Mexican system a mix of public and private providers

The following article is one of a series that deal with the provision of health care services around the world. Other countries in the series include Canada, Germany, Italy, Japan, the Netherlands, and the United States. Countries scheduled for coverage in the series include Austria, France, Singapore, Spain, and the United Kingdom. The countries are described using a grid of characteristics so that comparisons may be made more easily. All of the analyses, along with further comparative data, will be gathered into a freestanding book to be published later in the year. Dr. Mendoza serves as the editor for the project.     

Constitutional guarantees to health care in Spain

This analysis of the Spanish health care system is one in a series of such studies undertaken by the author, following a grid of factors that influence the delivery and financing of health care. The purpose of the national analyses is to facilitate a comparison of the United States' and other health care systems in terms of anticipated reform of the U.S. system. Analyses of the U.S. and nine other national systems are included in a book that has just been published by the College. Spain and nine additional countries will be studied in a book due for publication later this year. A final book with ten additional national analyses will appear in 1996.     

Study tour examines health care systems in Germany, Holland--Part II: The German system

In October 1992, the American College of Physician Executives sponsored a study tour to Berlin, Germany, and Amsterdam, Holland. Meetings were held with government officials, third-party payers, and providers, and on-site visits were made at hospitals, clinics, and academic centers. The purpose was to study the health care delivery system in those countries and to share some insights with the countries' hosts on the U.S. system. In a series of reports that began in the July issue of the journal, 5 of the 10 study tour participants describe their impressions of the tour and of the health care systems in the countries that were visited. In the first report, the health care delivery systems of the United States, Germany, and Holland were compared. In this report, the German system is analyzed in greater detail.     

Decision Style in British and Swedish Organizations: A Comparative Examination of Strategic Decision Making

In this paper results from parallel large scale studies of strategic decision making in Sweden and the United Kingdom are reported. Swedish decision makers are found to employ a decision making style which emphasizes negotiation within a restricted group. This style, which involves considerable information search, leads to very long decision times. Strategic decisions in Britain are made among groups which include fewer strongly committed participants. Delays are common and often serious, but do not lengthen the process unduly. Decision styles in both countries include contrasting tendencies which produce a dynamic tension in the decision arena.     

AN INTERNATIONAL COMPARISON OF LIFETIME INEQUALITY: HOW CONTINENTAL EUROPE RESEMBLES NORTH AMERICA

We compare earnings inequality and mobility across the United States, Canada, France, Germany and the United Kingdom during the late 1990s. A flexible model of earnings dynamics that isolates positional mobility within a stable earnings distribution is estimated. Earnings trajectories are then simulated, and lifetime annuity value distributions are constructed. Earnings mobility and employment risk are found to be positively correlated with base‐year inequality. Taken together they produce more equalization in countries with high cross‐section inequality such that the countries in our sample have more similar lifetime inequality levels than cross‐section measures suggest.     

THE POLITICAL COLOR OF FISCAL RESPONSIBILITY

We propose a dynamic general equilibrium model that yields testable implications about the fiscal policy run by governments of different political color. Successive generations of voters choose taxation, expenditure, and government debt through repeated elections. Voters are heterogeneous by age and by the intensity of their preferences for public good provision. The political equilibrium switches stochastically between left‐ (pro‐public goods) and right‐leaning (pro‐private consumption) governments. A shift to the left (right) is associated with a fall (increase) in government debt, an increase (fall) in taxation, and an increase (fall) in government expenditures. However, left‐leaning governments engage in more debt accumulation during recessions. These predictions are shown to be consistent with the time‐series evidence for the United States in the postwar period, and also with the evidence for a panel of OECD countries. (JEL: D72, E62, H41, H62, H63)     

Trust and Risk Perception in Western Europe: A Cross-National Study

The relationship between trust and risk perception was investigated, within and across four European countries (Sweden, Spain, United Kingdom, and France). Survey data were collected in 1996; total number of respondents was approximately 1,000 (United Kingdom and Spain), 1,350 (France), and 2,050 (Sweden). Trust was a significant predictor of perceived risk within countries, but the strength of the relationship varied from weak (Spain and France) to moderate (United Kingdom and Sweden). General trust was also a significant source of variation in perceived risk among countries, but much of the variation in perceived risk remained unexplained. Correlations between trust and risk perception also varied depending on the type of risk (i.e., nuclear risks were more influenced by trust) and trust measure (i.e., general trust explained perceived risk better than specific trust). It is concluded that trust may be an element in models explaining risk perception, but it is not as powerful as often argued in the risk perception literature.     

