医疗体制改革与社会医疗保险基金合理利用原则的研究

中国医疗体制改革是社会主义经济体制改革的重要部分。中国的公费和劳保医疗制度为保障人民健康 ,做出了巨大的贡献。然而 ,4 0多年的实践证明 ,这种公费医疗体制不适合社会主义市场经济体制改革的趋势 ,所以导致了一系列的问题 ,如 :医疗费用激增 ,医疗服务质量下降 ,医疗机构配置不合理 ,以及医疗资源的浪费等。本文在医疗保险基金的筹资—利用系统中 ,分析了改革试点各种统账方式的利弊。在了解了医疗基金的性质、特征及支付管理内容的基础上 ,探讨了中国医疗保险基金支付方式的原则 ,分析了总额预付制在现阶段实施的可行性 ,为合理利用医疗保险基金的原则提出了较基础的评价     

老龄化背景下的人口红利开发与经济发展

本文分析人口加速老龄化背景下人口红利影响经济效益的作用机制,将人口红利的具体作用机制拆分为三个效应,并使用2001—2010年中国285个地级及地级以上城市面板数据进行实证检验。计量估计显示,劳动力数量结构与人均产出间存在明显的正U型关系,劳动力的数量结构仍是人均产出提高的重要动力,中部地区作用最为显著,而东部地区劳动力成本上升倒逼经济转型。通过劳动力的跨部门、跨区域转移、加强人力资本投入以及产业结构升级等,可以进一步实现劳动力资源的优化配置,持续开发人口红利。     

“延龙图”区域人口发展战略研究

结合延边州及"延龙图"区域的自然、经济、社会发展情况,制定了"延龙图"区域未来20年的人口发展战略目标及主要任务,并提出促进"延龙图"区域人口增长的对策建议。通过动员社会资源的共同努力,促进人口资源的优化配置,来实现"延龙图"区域经济社会的全面协调可持续发展,将"延龙图"区域打造成吉林省东部地区的中心城市,确立它在东北亚图们江地区开发中的战略地位、在长白山旅游发展中的枢纽地位、在自治州体制改革中的示范地位、在东北地区具有民族地域个性的特色地位。     

挤入还是挤出:社会保障对子女经济供养老人的影响——关于医疗保障与家庭经济供养行为

社会保障对子女经济供养老人的影响一直是学术界关注的热点问题。基于实地调研数据,控制其他变量基础上,重点分析社会保障对子女经济供养老人的影响,研究结果显示,社会保障总体上对子女经济供养老人的水平具有挤入效应,老年人获得社会保障总体上将提高子女对其经济供养水平。而解释机制分析则发现,原因在于医疗保障释放了老年人的医疗卫生服务需求,进而增加了相应支出,并最终导致子女增加了经济供养支出。进一步分析发现了该效应的群体差异性,而该效应实质是医疗卫生资源和服务分配的阶层性差异,根源在于现行医疗卫生制度存在的各种弊病。在研究结论基础上,提出了建立公平的健康保障与福利改进体系等思考。     

Understanding racial differences in the economic costs of growing up in a single-parent family

This article examines whether the economic consequences of growing up in a single-parent family differ for black children and white children. It is important to understand whether the costs differ across racial groups because although much of the rhetoric about poor single-parent families focuses on inner-city blacks, most children who live in such families are white. If the costs of living with only one parent vary across groups, then policies that are aimed at reducing the costs that do not acknowledge this variation will not target resources efficiently. We found that the economic costs of living with a single parent are larger for black children than for white children. Most of the discrepancy can be attributed to differences in remarriage rates, marital stability, welfare participation, and female labor supply.     

发展循环经济提升自然资源承载力

自然资源是社会经济发展不可缺少的支撑基础,没有资源的支撑,任何国家和地区的经济和社会都不可能有相应的发展。而资源可承载的社会经济发展能力是有限的,无论发达国家还是发展中国家,必须考虑到资源承载力的限制。随着我国经济持续快速增长,资源消耗增加,自然资源对我国经济增长的约束日趋明显,针对资源效率低下、承载力减弱的现状,我国将发展循环经济纳入"十一五规划纲要"。发展循环经济要求以环境友好的方式利用自然资源,实现经济活动向生态化转变,这无异于增加了资源的总量,提升了资源的承载能力。     

