Healthy, educated and wealthy: A primer on the impact of public and private welfare expenditures on economic growth

In this paper, we provide first evidence of the impact of public and private expenditures in health and education on economic growth, via their influence on people's health, skills and knowledge. We consider a growth accounting framework in order to test whether countries that devote a larger amount of resources to the consumption of health and educational services experience higher growth rates. We also test whether the effects on economic growth of public expenditure in health and education differ from those of private expenditure. Our empirical analysis is based on a panel of 19 OECD countries observed between 1971 and 1998. The results are consistent with the hypothesis that health and education expenditure affects positively growth. The estimated impact is stronger for health than for education. More importantly, we find some evidence that public expenditure influences GDP growth more than private expenditure.     

The Gender Wage Gap in Belarus

A new release of the Belarusian Household Survey on Incomes and Expenditures provides the unique opportunity for an in-depth study of the gender pay gap in Belarus. The econometric analysis involves estimates of augmented earnings equations, also corrected for sample selection bias, as well as for least absolute deviations estimates at different quantiles of the wage distribution. The results suggest that the gender wage gap is smaller than in other countries of the Commonwealth of Independent States and Central and Eastern European countries, as one would expect considering the slow transition process, and is reduced after controlling for unobservable characteristics. Moreover, the gap increases as one moves from the 10th to the 90th quantile. This means that having jobs providing generally higher levels of wages for a woman, it is more and more difficult to get the same wage as that of a man.     

Immigrant Participation in Decision-Making Processes at the Local Level: A Comparison of Immigrants and Veterans in Israel

The issue of new immigrants' participation in policymaking and planning processes at the local level has not been adequately addressed. On the basis of qualitative research, the article examines a variety of different characteristics of immigrant participation in policymaking and planning in Israel. In particular, the research investigates aspects of participation, such as level of influence and typical tactics, of immigrant leaders from the Commonwealth of Independent States (specifically, Russia, the Ukraine, and Belarus) and Ethiopia. In addition, a comparison with veteran leaders in the same city examines whether the characteristics of the immigrants' participation express (a) adjustment to the character of the existing participation in their new city, (b) reliance on the character of participation common in their countries of origin, or (c) participation focusing on the immigrants' position within the power structure of the city. The findings show that the third pattern is prevalent. The article suggests reasons for the emergence of immigrants' participation characteristics, the advantages and limitations of this kind of participation, and means for dealing with the limitations.     

Inequitable Access to Health Services for Older Adults with Diabetes: Potential Solutions on a State Level

Diabetes is a serious global public health challenge. The cost for health services for diabetes care has increased 41% over the past 5 years. Despite escalating health expenditure, the United States continues to have higher rates of diabetes than many other developed countries. There is a need for health care reform in the United States not only in reducing health care costs but also in improving the quality of preventative care. This study presents the testing of a multilevel model investigating variables on the individual and state levels to develop a better understanding of the most important contextual pathways that can lead to providing older adults (50+) with type 2 diabetes with the recommended preventative quality care they require. The model was tested using a three-level repeated cross-sectional design with data from various existing data sources, using a national sample of 181,870 individuals aged 50 years and older. Results showed that differences in state health care systems contributed to inequitable access. Specifically, in a state where there was a higher percentage of adults 65 and older coupled with a shortage of health care professionals, the likelihood of receiving the recommended preventative quality care decreased. Also, older adults living in states with a higher percentage of people with diagnosed diabetes but with a lower-than-average annual per capita health care expenditure fared worse in receiving quality preventative care. Last, older adults in wealthy states with higher percentages of uninsured people had the lowest odds of receiving quality preventative care. Health care reform, similar to what is currently promoted by the Patient Protection and Affordable Care Act of 2010, is recommended to improve the performance of all health care systems in all states.     

Co‐operation of Eu/eea countries with the newly independent states of the former soviet union—a slow start

This paper summarizes the main findings of the report ‘Co‐operation of EU/EEA countries with the Newly Independent States of the Former Soviet Union’ (INCOPOL‐NIS study commissioned by DG XII). The objective is to outline the contemporary strategies of bilateral RTD co‐operation with the NIS as they have emerged in recent years. There are two focal points of attention, namely the bilateral level and the level of policy.     