Study tour examines health care systems in Germany, Holland--Part I: A comparison of three health care systems

In October 1992, the American College of Physician Executives sponsored a study tour to Berlin, Germany, and Amsterdam, Holland. Meetings were held with government officials, third-party payers, and providers, and onsite visits were made at hospitals, clinics, and academic centers. The purpose was to study the health care delivery system in those countries and to share some insights with the countries' hosts on the U.S. system. Beginning in this issue of the journal, 5 of the 10 study tour participants describe their impressions of the tour and of the health care systems in the countries that were visited. This first report compares the health care delivery systems of the United States, Germany, and Holland. In subsequent reports, the German and Dutch health care systems will be described in greater detail and the ability of the United States to adopt European health care systems will be assessed.     

The Contrast Between Risk Assessment and Rules of Evidence in the Context of International Trade Disputes: Can the U.S. Experience Inform the Process?

Risk assessment provides a formalized process to evaluate human, animal, and ecological responses associated with exposure to environmental agents. The purpose of risk assessment is to answer two related questions.

• ? How likely is an (adverse) event to occur?
• ? If it does, how severe will the impact be?

In the United States, the science of risk assessment has evolved out of the necessity to make public health decisions in the face of scientific uncertainty. Its basic propositions have been established over the past three decades and its applications have impacted virtually every aspect of public health and environmental protection in many countries, including the United States. More recently, the World Trade Organization's (WTO) dispute‐settlement process has provided additional incentive for the reliance on risk assessments internationally through the requirement that member countries be able to provide scientific justification, based on a risk assessment, for public health and environmental regulatory measures that are challenged. The purpose of this article is to review the history of risk assessment in the United States, emphasizing the development of both its scientific and policy aspects, as one example of the development of institutional capacity for risk assessment. This article discusses the importance of the social, political, and economic contexts of risk assessment and risk management in shaping the approaches taken while highlighting the reality that the analytic or risk assessment part of the decision‐making process, in the absence of scientific data, can be completed only by inserting inferences, or policy judgments, which may differ among countries. This article recognizes these differences, and the consequent difference between risk assessment that incorporates public health protective assumptions and the rules of evidence that seek to answer questions of causality, and discusses implications for the WTO dispute‐settlement process. It further explores the value of country‐specific risk assessment guidelines to facilitate consistency within a country along with the appropriateness and feasibility of international risk assessment guidelines.     

The paradox of development planning

Economic planning has become the chief hope of developing countries for ultimately achieving parity with advanced countries in living standards and social progress. Yet, given the different degree of effective control over the economic environment that distinguishes advanced from developing countries, planning is apt to entail a low probability of failure only in the former, where it is less needed or desired. Magnitudes difficult to control in developing countries include agricultural output and export proceeds, yet are the most critical to the economic stability and initial advancement of these societies. Also seriously lacking are reliable and accurate sources of data on which development plans must be based. Acceptance of planning in low-income countries should be conditioned by an awareness that it will not close the development gap overnight and must incorporate broad tolerances with respect to targets.     

