Saving and consumption patterns of the elderly

The paper provides an empirical analysis of saving and consumption choices of the elderly in Germany, based on the German income and expenditure surveys 1978 and 1983. Main feature of these data is the large sample size making it possible to analyze saving and consumption patterns of the very old (aged 75 and above).The observed age-consumption profiles are very different from those predicted by the pure life-cycle theory. Although wealth is declining between age 60 and 70, it increases again after 70, such that the very old have the highest savings rates among all age groups and accumulate wealth rather than decumulate it. These profiles are not confounded by cohort effects and mortality differences. The corresponding expenditure data suggest the following explanation: due to the generous German pension system and the almost complete coverage of health expenses by the mandatory health insurance in Germany, the declining consumption n very old age cannot exhaust the annuity income of the elderly such that wealth is being accumulated in old age.Research in this paper was supported by the National Institute on Aging, grant no. 3 PO1 AG05842-01. I appreciate the helpful comments by Doug Bernheim, Angus Deaton, Daniel McFadden, Jonathan Skinner, Konrad 'Stahl and David Wise, and two anonymous referees. I am indebted to Hermann Buslei and Johannes Velling who provided most valuable and able assistance.     

Marriage and its transition in Bangladesh

The author examines developments in marriage patterns in Bangladesh in light of social, cultural, and economic conditions. Previous literature on the subject is used to discuss Muslim marriage, Hindu marriage, child marriage, mate selection and social mobility, and the question of a marriage squeeze. "The analysis presents evidence that the society is experiencing a change in its family formation, mating process and family type. This transition is to some extent towards the characteristics of [the] Western World, but in a poor economy. Part of this transition is due to the effect of modernization and part due to increasing poverty."     

Sociological aspects of migration policy: the case of the Federal Republic of Germany

In March 1980 the Federal Republic of Germany (FRG) adopted guidelines for the further development of migration policy in which the social integration of 2nd- and 3rd-generation foreigners was a priority of migration policy in the future. However, there was no corresponding information and education for the German population on the envisaged integration of foreigners. At the end of 1981 the FRG was still not a country of immigration. From 1980-1982 the pressure of public opinion to restrict the number of incoming foreigners and the latent hostility towards foreigners constantly increased. In February 1982, the Federal Government adapted the following principles for their immigration policy: 1) to limit effectively further immigration of foreigners into the FRG; 2) to strengthen the desire of foreigners to return to their native countries; and 3) to improve the economic and social integration of foreigners who have lived in the FRG for many years and to define their rights of residence more precisely. In 1982, migration policy became an important aspect of German domestic affairs. The 1st decision on migration policy taken by the Federal Government (Christian-Democrats and Liberals) was to offer financial incentives for foreigners to remigrate. An opinion poll conducted in late 1981 showed that 1/2 the German population was hostile to foreigners, 58% of Germans wanted to see the number of foreigners limited or reduced, and 62% disapproved of foreign workers being allowed to bring their families into Germany. The Remigration Assistance Act of 1983 has had the following effects: 1) foreigners have become uncertain about their plans for the future, and 2) it gives the German population the illusion that the "problem caused by foreigners" will be automatically solved by their return. Young foreigners encounter unfavorable situations in the training and employment sectors. Another obstacle in their way is hostility to foreigners. A survey in 1985 showed that most older foreigners planned to return to their native country, while most younger ones did not. It is essential for the 1-sided emphasis on remigration assistance to be abandoned in the FRG's migration policy. The commission on migration set up by the Federal Government has also emphasized that the integration of foreigners is a fundamental element of migration policy.     

Time use in child care and housework and the total cost of children

The use of time for child care and housework among Swedish families is investigated. We allow the effect of children on child care and housework to vary by age of the child and also by whether the child is cared for outside the home or not. Our estimates allow us to compute the total cost of children in the form of the cost of time, and the cost of goods, services and housing.The result shows that time used for child care decreases sharply with the age of the child but this is not the case for time used for other housework. Considerable economies of scale is found to prevail for time used for child care. Child care outside the home reduces time use for other housework but the effect on time used for child care is quite small. For the average family time use cost make up more than half of total child cost. Our estimates indicate that decreased time use cost for children caused by care outside the home are not very different from a typical parental fee for public day care.This research was supported by a grant from the Swedish Council of Social Research (SFR). We thank Lennart Flood for useful comments on an earlier version.     

