, P = 0.63) and price elasticity (-1.40, P tax. In analyses stratified by year, the R-squares for models using the beer combined tax measure were stable across the study period (P = 0.11), while the R-squares for models rely only on volume-based tax declined (P tax measures, combined tax measures (i.e. those incorporating volume-based tax and value-based taxes) yield substantial improvement in model fit and find more negative tax elasticity and price elasticity predicting adult binge drinking prevalence in U.S. states. © 2014 Society for the Study of Addiction.

  19. IRS’ Administration of the Crude Oil Windfall Profit Tax Act of 1980.

    Science.gov (United States)

    1984-06-18

    because the windfall profit tax is deductible on both individual and corporate income tax returns and thus reduces the producer’s income tax liability...examinations generally are about 3 years more current than corporate income tax examinations, cross-tax-year coordina- - S . tion is needed to avoid...annual individual or corporate income tax return. In any case, taxpayers summarize the supporting net income limitation calculation on Form 6249

  20. A choice experiment on tax: Are income and consumption taxes equivalent?

    OpenAIRE

    Kurokawa, Hirofumi; Mori, Tomoharu; Ohtake, Fumio

    2016-01-01

    We test the equivalence of income and consumption taxes through a choice experiment. Under a given set of income and consumption parameters, subjects were asked to choose among an income tax of 20%, a consumption tax of 25% (which is an equivalent tax burden), a consumption tax of 22%, and a consumption tax of 20%. Our results showed that subjects prefer income tax to consumption tax when the nominal consumption tax rate is higher than the nominal income tax rate. However, subjects tend to pr...

  1. Taxing Sugar-Sweetened Beverages: Not a “Holy Grail” but a Cup at Least Half; Comment on “Food Taxes: A New Holy Grail?”

    Directory of Open Access Journals (Sweden)

    Jason Block

    2013-01-01

    Full Text Available In this commentary, we argue for the implementation of a sugar-sweetened beverage (SSB tax as a tool to help address the global obesity and diabetes epidemics. Consumption of SSBs has increased exponentially over the last several decades, a trend that has been an important contributor to the obesity and diabetes epidemics. Prior evidence demonstrates that a SSB tax will likely decrease SSB consumption without significantly increasing consumption of other unhealthy food or beverages. Further, this tax is unlikely to have effects on income inequality and should not contribute to weight-based discrimination. A SSB tax also should raise revenue for government entities that already pay, through health care expenditures and health programs, for the consequences of excess SSB consumption.

  2. Tax competition and tax harmonization in the European Union

    Directory of Open Access Journals (Sweden)

    Danuše Nerudová

    2004-01-01

    Full Text Available The article deals with the problems of tax competition and harmonization within the European Union. It reveals the single difficulties connected with harmonization, identifies the problems arising from tax competition and points out the harmful tax competition as well. Single compulsory harmonized tax base in connection with prevailing tax competition in the area of tax rates is the suggested solution in the scope of direct taxation. As the solution in the area of indirect taxation could serve the introduction of “principle of origin”. This would cause remarkable administrative costs decrease not only for economic subjects but for tax authorities as well.

  3. THE IMPLICATIONS OF TAX MORALE ON TAX COMPLIANCE BEHAVIOR

    Directory of Open Access Journals (Sweden)

    Nichita Ramona-Anca

    2012-07-01

    Full Text Available The present paper focuses on the analysis of tax compliance behavior from the tax morale standpoint. We grounded our research on the idea that empirical studies constantly invalidating the assumptions of theoretical models of tax evasion show there are more factors influencing compliance than just the economic ones (e.g., audit probability, fine, tax rate, income. Giving the fact that audit probabilities are generally very low and that tax evasion is not as high as one could expect, tax morale might have to do with the high degrees of tax compliance registered around the world. In a stream of articles on taxation published beginning with the late 60n#8217;s, tax morale defined as the intrinsic motivation to comply or n#8220;internalised obligation to pay taxn#8221; (Braithwaite and Ahmed 2005 has been found to positively relate to tax compliance and negatively relate to shadow economy. This paper attempts to offer a broader view on the influence of tax morale on compliance behavior, covering articles ranging from national and cross-cultural surveys to experimental games. Moreover, the aim of the article is to emphasize the policy implications of tax morale research and the changes governments could make in order to raise the amount of public levies.

  4. Aggressive Tax Strategies and Corporate Tax Governance: An Institutional Approach

    OpenAIRE

    Garbarino, Carlo

    2009-01-01

    This paper deals with the impact of tax-aggressive strategies on corporate governance by adopting an agency perspective of the firm and discusses how certain corporate tax governance measures may limit these kinds of managerial actions. We first clarify a few basic concepts such as tax minimization, effective tax planning, tax avoidance, and tax evasion, which are important to understand in the discussion about aggressive tax behaviour. We further define the regulative concept of effective ta...

  5. The green treasure. Fifteen tax proposals for the environment and innovation

    International Nuclear Information System (INIS)

    Wit, R.; De Vries, J.

    2006-10-01

    The Dutch environmental organization 'Natuur en Milieu' (Nature and the Environment) proposes new taxes to protect and improve the environment by means of innovative means. The proposals can be subdivided over (1) taxes from which both the environment and the Dutch National Treasury will profit; (2) taxes that support the environment and are neutral for the treasury; and (3) stimulation of greening of taxes in a European context [nl

  6. Effects of state-level Earned Income Tax Credit laws in the U.S. on maternal health behaviors and infant health outcomes.

    Science.gov (United States)

    Markowitz, Sara; Komro, Kelli A; Livingston, Melvin D; Lenhart, Otto; Wagenaar, Alexander C

    2017-12-01

    The purpose of this paper is to investigate the effects of state-level Earned Income Tax Credit (EITC) laws in the U.S. on maternal health behaviors and infant health outcomes. Using multi-state, multi-year difference-in-differences analyses, we estimated effects of state EITC generosity on maternal health behaviors, birth weight and gestation weeks. We find little difference in maternal health behaviors associated with state-level EITC. In contrast, results for key infant health outcomes of birth weight and gestation weeks show small improvements in states with EITCs, with larger effects seen among states with more generous EITCs. Our results provide evidence for important health benefits of state-level EITC policies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Public acceptance for environmental taxes: Self-interest, environmental and distributional concerns

    International Nuclear Information System (INIS)

    Kallbekken, Steffen; Saelen, Hakon

    2011-01-01

    While strongly recommended by economists, it has often been politically difficult to impose taxes on externalities. There is a substantial literature on public attitudes towards environmental taxes. There has, however, been few comprehensive attempts to understand attitudes towards environmental taxes. The main research question in this paper is which factors influence support for fuel taxation. We propose a model of attitudes towards fuel taxation, and test this model as well as more specific hypotheses, using data from a representative survey of the adult Norwegian population. Our results suggest that support for fuel taxation is best predicted by beliefs about environmental consequences, followed by beliefs about consequences to others. Beliefs about consequences to self (self-interest) is the factor that explains the least variation in support for fuel taxation. The academically interesting result that support cannot be well explained without capturing a broad range of motivational factors is also highly policy relevant. It implies that there is no magic formula for increasing public support for environmental taxes. There are, however, some issues which can be addressed: trust in how well the government spends the revenue, and the perception that taxation does very little to change behaviour and thus to reduce environmental problems. - Research highlights: → Which factors influence support for fuel taxation? → We test a model of attitudes towards fuel taxes with data from a Norwegian survey. → Support for fuel taxation best predicted by beliefs about environmental consequences. → Support for fuel taxation followed by beliefs about consequences to others. → Self-interest is the factor that explains the least variation in support.

  8. Public acceptance for environmental taxes: Self-interest, environmental and distributional concerns

    Energy Technology Data Exchange (ETDEWEB)

    Kallbekken, Steffen, E-mail: steffen.kallbekken@cicero.uio.n [CICERO Center for International Climate and Environmental Research-Oslo, PO Box 1129 Blindern, 0318 Oslo (Norway); Saelen, Hakon [CICERO Center for International Climate and Environmental Research-Oslo, PO Box 1129 Blindern, 0318 Oslo (Norway)

    2011-05-15

    While strongly recommended by economists, it has often been politically difficult to impose taxes on externalities. There is a substantial literature on public attitudes towards environmental taxes. There has, however, been few comprehensive attempts to understand attitudes towards environmental taxes. The main research question in this paper is which factors influence support for fuel taxation. We propose a model of attitudes towards fuel taxation, and test this model as well as more specific hypotheses, using data from a representative survey of the adult Norwegian population. Our results suggest that support for fuel taxation is best predicted by beliefs about environmental consequences, followed by beliefs about consequences to others. Beliefs about consequences to self (self-interest) is the factor that explains the least variation in support for fuel taxation. The academically interesting result that support cannot be well explained without capturing a broad range of motivational factors is also highly policy relevant. It implies that there is no magic formula for increasing public support for environmental taxes. There are, however, some issues which can be addressed: trust in how well the government spends the revenue, and the perception that taxation does very little to change behaviour and thus to reduce environmental problems. - Research highlights: {yields} Which factors influence support for fuel taxation? {yields} We test a model of attitudes towards fuel taxes with data from a Norwegian survey. {yields} Support for fuel taxation best predicted by beliefs about environmental consequences. {yields} Support for fuel taxation followed by beliefs about consequences to others. {yields} Self-interest is the factor that explains the least variation in support.

  9. Preparing emergency personnel in dialysis: a just-in-time training program for additional staffing during disasters.

    Science.gov (United States)

    Stoler, Genevieve B; Johnston, James R; Stevenson, Judy A; Suyama, Joe

    2013-06-01

    There are 341 000 patients in the United States who are dependent on routine dialysis for survival. Recent large-scale disasters have emphasized the importance of disaster preparedness, including supporting dialysis units, for people with chronic disease. Contingency plans for staffing are important for providing continuity of care for a technically challenging procedure such as dialysis. PReparing Emergency Personnel in Dialysis (PREP-D) is a just-in-time training program designed to train individuals having minimum familiarity with the basic steps of dialysis to support routine dialysis staff during a disaster. A 5-module educational program was developed through a collaborative, multidisciplinary effort. A pilot study testing the program was performed using 20 nontechnician dialysis facility employees and 20 clinical-year medical students as subjects. When comparing pretest and posttest scores, the entire study population showed a mean improvement of 28.9%, with dialysis facility employees and medical students showing improvements of 21.8% and 36.4%, respectively (P just-in-time training format. The knowledge gained by using the PREP-D program during a staffing shortage may allow for continuity of care for critical services such as dialysis during a disaster.

  10. The relationship between alcohol taxes and binge drinking: evaluating new tax measures incorporating multiple tax and beverage types

    Science.gov (United States)

    Xuan, Ziming; Chaloupka, Frank J.; Blanchette, Jason G.; Nguyen, Thien H.; Heeren, Timothy C.; Nelson, Toben F.; Naimi, Timothy S.

    2015-01-01

    Aims U.S. studies contribute heavily to the literature about the tax elasticity of demand for alcohol, and most U.S. studies have relied upon specific excise (volume-based) taxes for beer as a proxy for alcohol taxes. The purpose of this paper was to compare this conventional alcohol tax measure with more comprehensive tax measures (incorporating multiple tax and beverage types) in analyses of the relationship between alcohol taxes and adult binge drinking prevalence in U.S. states. Design Data on U.S. state excise, ad valorem and sales taxes from 2001 to 2010 were obtained from the Alcohol Policy Information System and other sources. For 510 state-year strata, we developed a series of weighted tax-per-drink measures that incorporated various combinations of tax and beverage types, and related these measures to state-level adult binge drinking prevalence data from the Behavioral Risk Factor Surveillance System surveys. Findings In analyses pooled across all years, models using the combined tax measure explained approximately 20% of state binge drinking prevalence, and documented more negative tax elasticity (−0.09, P=0.02 versus −0.005, P=0.63) and price elasticity (−1.40, Ptax. In analyses stratified by year, the R-squares for models using the beer combined tax measure were stable across the study period (P=0.11), while the R-squares for models rely only on volume-based tax declined (Ptax measures, combined tax measures (i.e. those incorporating volume-based tax and value-based taxes) yield substantial improvement in model fit and find more negative tax elasticity and price elasticity predicting adult binge drinking prevalence in U.S. states. PMID:25428795

  11. Legal aspects of Polish Tax and Social Security in Agriculture

    Directory of Open Access Journals (Sweden)

    Agnieszka Parlińska

    2008-12-01

    Full Text Available In the paper are describing legal aspects of treatment of farming sector in the tax and social security system in Poland. Tax System in Polish Agriculture is an integral part of Polish Tax System. Most taxes paid by farmers are property taxes, which supplied the budget of main local authority in Poland (municipality. In some cases farmers pay also personal income tax and value added tax like those, who run specific agricultural production as well individual farmers who operate through a limited liability company are subject to corporate income tax. The social security fund for farmers (known as KRUS was speared in 1990 from the social security system (ZUS. Farmers receive similar benefits with regard to health care, education, and social welfare although the contributions into the farmers system are lower then under the ZUS system.

  12. Overcoming challenges to tax-exempt status.

    Science.gov (United States)

    Wolfson, J

    1996-04-01

    The tax-exempt status of not-for-profit healthcare organizations increasingly is being challenged by private, for-profit, investor-owned organizations. Often, the business practices of not-for-profit organizations are virtually indistinguishable from those of for-profit organizations, and not-for-profit organizations sometimes provide less charity and unfunded care than their for-profit competitors. Moreover, the tax subsidies not-for-profit organizations sometimes are used to support activities that compete with those of for-profit organizations. To withstand challenges to their tax status, financial managers in not-for-profit organizations should assume an active role in developing clearly articulated, empirically based information about the extent of community benefit their organizations provide and its value.

  13. Indigenous and non-indigenous experiences and views of tobacco tax increases: findings from the ITC New Zealand Survey

    Directory of Open Access Journals (Sweden)

    Andrew Waa

    2018-03-01

    While tobacco taxes can reduce smoking, they may have slightly less effect among Māori. This may mean Māori bear a disproportionate amount of burden from tobacco tax. Despite this, there is good support among Māori and non-Māori for ongoing tax increases and use of tobacco tax revenue to support tobacco control interventions. There is good support among smokers for tobacco tax to be used as a strategy to help achieve NZ's tobacco endgame goal.

  14. Tax havens: Features, operations and solving tax evasion problems

    Directory of Open Access Journals (Sweden)

    Obradović-Ćuk Jelena

    2016-01-01

    Full Text Available Tax haven offers minimal or no tax liability to foreign individuals and enterprises in economically and politically stable environment, where little or no financial information is shared with foreign tax authorities. The aim of this research is to create a comprehensive overview of the characteristics and operations of tax havens, as well as to point out to the ways to overcome the problem of tax evasion. The methodology used in the work is characteristic of social science research: analysis, synthesis and discussion, comparative, inductive and historical analysis, together with the usage of relevant national and international sources. This paper describes the basic features of tax havens, as well as specific business models applied in them. A separate chapter deals with overcoming the problem of tax evasion, which is the main adverse effect of doing business through tax havens.

  15. GOODS AND SERVICE TAX ONE NATION ONE TAX IN INDIA.

    OpenAIRE

    Shuchi Sharma; Rupendra Prakash Yadav.

    2018-01-01

    Goods and Service Tax is a significant and logical step towards a comprehensive Indirect tax reform in India. This paper analyses the concept of Goods Service Tax and further discusses their impact on the various sectors in India. Brief description is given on Goods Service Tax background and Goods and Service Tax models helps to reduce tax burden. It aims at creating a single and unified market benefiting both corporate and economy because this is the only Indirect tax that directly affects ...