The value and cost of children

Recent research on actual and perceived benefits and costs of children to their parents in both developed and less developed countries is summarized. Such figures and research cannot only help predict fertility behavior but can also provide data for welfare departments figuring support costs, courts setting support costs, and government planners allocating resources. Findings on costs and satisfactions from several major surveys are presented and then actual costs in the U.S. are presented in a series of tables. Research indicates that efforts to popularize small families could well take an economic approach - developing social security systems for the aged, substituting mother's for children's work in developing countries. Compulsory education might also help. 1 researcher suggests publicizing exact costs of raising a child. A survey in Hawaii found that parents uniformly underestimated the direct costs of each child. Also, couples might be most receptive to family planning during the years when economic costs are highest.     

A GIS-Based Interval Fuzzy Linear Programming for Optimal Land Resource Allocation at a City Scale

A geography information system based interval fuzzy linear programming model for city land resource allocation is developed in this study for dealing with land-use planning. The developed model improves upon the existing land resource allocation model with advantages in uncertainty reflection, model coupling, data availability and spatial analysis. The model can deal with uncertainties expressed as not only discrete interval values but also fuzzy sets. Therefore, it can effectively reflect dynamic, interactive complex, and uncertain characteristics of land-use system without unrealistic simplification. Moreover, the model can be used for supporting spatial allocation of land resources under a variety of ecological, environmental and socio-economic conditions. The developed model is applied to a real case of land resources allocation in Hangzhou City, China. Results demonstrate that the desired system benefit will be between $ [427.66, 549.83] × 10⁹; The model could help decision makers to generate stable and spatial land resources allocation patterns and strategic land use policies, gain in-depth insights into effects of the uncertainties and analyze trade-offs among economic objective, eco-environmental protection and social demands.     

Diabetes mellitus in Native Americans: The problem and its implications

Since World War II, diabetes has become one of the most common serious diseases among Native Americans. Rates of diabetes and its complications, which include premature death, renal failure, and limb amputation, are substantially higher among Native Americans than among the US general population, and the frequency of diabetes among Native Americans is increasing. Several potentially modifiable factors, including obesity, dietary composition, and physical inactivity, are thought to be contributing to these high rates. The potential benefit from prevention of diabetes is considerable, and a population-based approach may be the most effective way of achieving sustainable lifestyle changes among Native Americans. Estimation of the social and economic costs of diabetes and assessment of the marginal costs and benefits of various diabetes control measures can support resource allocation decisions aimed at improving the health of Native American people.     

Immigration and the low-cost housing crisis: The Los Angeles area's experience

Arrivals of new immigrants and the secondary migration of other immigrants to the Los Angeles area are estimated to be as many as 180,000 each year in the 1980s. The Southern California Association of Governments found three-quarters of the immigrants were low-income minorities who are more likely to live in overcrowded enclaves and pay disproportionately high rents. Other data suggest that immigrants—many of them undocumented and Hispanic—are both victims of and contributors to the housing crisis.Although aggravated by immigration, Los Angeles' low-cost housing ills stem from broader national, social and economic trends: gentrification and other commercial conversion of low-cost housing, stagnating federal housing aid, and diminished tax and loan incentives. Skyrocketing costs have dropped the rate of home ownership well below the national average, forcing more people to rent. Condominium conversions, costly safety regulations, rent controls and successful no-growth movements also have contributed to Los Angeles' housing crisis.     

Drivers of rural exodus from Amazonian headwaters

Rural–urban migration can have both positive and negative environmental consequences for tropical forests. Rural residents exert pressure on the environment through farming, fishing, and forest extraction, yet conversely, protecting rural livelihoods is often the motivation for conserving large areas of threatened forest. This research examines rural settlement within the Brazilian Amazon to shed light on the drivers of on-going rural exodus and its environmental implications. Specifically, we examine the relative importance of public service provision and natural resources in determining settlement patterns along, and rural–urban migration from, eight rivers in road-less regions of the Brazilian Amazon. Data include biophysical, social, and economic variables that were assessed in 184 riverine settlements along rural–urban gradients up to 740 km from the nearest urban center. Settlements were smaller upstream, and lacked key services such as schools and healthcare. We found that clustering of rural populations close to urban centers reflects the high costs of living in remote areas, despite abundant natural resources which previously justified migration to headwaters. Impeded dry-season navigability and transport costs restricted the flow of goods and services to and from remote areas, and transaction costs of trade exchange were higher upstream. A lack of school access was the main motivation for rural–urban migration and the abandonment of remote riverine settlements. A key policy implication is that while education services could provide a powerful tool to stabilize and support rural populations, delivery is challenging in remote areas and may also encourage further rural–urban migration in the longer term. Furthermore, river-dwellers in remote areas rarely visited remote urban centers, presumably because these journeys are too costly. We examine the implications of our findings for anti-poverty subsidies and payment for ecosystem services and conclude that transport costs required to receive payment could encourage further depopulation of remote areas.     