Effects of air pollution and weather on the initial COVID-19 outbreaks in United States,Italy, Spain,and China: A comparative study

Contrasting effects have been identified in association of weather (temperature and humidity) and pollutant gases with COVID-19 infection, which could be derived from the influence of lockdowns and season change. The influence of pollutant gases and climate during the initial phases of the pandemic, before the closures and the change of season in the northern hemisphere, is unknown. Here, we used a spatial-temporal Bayesian zero-inflated-Poisson model to test for short-term associations of weather and pollutant gases with the relative risk of COVID-19 disease in China (first outbreak) and the countries with more cases during the initial pandemic (the United States, Spain and Italy), considering also the effects of season and lockdown. We found contrasting association between pollutant gases and COVID-19 risk in the United States, Italy, and Spain, while in China it was negatively associated (except for SO₂). COVID-19 risk was positively associated with specific humidity in all countries, while temperature presented a negative effect. Our findings showed that short-term associations of air pollutants with COVID-19 infection vary strongly between countries, while generalized effects of temperature (negative) and humidity (positive) with COVID-19 was found. Our results show novel information about the influence of pollution and weather on the initial outbreaks, which contribute to unravel the mechanisms during the beginning of the pandemic.     

Living with Nuclear Power: A Q-Method Study of Local Community Perceptions

The issue of new nuclear power is once again high up on the public policy agenda in many countries, and candidate sites for new civilian stations are likely to include those that have existing nuclear facilities. A common assumption is that existing nuclear communities will be more accepting of new build because of the direct economic and other benefits nuclear power already makes to a local area. Surprisingly, there is a dearth of contemporary data on perceptions of the risks, benefits, and values associated with nuclear power within such communities. This study uses Q-methodology to investigate the perspectives on living with nuclear risk among people ( n  = 84) drawn from communities near to two nuclear power stations in the United Kingdom. Both stations, at Bradwell-on-Sea and Oldbury-on-Severn, had been in operation for over 40 years. The Q-analysis identified four main perspectives, or points of view, accounting for 53% of total variance. These were interpreted as: Beneficial and Safe; Threat and Distrust; Reluctant Acceptance; and There's No Point Worrying. We conclude that the "landscape of beliefs" about nuclear power in such communities is both subtle and complex, avoiding simplistic bipolar dichotomies such as "for" or "against," and that there is a need for extensive and meaningful dialogue with such communities over any new build plans. The usefulness of Q-methodology for investigating the ways in which people live with risk is highlighted, as are the implications of the results for theories of risk and trust.     

Methylmercury Risks and EPA + DHA Benefits Associated with Seafood Consumption in Europe

The intake of methyl‐Hg and EPA + DHA through consumption of seafood in Europe as well as the associated probability of exceeding the provisional tolerable weekly intake (PTWI) and the recommended daily intake (RDI), respectively, were estimated by combining methyl‐Hg and EPA + DHA contents in the five most consumed seafood species with hypothesized consumption distributions for eight European countries, chosen on the basis of size and representative significance. Two estimators were used: plug‐in (PI) and tail estimation (TE). The latter was based on the application of the extreme value theory to the intakes distribution curves. Whereas contents data were collected from own database and published scientific papers, consumption data were obtained from statistical sources of the various countries. Seafood consumption levels varied considerably between countries, from 140 in the United Kingdom to 628.5 g/(person.week) in Iceland. The main consumed species were also different between countries. The probability of exceeding the methyl‐Hg PTWI ranged from 0.04% in the United Kingdom to 9.61% in Iceland. Concerning the probability of exceeding the RDI of EPA + DHA, Iceland was third, after Portugal (66.05%) and Spain (61.05%) and the United Kingdom was the last (0.32%). While TE was most accurate for small probabilities, PI yielded best estimates for larger probabilities.     

中美对非援助政策的比较分析

中国是援助非洲最多的发展中国家之一,美国是援助非洲最多的发达国家之一。比较两国的对非援助形式、阶段性特征及本质,不仅有助于我们认识南北援助和南南援助的区别,而且也可以为中国援外政策的发展和完善提供一些新的思路。     

Potential Climate Change Health Risks from Increases in Heat Waves: Abnormal Birth Outcomes and Adverse Maternal Health Conditions