  16. A North Carolina Model for Improving Rural Health Care: 1/10 Albert Schweitzer, 9/10 ORHS.

    Science.gov (United States)

    Coogan, Mercy Hardie

    1980-01-01

    The article describes North Carolina's precedent setting Office of Rural Health Services, its background and design, and its significant role in the development of primary health care clinics such as that in Balsom Grove which is staffed by a family nurse practitioner and enjoying wide community support. (SB)

  17. Excise tax differences at Oklahoma smoke shops: an opportunity for inter-tribal coordination.

    Science.gov (United States)

    Laux, Fritz L; Chaloupka, Frank J; Beebe, Laura A

    2015-01-01

    Oklahoma's tribal tobacco shops are distributed throughout the state, including in urban areas. During the time frame of this study, state excise tax rates for cigarettes varied by tribe and region, and took five distinct levels, ranging from 5.75 cents to $1.03 per pack. To describe the pricing behavior of these smoke shops in a way that could support potential increases in the tribal taxation of cigarettes within the state. Two waves (2010 and 2011) of site visits were conducted, covering nearly all tribal smoke shops in the northeastern quarter of the state, an area containing the city of Tulsa and 60% of all tribal outlets. Researchers recorded representative prices and verified the tax rate paid (via tax stamp) for each shop. Data were analyzed in 2013. Lower-taxed tribal cigarettes tended to be priced at discounts that were even greater than the differential in tax rates. For example, across waves, the average pack of Marlboros from a shop with a 5.75-cent tax stamp sold for 52 cents less than the same pack from a 25.75-cent shop and 60 cents less than from a 51.5-cent shop. The minimal inter-tribal price response to the discontinuation of large quantities of contraband cigarette sales suggests that inter-tribal price competition in the Tulsa area is not as intense as expected. Ample scope exists for either unilateral or coordinated cross-tribal tax and price increases that will increase tribal cigarette tax revenue collections and improve public health. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  18. Book-tax conformity in Polish private companies

    Directory of Open Access Journals (Sweden)

    Anna Białek-Jaworska

    2016-12-01

    Full Text Available The purpose of this paper is to identify whether financial income differs significantly from the tax base in Poland and what determines these differences between accounting and taxable results in Polish private entities that are not listed on the stock exchange. In this paper, besides examining the level of book-tax conformity in Poland, we investigate the determinants of book-tax differences in the one-book and twobook accounting systems, with deferred income tax. We use the single factor ANOVA variance analysis, robust fixed effects estimator and the fixed effects linear model with an AR(1 disturbance estimator for panel data of 26,657 private limited liability and non-public joint-stock companies for the period of 2003–2014 (177,667 firm-year observations. The originality of this paper results from the deep quantita-tive analysis of the determinants of book-tax conformity on a novel dataset of Polish private firms. We confirm a strong significant influence of tax law on the shape of the one-book accounting system in Poland. Larger enterprises show fewer book-tax differences. Book-tax conformity is lower in private companies that incur financial losses and in private companies conducting the one-book accounting system. Family-owned companies have higher mean and median book-tax conformity than businessgroups members, due to higher demand for information from their accounts to support stewardship func-tions and to monitor the activities of the management board in the business groups.

  19. Imperfect tax competition for profits, asymmetric equilibrium and beneficial tax havens

    DEFF Research Database (Denmark)

    Johannesen, Niels

    2010-01-01

    We present a model of tax competition for real investment and profits and show that the presence of tax havens in some cases increases the tax revenue of countries. In the first part of the paper, we argue that tax competition for profits is likely to be imperfect in the sense that the jurisdicti...... countries. We demonstrate that the latter effect may dominate the former effects so that countries, on balance, benefit from the presence of tax havens.......We present a model of tax competition for real investment and profits and show that the presence of tax havens in some cases increases the tax revenue of countries. In the first part of the paper, we argue that tax competition for profits is likely to be imperfect in the sense that the jurisdiction...... countries. In the second part of the paper, we introduce tax havens. Starting from a symmetric equilibrium, tax havens unambiguously reduce the tax revenue of countries due to a ‘leakage effect' - tax havens attract tax base from countries - and a 'competition effect' - the optimal response to the increased...

  20. Taxing Snack Foods: Manipulating Diet Quality or Financing Information Programs?

    OpenAIRE

    Fred Kuchler; Abebayehu Tegene; J. Michael Harris

    2005-01-01

    This paper investigates consumers' likely response to a proposed tax on snack foods that addresses public health issues generated by rising U.S. obesity rates. We estimate demands for particular snack foods and show they are price inelastic after accounting for quality variation. We calculate impacts of a range of ad valorem taxes on the demand for salty snack food. The impacts on dietary quality are small, and negligible at the lower tax rates. If taxes were earmarked for funding information...

  1. Nurse burnout in China: a questionnaire survey on staffing, job satisfaction, and quality of care.

    Science.gov (United States)

    Lu, Minmin; Ruan, Hui; Xing, Weijie; Hu, Yan

    2015-05-01

    The investigators examined how nurse staffing affects nurse job satisfaction and quality of care. Inadequate nurse staffing is a worldwide issue with profound effects on nurse job satisfaction and quality of care. Few studies have examined the relationship between nurse staffing and job satisfaction and quality of care in China. A cross-sectional design was adopted, wherein 873 nurses were surveyed on demographics, nurse staffing, job-related burnout, job dissatisfaction, intent to leave, and quality of care. The median patient-nurse ratio was five; 45.1% nurses reported high levels of job-related burnout, and 55.6%, job dissatisfaction. In adjusted regression models, patient-nurse ratios of four or less were related to a decrease in the odds of job dissatisfaction (odds ratio 0.55, 95% confidence interval 0.36-0.85) and increase in the odds of quality of care (odds ratio 1.78, 95% confidence interval 1.02-2.82). Nurse staffing is associated with job dissatisfaction and quality of care. Nurse managers should maintain an adequate level of nurse staffing, referring to the patient-nurse ratio. They should create new initiatives to increase job satisfaction among nurses and to evaluate their effects. © 2013 John Wiley & Sons Ltd.

  2. BEPS Action Plan: Global Tax Cooperation

    Directory of Open Access Journals (Sweden)

    Andrei Shelepov

    2016-12-01

    Full Text Available Given the dynamics of economic and financial globalization, national tax authorities often do not have adequate tools to effectively combat tax avoidance practices that exploit gaps in the existing tax rules. To address the global problem of tax base erosion and profit shifting (BEPS, the Organisation for Economic Co-operation and Development (OECD and the Group of 20 (G20 have consolidated their efforts on an equal footing. Their joint BEPS Action Plan allowed to involve more than 100 countries, both developing and advanced, in designing and implementing rules aimed at aligning the generation of profits and their taxation and increasing the predictability, transparency and flexibility of the international tax environment for business. This article examines the history of the BEPS project, emphasizing the mode of OECD-G20 engagement in global tax governance, describes the key recommendations made by international institutions to tackle BEPS and forecasts further developments in the area. The author pays special attention to the mechanisms designed to stimulate participation by non-OECD and non-G20 members in the BEPS project and the stance of business on the proposed reforms. He concludes that the work on BEPS is far from finished. Different interpretations of standards, risks of strengthening tax competition between countries and potentially excessive tax burdens on businesses should be addressed. In this regard, OECD and G20 should strengthen their efforts to ensure the participation of developing countries and the private sector, which would stimulate other reforms in international taxation to support global growth and development.

  3. Bureaucratic Tax-Seeking: The Danish Waste Tax

    DEFF Research Database (Denmark)

    Christoffersen, Henrik; Svendsen, Gert Tinggaard

    2002-01-01

    model. These suggestions are confirmed by the case of the Danish waste tax with its fixed price approach and perverse incentives compared to that of achieving environmental target levels in a cost-minimising way. Thus, we recommend that bureaucratic institutions should coordinate their tax......-seeking efforts to maximise budgets in the long run and that the ministries that collect green tax revenues should not be allowed to control these revenues. Furthermore, our results dictate that postulated effects from green tax intervention need to be demonstrated....

  4. Slovenian income taxes and analysis of their tax expenditure in 2006-2010

    Directory of Open Access Journals (Sweden)

    Maja Klun

    2012-09-01

    Full Text Available Tax expenditure analyses have been an important element in the supervision of reform processes linked to implementing different kinds of tax incentive and the management of a correct tax policy. The paper provides an evaluation of tax expenditure in Slovenia relating to personal income tax and corporate income tax. Four consecutive tax years were selected for the calculation of the tax expenditure on personal income tax (2006-09, while three consecutive years were selected for the corporate income tax calculation (2008-10. The tax expenditure calculated for personal income tax was highest in 2006 and reached 5.2% of GDP. After several changes in personal income tax, expenditures decreased to around 3% of GDP in the following three years. The tax expenditure calculated for corporate income tax was much lower as compared to GDP than for personal income tax, reaching around 0.2% of GDP.

  5. Tax Governance

    DEFF Research Database (Denmark)

    Boll, Karen; Brehm Johansen, Mette

    to wider international trends within tax administration, especially concerning the development of risk assessments and internal control in the corporations and a greater focus on monitoring of these elements by the tax authorities. Overall, the working paper concludes that Tax Governance as a model......This working paper presents an analysis of the experiences of Cooperative Compliance in Denmark. Cooperative Compliance denotes a specific kind of collaborative program for the regulation of large corporate taxpayers by the tax authorities. Cooperative Compliance programs have been implemented...... in several countries worldwide. In Denmark the program is called Tax Governance. Tax Governance has been studied using qualitative method and the analyses of the working paper build on an extensive base of in-depth interviews – primarily with tax directors from corporations participating in the program...

  6. Using a complex audit tool to measure workload, staffing and quality in district nursing.

    Science.gov (United States)

    Kirby, Esther; Hurst, Keith

    2014-05-01

    This major community, workload, staffing and quality study is thought to be the most comprehensive community staffing project in England. It involved over 400 staff from 46 teams in 6 localities and is unique because it ties community staffing activity to workload and quality. Scotland was used to benchmark since the same evidence-based Safer Nursing Care Tool methodology developed by the second-named author was used (apart from quality) and took into account population and geographical similarities. The data collection method tested quality standards, acuity, dependency and nursing interventions by looking at caseloads, staff activity and service quality and funded, actual, temporary and recommended staffing. Key findings showed that 4 out of 6 localities had a heavy workload index that stretched staffing numbers and time spent with patients. The acuity and dependency of patients leaned heavily towards the most dependent and acute categories requiring more face-to-face care. Some areas across the localities had high levels of temporary staff, which affected quality and increased cost. Skill and competency shortages meant that a small number of staff had to travel significantly across the county to deliver complex care to some patients.

  7. Funding quality pre-kindergarten slots with Philadelphia's new 'sugary drink tax': simulating effects of using an excise tax to address a social determinant of health.

    Science.gov (United States)

    Langellier, Brent A; Lê-Scherban, Félice; Purtle, Jonathan

    2017-09-01

    Philadelphia passed a 1·5-cent-per-ounce sweetened beverage tax (SBT). Revenue will fund 10 000 quality pre-kindergarten slots for poor children. It is imperative to understand how revenue from SBT can be used to fund programmes to address education and other social determinants of health. The objective of the present study was to simulate quality pre-kindergarten attendance, educational achievement and sugar-sweetened beverage (SSB) consumption among Philadelphia children and adolescents under six intervention scenarios: (i) no intervention; (ii) 10 000 additional quality pre-kindergarten slots; (iii) a 1·5-cent-per-ounce SBT; (iv) expanded pre-kindergarten and 1·5-cent-per-ounce SBT; (v) a 3-cent-per-ounce SBT; and (vi) expanded pre-kindergarten and 3-cent-per-ounce SBT. We used an agent-based model to estimate pre-kindergarten enrolment, educational achievement and SSB consumption under the six policy scenarios. We identified key parameters in the model from the published literature and secondary analyses of the Panel Study of Income Dynamics - Child Development Supplement. Philadelphia, Pennsylvania, USA. Philadelphia children and adolescents aged 4-18 years. A 1·5-cents-per-ounce tax would reduce SSB consumption by 1·3 drinks/week among Philadelphia children and adolescents relative to no intervention, with larger effects among children below the poverty level. Quality pre-kindergarten expansion magnifies the effect of the SBT by 8 %, but has the largest effect on moderate-income children just above the poverty level. The SBT and quality pre-kindergarten programme each reduce SSB consumption, but primarily benefit different children and adolescents. Pairing an excise tax with a complementary programme to improve a social determinant of health represents a progressive strategy to combat obesity, a disease regressive in its social patterning.

  8. Classical Corporation Tax as a Global Means of Tax Harmonization

    OpenAIRE

    Kari, Seppo; Ylä-Liedenpoha, Jouko

    2002-01-01

    Classical corporation tax entails double taxation of corporate income. The alternative practice of imputing corporation tax to the domestic recipients of dividends is shown, in the case of a company with international owners, to effectively convert the imputation system back to a classical corporation tax. It also requires complex rules for exempting flow-through dividends from equalization tax to avoid the cumulation of corporation tax internationally. In contrast, classical corporation tax ...

  9. Is tax funding of health care more likely to be regressive than systems based on social insurance in low- and middle-income countries?

    Directory of Open Access Journals (Sweden)

    Aurelio Mejía Mejía

    2013-06-01

    Full Text Available One of the main functions of health care systems is to collect enough revenue to finance health expenditures. This revenue can be obtained through different sources (taxes, social insurance contributions, out-of-pocket payments, donations, each of which has different implications in terms of equity. The equity implications of the different forms of revenue collection are an important component of health systems performance evaluation. The international evidence suggests that tax funded systems seem to be a more progressive health care financing mechanism than systems based on social insurance in low- and middle-income countries. However, progressivity results are sensitive to the choice of ability to pay measures and, therefore, policy makers must be aware of this fact when interpreting results of studies on health care financing.

  10. The Size and Scope of Collegiate Athletic Training Facilities and Staffing.

    Science.gov (United States)

    Gallucci, Andrew R; Petersen, Jeffrey C

    2017-08-01

      Athletic training facilities have been described in terms of general design concepts and from operational perspectives. However, the size and scope of athletic training facilities, along with staffing at different levels of intercollegiate competition, have not been quantified.   To define the size and scope of athletic training facilities and staffing levels at various levels of intercollegiate competition. To determine if differences existed in facilities (eg, number of facilities, size of facilities) and staffing (eg, full time, part time) based on the level of intercollegiate competition.   Cross-sectional study.   Web-based survey.   Athletic trainers (ATs) who were knowledgeable about the size and scope of athletic training programs.   Athletic training facility size in square footage; the AT's overall facility satisfaction; athletic training facility component spaces, including satellite facilities, game-day facilities, offices, and storage areas; and staffing levels, including full-time ATs, part-time ATs, and undergraduate students.   The survey was completed by 478 ATs (response rate = 38.7%) from all levels of competition. Sample means for facilities were 3124.7 ± 4425 ft 2 (290.3 ± 411 m 2 ) for the central athletic training facility, 1013 ± 1521 ft 2 (94 ± 141 m 2 ) for satellite athletic training facilities, 1272 ± 1334 ft 2 (118 ± 124 m 2 ) for game-day athletic training facilities, 388 ± 575 ft 2 (36 ± 53 m 2 ) for athletic training offices, and 424 ± 884 ft 2 (39 ± 82 m 2 ) for storage space. Sample staffing means were 3.8 ± 2.5 full-time ATs, 1.6 ± 2.5 part-time ATs, 25 ± 17.6 athletic training students, and 6.8 ± 7.2 work-study students. Division I schools had greater resources in multiple categories (P facilities in recent years was common, and almost half of ATs reported that upgrades have been approved for the near future.   This study provides benchmark descriptive data on athletic training staffing and

  11. Economic analysis of the TAX 317 trial: docetaxel versus best supportive care as second-line therapy of advanced non-small-cell lung cancer.