Caspian Oil in a Global Context

This paper provides a brief overview of the political economy of Caspian oil. It begins by situating the Caspian region's oil sectors in the larger global market, before proceeding to examine the ways in which the Azerbaijani, Turkmen, and Kazakh oil sectors have been organised and governed since 1991. The paper then considers the likely consequences of recent policy shifts in Kazakhstan, the region's most important oil producer. A further section considers the questions of transport infrastructure and export routes, which remain particularly complex problems for Central Asia's landlocked producers. This is followed by a brief conclusion. The paper's central argument is that it is by no means certain that the Caspian region's hydrocarbon potential will be developed in a timely, economically efficient way. While the impact of geology, geography, and international price movements can hardly be ignored, policy-makers can do much to raise or lower the long-term elasticity of the supply by the Commonwealth of Independent States. Unfortunately, policy in the region seems, on present trends, likely to lower it.     

Determinants of Bank Performance in Transition Countries: A Data Envelopment Analysis

We analyze what drives bank efficiency in the transition countries of Central Europe and compare the results with those for the United States. This paper is one of the few that use data envelopment analysis for the computation of efficiency scores in transition countries, and, to our knowledge, it is the first to explore systematically how different specifications of data envelopment analysis affect the results. Our findings corroborate the common wisdom that foreign-owned banks operating in transition countries are more efficient than domestic banks. While in the United States large banks are in general more efficient, the result for transition countries depends on the design of data envelopment analysis.     

FISCAL STRUCTURES AND ECONOMIC GROWTH: INTERNATIONAL EVIDENCE

Our paper systematically examines the effects of fiscal structure on economic growth. We find that for developing countries, debt-financed increases in government expenditure retard growth and tax-financed increases stimulate growth, while for developed countries, debt-financed increases in government expenditure do not affect growth and tax-financed increases lower growth. We impose the government budget constraint on the regression equations so that the precise changes in fiscal policy can be identified (e.g., the effect of a debt-financed increase in health expenditure), employing a pooled cross-section, time-series sample and fixed- and random-effect methods. (JEL 04, E6)     

Inequality as an Explanation for Obesity in the United States

Over the past several decades, there has been a sharp increase in obesity across all population groups in the United States. In fact, the United States has one of the highest rates of obesity compared to other countries throughout the world. Obesity has become a national public health concern because it is related to a number of negative health, social, psychological, and economic outcomes. It is particularly concerning because racial/ethnic minorities and populations with the least education and highest poverty rates bear the largest burden of obesity. In addition, disparities in obesity tend to be gendered, with women experiencing the largest disparities in obesity by income, education, and race/ethnicity. In this review, I describe how social inequality is linked to obesity in the United States. I highlight elements of disadvantage at the individual‐, family‐, school‐, and neighborhood‐level that are linked to energy intake and expenditure, which are directly related to obesity, and draw from evidence and theories from multiple fields of the social and medical sciences. I also highlight the important role stress may play in linking disadvantage to obesity, particularly for women. I argue that understanding the complex mechanisms and processes that link social inequality to obesity requires multidisciplinary and multilevel frameworks.     

Controlling health care costs: An evaluation of strategies

There has been much discussion about the factors underlying inflation in the health care sector and the means to moderate increases in health expenditures. This paper identifies various costcontainment strategies and synthesizes research findings that may be helpful in evaluating their effectiveness. The review demonstrates the complexity of the issues and relationships that must be confronted and understood in cost containment. The delivery system is shown to be not well-suited to improving efficiency and restraining health care expenditure. Any single strategy, whether it involves restructuring the market or more direct regulation, cannot in itself accomplish the combination of expenditure control and adequacy of services that is socially desirable. A number of mutually reinforcing strategies are required. Finally, more empirical and analytical information on incentives, provider and regulatory decisionmaking, costs of regulation, and the dynamics of negotiation, is essential for the design of an effective costcontainment program.     