Invisible Scars: Comparing the Mental Health of LGB and Heterosexual Intimate Partner Violence Survivors

Intimate partner violence (IPV) affects countless women and men in lesbian, gay, and bisexual (LGB) as well as heterosexual relationships, but few studies have examined how such abuse is associated with the mental health of LGB victims. The present study addresses this issue using data from the 2006 Behavioral Risk Factor Surveillance System (BRFSS) survey to examine differences in depression and anxiety among IPV victims in LGB and heterosexual partnerships. The findings indicate LGB IPV victims are much more likely to have a history of depression (OR 1.70, p < .05) and anxiety (OR 1.70, p < .05) than heterosexual victims. These differences are slightly mediated by the victim’s perceived emotional support but not the type of abuse experienced. Our findings accentuate the need for greater inclusion of LGB persons in the IPV and mental health discourse, as well as the importance of social support for IPV victims. Policy implications for members of the LGB community are discussed.     

Nativity and older women's health: constructed reliance in the health and retirement study

Gender and nativity are known risk factors for physical and economic dependency. Immigrant women are particularly disadvantaged because of their greater lack of social and economic resources. In this study, we investigate how women immigrants coordinate and utilize various support systems as they approach retirement age, as well as how choices and constraints affect their physical wellbeing. Experiences throughout the life course play a role in the maintenance of health, but the pre-retirement years are particularly crucial to the establishment of patterns of reliance to be used in later life. We examine the effects of economic resources, social support, and family ties (as well as several exogenous variables) on women's physical health using data from the Health and Retirement Survey. For the women in this study, demographic characteristics, such as Hispanic ethnicity and low education are strong risk factors for poor health. Findings also indicate that reliance patterns across resource domains do not differ significantly by nativity and that both economic and familial resource access significantly lessens the risk of poor health for both native and foreign born women.     

Shifts in Reproductive Patterns in China

The People's Republic of China, during the second half of the twentieth century, has been repeatedly affected by social and political upheavals associated with government policies. These have produced strong but unexpected impacts on Chinese demographic patterns. Many of these policies are of the sorts that alter reproductive costs and benefits. This study examines patterns in Hebei, Shaanxi, and Shanghai, three provinces with differing ecological, geographic, and economic characteristics. Government policies affected the three populations differentially; this was evident at both aggregate and individual levels. The Great Leap Forward and subsequent famine created higher birth deficits and mortality among the largely rural populations of Hebei and Shaanxi than the more urban Shanghai. In contrast, the Cultural Revolution and family planning resulted in lower fertility levels for women in Shanghai. The population history of China during the second half of last century thus reflects strong state interventions in the lives of its citizens. Government policies, along with regional variations in geographic, social, and economic conditions, strongly influence individual access to resources in China. Variations in timing and intensity of women's reproductive patterns reflect differential access to resources and subsequent trade-offs.     

央地支出责任划分对基本医疗卫生资源配置均等化的影响

1994分税制改革后,中央政府财政收入增加,地方政府支出责任增加,造成各级政府财力和支出责任不对应。基本医疗卫生资源配置均等会直接影响居民医疗服务的利用的均等化间接影响到居民的健康水平。本文利用《中国卫生统计年鉴》和《中国财政年鉴》中数据,使用基尼系数测度基本医疗卫生资源配置的均等化,利用分位数回归分析央地支出责任划分对基本医疗卫生资源配置均等化的影响,得出我国应该通过增加地方政府财政收入和减少地方政府支出责任特别是卫生支出责任的方式提高基本医疗卫生资源配置的均等化水平。     

Abortion demand

Abortion may be characterized as fertility control. Costs and benefits of an additional child are weighed over time. If costs exceed benefits, fertility control is employed. An economic model of abortion demand is developed that incorporates price, income, demographic factors (tastes), and public policy issues such as abortion funding. A key finding is that state abortion funding, substituted for federal funding under Medicaid as a result of the Hyde Amendments, may be important to abortion demand but it is difficult to differentiate its effect from other effects at the state level with an econometric model.     