    Science.gov (United States)

    Leighl, Natasha B; Shepherd, Frances A; Kwong, Rita; Burkes, Ronald L; Feld, Ronald; Goodwin, Pamela J

    2002-03-01

    To determine the cost-effectiveness (CE) of second-line docetaxel compared with best supportive care (BSC) in the TAX 317 trial, a randomized clinical trial of second-line chemotherapy in non-small-cell lung cancer. A retrospective CE analysis of the TAX 317 trial was undertaken, evaluating direct medical costs of therapy from the viewpoint of Canada's public health care system. Costs were derived in 1999 Canadian dollars, and resource use was determined through prospective trial data. The incremental survival benefit in the docetaxel arm over BSC was 2 months (P =.047). The CE of docetaxel was $57,749 per year of life gained. For patients treated with docetaxel 75 mg/m(2), the CE was $31,776 per year of life gained. In univariate sensitivity analyses, CE estimates were most sensitive to changes in survival, ranging from $18,374 to $117,434 with 20% variation in survival at the recommended dose. The largest cost center in both arms was hospitalization, followed by the cost of drugs, investigations, radiotherapy, and community care. BSC patients had fewer hospitalizations than patients in the chemotherapy arm and were more often palliated at home. Although the decision to treat should not be based on economic considerations alone, our CE estimate of $31,776 per year of life gained (at the currently recommended dose of docetaxel) is within an acceptable range of health care expenditures, and the total costs of therapy are similar to those of second-line palliative chemotherapy for other solid tumors.

  12. Projected impacts of federal tax policy proposals on mortality burden in the United States: A microsimulation analysis.

    Science.gov (United States)

    Kim, Daniel

    2018-06-01

    The public health consequences of federal income tax policies that influence income inequality are not well understood. I aimed to project the impacts on mortality of modifying federal income tax structures based on proposals by two recent United States (U.S.) Presidential candidates: Donald Trump and Senator Bernie Sanders. I performed a microsimulation analysis using the latest U.S. Internal Revenue Service public-use tax file with state identifiers (2008 tax year), containing nationally-representative data from 139,651 tax returns. I considered five tax plan scenarios: 1) actual 2008 tax structures; proposals in 2016 by then-candidates 2) Trump and 3) Sanders; 4) a modified Sanders plan with higher top tax rates (75%); and 5) a modified Sanders plan with higher top rates plus revenue redistribution to lower-income households (Trump and Sanders plans, respectively. Under the modified Sanders plan including higher top rates, 68,919 (95% CI: 25,221-113,561) fewer deaths/year are projected. Under the modified Sanders plan with redistribution, 333,504 (95% CI: 192,897-473,787) fewer deaths/year are expected. Policies that both raise federal income tax rates and redistribute tax revenue could confer large reductions in the total number of annual deaths among Americans. In this era of high income inequality and growing public support to address the rich-poor gap, policymakers should consider joint federal tax and redistributive policies as levers to reduce the burden of mortality in the United States. Copyright © 2017 The Author. Published by Elsevier Inc. All rights reserved.

  13. Tax Information Exchange with Developing Countries and Tax Havens

    OpenAIRE

    Braun, Julia; Zagler, Martin

    2015-01-01

    The exchange of tax information has received ample attention recently, due to a number of recent headlines on aggressive tax planning and tax evasion. Whilst both participating tax authorities will gain when foreign investments (FDI) are bilateral, we demonstrate that FDI receiving nations will lose in asymmetric situations. We solve a bargaining model that proves that tax information exchange will only happen voluntarily with compensation for this loss. We then present empirical evidence in ...

  14. The Tax Base And The Tax Bill. Tax Implications of Development: A Workbook.

    Science.gov (United States)

    Brighton, Deb; Northup, Jim

    The property tax base in Vermont's towns are overburdened as property taxes are usually the only funding method available to finance schools, police departments, highway work, recreation programs, and government in general. Attempting to offer their citizens a balanced program of services without exorbitant taxes, local officials are striving to…

  15. Impact of a physician-staffed helicopter on a regional trauma system

    DEFF Research Database (Denmark)

    Hesselfeldt, R; Steinmetz, J; Jans, H

    2013-01-01

    This study aims to compare the trauma system before and after implementing a physician-staffed helicopter emergency medical service (PS-HEMS). Our hypothesis was that PS-HEMS would reduce time from injury to definitive care for severely injured patients.......This study aims to compare the trauma system before and after implementing a physician-staffed helicopter emergency medical service (PS-HEMS). Our hypothesis was that PS-HEMS would reduce time from injury to definitive care for severely injured patients....

  16. Mobilising public opinion for the tobacco industry: the Consumer Tax Alliance and excise taxes.

    Science.gov (United States)

    Campbell, R; Balbach, E D

    2008-10-01

    Tobacco industry funding was instrumental in creating and financing the Consumer Tax Alliance in 1989 as an organisation that relied upon extensive media outreach to build opposition to excise taxes as a regressive form of taxation. By obscuring its own role in this effort, the tobacco industry undermined the public's reasonable expectations for transparency in the policy-making process. To examine the formation and activities of the Consumer Tax Alliance as a "hybrid" form of interest group in order to provide tobacco control and public health advocates with a better understanding of unanticipated tobacco industry coalitions and facilitate appropriate countermeasures. Document searches through the Legacy Tobacco Documents Library and through Tobacco Documents Online and review of background literature. The Tobacco Institute actively sought liberal allies beginning in the mid-1980s in seeking to build public opposition to cigarette excise tax increases by promoting them as a regressive form of taxation. The creation of the Consumer Tax Alliance in 1989 was expressly intended to turn labour and middle-class opinion against prospective excise tax increases in federal budget deficit negotiations, without divulging the tobacco industry's role in its formation. It is important to understand the dynamic by which trusted organisations can be induced to alter their agendas in response to funding sources. Advocates need to understand this form of interest group behaviour so that they are better able to negotiate the policy arena by diagnosing and exposing this influence where it occurs and, by doing so, be better prepared to take appropriate countermeasures.

  17. Risk diversification and tax competition : the influence of risk correlations and tax provisions on tax competition

    OpenAIRE

    Berndt, Markus; Reichl, Bettina

    2000-01-01

    From standard-portfolio-models the authors derive demand elasticities for risky assets, and combine the results with a simple non-cooperative model of tax competition between capital importing countries. They find that tax rates resulting from tax competition depend heavily on the correlations of capital market indices. If investment alternatives are not correlated, the outcome of both tax competition and a cooperative solution of tax harmonization are identical. The results suggest regional ...

  18. Tax Morality and Progressive Wage Tax

    OpenAIRE

    Andras Simonovits

    2010-01-01

    We analyze the impact of tax morality on progressive income (wage) taxation. We assume that transfers (cash-back) and public expenditures are financed from linear wage taxes. We derive the reported wages from individual utility maximization, when individuals obtain partial satisfaction from reporting wages (depending on their tax morality), and cannot be excluded from the use of public services. The government maximizes a utilitarian social welfare function, also taking into account the utili...

  19. Tax havens: Features, operations and solving tax evasion problems

    OpenAIRE

    Obradović-Ćuk, Jelena; Mitić, Petar; Dinić, Vladimir

    2016-01-01

    Tax haven offers minimal or no tax liability to foreign individuals and enterprises in economically and politically stable environment, where little or no financial information is shared with foreign tax authorities. The aim of this research is to create a comprehensive overview of the characteristics and operations of tax havens, as well as to point out to the ways to overcome the problem of tax evasion. The methodology used in the work is characteristic of social science research: analysis,...

  20. Accelerating the Worldwide Adoption of Sugar-Sweetened Beverage Taxes: Strengthening Commitment and Capacity

    Science.gov (United States)

    Baker, Phillip; Jones, Alexandra; Marie Thow, Anne

    2018-01-01

    In their recent article Roache and Gostin outline why governments and public health advocates should embrace soda taxes. The evidence is strong and continues to grow: such taxes can change consumer behavior, generate significant revenue and incentivize product reformulation. In essence, such taxes are an important and now well-established instrument of fiscal and public health policy. In this commentary we expand on their arguments by considering how the worldwide adoption of such taxes might be further accelerated. First, we identify where in the world taxes have been implemented to date and where the untapped potential remains greatest. Second, drawing upon recent case study research on country experiences we describe several conditions under which governments may be more likely to make taxation a political priority in the future. Third, we consider how to help strengthen the technical and legal capacities of governments to design and effectively administer taxes, with emphasis on low- and middle-income countries. We expect the findings to be most useful to public health advocates and policy-makers seeking to promote healthier diets and good nutrition. PMID:29764114

  1. A taxing environment: evaluating the multiple objectives of environmental taxes.

    Science.gov (United States)

    Miranda, Marie Lynn; Hale, Brack W

    2002-12-15

    Environmental taxes have attracted attention in recent years as a tool to internalize environmental externalities. This paper evaluates Sweden's experience with environmental taxes in the energy sector by examining how environmental taxes compare with estimated environmental externalities associated with the use of oil, coal, natural gas, and forest residue fuels. We also analyze how environmental taxes influence fuel choices in the energy sector by comparing the production, environmental, and tax costs for the same fuels. We find that (i) the Swedish environmental taxes correspond imperfectly with environmental costs; (ii) the Swedish tax and subsidy system introduces changes in fuel choice decisions; (iii) the energy users are responding to the incentives created by the tax and subsidy systems in ways that are consistent with economic theory; and (iv) the Swedish experience with environmental taxes and subsidies bears directly on wider evaluations of energy policy approaches internationally.

  2. The Untapped Power of Soda Taxes: Incentivizing Consumers, Generating Revenue, and Altering Corporate Behavior.

    Science.gov (United States)

    Roache, Sarah A; Gostin, Lawrence O

    2017-06-14

    Globally, soda taxes are gaining momentum as powerful interventions to discourage sugar consumption and thereby reduce the growing burden of obesity and non-communicable diseases (NCDs). Evidence from early adopters including Mexico and Berkeley, California, confirms that soda taxes can disincentivize consumption through price increases and raise revenue to support government programs. The United Kingdom's new graduated levy on sweetened beverages is yielding yet another powerful impact: soda manufacturers are reformulating their beverages to significantly reduce the sugar content. Product reformulation - whether incentivized or mandatory - helps reduce overconsumption of sugars at the societal level, moving away from the long-standing notion of individual responsibility in favor of collective strategies to promote health. But as a matter of health equity, soda product reformulation should occur globally, especially in low- and middleincome countries (LMICs), which are increasingly targeted as emerging markets for soda and junk food and are disproportionately impacted by NCDs. As global momentum for sugar reduction increases, governments and public health advocates should harness the power of soda taxes to tackle the economic, social, and informational drivers of soda consumption, driving improvements in food environments and the public's health. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  3. Everyday Representations of Tax Avoidance, Tax Evasion, and Tax Flight: Do Legal Differences Matter?

    OpenAIRE

    Kirchler, Erich; Maciejovsky, Boris; Schneider, Friedrich

    2001-01-01

    From an economic point of view, legal considerations apart, tax avoidance, tax evasion and tax flight have similar effects, namely a reduction of revenue yields, and are based on the same desire to reduce the tax burden. Due to legal differences and moral concerns it is, however, likely that individuals perceive them as different and as unequally fair. Overall, 252 fiscal officers, business students, business lawyers, and entrepreneurs produced spontaneous associations to a scenario either de...

  4. Tax Policy Trends: Republicans Reveal Proposed Tax Overhaul

    Directory of Open Access Journals (Sweden)

    Philip Bazel

    2017-10-01

    Full Text Available REPUBLICANS REVEAL PROPOSED TAX OVERHAUL The White House and Congressional Republicans have revealed their much-anticipated proposal for reform of the U.S. personal and corporate tax systems. The proposal titled, “UNIFIED FRAMEWORK FOR FIXING OUR BROKEN TAX CODE” outlines a number of central policy changes, which will significantly alter the U.S. corporate tax system. The proposal includes a top federal marginal rate reduction for the sole proprietorships, partnerships and S corporation—small business equivalents— from 39.6% to 25% (state income tax rates would no longer be deductible. Large corporations would also see a meaningful federal rate reduction given the proposed drop in the federal corporate income tax rate from 35% to 20%. Additionally, the proposal includes a generous temporary measure intended to stimulate investment, full capital expensing for machinery with a partial limitation of interest deductions.

  5. The rise and fall of the world's first fat tax

    DEFF Research Database (Denmark)

    Bødker, Malene; Pisinger, Charlotta Holm; Toft, Ulla

    2015-01-01

    and the public. In the end, the fat tax was abolished for financial reasons. This study demonstrates how politicians considered the fat tax as a funding source rather than a public health initiative, which resulted in significant shortcomings. Furthermore, we demonstrate that the massive influence by industry...... stakeholders was not balanced with inputs from public health professionals, who should assume a more proactive role in policy-making....

  6. In-work tax credits for families and their impact on health status in adults.

    Science.gov (United States)

    Pega, Frank; Carter, Kristie; Blakely, Tony; Lucas, Patricia J

    2013-08-06

    By improving two social determinants of health (poverty and unemployment) in low- and middle-income families on or at risk of welfare, in-work tax credit for families (IWTC) interventions could impact health status and outcomes in adults. To assess the effects of IWTCs on health outcomes in working-age adults (18 to 64 years). We searched 16 electronic academic databases, including the Cochrane Public Health Group Specialised Register, Cochrane Database of Systematic Reviews (The Cochrane Library 2012, Issue 7), MEDLINE and EMBASE, as well as six grey literature databases between July and September 2012 for records published between January 1980 and July 2012. We also searched key organisational websites, handsearched reference lists of included records and relevant journals, and contacted academic experts. We included randomised and quasi-randomised controlled trials and cohort, controlled before-and-after (CBA) and interrupted time series (ITS) studies of IWTCs in working-age adults. Included primary outcomes were: self rated general health; mental health/psychological distress; mental illness; overweight/obesity; alcohol use and tobacco use. Two review authors independently extracted data and assessed the risk of bias in included studies. We contacted study authors to obtain missing information. Five studies (one CBA and four ITS) comprising a total of 5,677,383 participants (all women) fulfilled the inclusion criteria and were synthesised narratively. The in-work tax credit intervention assessed in all included studies is the permanent Earned Income Tax Credit in the United States, established in 1975. This intervention distributed nearly USD 62 billion to over 27 million individuals in 2011, and its administration costs were less than one per cent of its total costs. All included studies carried a high risk of bias (especially from confounding and insufficient control for underlying time trends). Due to the small number of (observational) studies and their

  7. VHA Support Service Center Primary Care Support Staff and Exam Room Database

    Data.gov (United States)

    Department of Veterans Affairs — Networks are able to update on an ongoing basis data originally added to the Veterans Health Administration Physician Productivity and Staffing initiative to ensure...

  8. What do Americans think about federal tax options to support public transit, highways, and local streets and roads? results from year 3 of a national survey.

    Science.gov (United States)

    2012-06-01

    This report summarizes the results of a national random-digit-dial public opinion poll that asked 1,519 respondents if they would support various tax options for raising federal transportation revenues, with a special focus on understanding support f...