Multiple roles and mental health in cross-cultural perspective: the elderly in the United States and Japan

This paper examines how multiple roles affect the mental health of the elderly in Japan and the United States, two countries with vastly different cultures. Hypotheses were drawn based on the cultural differences in role experiences, and these hypotheses are tested by analyzing nationally representative samples of the elderly in these countries. The results show that Americans are more likely to be involved in roles related to family, work, and community, while the Japanese are more likely to be involved in only those roles related to family and work. Multiple roles are also found to be less beneficialfor the mental health of Japanese elderly compared to American counterparts. National differences in the effects of individual roles and role configurations on mental health are also documented. Overall, the results show the importance of broad cultural contexts for understanding the relationship between roles and mental health.     

Health beliefs of college students born in the United States,China, and India

The authors surveyed 243 urban public university students who were born in the United States, China, and India to compare the health beliefs of the China-born, India-born, and US-born students. Although the China- and India-born students shared beliefs in many preventive and therapeutic practices of Western medicine with the US-born students, they retained some of their traditional health beliefs. This suggests that student health service clinicians should assess students' cultural beliefs and individualize healthcare for students from different countries.     

Tax policy toward non-profit organisations: an eleven-country survey

The role of private non-profit organisations in modern economic systems is poorly understood. The tax and subsidy treatment of non-profits relative to private firms affects the competitive position of each, and thus their relative strength within any industry; in the United States, for example, non-profit organisations play major competitive roles in such industries as hospitals, nursing homes, day care centres, schools and arts organisations.This paper reports results from a survey of tax policies toward non-profit organisations in eleven countries. The major findings are: (1) the definition and scope of such organisations varies considerably; (2) non-profit organisations are typically regulated by the tax collection agency, but in some countries there is also involvement from the government agency responsible for the particular realm of activity, such as health or education; (3) tax subsidies to non-profits take many forms — not only exemption from corporate profits tax but, depending on the country, for land, buildings, mail and motor vehicles; (4) almost every country limits non-profit organisations' unrelated business activities; and (5) donors are generally permitted to deduct donations of money from taxable income, although there are typically both minimum and maximum limits. These findings point up the larger task of understanding why such differences exist across countries, and what are the effects.Burton Weisbrod is John Evans Professor of Economics and Director of the Center for Urban Affairs and Policy Research, Northwestern University, Evanston, Illinois.Elizabeth Mauser is a PhD candidate in Economics at the University of Wisconsin-Madison.We thank the Ford Foundation for financial support. We also thank those people who responded to the survey questionnaire: Christoph Badelt (Austria), Patrick De Bucquois (Belgium), Miklos Marschall (Hungary), Jimmy Weinblatt (Israel), Disiano Preite (Italy), Mark Robson (United Kingdom), Julia Montserrat (Spain), Ching-chang Yen (Taiwan), Somchai Richupan (Thailand), John Simon (United States) and Wolfgang Seibel (West Germany). In addition, we benefited from reading draft papers by Frits W. Hondius (Council of Europe) and Sheila Avrin McLean (McLean & Co. Ltd), both of whom have done related work on tax treatment of charities in various countries, and from comments by Christoph Franz on an earlier draft of this paper. A version of this paper will appear in a forthcoming volume published by the Center for Social Policy Studies, Jerusalem, Israel. The editors are grateful for the permission of Dr Yaakov Kop, Director of the Center, to publish this paper inVoluntas.     

The demand for job protection: Some clues from behavioural economics

Radical differences in labour market regulations among countries that in other institutional respects are quite similar are still surprisingly frequent. Nonetheless, traditional theoretical analysis meets enormous difficulties in explaining these differences. The scope of our paper is to show that some clues from behavioural economics could be used to better theoretically treat this problem. Our argument is that workers are different, due to the effects of both culture and education. In particular, building on empirical evidence, we argue that loss aversion and hedonic adaptation are culturally-determined and country-specific aptitudes and that they may help explaining why workers, either employed or unemployed, ask for job protection and are willing to pay the cost of it. The main conclusion of our analysis is that, for poorly educated workers sharing a fatalist view of life, job protection can be more effective than public social expenditure. As a consequence, we suggest that countries with a poorly educated and fatalist workforce will be more prone to offer protection through job protection rather than public social expenditure, which is exactly what the empirical evidence shows.     