Nativity and Older Women's Health: Constructed Reliance in the Health and Retirement Study

ABSTRACT

Gender and nativity are known risk factors for physical and economic dependency. Immigrant women are particularly disadvantaged because of their greater lack of social and economic resources. In this study, we investigate how women immigrants coordinate and utilize various support systems as they approach retirement age, as well as how choices and constraints affect their physical well-being. Experiences throughout the life course play a role in the maintenance of health, but the pre-retirement years are particularly crucial to the establishment of patterns of reliance to be used in later life. We examine the effects of economic resources, social support, and family ties (as well as several exogenous variables) on women's physical health using data from the Health and Retirement Survey. For the women in this study, demographic characteristics, such as Hispanic ethnicity and low education are strong risk factors for poor health. Findings also indicate that reliance patterns across resource domains do not differ significantly by nativity and that both economic and familial resource access significantly lessens the risk of poor health for both native and foreign born women.     

人口政策与人力资源开发

人口政策是宏观调控人口数量和质量的政策 ,是对国家未来发展具有决定性影响的战略政策。一个国家的人口政策如何 ,将会极大地影响这个国家的人口发展 ,影响人力资源的发展方向和发展趋势 ,进而影响到国家未来社会经济的发展和国家的综合国力。我国的人口政策 ,在促使人力资源数量与社会经济发展相适应 ,提高人力资源的身体素质和科学文化素质 ,促进人力资源的合理利用方面 ,发挥了巨大的作用 ,产生了巨大的经济效益和社会效益     

欧债危机下的养老金制度改革——从福利国家到高债国家的教训

文章从人口老龄化的角度,分析了老龄化成本的含义和构成及其导致希腊陷入债务危机的诱因,认为欧洲尤其是希腊的养老金体系存在的替代率过高、待遇率严重失衡、养老金财富总值超出支付能力等问题提升了老龄化的财务成本;作者在分析了欧债危机下世界改革养老金的趋势后,认为中国养老金制度中存在参数不合理、缺乏个人激励机制、市场激励因素弱化、再分配因素失衡等潜在的财务风险,建议重视第二支柱的建设以部分转移第一支柱的财务风险,逐渐提高退休年龄以重建科学的制度参数,重塑账户的激励功能以增强制度收入能力,建立制度防火墙以规避潜在财务风险。     

Prevalence of Low Physical Activity and its Relation to Social Environment in Deprived Areas in the London Borough of Redbridge

Achieving adequate levels of physical activity (PA) is important to maintain health and prevent chronic disease. The costs of inadequate physical activity to the NHS have been estimated at over a billion pounds annually. While socio-demographic characteristics such as age, sex and ethnicity have been reported to be associated with different levels of PA, there is evidence that people??s social environments may also be important in encouraging a physically active lifestyle. The objective of this paper is to describe associations between the social environment and physical activity among the poorer communities in an outer London Borough, when other socio-demographic factors are controlled for. A household survey was carried out in six poorer neighbourhoods in Redbridge in 2008 as part of a wider health needs assessment. The questionnaire included questions allowing estimation of levels of physical activity as well as extent of social environment [social network score (SNS) and social support score (SSS)]. A random sample of households was taken and a total of 799 completed responses from over 16 year old were obtained. The association between physical activity and the social environment controlling for socio-demographic characteristics was estimated using a logistic nested model. Higher SNS was significantly associated with younger age, Black ethnicity, higher education level, higher household income and higher levels of PA in bivariate analyses. Higher SSS was positively associated with Indian ethnicity, higher household income and area of residence. In multivariate analyses higher levels of PA were significantly associated with wider social networks and stronger social support, educational level and marital status. Despite its limitations, our findings confirm that the relationship between low physical activity and weak social networks and low social support, observed in general population studies, also occurs in deprived communities in London. The relationship merits further exploration given the limited evidence on the effectiveness of interventions to promote physical activity.