  9. Canada's gas taxes = highway robbery

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-05-01

    This report was prepared for the second annual 'gas honesty day' (May 18, 2000) in an effort to draw attention to the frustration of Canadian taxpayers with gasoline retailers and the petroleum industry for the inordinately and unjustifiably high prices for gasoline at the pump. The report points out that the public outcry is, in fact, misdirected since the largest profiteers at the pumps, the federal government, remains largely unscathed. It is alleged in the report that gas taxes are tantamount to highway robbery. Ostensibly collected for road construction and maintenance, of the almost $ 5 billion collected in 1999, only a paltry $ 194 million was returned to the provinces for roadway and highway spending. The 10-year average of federal returns to the the provinces from tax on gasoline is a meager 4.7 per cent, which fell even further to 4.1 per cent in 1998-1999. Gasoline tax revenues continue to climb, while government commitment to real roadway and highway spending continues to decline. This document attempts to shed some light on the pricing structure for gasoline. Without defending or explaining the non-tax portion of the pump price charged by Canada's oil companies, which is a task for the oil companies to undertake, the document makes a concerted effort to raise public awareness and focus public attention on government's involvement, namely that gas taxes represent on average about 50 per cent of the pump price and that the majority of the taxes collected are not put back into road and highway improvements. The Canadian Taxpayers Federation, authors of this report, expect that by focusing debate on the issue of gasoline taxes a broad support for a lowering of the overall tax burden on motorists will result. Among other things, the CTF advocates reduction of federal and provincial fuel taxes to levels commensurate with highway funding; dedication of fuel tax revenues to highway construction and maintenance; elimination of the sales and

  10. An international comparison of commercial nuclear power plant staffing regulations and practice, 1980--1990

    International Nuclear Information System (INIS)

    Melber, B.; Hauth, J.; Terrill, E.; Berk, B.; Gore, B.

    1994-03-01

    In this report an international review of regulatory and industry practices is provided in the area of nuclear power plant staffing during the 1980s in Canada, France, Germany, Japan, Sweden, and the United Kingdom. The objective of this review is to highlight trends in staffing regulatory approaches, industry practices, and issues of concern in other countries that have potential relevance to nuclear power plant staffing issues in the United States. The decade of the 1980s was marked by a great deal of growth in nuclear power operations internationally; however, growth of nuclear power is not expected to continue in the 1990s except in France and Japan. A continuum of regulatory approaches to staffing was identified, ranging from prescribed regulations that are applied to all licensees (Germany is most similar to the United States in this regard), to indirect staffing regulations where the regulatory authority oversees plant operating practices that are agreed to in the plant operating license (most notably, France and the United Kingdom). Most of the changes observed in staffing regulations and practices in the early 1980s were made in response to the accident at the Three Mile Island Unit 2 nuclear power plant (TMI) in 1979. These changes included the widespread issuance of new operator and licensing requirements and the establishment of national training centers. After the post-TMI changes were implemented, a period of relative stability followed. Changes in the latter half of the 1980s have focused on continuing improvements and additions to training curricula and methods, most notably increased reliance on simulator training

  11. Corporate Social Responsibility Disclosure, Environmental Performance, and Tax Aggressiveness

    Directory of Open Access Journals (Sweden)

    Dahlia Sari

    2016-08-01

    Full Text Available This study aims to examine the influence of the corporate taxpayers’ level of CSR disclosure and environmental performance on the level of tax aggressiveness. This study took a sample of non-financial companies listed on the Indonesian Stock Exchange during 2009-2012. This study shows that the corporate taxpayers’ level of CSR disclosure has significant negative effect towards the tax aggressiveness. It means the higher the level of the CSR disclosure, the lower the company’s tax aggressiveness. This study also proves that good environmental performance will strengthen the negative effect of CSR disclosure on tax aggressiveness. The assessment of environmental performance is conducted by the Ministry of Environment as independent party. It means that the higher the score of company’s environmental performance, the higher the commitment to pay taxes. This study supports the view that more socially responsible corporations are likely to be less tax aggressive.

  12. Social and political barriers to green tax reform. The case of CO{sub 2} taxes in Norway

    Energy Technology Data Exchange (ETDEWEB)

    Kasa, Sjur

    1999-06-29

    This paper presents the story of several attempts to tax Norwegian mainland emission intensive industries during the 1990s. These industries, mainly made up of aluminium and ferro-alloy producers located in the Norwegian countryside and a series of planned gas powered power stations along the coast, have enjoyed full exemption form CO{sub 2} taxes during a period in which relatively high CO{sub 2} taxes have been imposed on Norwegian consumers and some other industries. The various sources of the emission intensive industries are explored, included their ability to amass broad support for ``pro-industrial`` social norms among politicians, media and the bureaucracy. Theoretically these capabilities are described in terms of the policy network approach developed in British political science. 34 refs.

  13. The Spanish tobacco tax loopholes and their consequences.

    Science.gov (United States)

    López-Nicolás, Ángel; Cobacho, María Belén; Fernández, Esteve

    2013-05-01

    The Spanish government has strengthened tobacco control policies since 2005, including changes in tobacco taxes. Because these changes have targeted cigarettes mainly, the tobacco industry has marketed cheaper alternative tobacco products, offering smokers the possibility to downtrade. This paper traces the evolution of patterns of demand for cigarettes and other tobacco products in Spain over the period 2005-2011 in order to assess the impact of such tax loopholes. The authors use data on tobacco products prices and sales as well as changes in the structure and levels of tobacco taxes to relate tax changes to price changes and subsequent market share changes. Tax reforms have lifted the bottom end of the cigarette price distribution, but the industry has been successful in marketing fine-cut tobacco at cheap prices. There have been partial attempts to correct this asymmetric tax treatment, but these have not avoided a remarkable increase in the market share of fine-cut tobacco. The absence of a minimum tax on quantity for the rest of tobacco products allows the industry to place them as potential future downtrading vehicles. In order to address public health objectives, tax policies should aim to equalise the cost of smoking across different tobacco products. Otherwise the tobacco industry can exploit tax loopholes to market cheap alternatives to cigarettes. This requires all tobacco products to bear a minimum tax on quantity, whose levels need to be adjusted in order to reflect the equivalence between different forms of smoking.

  14. Mapping Tax Compliance

    DEFF Research Database (Denmark)

    Boll, Karen

    2014-01-01

    Tax compliance denotes the act of reporting and paying taxes in accordance with the tax laws. Current social science scholarship on tax compliance can almost entirely be divided into behavioural psychology analyses and critical tax studies. This article, which presents two cases of how tax...... compliance is constructed, challenges the explanatory reaches of today's social science approaches, arguing that an alternative approach to understanding tax compliance is worthwhile exploring. This other choice of approach, inspired by actor–network theory (ANT), adopts a more practice-oriented focus...... that studies tax compliance where it takes place as well as what it is made of. Consequently, this article argues that tax compliance is a socio-material assemblage and that complying is a distributed action. The article concludes by highlighting how an ANT approach contributes to the further theoretical...

  15. The UK sugar tax - a healthy start?

    Science.gov (United States)

    Jones, C M

    2016-07-22

    The unexpected announcement by the UK Chancellor of the Exchequer of a levy on sugar sweetened beverages (SSBs) on the 16 March 2016, should be welcomed by all health professionals. This population based, structural intervention sends a strong message that there is no place for carbonated drinks, neither sugared nor sugar-free, in a healthy diet and the proposed levy has the potential to contribute to both general and dental health. The sugar content of drinks exempt from the proposed sugar levy will still cause tooth decay. Improving the proposed tax could involve a change to a scaled volumetric tax of added sugar with a lower exemption threshold. External influences such as the Common Agricultural Policy and the Transatlantic Trade and Investment Partnership may negate the benefits of the sugar levy unless it is improved. However, the proposed UK sugar tax should be considered as a start in improving the nation's diet.

  16. A tax proposal for a cash flow corporate tax

    Directory of Open Access Journals (Sweden)

    Lourdes Jerez Barroso

    2013-12-01

    Full Text Available Purpose: Due to its advantages in terms of neutrality and simplicity, the aim of this paper is to design a tax base for corporation cash flows, as well as to develop its practical implementation.Design/Methodology: The conceptual aspects and the background of tax on corporation tax flows are reviewed and a tax base that levies a charge on the corporation’s economical activities’ cash flow is then proposed. In order to carry this out, a methodological procedure is developed on the basis of the accounting documents that companies must present and through which the stock variables and the accounting documents’ work flow is transformed into cash flow.Findings: An implementation on the basis of the accounting documents that Spanish companies must present. Practical Implications: This paper defines the procedure to follow in order to determine the tax base of a cash flow corporate income tax on the basis of its accounts, which would allow an estimation of this tax figure’s revenue impact.Originality/ Value: The design of a tax base of cash flows for companies. The accounting approximation carried out to determine the cash flows justifies the fact that the tax base proposal is technically possible.

  17. The impact of an unconditional tax credit for families on self-rated health in adults: further evidence from the cohort study of 6900 New Zealanders.

    Science.gov (United States)

    Pega, Frank; Carter, Kristie; Kawachi, Ichiro; Davis, Peter; Blakely, Tony

    2014-05-01

    It is hypothesized that unconditional (given without obligation) publicly funded financial credits more effectively improve health than conditional financial credits in high-income countries. We previously reported no discernible short-term impact of an employment-conditional tax credit for families on self-rated health (SRH) in adults in New Zealand. This study estimates the effect of an unconditional tax credit for families, called Family Tax Credit (FTC), on SRH in the same study population and setting. A balanced panel of 6900 adults in families was extracted from seven waves (2002-2009) of the Survey of Family, Income and Employment. The exposures, eligibility for and amount of FTC, were derived by applying government eligibility and entitlement criteria. The outcome, SRH, was collected annually. Fixed effects regression analyses eliminated all time-invariant confounding and adjusted for measured time-varying confounders. Becoming eligible for FTC was associated with a small and statistically insignificant change in SRH over the past year [effect estimate: 0.013; 95% confidence interval (CI) -0.011 to 0.037], as was an increase in the estimated amount of FTC by $1000 (effect estimate: -0.001; 95% CI -0.006 to 0.004). The unconditional tax credit for families had no discernible short-term impact on SRH in adults in New Zealand. It did not more effectively improve health status than an employment-conditional tax credit for families. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Mobilizing Public Opinion for the Tobacco Industry: The Consumer Tax Alliance and Excise Taxes

    Science.gov (United States)

    Campbell, Richard; Balbach, Edith D.

    2009-01-01

    Background Tobacco industry funding was instrumental in creating and financing the Consumer Tax Alliance in 1989 as an ostensibly organization that relied upon extensive media outreach to build opposition to excise taxes as a regressive form of taxation. By obscuring its own role in this effort, the tobacco industry undermined the public’s reasonable expectations for transparency in the policy making process. Aim To examine the formation and activities of the Consumer Tax Alliance as a “hybrid” form of interest group in order to provide tobacco control and public health advocates with a better understanding of unanticipated tobacco industry coalitions and facilitate appropriate counter measures. Methods Document searches through the Legacy Tobacco Documents Library and through Tobacco Documents Online and review of background literature. Results The Tobacco Institute actively sought liberal allies beginning in the mid-1980s in seeking to build public opposition to cigarette excise tax increases by promoting them as a regressive form of taxation. The creation of the Consumer Tax Alliance in 1989 was expressly intended to turn labor and middle class opinion against prospective excise tax increases in federal budget deficit negotiations, without divulging the tobacco industry’s role in its formation. Conclusion It is important to understand the dynamic by which trusted organizations can be induced to alter their agendas in response to funding sources. Advocates need to understand this form of interest group behavior so that they are better able to negotiate the policy arena by diagnosing and exposing this influence where it occurs and, by doing so, be better prepared to take appropriate counter measures. What this paper adds The tobacco industry’s political strategies for utilizing third party efforts to contest cigarette excise tax increases have not been extensively studied. While there has been some attention to industry sponsorship of third parties, the

  19. Energy taxes in practice. Energy tax - electricity tax - biofuel quota - energy tax compliance. 3. upd. and rev. ed.

    International Nuclear Information System (INIS)

    Stein, Roland M.; Thoms, Anahita

    2016-01-01

    You need a quick and easy overview of the legal provisions of the energy tax law? You would like to understand the relationship between the European and national regulations and their impact on the daily practice? This manual prepares the energy tax, electricity tax and biofuel quota law for you clearly on and illustrated by examples, what to look in practice in order to avoid pitfalls. It picks up especially contentious issues and problems, discusses the relevant case law and the relevant regulations and finally gives precise recommendations for daily practice. Based on practice notes, examples and diagrams you can easily identify how to transfer the legal requirements on the own workspaces or optionally can use tax breaks. This includes information on both simplified - and thus less subject to error - methods and to tax exemptions and credits. The manual is complemented by forms, extracts from the Combined Nomenclature and an online material collection with regulatory and legal texts. [de

  20. Staffing Policy for Solving the Information Security

    Directory of Open Access Journals (Sweden)

    A. I. Tolstoy

    2012-06-01

    Full Text Available Determining staffing policy implementation of information security tasks is given. The basic requirements that must be taken into account when developing policies are defined. The policy framework is determined and recommendations for the design of such policies are formulated. Requirements for the implementation of the policy are defined.

  1. Faktor-Faktor yang Menyebabkan Wajib Pajak Melakukan Tax Offenses, Tax Fraud, dan Tax Evasion (Studi Empiris di KPP Pratama Medan-Polonia)

    OpenAIRE

    Amalia, Gita

    2016-01-01

    This research aims to analyze the influence of tax fairness, tax compliance, tax knowledge, tax system, and discrimination against taxpayer perception about the ethical of tax offenses, tax fraud, and tax evasion. This research was conducted at the tax service office Pratama MedanPolonia, with a sampling technique is convenience sampling and distributing the questionnaires until fifty questionnaires. All of the questionnaires given to the taxpayer who listed on tax service office Pratama Meda...

  2. Tax policy to combat global warming: On designing a carbon tax

    International Nuclear Information System (INIS)

    Poterba, J.

    1991-01-01

    This chapter is divided into five sections. The first describes the basic structure of the carbon tax, focusing on the policies already in place in Europe as well as proposed taxes for the US. The second section considers the distributional burden of carbon taxes across income groups. The third section examines the production and consumption distortions from a carbon tax, using a simple partial-equilibrium model of the energy market. These estimates do not correspond to the net efficiency cost of carbon taxes because they neglect the reduction in negative externalities associated with these taxes, but they indicate the cost that must be balanced against potential efficiency gains from the externality channel. The fourth section discusses the short- and long-run macroeconomic effects of adopting a carbon tax, drawing on previous empirical studies of the relationship between tax rates and real output growth. A central issue in this regard is the disposition of carbon tax revenues. The fifth section considers several design issues relating to carbon taxes, such as harmonization with other greenhouse taxes and the difficulty of taxing fossil-fuel use in imported intermediate goods. There is a brief concluding section that discusses broader issues of policy design

  3. Measuring the impact of marginal tax rate reform on the revenue base of South Africa using a microsimulation tax model

    Directory of Open Access Journals (Sweden)

    Yolande Jordaan

    2015-08-01

    Full Text Available This paper is primarily concerned with the revenue and tax efficiency effects of adjustments to marginal tax rates on individual income as an instrument of possible tax reform. The hypothesis is that changes to marginal rates affect not only the revenue base, but also tax efficiency and the optimum level of taxes that supports economic growth. Using an optimal revenue-maximising rate (based on Laffer analysis, the elasticity of taxable income is derived with respect to marginal tax rates for each taxable-income category. These elasticities are then used to quantify the impact of changes in marginal rates on the revenue base and tax efficiency using a microsimulation (MS tax model. In this first paper on the research results, much attention is paid to the structure of the model and the way in which the database has been compiled. The model allows for the dissemination of individual taxpayers by income groups, gender, educational level, age group, etc. Simulations include a scenario with higher marginal rates which is also more progressive (as in the 1998/1999 fiscal year, in which case tax revenue increases but the increase is overshadowed by a more than proportional decrease in tax efficiency as measured by its deadweight loss. On the other hand, a lowering of marginal rates (to bring South Africa’s marginal rates more in line with those of its peers improves tax efficiency but also results in a substantial revenue loss. The estimated optimal individual tax to gross domestic product (GDP ratio in order to maximise economic growth (6.7 per cent shows a strong response to changes in marginal rates, and the results from this research indicate that a lowering of marginal rates would also move the actual ratio closer to its optimum level. Thus, the trade-off between revenue collected and tax efficiency should be carefully monitored when personal income tax reform is being considered.