We investigate the risks presented by heat waves for adverse health conditions for babies and expectant mothers when these mothers have been exposed to heat waves during gestation or during the period just prior to conception. Rather than just birth weight and gestational age, we focus on less common metrics such as abnormal conditions in the newborn (fetal distress, reliance on a ventilator, and meconium aspiration) and adverse health conditions in the mother (pregnancy‐related hypertension, uterine bleeding during pregnancy, eclampsia, and incompetent cervix). We use monthly panel data for over 3,000 U.S. counties, constructed from the confidential version of the U.S. Natality Files for 1989–2008. Our models control for sociodemographic factors and include county, month, and state‐by‐year fixed effects to control for unobserved spatial and timewise heterogeneity in the data. Even within the United States, where there is widespread access to air conditioning, heat waves increase the fraction of babies with abnormal conditions related to maternal stress, as well as the fraction of mothers who experience pregnancy‐related adverse health conditions. The scope for these risks in developing countries is likely to be even greater.     

Future trends in world trade (A review of the Lima target)

In March 1975, the United Nations Industrial Development Organization held an important conference at Lima to discuss ways of speeding up the industrialization of developing countries. Various targets were formulated by the conference to achieve further growth in the developing areas of the world, which could have far-reaching implications not only for the developing countries, but also for the developed. The whole structure of world trade could be radically changed by the year 2000 and, as the authors of this article argue, the likely growth of various industries could be altered significantly over the next 25 years.     

An International Comparative Study on Job Mobility

Abstract. Job mobility refers to the movement of people between jobs with different employers. It is an important means of adjustment in the labour market because it facilitates structural changes in the economy. This paper presents the results of a comparative study on job mobility in 6 countries: France, Japan, the Netherlands, Sweden, United Kingdom and the USA. Some of these countries use both labour force surveys and establishment surveys to gather information on job mobility, while other countries only use one of them. The paper uses information from both types of survey held in the seventies and the eighties and describes the developments and the structure of job mobility in the 6 countries. An empirical cross-country analysis shows that job mobility is positively correlated with the growth of employment and negatively correlated with the unemployment rate. There appear to be hardly any structural differences in job mobility between the USA, Sweden, France and the UK. Job mobility in the Netherlands is structurally lower than in the other countries, while job mobility in Japan is structurally lower than in the Netherlands.     

Trait Predictors of Aggression and Crash‐Related Behaviors Across Drivers from the United Kingdom and the Irish Republic

Aggressive driving is acknowledged as a contributor to motor vehicle crashes. This study explored a theoretical model of aggressive expression and crash‐related outcomes using self‐report data collected, using an online questionnaire, from drivers in the United Kingdom and the Republic of Ireland. The proposed model tested whether the personality traits of boredom proneness, sensation seeking, and impulsivity, coupled with trait driving anger, predicted aggressive driving; and whether aggressive driving predicted crash‐related outcomes (loss of concentration and control, near misses, and moving violations). The structural model was confirmed, with aggressive expressions of anger being found to mediate the relationships driving anger and impulsivity had with the crash‐related outcomes. Multigroup invariance analysis showed that the model remained invariant across drivers from the United Kingdom and Ireland, suggesting that the contributing factors for aggressive expression and crash involvement are similar across both countries. When self‐reported crash‐related conditions were compared between drivers in the United Kingdom and Ireland, drivers in the United Kingdom reported more aggressive driving, more minor crashes, more incidents of road rage, and more frequent losses of concentration and vehicle control.     

Measuring human development via data envelopment analysis: the case of Asia and the Pacific

The United Nations Development Program introduced in 1990 the Human Development Index (HDI), which ever since is published annually in the Human Development Report. In this paper, the assessment of the HDI is reconsidered in the light of data envelopment analysis (DEA). The new approach is applied to the countries of the regional aggregate of Asia and the Pacific. Human development is benchmarked on the basis of empirical observations of best practice countries. First, on the same line with HDI, we develop a DEA-like linear programming model to assess the relative performance of the countries in terms of human development. Then we extend our calculations with a post-DEA goal-programming model to derive estimates of a new development index by using optimal weights for the socioeconomic indicators. Finally, we estimate the relative efficiency of the countries in converting income to human development. We develop and solve for this purpose a pure DEA model with variable returns to scale.