Computerizing the welfare state

Although computer technology is central to the operation of the modern welfare state, there has been little analysis of its role or of the factors shaping the way in which it is used. Using data generated by expert informants from 13 OECD countries, this paper provides an indicative comparison of the aims of computerization in national social security systems over a 15-year period from 1985 to 2000. The paper seeks to identify and explain patterns in the data and outlines and examines four hypotheses. Building on social constructivist accounts of technology, the first three hypotheses attribute variations in the aims of computerization to different welfare state regimes, forms of capitalism, and structures of public administration. The fourth hypothesis, which plays down the importance of social factors, assumes that computerization is adopted as a means of improving operational efficiency and generating expenditure savings. The findings suggest that, in all 13 countries, computerization was adopted in the expectation that it would lead to increased productivity and higher standards of performance, thus providing most support for the fourth hypothesis. However, variations between countries suggest that the sociopolitical values associated with different welfare state regimes have also had some effect in shaping the ways in which computer technology has been used in national social security systems.     

Sweden and the United States: is the challenge of an aging society leading to a convergence of policy?

The aging of the population is one of many forces behind a current reconstruction of welfare benefits in both Sweden and the United States. While both countries represent ideological polarities regarding social policy, they are struggling to meet their welfare goals with limited resources, and both are adopting similar strategies, for example, decentralization, targeting, and an increased emphasis on privatization and evaluation. This paper summarizes some of the differences between Sweden and the United States and describes some of the forces at work that are lessening the differences between the two countries in strategies and policy regarding care services for elderly people.     

Accident Prevention Among the Elderly

In 1980 the World Health Organization (WHO) published a set of health targets to guide the health policy of its member states as part of its "Health For All by the Year 2000" (HFA-2000) initiatives. However, the translation of health targets into health and social program guidelines is a complex process. This paper illustrates this process through an analysis related to accident prevention among the elderly as conducted by Israeli researchers. Several types of comparative data were used in the analysis. First, the health policy guidelines published by WHO, the United States, and Israel were compared along specific parameters. Then, mortality statistics on accidents among those aged 65 and over were compared for Israel, the United States, Sweden, and Ireland in order to examine the different components of mortaliiy and suggest different priorities for accident prevention. Specific health policy recommendations made to prevent accidents among Israeli elderly are noted; they are compared to those adopted by Israel's Ministry of Health. Finally, exemplary community accident prevention programs from several countries that can serve as models for translating general targets into specific social programs are described.     

Health Beliefs of College Students Born in the United States,China, and India

Abstract

The authors surveyed 243 urban public university students who were born in the United States, China, and India to compare the health beliefs of the China-born, India-born, and US-born students. Although the China- and India-born students shared beliefs in many preventive and therapeutic practices of Western medicine with the US-born students, they retained some of their traditional health beliefs. This suggests that student health service clinicians should assess students' cultural beliefs and individualize healthcare for students from different countries     

Einkommen, Gesundheit und Mortalität in Deutschland, Grossbritannien und den USA

The paper examines the effect of income on mortality with respect to different health statuses and institutional characteristics of the health care system in the USA, Great Britain and West Germany. It is hypothesized that the nature of the theoretical contribution of income in explaining mortality risks changes on whether good or poor health is considered. Taking into account that the health care systems of the countries in question vary by their degree of household out-of-pocket expenditure, we expect an association between income and mortality that differs by country. The analysis is based on the German Socio-economic Panel (GSOEP), the British Household Panel Study (BHPS), and the Panel Study of Income Dynamics (PSID). The effect of income on mortality is found to be weakest when medical services are sought in the presence of poor health within the framework of a national health insurance that renders free primary health care (Great Britain, Germany). The effect is strongest when the provision of primary health care depends strongly on private expenditures (USA).