  4. High School Administrative Staffing in Washington State: Principal Perspectives on Resource Needs and Utilization

    Science.gov (United States)

    Steach, John C.

    2011-01-01

    This mixed methods study explored how high school principals prioritize their work and utilize available human resources to adjust to inadequate administrative staffing. Analysis of staffing levels across the state of Washington and specifically inside two eastern Washington districts framed interview questions for central office administration…

  5. Estonian Tax Structure

    Directory of Open Access Journals (Sweden)

    Viktor Trasberg

    2014-08-01

    Full Text Available The paper analyses Estonian tax structure changes during the last decade and critically assesses the current situation. The country’s tax mix is rather unique among EU countries – it has one of the highest proportions of consumption taxes in total taxes and the lowest level of capital and profit taxes. Such an unbalanced tax structure creates risks for public finances, limits revenue collection and distorts the business environment.

  6. Creating pharmacy staffing-to-demand models: predictive tools used at two institutions.

    Science.gov (United States)

    Krogh, Paul; Ernster, Jason; Knoer, Scott

    2012-09-15

    The creation and implementation of data-driven staffing-to-demand models at two institutions are described. Predictive workload tools provide a guideline for pharmacy managers to adjust staffing needs based on hospital volume metrics. At Abbott Northwestern Hospital, management worked with the department's staff and labor management committee to clearly outline the productivity monitoring system and the process for reducing hours. Reference charts describing the process for reducing hours and a form to track the hours of involuntary reductions for each employee were created to further enhance communication, explain the rationale behind the new process, and promote transparency. The University of Minnesota Medical Center-Fairview, found a strong correlation between measured pharmacy workload and an adjusted census formula. If the daily census and admission report indicate that the adjusted census will provide enough workload for the fully staffed department, no further action is needed. If the census report indicates the adjusted census is less than the breakeven point, staff members are asked to leave work, either voluntarily or involuntarily. The opposite holds true for days when the adjusted census is higher than the breakeven point, at which time additional staff are required to synchronize worked hours with predicted workload. Successful staffing-to- demand models were implemented in two hospital pharmacies. Financial savings, as indicated by decreased labor costs secondary to reduction of staffed shifts, were approximately $42,000 and $45,500 over a three-month period for Abbott Northwestern Hospital and the University of Minnesota Medical Center-Fairview, respectively. Maintenance of 100% productively allowed the departments to continue to replace vacant positions and avoid permanent staff reductions.

  7. Tax tips for forest landowners for the 2008 tax year

    Science.gov (United States)

    Linda Wang; John L. Greene

    2009-01-01

    This article summarizes key federal income tax provisions for forestland owners, foresters, loggers, forest product businesses, and tax practioners, and is current as of October 1, 2008.  Consult your tax and legal professionals for advice on your particular tax situation.

  8. Tax planning in corporation

    OpenAIRE

    Nevodnicheva, Yulia

    2010-01-01

    This thesis "Tax planning in corporation" puts brain to legal entity income tax and it is looking for possible solutions in tax planning in corporation. The first part deals with the tax theory, the other part is the theory of tax planning, comparison of tax regimes and tax policy and tax revenue by optimizing both internationally and in the local aspect. The last part discusses options for optimizing tax

  9. CDC STATE System Tobacco Legislation - Tax

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1995-2017. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. Legislation-Tax. The STATE System...

  10. CDC STATE System Tobacco Legislation - Tax

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1995-2018. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. Legislation-Tax. The STATE System...

  11. Lifestyle, socioeconomic characteristics, and medical history of elderly persons who receive seasonal influenza vaccination in a tax-supported healthcare system

    DEFF Research Database (Denmark)

    Hellfritzsch, Maja; Thomsen, Reimar Wernich; Baggesen, Lisbeth Munksgård

    2017-01-01

    inactivity (aPR: 1.08, 95% CI 1.03–1.13). Levels of education and income were similar in the two groups. Vaccinated persons had a higher prevalence of major physical limitations (aPR: 1.40, 95% CI 1.17–1.66) and need for assistance with activities of daily living (aPR: 1.29, 95% CI 1.13–1.47). Conclusion......Background Observational studies on effectiveness of influenza vaccination in the elderly are thought to be biased by healthier lifestyles and higher socioeconomic status among vaccinated vs. unvaccinated persons. We examined this hypothesis in a uniform tax-supported health care system with free......-of-charge influenza vaccination to the elderly. Methods We conducted a cross-sectional study among Danes aged 65–79 years participating in a survey. We compared elderly persons with and without a recent (within six months) influenza vaccination in terms of (i) lifestyle and socioeconomic characteristics obtained from...

  12. Consequences of Debt Capitalization: Property Ownership and Debt/Tax Choice

    OpenAIRE

    Reiner Eichenberger; David Stadelmann

    2009-01-01

    Public debts capitalize into property prices. Therefore, property owners tend to favor tax over debt financing for government spending. In contrast, tenants do not suffer from debt capitalization. Thus, they tend to favor debt over tax financing. Our model of the resulting democratic fight between property owners and tenants over public debts and taxes predicts that the property ownership rate in a jurisdiction negatively effects the debt level. We provide empirical support for this hypothesi...

  13. Public accept for environmental taxes: self-interest, environmental and distributional concerns

    Energy Technology Data Exchange (ETDEWEB)

    Kallbekken, Steffen; Saelen, Haakon

    2010-07-15

    While strongly recommended by economists, it has often been politically difficult to impose taxes on externalities. There is a substantial literature on public attitudes towards environmental taxes. There have, however, been few comprehensive attempts to understand attitudes towards environmental taxes, and few attempts to isolate the effects of selfish and social preferences. The main research question in this paper is which factors influence support for fuel taxation. We propose a model of attitudes towards fuel taxation, and test this model as well as more specific hypotheses, using data from a representative survey of the adult Norwegian population. Our results suggest that support for fuel taxation is best predicted by beliefs about environmental consequences, followed by beliefs about consequences to others. Beliefs about consequences to self ( self interest ) is the factor that explains the least variation in support for fuel taxation. The academically interesting result that support cannot be well explained without capturing a broad range of motivational factors is also highly policy relevant. It implies that there is no magic formula for increasing public support for environmental taxes. There are, however, some issues which can be addressed: trust in how well the government spends the revenue, and the perception that taxation does very little to change behaviour and thus to reduce environmental problems. (Author)

  14. Paying taxes in Euro area countries: issues behind tax morale

    Directory of Open Access Journals (Sweden)

    Virgilijus Rutkauskas

    2016-10-01

    Full Text Available This article investigates theoretical and practical aspects of tax morale in euro area countries. The attitude of households on tax payment – whether to pay taxes or not – is assessed quantitatively by employing dichotomous logit-probit regression analysis. Research is based on household level data received from World Values Survey and European Values Study. The results suggest that the main issues behind weak tax morale are corruption, disrespect to the country. Additionally tax morale is significantly affected by factors like age, gender, religiousness, gender, income and education. Article concludes on possible policy options in order to increase tax morale.

  15. Tax havens or tax hells? A discussion of the historical roots and present consequences of tax havens

    Directory of Open Access Journals (Sweden)

    Ana Margarida Raposo

    2013-09-01

    Full Text Available Tax havens are not recent phenomena. However, in contrast to historical precedents, tax havens in the age of mobile capital allow for non-consensual transfers and are not profitable for every citizen. We discuss the four main groups of tax havens (former Western possessions, sovereign nations, countries controlled by cartels, and emerging economies. This article also synthesizes the history of tax havens and describes their current heterogeneity, discussing the main methods available to regulate tax haven flows. Some of the most efficient methods involve unilateral measures (such as the Fiscal Transparency of Outland Societies but also encompass multilateral measures (such as Tax Harmonization and the Request for Information.

  16. Tax Expenditures in Croatia

    Directory of Open Access Journals (Sweden)

    Vjekoslav Bratić

    2006-06-01

    Full Text Available The tax system of the Republic of Croatia contains a large number of very diverse kinds of tax expenditures whose the declared aim is to achieve certain social and economic objectives. This paper considers all the items that constitute tax expenditures in Croatia, within the systems of the personal income tax, corporate income tax, and real estate transfer tax and value added tax. The objective of the article is to determine the real level of tax expenditures per form of tax in the 2001-2004 period. We hypothesised that the tax expenditures in the analysed forms of tax are both high and growing, which was ultimately borne out, for almost all the analysed items in the tax forms considered are growing.

  17. Good Corporate Governance in Manufacturing Companies Tax Avoidance

    Directory of Open Access Journals (Sweden)

    Uun Sunarsih

    2016-10-01

    Full Text Available This study aimed to examine the effect of good corporate Governance against tax avoidance peroxided by the book tax gap and corporate governance is peroxided by institutional ownership, managerial ownership, independent board, audit committee and audit quality. This study was performed on companies listed on the Stock Exchange on the observation period 2011-2014. The method used is purposive sampling and obtained a sample of 10 companies. The data used is secondary data that can be downloaded through www.idx.co.id and www.sahamok.com.  The results showed that the variables of the board of managerial ownership, independent directors, audit committee, and audit quality effect on tax avoidance while institutional ownership variable has no effect on tax avoidance. It is suspected that institutional ownership as a monitoring tool in any decision taken by the manager does not support an optimal oversight of management performance related to tax evasion.DOI: 10.15408/etk.v15i2.3541

  18. Provision of community benefits by tax-exempt U.S. hospitals.

    Science.gov (United States)

    Young, Gary J; Chou, Chia-Hung; Alexander, Jeffrey; Lee, Shoou-Yih Daniel; Raver, Eli

    2013-04-18

    The Patient Protection and Affordable Care Act (ACA) requires tax-exempt hospitals to conduct assessments of community needs and address identified needs. Most tax-exempt hospitals will need to meet this requirement by the end of 2013. We conducted a national study of the level and pattern of community benefits that tax-exempt hospitals provide. The study comprised more than 1800 tax-exempt hospitals, approximately two thirds of all such institutions. We used reports that hospitals filed with the Internal Revenue Service for fiscal year 2009 that provide expenditures for seven types of community benefits. We combined these reports with other data to examine whether institutional, community, and market characteristics are associated with the provision of community benefits by hospitals. Tax-exempt hospitals spent 7.5% of their operating expenses on community benefits during fiscal year 2009. More than 85% of these expenditures were devoted to charity care and other patient care services. Of the remaining community-benefit expenditures, approximately 5% were devoted to community health improvements that hospitals undertook directly. The rest went to education in health professions, research, and contributions to community groups. The level of benefits provided varied widely among the hospitals (hospitals in the top decile devoted approximately 20% of operating expenses to community benefits; hospitals in the bottom decile devoted approximately 1%). This variation was not accounted for by indicators of community need. In 2009, tax-exempt hospitals varied markedly in the level of community benefits provided, with most of their benefit-related expenditures allocated to patient care services. Little was spent on community health improvement.

  19. Budget strategies for alcohol and tobacco tax in 1987 and beyond

    OpenAIRE

    Christine Godfrey; Melanie Powell

    1987-01-01

    Pre-budget months of recent years have seen the opposing factions of industrial and public health lobbies jostling for influence over the Chancellor's alcohol and tobacco tax policy. Industry petitions for lower tax rates, citing factory closures and redundancy figures as evidence of the consequences of past budget decisions. The public health lobby demand increased taxation, citing rising trends in indicators of alcohol and tobacco related harm as evidence for a public health approach. In th...

  20. Health Promotion and Wellness Staffing Methods

    National Research Council Canada - National Science Library

    Thomsen, Kim

    1999-01-01

    .... Health promotion and wellness programs positively influence the military mission readiness and force protection, increase productivity, reduce health care costs, minimize illness and non-battle...

  1. Vehicular air pollution and environmental tax law in Brazil: proposed tax restructuring for sustainable development

    Directory of Open Access Journals (Sweden)

    Pedro Monteiro Machado de Almeida Penna

    2013-12-01

    Full Text Available This work presents a restructuring of taxes in the automotive sector in Brazil in order to foster sustainable development. Personal vehicles, trucks or buses emit gases that contribute to global warming and cause human health problems. There are policies in Brazil to reduce the emission of air pollutants from vehicles; however, these neither punish the polluter nor provide for damage compensation. The Tax Law, with the Constitutional Polluter Pays Principle, is an efficient instrument for State intervention in the economy. The work compared environmental and economic views regarding fuel and both personal and public vehicles. We estimated the environmental benefits of recycling vehicles in use more than 10 years, taking into consideration pollution engendered in the manufacture of a new vehicle. Finally, we propose to unify vehicular taxation when the vehicle is acquired, by ending the ICMS and PIS / COFINS taxes on fuels and instead taxing CIDE-fuels, without reducing overall collection by the Brazilian government. The ensuing revenue would be used for repairing environmental damages. We have also made suggestions for the improvement of public policies to control emissions of atmospheric pollutants.

  2. Tax morale : theory and empirical analysis of tax compliance

    OpenAIRE

    Torgler, Benno

    2003-01-01

    Tax morale is puzzling in our society. Observations show that tax compliance cannot be satisfactorily explained by the level of enforcement. Other factors may well be relevant. This paper contains a short survey of important theoretical and empirical findings in the tax morale literature, focussing on personal income tax morale. The following three key topics are discussed: moral sentiments, fairness and the relationship between taxpayer and government. The survey stresses the ...

  3. International capital tax evasion and the foreign tax credit puzzle

    OpenAIRE

    Kimberley A. Scharf

    2001-01-01

    This paper examines the role of international tax evasion for the choice of an optimal foreign tax credit by a capital exporting region. Since a foreign tax credit raises the opportunity cost of concealing foreign source income, it can be employed to discourage evasion activity. The existence of international tax evasion possibilities could thus help rationalize a choice of tax credit in excess of a deduction-equivalent credit level. Our analysis shows that, in general the optimal credit will...

  4. 26 CFR 1.641(a)-1 - Imposition of tax; application of tax.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 8 2010-04-01 2010-04-01 false Imposition of tax; application of tax. 1.641(a... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Estates, Trusts, and Beneficiaries § 1.641(a)-1 Imposition of tax; application of tax. For taxable years beginning after December 31, 1970, section 641 prescribes...

  5. A qualitative study of the impact of the UK 'bedroom tax'.

    Science.gov (United States)

    Moffatt, S; Lawson, S; Patterson, R; Holding, E; Dennison, A; Sowden, S; Brown, J

    2016-06-01

    The implementation of the 'Removal of the Spare Room Subsidy' in April 2013, commonly known as the 'bedroom tax', affects an estimated 660 000 working age social housing tenants in the UK, reducing weekly incomes by £12-£22. This study aimed to examine the impact of this tax on health and wellbeing in a North East England community in which 68.5% of residents live in social housing. Qualitative study using interviews and a focus group with 38 social housing tenants and 12 service providers. Income reduction affected purchasing power for essentials, particularly food and utilities. Participants recounted negative impacts on mental health, family relationships and community networks. The hardship and debt that people experienced adversely affected their social relationships and ability to carry out normal social roles. Residents and service providers highlighted negative impacts on the neighbourhood, as well as added pressure on already strained local services. The bedroom tax has increased poverty and had broad-ranging adverse effects on health, wellbeing and social relationships within this community. These findings strengthen the arguments for revoking this tax. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health.

