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In Canada, as in other industrialized welfare states, definitions of health system sustainability reflect different goals and correspondingly diverse ways of understanding exactly what is to be sustained and how. In this article, we report on results from a survey of documents and groups involved in and/or concerned about sustainability of the healthcare system. We identify four broad narratives of sustainability in Canadian healthcare reform discourse, and explore what these different sustainability narratives tell us about the character and contours of these often‐fractious debates. We argue that sustainability itself may not be a paradigm shift, as has been suggested, but a plot device that helps to steer the story in a particular direction, ‘black‐boxing’ certain aspects of context and emphasizing others. 相似文献
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Michael J. Rosenfeld 《Journal of marriage and the family》2014,76(5):905-918
The author used a new longitudinal data set, the How Couples Meet and Stay Together surveys (N = 3,009), to generate the first nationally representative comparison of same‐sex couple stability and heterosexual couple stability in the United States. He measured the association between marriage (by several definitions of marriage) and couple longevity for same‐sex couples in the United States. Reports of same‐sex relationship instability in the past were due in part to the low rate of marriages among same‐sex couples. After controlling for marriage and marriage‐like commitments, the break‐up rate for same‐sex couples was comparable to (and not statistically distinguishable from) the break‐up rate for heterosexual couples. The results revealed that same‐sex couples who had a marriage‐like commitment had stable unions regardless of government recognition. A variety of predictors of relationship dissolution for heterosexual and for same‐sex couples are explored. 相似文献
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Elke Loichinger Bernhard Hammer Alexia Prskawetz Michael Freiberger Joze Sambt 《Revue europeenne de demographie》2017,33(3):351-380
In this paper we compare several types of economic dependency ratios for a selection of European countries. These dependency ratios take into account not only the demographic structure of the population, but also the differences in age-specific economic behaviour such as labour market activity, income and consumption as well as age-specific public transfers. In selected simulations where we combine patterns of age-specific economic behaviour and transfers with population projections, we show that in all countries population ageing would lead to a pronounced increase in dependency ratios if present age-specific patterns were not to change. Our analysis of cross-country differences in economic dependency demonstrates that these differences are driven by both differences in age-specific economic behaviour and in the age composition of the populations. The choice of which dependency ratio to use in a specific policy context is determined by the nature of the question to be answered. The comparison of our various dependency ratios across countries gives insights into which strategies might be effective in mitigating the expected increase in economic dependency due to demographic change. 相似文献