Physician-sponsored networks. Will physicians take back medicine?

Until about the late 1980s, American physicians and their allies, hospitals and the health care manufacturing industries, dominated all facets of the health system--the clinical, the economic, and the political. The bulk of these providers' revenue flowed to them from a highly fragmented insurance system whose governing principle was to provide each insured patient free choice of doctor and hospital. Two distinct, concurrent shifts threaten to erode the medical profession's traditional dominance. The first is a rapid, general shift of control from the supply side of the health sector to its demand side. The second is a shift away from government control, over which organized medicine held much sway in the past, toward private regulators--the executives of the managed care industry. Is the trend towards greater dependence of practicing physicians on non-physician executives inevitable, or can physicians retain--and, in part, regain--their hitherto autonomous position in the health system?     

Health care futures. Part 2: The future of physician executives? Panel discussion

What is the future of health care in America? This is Part 2 of The Physician Executive panel discussion that explores the future of health care in America. To narrow this ambitious focus somewhat, the future is defined as five to 10 years hence. In Part 1, which was published in the May/June issue, Russell C. Coile, Jr., Barbara LeTourneau, MD, MBA, FACPE, James Reinertsen, MD, Uwe Reinhardt, PhD, Marshall Ruffin, MD, MPH, MBA, FACPE, and David Vogel, MS, shared their opinions about what the future holds in managed care, information technology, and biotechnology. In Part 2, Susan Cejka, Barbara LeTourneau, MD, MBA, FACPE, John Henry Pfifferling, PhD, Uwe Reinhardt, PhD, and James Todd, MD, share their views on the future of medical education and physician executives.     

Temporary and illegal labour migration: the Israeli experience

In recent years, Israel has become a major recipient of documented and undocumented temporary labour migrants from many countries outside the Middle East region. The purposes of this article are to describe Israel's experience of temporary labour migration and its concomitant, illegal labour migration; and also to explore what her policies on temporary labour migration indicate about the nature of the policy-making process in this policy domain in Israel.
To these ends the article traces the evolution of temporary labour migration – legal and illegal – and recent policy initiatives of the Israeli government. It then considers some of the major conceptions of the policy-making process found in public policy literature. The article concludes by pointing to the uniqueness of Israel's experience of temporary labour migration and to the fact that her policies have been overwhelmingly reactive – inadequately considered, ill-conceived, ambivalent in relation to their ultimate purpose and, in the course of implementation, vulnerable to "privatization" (being taken over by vested interest groups).
Analysis of the most recent policy initiatives designed to reduce the number of legal labour migrants and address the problem of illegal labour migrants, reflect a policy-making process that is not followed by commensurate action.     

An elusive concept: the changing definition of illegal immigrant in the practice of immigration control in the United Kingdom

This paper examines changing concepts of immigration practice in the UK. Immigration control at the port of entry has extended to internal control within the UK. The burden of proof of legality of status is increasingly on the immigrant, against a background of administrative rather than criminal justice. The changing and broadening definition of illegal immigration in the UK is part of a set of policies, which are governmental responses to what is conceived of as public opinion. THE GUARDIAN suggested that the Home Office has tightened up its application of the rules as the price to the Tory Right for their silence over further changes to the immigration law, thus demonstrating the political aspects of the concept of illegality. The Home Office replied that the UK was now one of the most densely populated countries in Europe and that, in terms of services, the country simply could not support all those who would like to come there. Nor can more than a certain number of newcomers be absorbed by any host community without the risk of friction. However, the host community is now multi-ethnic, and there is a black vote. The growth of administrative justice against which there is little effective appeal, the retrospective application of the 1971 Immigration Act, the ever-widening definition of the concept of illegality along with the fact that there is no time limit under the 1971 Act for one of the most common offenses, that of over-staying, have given rise to an increasing number of campaigns in support of individuals or families. These campaigns against the deportation of "illegal" immigrants may be an indication of a change in public opinion.