  6. The relationship between cigarette taxes and child maltreatment.

    Science.gov (United States)

    McLaughlin, Michael

    2018-05-01

    Prior research suggests that income and child maltreatment are related, but questions remain about the specific types of economic factors that affect the risk of maltreatment. The need to understand the role of economics in child welfare is critical, given the significant public health costs of child maltreatment. One factor that has been overlooked is regressive taxation. This study addresses this need by examining whether state-level changes in cigarette tax rates predict changes in state-level child maltreatment rates. The results of both a fixed effects (FE) and a fixed effects instrumental variables (FE-IV) estimator show that increases in state cigarette tax rates are followed by increases in child abuse and neglect. An additional test finds that increases in the sales tax (another tax deemed to be regressive) also predict increases in child maltreatment rates. Taken as a whole, the findings suggest that regressive taxes have a significant effect on the risk of child maltreatment. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. 26 CFR 1.511-4 - Minimum tax for tax preferences.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 7 2010-04-01 2010-04-01 true Minimum tax for tax preferences. 1.511-4 Section 1.511-4 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Taxation of Business Income of Certain Exempt Organizations § 1.511-4...

  8. Improving Allocation And Management Of The Health Workforce In Zambia.

    Science.gov (United States)

    Walsh, Fiona J; Musonda, Mutinta; Mwila, Jere; Prust, Margaret Lippitt; Vosburg, Kathryn Bradford; Fink, Günther; Berman, Peter; Rockers, Peter C

    2017-05-01

    Building a health workforce in low-income countries requires a focused investment of time and resources, and ministries of health need tools to create staffing plans and prioritize spending on staff for overburdened health facilities. In Zambia a demand-based workload model was developed to calculate the number of health workers required to meet demands for essential health services and inform a rational and optimized strategy for deploying new public-sector staff members to the country's health facilities. Between 2009 and 2011 Zambia applied this optimized deployment policy, allocating new health workers to areas with the greatest demand for services. The country increased its health worker staffing in districts with fewer than one health worker per 1,000 people by 25.2 percent, adding 949 health workers to facilities that faced severe staffing shortages. At facilities that had had low staffing levels, adding a skilled provider was associated with an additional 103 outpatient consultations per quarter. Policy makers in resource-limited countries should consider using strategic approaches to identifying and deploying a rational distribution of health workers to provide the greatest coverage of health services to their populations. Project HOPE—The People-to-People Health Foundation, Inc.

  9. Management of Tax Payments Under the Definitive Value Added Tax Regime

    Directory of Open Access Journals (Sweden)

    Jurušs Māris

    2018-04-01

    Full Text Available There is a large value added tax fraud in the European Union. The current value added tax system is universal as tax is applied to all parties involved in the chain transactions, thus creating a risk of tax losses if one of the parties involved in the chain transaction does not pay tax in good faith. There is the action plan to introduce the definitive value added tax to prevent tax fraud in intra-community transactions. However, in order to ensure normal value added tax administration in all member states, a number of measures are needed to be done. It is necessary to develop a mutual settlement mechanism in cases of intra-community transactions. The aim of this research is to develop a possible solution for the management of tax payments under the definitive value added tax regime. The results of the research show that to manage tax payments, several payment management systems can be used. However, as a solution, a special clearing system could be introduced. Quantitative research methods such as statistical methods were used in order to analyze the situation of tax fraud in EU and its main causes, as well as mathematical modeling methods to analyze the definitive VAT system and to calculate the balance between countries in an example for clearing mechanism.

  10. 26 CFR 1.903-1 - Taxes in lieu of income taxes.

    Science.gov (United States)

    2010-04-01

    ... taxes. (a) In general. Section 903 provides that the term “income, war profits, and excess profits taxes” shall include a tax paid in lieu of a tax on income, war profits, or excess profits (“income tax... X currency) but is allowed a credit for 30u of excise tax that it has paid. Pursuant to paragraph (e...

  11. Opinion poll tests support for democratic initiatives

    International Nuclear Information System (INIS)

    Burkhart, L.A.

    1993-01-01

    A national opinion poll designed to test public support for a position paper on energy policy for the Clinton Administration and the new Congress, was released February 9 at a Capitol Hill press conference sponsored by the Environmental and Energy Study Institute. The poll, conducted by the Democratic polling firm Greenberg/Lake and Republican pollster Lance Tarrance, found voters want energy efficiency, conservation, and renewable energy as top priorities for the nation's energy policy. It also found voters are willing to seek these policies with tough regulation, tax incentives, and their own behavior. Also, voters appear to support taxes on pollution and energy use, whether the income is used to decrease taxes on personal income, or to reduce the deficit. However, voters oppose gas taxes and are divided on taxes for fossil fuels. Support for energy taxes increases if revenues generated by them are dedicated to deficit reduction. The poll also revealed: the public's desire for less emphasis on polluting sources of energy such as oil and coal; low levels of support for nuclear power; support for government initiatives to increase the fuel efficiency of consumer goods such as appliances and automobiles; opposition to a substantial increase in the gasoline tax; and support for green taxes on polluting sources of energy use at the same time policy makers remove federal tax subsidies on fuels that pollute

  12. Experiences and lessons learnt on staffing from the first Indian nuclear power plant (PHWR)

    International Nuclear Information System (INIS)

    Bhattacharya, A.S.

    2001-01-01

    Three decades of operating experience in India has led to sustained high performance of NPPs. The staffing modules and policies are standardised. The basic functions of operation, maintenance, technical support and quality assurance are carried out by a team of 727 in-plant persons (for a 2 x 220 MW PHWR station) organised at five levels, for fifty positions in ten job families. Specific qualification levels apply to each position - six at management positions, five licensed positions with the rest qualified through an equivalent training scheme. Practically all O and M activities are carried out on-site by the utility manpower with minimum involvement of contractors. The entire process of human resource development is in-house - with each NPP organisation comprised of 30% experienced staff transferred from older NPPs and 70% totally developed out of fresh recruits. Four to eight years lead time goes to qualify fresh recruits depending on the position. This optimisation of manpower is a result of continuous learning - through operating experience and regulatory feed back and self assessment for (i) optimising quantum of work load and (ii) improving productivity. For the first category, design improvements over older NPP's increased reliability, operability, maintainability and human factors are described separately in the companion paper. In this paper the organisation factors are discussed, starting with the initial lessons that demanded improved management and enhanced quality programmes and caused temporarily, high demand of staffing for bringing out new systems, e.g., (i) attaining maturity of units; (ii) standardising training, retraining and cross training and qualifications; (in) job rotations, (iv) in service inspection of reactor components; (v) quality audits. The experiences on subsequent optimisation of staffing levels are outlined. (author)

  13. A comparison of the International Classification of Functioning, Disability, and Health to the disability tax credit.

    Science.gov (United States)

    Conti-Becker, Angela; Doralp, Samantha; Fayed, Nora; Kean, Crystal; Lencucha, Raphael; Leyshon, Rhysa; Mersich, Jackie; Robbins, Shawn; Doyle, Phillip C

    2007-01-01

    The Disability Tax Credit (DTC) Certification is an assessment tool used to provide Canadians with disability tax relief The International Classification of Functioning, Disability and Health (ICF) provides a universal framework for defining disability. The purpose of this study was to evaluate the DTC and familiarize occupational therapists with the process of mapping measures to the ICF classification system. Concepts within the DTC were identified and mapped to appropriate ICF codes (Cieza et al., 2005). The DTC was linked to 45 unique ICF codes (16 Body Functions, 19 Activities and Participation, and 8 Environmental Factors). The DTC encompasses various domains of the ICF; however, there is no consideration of Personal Factors, Body Structures, and key aspects of Activities and Participation. Refining the DTC to address these aspects will provide an opportunity for fair and just determinations for those who experience disability.

  14. The impact of cigarette excise tax increases on purchasing behaviors among New York city smokers.

    Science.gov (United States)

    Coady, Micaela H; Chan, Christina A; Sacks, Rachel; Mbamalu, Ijeoma G; Kansagra, Susan M

    2013-06-01

    We examined the relationship between cigarette excise tax increases and tax-avoidant purchasing behaviors among New York City adult smokers. We analyzed data from the city's annual Community Health Survey to assess changes in rates of tax avoidance over time (2003-2010) and smokers' responses to the 2008 state cigarette tax increase. Multivariable logistic regression analysis identified correlates of buying more cigarettes on the street in response to the increase. After the 2002 tax increase, the percentage of smokers engaged in tax-avoidant behavior decreased with time from 30% in 2003 to 13% in 2007. Following the 2008 tax increase, 21% of smokers reported buying more cigarettes from another person on the street. Low-income, younger, Black, and Hispanic smokers were more likely than respondents with other sociodemographic characteristics to purchase more cigarettes on the street. To maximize public health impact, cigarette tax increases should be paired with efforts to limit the flow of untaxed cigarettes entering jurisdictions with high cigarette pack prices.

  15. NURSE STAFFING AND RENAL ANAEMIA OUTCOMES IN HAEMODIALYSIS CARE.

    Science.gov (United States)

    Erlingmark, Julia; Hedström, Mariann; Lindberg, Magnus

    2016-09-01

    Current trends in renal anaemia management place greater emphasis, and thus increased workload, on the role of the nurse in haemodialysis settings. However, there is little evidence that demonstrates the relationship between nurse staffing and patient outcomes. To describe nurse staffing in haemodialysis settings, its relationship with target levels of renal anaemia management and to describe target level achievement for different ways of organising anaemia management. Cross-sectional audit. Forty (out of 78) haemodialysis centres in Sweden reported quality assurance data. The numbers of bedside registered nurses, licensed nurse assistants and patients undergoing haemodialysis during a predefined morning shift; type of anaemia management and achieved target levels of anaemia management. The mean patient:registered nurse ratio was 2.4 and the mean patient:nurse assistant ratio was 12.8. There were no significant relationships between registered nurse staffing and target level achievement. On average, 45.6% of the patients had haemoglobin within the target levels at centres applying nurse-driven anaemia management, compared with 47.3% at physician-driven centres. These cross-sectional data suggest that renal anaemia outcomes are unrelated to the patient:registered nurse ratio. There is, however, room for improvement in renal anaemia management in the units included in this study, particularly the achievement of target levels of haemoglobin and transferrin saturation. © 2016 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  16. The need for strategic tax planning among nonprofit hospitals.

    Science.gov (United States)

    Smith, Pamela C

    2005-01-01

    Strategic tax planning issues are important to the nonprofit health care sector, despite its philanthropic mission. The consolidation of the industry has led management to fight for resources and develop alternative strategies for raising money. When management evaluates alternative collaborative structures to increase efficiency, the impact on governance structures must also be considered. The increased governmental scrutiny of joint ventures within the health care sector warrants management's attention as well. The financial incentives must be considered, along with the various tax policy implications of cross-sector collaborations.

  17. Tax Rate and Tax Base Competition for Foreign Direct Investment

    OpenAIRE

    Peter Egger; Horst Raff

    2011-01-01

    This paper argues that the large reduction in corporate tax rates and only gradual widening of tax bases in many countries over the last decades are consistent with tougher international competition for foreign direct investment (FDI). To make this point we develop a model in which governments compete for FDI using corporate tax rates and tax bases. The model’s predictions regarding the slope of policy reaction functions and the response of equilibrium tax parameters to trade costs and mark...

  18. Tax-Rate Biases in Tax-Planning Decisions: Experimental Evidence

    OpenAIRE

    Amberger, Harald; Eberhartinger, Eva; Kasper, Helmut

    2016-01-01

    Contrary to standard economic theory, recent empirical findings suggest that firms do not always engage in economically optimal tax planning. We conduct a laboratory experiment and find robust evidence that decision biases offer a behavioral explanation for suboptimal tax planning. When facing time pressure in an intra-group cross-border financing decision, subjects apply heuristics based on the salience of statutory tax rates. This stirs decision makers to underestimate the effects of tax-ba...

  19. 75 FR 28295 - Cummins Filtration, Including On-Site Leased Workers From Manpower and Spherion Staffing...

    Science.gov (United States)

    2010-05-20

    .... The Department has determined that workers from Spherion Staffing were sufficiently under the control..., Including On-Site Leased Workers From Manpower and Spherion Staffing, Including On-Site Workers From Hagemeyer North America, Lake Mills, IA; Amended Certification Regarding Eligibility To Apply for Worker...

  20. Efficiency of road tax in the tax system of the Czech Republic

    Directory of Open Access Journals (Sweden)

    Břetislav Andrlík

    2012-01-01

    Full Text Available The paper deals with the efficiency of road tax in the tax system of the Czech Republic, focusing on the administrative costs of taxation on the timeline 2005 to 2009. It contains a theoretical definition of tax efficiency, and describes the types of costs connected with taxes. From this perspective it focuses on quantifying the direct administrative costs of road tax. Direct measurement of administrative costs is done by using the method called the method of recounted worker which classifies employees of local tax authorities in separate groups and assigns each group a specific number of employees for each reference road tax using the conversion factors. Then it defines the total expenditure of local tax authorities using the coefficients for a particular monitored tax and it provides administrative costs as a percentage of road tax receipts. It can be said from obtained results that direct administrative costs of road taxes are higher, especially if the Ministry of Finance (2004 states that the average direct administrative costs of the tax system in the Czech Republic reach about 2 %. The results achieved in individual surveyed years are for road tax in relation to the reported average value of direct administrative costs of the tax system in the Czech Republic, increased on average by about 1.96 percentage point. Finally, the results of measurements indicating the proposed amendment are discussed.

  1. Estimating the potential of taxes on sugar-sweetened beverages to reduce consumption and generate revenue.

    Science.gov (United States)

    Andreyeva, Tatiana; Chaloupka, Frank J; Brownell, Kelly D

    2011-06-01

    Beverage taxes came into light with increasing concerns about obesity, particularly among youth. Sugar-sweetened beverages have become a target of anti-obesity initiatives with increasing evidence of their link to obesity. Our paper offers a method for estimating revenues from an excise tax on sugar-sweetened beverages that governments of various levels could direct towards obesity prevention. We construct a model projecting beverage consumption and tax revenues based on best available data on regional beverage consumption, historic trends and recent estimates of the price elasticity of sugar-sweetened beverage demand. The public health impact of beverage taxes could be substantial. An estimated 24% reduction in sugar-sweetened beverage consumption from a penny-per-ounce sugar-sweetened beverage tax could reduce daily per capita caloric intake from sugar-sweetened beverages from the current 190-200 cal to 145-150 cal, if there is no substitution to other caloric beverages or food. A national penny-per-ounce tax on sugar-sweetened beverages could generate new tax revenue of $79 billion over 2010-2015. A modest tax on sugar-sweetened beverages could both raise significant revenues and improve public health by reducing obesity. To the extent that at least some of the tax revenues get invested in obesity prevention programs, the public health benefits could be even more pronounced. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Tax Rates, Tax Evasion, and Growth in a Multi-period Economy

    OpenAIRE

    Jordi Caballé; Judith Panadés

    2007-01-01

    We extend the basic tax evasion model to a multi-period economy exhibiting sustained growth. When individuals conceal part of their true income from the tax authority, they face the risk of being audited and hence of paying the corresponding fine. Both taxes and fines determine individual saving and the rate of capital accumulation. We show that, if the penalty imposed on tax evaders is proportional to the amount of evaded taxes, then the growth rate is decreasing in the tax rate. However, th...

  3. Tax Policy Design and the Role of a Tax-Free Threshold

    OpenAIRE

    John Creedy; Nicolas Hérault; Guyonne Kalb

    2008-01-01

    This paper examines the role of the tax-free income tax threshold in a complex tax and transfer system consisting of a range of taxes and benefits, each with their own taper rates and thresholds. Considering a range of tax and benefit systems, particularly those having benefit taper rates whereby some benefits are received by income groups other than those at the bottom of the distribution, it is suggested that a tax-free threshold is not a necessary requirement to achieve redistribution. A p...

  4. Consumption tax incidence: evidence from natural experiment in the Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Zápal, Jan

    2014-01-01

    Roč. 8, č. 2 (2014), s. 149-166 ISSN 1802-792X Institutional support: PRVOUK-P23 Keywords : tax incidence * value added tax * difference-in-differences estimation Subject RIV: AH - Economics http://www.vsfs.cz/periodika/acta-2014-02.pdf

  5. Consumption tax incidence: evidence from natural experiment in the Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Zápal, Jan

    2014-01-01

    Roč. 8, č. 2 (2014), s. 149-166 ISSN 1802-792X Institutional support: RVO:67985998 Keywords : tax incidence * value added tax * difference-in-differences estimation Subject RIV: AH - Economics http://www.vsfs.cz/periodika/acta-2014-02.pdf

  6. Accumulation of Tax-Loss Carryforwards : The Role of Book-Tax Non-Conformity

    NARCIS (Netherlands)

    S. Kohlhase (Saskia)

    2016-01-01

    textabstractUsing confidential corporate income tax return data, this paper investigates the association between book-tax non-conformity (measured as book-tax differences) and tax-loss carryforwards (TLCFs). I find that TLCFs are positively associated with temporary and permanent book-tax

  7. 20 CFR 653.111 - State agency staffing requirements.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false State agency staffing requirements. 653.111 Section 653.111 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR SERVICES... ethnic characteristics in the work force shall be distributed in substantially the same proportion among...

  8. Do beneficiaries' views matter in healthcare purchasing decisions? Experiences from the Nigerian tax-funded health system and the formal sector social health insurance program of the National Health Insurance Scheme.

    Science.gov (United States)

    Ibe, Ogochukwu; Honda, Ayako; Etiaba, Enyi; Ezumah, Nkoli; Hanson, Kara; Onwujekwe, Obinna

    2017-12-28

    Purchasing is a health financing function that involves the transfer of pooled resources to providers on behalf of a covered population. Little attention has been paid to the extent to which the views of that population  are reflected in purchasing decisions. This article explores how purchasers in two financing mechanisms: the Formal Sector Social Health Insurance Programme (FSSHIP) operating under the Nigerian National Health Insurance Scheme (NHIS), and the tax-funded health system perform their roles in light of their responsibilities to the populations. A case study approach was adopted in which each financing mechanism is a case. Sixteen (16) in-depth interviews with purchasers and eight (8) focus group discussions with beneficiaries were held. Agency and organizational behavioural theories were used to characterise the purchaser-citizen relationships. A deductive framework approach was used to assess whether actions identified in a model of 'ideal' strategic purchasing actions were undertaken in each case. For both cases, mechanisms exist to reflect people's health needs in purchasing decisions, including quantitative and qualitative needs assessment, mechanisms to raise awareness of benefit entitlements and allow choice. However, purchasers do not use the mechanisms to effectively engage with and hold themselves accountable to the people. In the tax-funded system, weak information systems and unclear communication channels between the purchaser and citizens constrain assessment of needs; while timeliness of health information and poor engagement practices of Health Maintenance Organisations (HMOs) are the main constraints in FSSHIP. Inadequate information sharing in both mechanisms limits beneficiaries' awareness of entitlements. Although beneficiaries of FSSHIP can choose providers, lack of information on the quality of services offered by providers constrains rational decision-making and the inability to change HMOs reduces HMO responsiveness to

  9. Tax tips for forest landowners for the 2009 tax year

    Science.gov (United States)

    Linda Wang; John Greene

    2010-01-01

    This bulletin summarizes federal income tax information useful to woodland owners in preparing their 2009 tax returns. It is current as of October 1, 2009, and supersedes Management Bulletin R8-MB 132. It should not be sonstrued as legal or accounting advice: consult your legal and tax professionals for advice on your particular tax situation.

  10. Nurses experiences regarding staffing patterns in the surgical wards of a private hospital in Gauteng South Africa

    Directory of Open Access Journals (Sweden)

    Moloko Malatji

    2017-12-01

    Purpose: The purpose of this study was to explore and describe nurses' experiences regarding staffing patterns in the surgical wards of a private hospital in Gauteng in order to develop recommendations for staffing patterns in these wards. Methodology: A qualitative, exploratory, descriptive and contextual research design was used. Data was collected by means of in-depth semi structured individual interviews from a purposive sample of professional nurses working in the surgical wards of this hospital. Data was analysed using Tesch's method of qualitative thematic analysis. Principles of trustworthiness and ethical principles to ensure the protection of human rights were applied throughout the study. Results: The findings of the study revealed one central theme which reflected that participants experienced the staffing patterns of the surgical wards negatively. Two main themes emerged as, nurses had negative experiences in the surgical wards as well as negative emotional experiences related to the staffing patterns. Conclusion: It is evident from the findings of the study that nurses are experiencing staffing patterns negatively.

  11. Cost Effectiveness of a Sugar-Sweetened Beverage Excise Tax in the U.S.

    Science.gov (United States)

    Long, Michael W; Gortmaker, Steven L; Ward, Zachary J; Resch, Stephen C; Moodie, Marj L; Sacks, Gary; Swinburn, Boyd A; Carter, Rob C; Claire Wang, Y

    2015-07-01

    Reducing sugar-sweetened beverage consumption through taxation is a promising public health response to the obesity epidemic in the U.S. This study quantifies the expected health and economic benefits of a national sugar-sweetened beverage excise tax of $0.01/ounce over 10 years. A cohort model was used to simulate the impact of the tax on BMI. Assuming ongoing implementation and effect maintenance, quality-adjusted life-years gained and disability-adjusted life-years and healthcare costs averted were estimated over the 2015-2025 period for the 2015 U.S. Costs and health gains were discounted at 3% annually. Data were analyzed in 2014. Implementing the tax nationally would cost $51 million in the first year. The tax would reduce sugar-sweetened beverage consumption by 20% and mean BMI by 0.16 (95% uncertainty interval [UI]=0.06, 0.37) units among youth and 0.08 (95% UI=0.03, 0.20) units among adults in the second year for a cost of $3.16 (95% UI=$1.24, $8.14) per BMI unit reduced. From 2015 to 2025, the policy would avert 101,000 disability-adjusted life-years (95% UI=34,800, 249,000); gain 871,000 quality-adjusted life-years (95% UI=342,000, 2,030,000); and result in $23.6 billion (95% UI=$9.33 billion, $54.9 billion) in healthcare cost savings. The tax would generate $12.5 billion in annual revenue (95% UI=$8.92, billion, $14.1 billion). The proposed tax could substantially reduce BMI and healthcare expenditures and increase healthy life expectancy. Concerns regarding the potentially regressive tax may be addressed by reduced obesity disparities and progressive earmarking of tax revenue for health promotion. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  12. THE SUCCESS OF COMPANIES OPERATING IN THE AREA OF TAX HAVENS

    Directory of Open Access Journals (Sweden)

    ENEA CONSTANTIN

    2015-12-01

    Full Text Available What is an offshore company? It is a company operating outside the country in which it was established. What is a tax haven? It is a country or jurisdiction where companies have tax advantages usually zero tax. (eg Andorra, British Virgin Islands, Panama, Liechtenstein, Cayman Islands, Seychelles, Cyprus, Malta, etc. How do I open an offshore bank account? Opening an account is a particular problem, which is mostly open once the offshore company is established. Paradise is characterized by the absence levies tax as tax on the income of individuals or legal entities, in respect of succession duties, and of course as tax on capital. Consequently, these areas generally did not sign tax agreement designed to avoid double taxation, having nothing to negotiate in this direction; the several agreements signed disclaim reception facilities made available to foreign investors. Foreign source income will generally support the tax levy the maximum light source of local law provisions. The rule that a very low tax burden, or even an absence of tax levy, generates tax havens should be relaxed. In this paper we decided to present three main areas of interest are the old tax havens: banking and insurance companies, shipping companies and investment and development activities.

  13. The role of offshore tax havens in the international tax system

    OpenAIRE

    Jules Hendriksen

    2016-01-01

    The purpose of this paper is to provide a clear and critical overview of the function and role of offshore tax havens in the current tax system. The paper uses a deductive approach and starts from a basic level to gradually work up to deeper insights on the topic. These have been formed by the examination of literature written on tax havens and through research on tax data. On the basis of this research it is argued that offshore tax havens play a contradictory role in the international tax s...

  14. Religion, Culture, and Tax Evasion: Evidence from the Czech Republic

    Directory of Open Access Journals (Sweden)

    Wadim Strielkowski

    2015-06-01

    Full Text Available Our paper analyzes the impact of culture and religion on tax evasions in the Czech Republic, which represents one of the most atheistic countries in Europe, and a very interesting example of attitudes to the church and religion, as well as the influence of religion on the social and economic aspects of everyday life. Our results suggest that, in the Czech Republic, religion plays the role of tax compliance, but only through a positive effect of visiting the church. National pride supports tax morality while trust in government institutions and attitudes towards government are not associated with tax compliance. These results suggest that the Czech Republic is no different from other countries regarding the relationship between religion and tax compliance. Moreover, the role of government as the authority for improving tax compliance is different from what is observed in other countries.

  15. Collaborative Tax Regulation

    DEFF Research Database (Denmark)

    Boll, Karen

    2016-01-01

    This article shows a new form of regulation within a tax administration where tax administrators abate tax evasion by nudging and motivating consumers to only purchase services from tax compliant businesses. This indirectly closes or forces tax evading businesses to change their practices, because...... stakeholders, i.e. the consumers, in the regulatory craft. The study is based on a qualitative methodology and draws on a unique case of regulation in the cleaning sector. This sector is at high risk of tax evasion and human exploitation of vulnerable workers operating in the informal economy. The article has...

  16. Tax incentives as a solution to the uninsured: evidence from the self-employed.

    Science.gov (United States)

    Gumus, Gulcin; Regan, Tracy L

    2013-11-01

    Between 1996 and 2003, a series of amendments were made to the Tax Reform Act of 1986 that gradually increased the tax deduction for health insurance purchases by the self-employed (SE) from 25 to 100 percent. We study how these changes have influenced the likelihood that a SE person has health insurance coverage as the policyholder. The Current Population Survey is used to construct a data set corresponding to 1995-2005. Both the difference-in-differences and price elasticity of demand estimates suggest that the series of tax deductions did not provide sufficient incentives for the SE to obtain health insurance coverage. © The Author(s) 2014.

  17. Capacity Adjustment through Contingent Staffing Outsourcing

    OpenAIRE

    Neubert , Gilles; Adjadj , Philippe

    2009-01-01

    International audience; For a long time, contingent staffing was considered as the responsability of the Human Resource department. The high needs of workforce flexibility combined with disseminated agencies have led some companies to a great number of labor suppliers. This situation has produced important cost variation, poor quality of service, and important risk due to the mistunderstanding by local managers of legal considerations. To face this situation, companies have started to move fr...

  18. Taxing energy

    International Nuclear Information System (INIS)

    Deacon, R.; DeCanio, S.; Frech, H.E. III; Johnson, M.B.

    1990-01-01

    In this book, the authors have produced an analysis of state energy taxation. Their factual findings are of particular relevance to California and other states in their consideration of severance taxes on oil production. It turns out, for example, that while California's tax burden on oil producers is slightly below average among the states, the combined revenues from taxes and royalties (expressed as a percent of the value of production) indicate that California is not easy on oil producers. In fact, California's oil tax system appears to be particularly well suited to its oil industry. Much of the production in the state is relatively high-cost and economically marginal. The state must tread carefully in taxing this production, lest it force it to be curtailed

  19. Capital Market Effects of Taxes and Corporate Tax Avoidance

    OpenAIRE

    Tassius, Alexander

    2016-01-01

    This thesis consists of four essays: The first essay entitled “Tax Effects on Asset Pricing – New Evidence from Tax Reform Announcements in Germany”, co-authored with Michael Overesch, Chair of Business Taxation at the University of Cologne, not only presents price effects for German shares given rumors about lowering the German corporate tax rate but also shows price effects for bonds following a substantial cut in the German personal interest tax rate. The second essay “Capital Inco...

  20. The welfare comparison of corrective ad valorem and unit taxes under monopolistic competition

    DEFF Research Database (Denmark)

    Dröge, Susanne; Schröder, Philipp J.H.

    2009-01-01

    such as environmental, health, and trade economics, policy makers use taxes to reduce the production/consumption volume in an industry, i.e., to correct an externality rather than to improve tax yield. This paper compares the two tax instruments with respect to equal corrective effect in a Dixit--Stiglitz setting...

  1. Accelerating the Worldwide Adoption of Sugar-Sweetened Beverage Taxes: Strengthening Commitment and Capacity Comment on "The Untapped Power of Soda Taxes: Incentivizing Consumers, Generating Revenue, and Altering Corporate Behavior".

    Science.gov (United States)

    Baker, Phillip; Jones, Alexandra; Thow, Anne Marie

    2017-10-29

    In their recent article Roache and Gostin outline why governments and public health advocates should embrace soda taxes. The evidence is strong and continues to grow: such taxes can change consumer behavior, generate significant revenue and incentivize product reformulation. In essence, such taxes are an important and now well-established instrument of fiscal and public health policy. In this commentary we expand on their arguments by considering how the worldwide adoption of such taxes might be further accelerated. First, we identify where in the world taxes have been implemented to date and where the untapped potential remains greatest. Second, drawing upon recent case study research on country experiences we describe several conditions under which governments may be more likely to make taxation a political priority in the future. Third, we consider how to help strengthen the technical and legal capacities of governments to design and effectively administer taxes, with emphasis on low- and middle-income countries. We expect the findings to be most useful to public health advocates and policy-makers seeking to promote healthier diets and good nutrition. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  2. Pollution tax heuristics: An empirical study of willingness to pay higher gasoline taxes

    International Nuclear Information System (INIS)

    Hsu, S.-L.; Walters, Joshua; Purgas, Anthony

    2008-01-01

    Economists widely agree that in concept, pollution taxes are the most cost-effective means of reducing pollution. With the advent of monitoring and enforcement technologies, the case for pollution taxation is generally getting stronger on the merits. Despite widespread agreement among economists, however, pollution taxes remain unpopular, especially in North America. Some oppose pollution taxes because of a suspicion that government would misspend the tax proceeds, while others oppose pollution taxes because they would impose economic hardships upon certain individuals, groups, or industries. And there is no pollution tax more pathologically hated as the gasoline tax. This is unfortunate from an economic perspective, as a gasoline tax is easy to implement, and is a reasonable Pigouvian tax, scaling proportionately with the harms of consumption. Surprisingly, there is a dearth of theory explaining this cleave between economists and virtually everybody else. Drawing on behavioralist literatures, this paper introduces several theories as to why people and governments so vehemently oppose pollution taxes. Using the example of gasoline taxes, we provide some empirical evidence for these theories. We also show that 'revenue recycling,' the use of tax proceeds to reduce other taxes, is an effective means of reducing opposition to gasoline taxes

  3. 1977 guidebook to California taxes with special emphasis on relationship to Federal taxes

    Energy Technology Data Exchange (ETDEWEB)

    Bock, R.S.

    1977-01-01

    This book is designed to be a quick reference work on California State taxes. With this in mind, the amount of detail is kept to a minimum by assuming that the reader has some knowledge of Federal taxes that are generally similar to the major California taxes (or that he has access to the wealth of information about Federal taxes that is readily available). The book explains the four major California taxes (personal income tax, tax on corporate income, inheritance tax, and gift tax), whenever possible, in terms of the comparable Federal taxes. Differences between the two laws are pointed out, and cross-references make it possible to trace from a given provision in one law to a comparable provision in the other. Special attention is given to subjects peculiar to the California law. In addition to the major State taxes, the book provides general information about other taxes levied by the State. Property taxes are also discussed briefly, because of their statewide impact, although they are imposed by local governmental units.

  4. A carbon tax to reduce CO2 emissions in Europe

    International Nuclear Information System (INIS)

    Agostini, Paola; Botteon, Michele; Carraro, Carlo

    1992-01-01

    This paper examines the effects of introducing a tax on carbon dioxide emissions produced by combustion processes in OECD-European countries. A sectoral model of energy consumption is constructed to examine energy-saving and inter-fuel substitution effects induced by the introduction of various carbon taxes. The simulation period is 1989-94. Our results provide a mild support to the environmental role of a carbon tax. Energy-saving or inter-fuel substitution processes, that result from the introduction of environmental taxation, stabilize emissions at the 1988 level only in the electricity generation sector, and only if high tax rates are assumed ($100/ton.C). By contrast, total emissions (all sectors and all fuels) keep growing, and the implementation of a tax of $100/ton.C can only reduce the emission growth rate. (Author)

  5. Energy taxes, resource taxes and quantity rationing for climate protection

    Energy Technology Data Exchange (ETDEWEB)

    Eisenack, Klaus [Oldenburg Univ. (Germany). Dept. of Economics; Edenhofer, Ottmar; Kalkuhl, Matthias [Potsdam-Institut fuer Klimafolgenforschung e.V., Potsdam (Germany)

    2010-11-15

    Economic sectors react strategically to climate policy, aiming at a re-distribution of rents. Established analysis suggests a Pigouvian emission tax as efficient instrument, but also recommends factor input or output taxes under specific conditions. However, existing studies leave it open whether output taxes, input taxes or input rationing perform better, and at best only touch their distributional consequences. When emissions correspond to extracted ressources, it is questionable whether taxes are effective at all. We determine the effectiveness, efficiency and functional income distribution for these instruments in the energy and resource sector, based on a game theoretic growth model with explicit factor markets and policy instruments. Market equilibrium depends on a government that acts as a Stackelberg leader with a climate protection goal. We find that resource taxes and cumulative resource quantity rationing achieve this objective efficiently. Energy taxation is only second best. Mitigation generates a substantial ''climate rent'' in the resource sector that can be converted to transfer incomes by taxes. (orig.)

  6. European tax law

    NARCIS (Netherlands)

    Terra, B.J.M.; Wattel, P.J.

    2008-01-01

    This book is intended as a reference book for tax law and EC law pratitioners, tax administrators, academics, the judiciary and tax or Community law policy makers. For students, an abridged student edition textbook is available. The book offers a systematic survey of the tax implications of the EC

  7. Nursing Management Minimum Data Set: Cost-Effective Tool To Demonstrate the Value of Nurse Staffing in the Big Data Science Era.

    Science.gov (United States)

    Pruinelli, Lisiane; Delaney, Connie W; Garciannie, Amy; Caspers, Barbara; Westra, Bonnie L

    2016-01-01

    There is a growing body of evidence of the relationship of nurse staffing to patient, nurse, and financial outcomes. With the advent of big data science and developing big data analytics in nursing, data science with the reuse of big data is emerging as a timely and cost-effective approach to demonstrate nursing value. The Nursing Management Minimum Date Set (NMMDS) provides standard administrative data elements, definitions, and codes to measure the context where care is delivered and, consequently, the value of nursing. The integration of the NMMDS elements in the current health system provides evidence for nursing leaders to measure and manage decisions, leading to better patient, staffing, and financial outcomes. It also enables the reuse of data for clinical scholarship and research.

  8. Credits and Exemptions for Children. Tax Facts from the Tax Policy Center. Tax Notes[R

    Science.gov (United States)

    Maag, Elaine

    2009-01-01

    The Earned Income Tax Credit, Child Tax Credit (CTC), Additional Child Tax Credit (ACTC), and the dependent exemption all provide benefits to families with children. In 2009, a single mom (or dad) with two children can receive benefits ranging from $0 to about $7,500--depending on her income, age of the children, and where the children live. While…

  9. The potential impact on obesity of a 10% tax on sugar-sweetened beverages in Ireland, an effect assessment modelling study

    Science.gov (United States)

    2013-01-01

    Background Some governments have recently shown a willingness to introduce taxes on unhealthy foods and drinks. In 2011, the Irish Minister for Health proposed a 10% tax on sugar sweetened beverages (SSBs) as a measure to combat childhood obesity. Whilst this proposed tax received considerable support, the Irish Department of Finance requested a Health Impact Assessment of this measure. As part of this assessment we set out to model the impact on obesity. Methods We used price elasticity estimates to calculate the effect of a 10% SSB tax on SSB consumption. SSBs were assumed to have an own-price elasticity of −0.9 and we assumed a tax pass-on rate to consumers of 90%. Baseline SSB consumption and obesity prevalence, by age, sex and income-group, for Ireland were taken from the 2007 Survey on Lifestyle and Attitude to Nutrition. A comparative risk assessment model was used to estimate the effect on obesity arising from the predicted change in calorie consumption, both for the whole population and for sub-groups (age, sex, income). Sensitivity analyses were conducted on price-elasticity estimates and tax pass-on rates. Results We estimate that a 10% tax on SSBs will result in a mean reduction in energy intake of 2.1 kcal/person/day. After adjustment for self-reported data, the 10% tax is predicted to reduce the percentage of the obese adult population (body mass index [BMI] ≥30 kg/m2) by 1.3%, equating to 9,900 adults (95% credible intervals: 7,750 to 12,940), and the overweight or obese population (BMI ≥ 25 kg/m2) by 0.7%, or 14,380 adults (9,790 to 17,820). Reductions in obesity are similar for men (1.2%) and women (1.3%), and similar for each income group (between 1.1% and 1.4% across income groups). Reductions in obesity are greater in young adults than older adults (e.g. 2.9% in adults aged 18–24 years vs 0.6% in adults aged 65 years and over). Conclusions This study suggests that a tax on SSBs in Ireland would have a small but meaningful effect

  10. Work performance and tax compliance in flat and progressive tax systems

    NARCIS (Netherlands)

    Pantya, Jozsef; Kovacs, Judit; Kogler, C.; Kirchler, Erich

    2016-01-01

    Different tax systems, and their impact on work motivation and tax compliance are significant issues in contemporary political and economic debates. The proportional feature of a flat tax system is assumed to lead to higher performance, while the fairness of the redistributive progressive tax system

  11. The Analysis of Corporate Tax and Personal Income Tax in European Countries

    Directory of Open Access Journals (Sweden)

    Telnova Hanna V.

    2017-06-01

    Full Text Available The aim of the article is to reveal the relationship between the rates of corporate tax and personal income tax and the pace of economic development. The existence of the open financial market under conditions of globalization leaves its imprint on forming the vectors of development of the tax systems in the countries. Thus, the optimal corporate taxation creates a competitive and investment-attractive climate, facilitates encouraging foreign investments and locating economic activities. The study made it possible to establish the absence of a direct link between the tax rates and economic growth. At the same time, a linear relationship between the tax rates and the tax burden is revealed. On the basis of the presented mathematical expression, it can be concluded that an increase in the personal income tax causes an increase in the tax burden, and an increase in the corporate tax — its reduction. The cluster analysis of the corporate tax and the personal income tax in European countries allowed to justify the determinants of successful economic development presenting the formation of the vector of the tax policy in the aspect of moderate taxation of individuals and the need for low taxation of corporate profits.

  12. The progressive tax

    OpenAIRE

    Estrada, Fernando

    2010-01-01

    This article describes the argumentative structure of Hayek on the relationship between power to tax and the progressive tax. It is observed throughout its work giving special attention to two works: The Constitution of Liberty (1959) and Law, Legislation and Liberty, vol3; The Political Order of Free People, 1979) Hayek describes one of the arguments most complete information bout SFP progressive tax systems (progressive tax). According to the author the history of the tax progressive system...

  13. Turnover, staffing, skill mix, and resident outcomes in a national sample of US nursing homes.

    Science.gov (United States)

    Trinkoff, Alison M; Han, Kihye; Storr, Carla L; Lerner, Nancy; Johantgen, Meg; Gartrell, Kyungsook

    2013-12-01

    The authors examined the relationship of staff turnover to selected nursing home quality outcomes, in the context of staffing and skill mix. Staff turnover is a serious concern in nursing homes as it has been found to adversely affect care. When employee turnover is minimized, better care quality is more likely in nursing homes. Data from the National Nursing Home Survey, a nationally representative sample of US nursing homes, were linked to Nursing Home Compare quality outcomes and analyzed using logistic regression. Nursing homes with high certified nursing assistant turnover had significantly higher odds of pressure ulcers, pain, and urinary tract infections even after controlling for staffing, skill mix, bed size, and ownership. Nurse turnover was associated with twice the odds of pressure ulcers, although this was attenuated when staffing was controlled. This study suggests turnover may be more important in explaining nursing home (NH) outcomes than staffing and skill mix and should therefore be given greater emphasis.

  14. Nursing Personnel Planning for Rural Hospitals in Burdwan District, West Bengal, India, Using Workload Indicators of Staffing Needs

    Science.gov (United States)

    Roy, Rabindra Nath; Dasgupta, Samir; Bhattacharyya, Krishna Das; Misra, Raghu Nath; Roy, Sima; Saha, Indranil

    2014-01-01

    ABSTRACT Lack of appropriate human resources planning is an important factor in the inefficient use of the public health facilities. Workforce projections can be improved by using objective methods of staffing needs based on the workload and actual work undertaken by workers, a guideline developed by Peter J. Shipp in collaboration with WHO—Workload Indicators of Staffing Need (WISN). A cross-sectional study was carried out to estimate the nursing stuff requirement for the rural hospitals and provide a quantitative description of imbalances, if there is any, in the allocation at the district level during 2011. The average WISN turns out to be 0.35 for entire district, which means only 35% of the required nurses is available or 65% understaffed. So, there is an urgent need for more allocations and deployment of staff so that workload can be tackled and evenly distributed among all nursing personnel. PMID:25895199

  15. Cigarette Taxes, Smoking-and Exercise?

    Science.gov (United States)

    Conway, Karen Smith; Niles, David P

    2017-08-01

    This research provides the first in-depth analysis of the effect that increased cigarette taxes have on exercise behavior. Smoking may diminish the ability to exercise; individuals may also use exercise to compensate for the harmful health effects of smoking or to avoid gaining weight if they cut back. Our conceptual model highlights these and several other avenues for effect and reveals that the predicted effect of cigarette costs on exercise behavior is theoretically ambiguous. To investigate the relationship empirically, 1994-2012 data from the behavioral risk factor surveillance system are combined with state level cigarette tax rates and other state level variables. Several measures of both smoking and exercise behavior are created and estimated in reduced form models. Our results suggest that both smoking and exercise are reduced by cigarette taxes. However, the effects on exercise may be more complicated as we find that certain groups, such as young adults or those who have recently quit smoking, are affected differently. Our analyses also show that the responsiveness of both smoking and exercise behavior to cigarette costs is much smaller in the 2000s, an era of high-tax increases. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  16. A tax proposal for a cash flow corporate tax

    OpenAIRE

    Lourdes Jerez Barroso; Joaquín Texeira Quirós

    2013-01-01

    Purpose: Due to its advantages in terms of neutrality and simplicity, the aim of this paper is to design a tax base for corporation cash flows, as well as to develop its practical implementation.Design/Methodology: The conceptual aspects and the background of tax on corporation tax flows are reviewed and a tax base that levies a charge on the corporation’s economical activities’ cash flow is then proposed. In order to carry this out, a methodological procedure is developed on the basis of the...

  17. Local tax interaction with multiple tax instruments: evidence from Flemish municipalities

    OpenAIRE

    S. VAN PARYS; B. MERLEVEDE; T. VERBEKE

    2010-01-01

    We investigate the long run result of strategic interaction among local jurisdictions using multiple tax instruments. Most studies about local policy interaction only consider a single policy instrument. With multiple tax instruments, however, tax interaction is more complex. We construct a simple theoretical framework based on a basic spillover model, with two tax rates and immobile resources. We show that the signs of within and cross tax interaction crucially depend on the extent to which ...

  18. THE PROBLEM OF TAX HAVENS AND THE ROMANIAN TAX AUTHORITIES’ REACTION

    Directory of Open Access Journals (Sweden)

    Mihai-Bogdan Afrăsinei

    2013-07-01

    Full Text Available The opportunities to avoid paying taxes provided by tax havens have motivated numerous multinational companies to resort to offshore operations, generating a significant tax loss at a global level. Romania is facing the same problem and the Finance Minister estimates that offshore operations in tax havens are approximately between three and four billion Euros. The refusal to exchange information and the lack of transparency of many tax havens represent a barrier for tax authorities to control these transactions and facilitate the coverage of illegal activities. This has determined certain countries, among which Romania, to impose higher taxes on taxable income of non-residents who are residents in “uncooperative” jurisdictions. In this paper we have emphasized the issue of tax havens and we have presented their classification after the foreign contribution to the capital of Romanian companies. We have also listed the ones with which Romania has signed agreements for information exchange.

  19. Staffing for Cyberspace Operations: Summary of Analysis

    Science.gov (United States)

    2016-08-01

    military-unique knowledge or skills required; (2) military incumbency is required by law, Executive Order, treaty or international agreement (e.g., DPH...civilian employment . 1 Thomas H. Barth et al., “(U) Staffing for Cyberspace Operations,” IDA Paper P...DoD cyberspace strategies, doctrine, and current concepts of operation and employment for CMF. Additionally, the team conducted interviews with

  20. The effects of the Danish saturated fat tax on food and nutrient intake and modelled health outcomes: an econometric and comparative risk assessment evaluation.

    Science.gov (United States)

    Smed, S; Scarborough, P; Rayner, M; Jensen, J D

    2016-06-01

    The World Health Organisation recommends governments to consider the use of fiscal policies to promote healthy eating. However, there is very limited evidence of the effect of food taxation in a real-life setting, as most evidence is based on simulation studies. The objective of this study is to evaluate the effect of the Danish tax on saturated fat in terms of changes in nutritional quality of the diet, that is, changes in saturated fat consumption, as well as other non-targeted dietary measures, and to model the associated changes in mortality for different age groups and genders. On the basis of household scanner data, we estimate the impact of the tax on consumption of saturated fat, unsaturated fat, salt, fruit, vegetables and fibre. The resultant changes in dietary quality are then used as inputs into a comparative risk assessment model (PRIME (Preventable Risk Integrated ModEl)) to estimate the effect of these changes on non-communicable diseases (NCDs) and mortality. The tax resulted in a 4.0% reduction in saturated fat intake. Vegetable consumption increased, and salt consumption increased for most individuals, except younger females. We find a modelled reduction in mortality with 123 lives saved annually, 76 of them below 75 years equal to 0.4% of all deaths from NCDs. Modelling the effect of the changes in diet on health outcomes suggests that the saturated fat tax made a positive, but minor, contribution to public health in Denmark.