Private agencies for public purposes: some new perspectives on policy making in health insurance between the wars

The approved societies, who were charged with the administration of health insurance in Britain, have long been blamed for the failure of the scheme to expand its coverage or scope in the interwar period. This paper takes a closer look at the administrative process and argues that societies were more vulnerable to central regulation than is commonly thought and were unable to resist cuts in public subsidies and extensions in liability introduced at their expense. They provided a convenient scapegoat for policies emanating primarily from the economic orthodoxy subscribed to by both government and the Treasury, modified to protect the unemployed during the slump. Health insurance policy was dominated to a large extent by the Government Actuary, who aimed to guarantee the cost effectiveness of the scheme. This paper also shows how administrative definitions and practices affected the classification of claimants to state social insurance at this time. It re-establishes the major weaknesses of the system, arguing that--in the light of recent discussions about reviving a system of national health insurance--we have much to learn from looking again at the experience of the interwar period.     

The role of simulation techniques in the theory and observation of family formation

Summary The investigation of fertility change can involve the consideration of the results of micro-level empirical studies in the context of an economic theory of family formation. In particular, a change in the observable statistics can then be related to a change in behaviour, or factors influencing behaviour. The analysis of this relationship is hindered, however, by its complexity and by the large number of stochastic variables present. It is argued that an essential aid to such an analysis is the use of a model suitable for simulation. Here, we present such a model and illustrate possible applications with various experiments.     

Program evaluation: the experience in population education

The Population Education Program (PEP) of the Department of Education and Culture in the Philippines takes pride in a built-in evaluation system which assesses accomplishments primarily in light of objectives laid out and gathers feedback useful in improving future training programs. Its evaluation theoretically serves to measure 3 training dimensions -- before, during, and after each training course. Evaluation of both the 5- and 1-week training programs follows the same pattern. Pretraining evaluation is done by administering a pretest at the beginning of each course, which quantitatively measures trainees' baseline knowledge and attitudes. It is intended for the use of trainers in determining how the course should proceed. Assessment made while training is in progress (formative evaluation) is done through a steering committee meeting held at the end of a week or a day for the 5- and 1-week courses, respectively. The meetings focus on identifying weaknesses requiring immediate or future course revisions. At the end of the course, a posttest is given to measure positive or negative changes in the trainees' knowledge and attitudes. These changes are assumed to have been caused by training. Additional qualitative information is collected through an evaluation sheet containing open-ended questions on different aspects of the course. Problems of "who" should evaluate and "how to" evaluate are among current problems evident in practice, and a revised training scheme has been implemented to deal with these problems.     

Can fertility be estimated from current pregnancy data?

Summary This paper explores the feasibility of estimating fertility from reports on current pregnancies collected in single-round sample surveys. Data from 15 countries in the World Fertility Survey are used to evaluate the possibilities. The results indicate that neither the age pattern of fertility nor the total fertility ratio can be reliably estimated from current pregnancy data. For almost all countries, the total fertility ratio based on recent births is higher than that based on current pregnancies, even when the latter estimate is restricted to higher durations of pregnancy.     

Far eastern patterns of Mortality

Summary In this paper a mortality pattern is identified which has not previously been described by model mortality schedules and seems to have occurred only in populations in the Far East. Mortality schedules in Taiwan, Hong Kong, Singapore, and Korea during the past several decades have been characterized by excessively high death rates of men at the older ages. This excess mortality has progressively diminished and most recent death rates for men show only slight deviations from West model life tables. An examination of statistics on causes of death suggests that tuberculosis is at least partly responsible for the excess mortality of men.     

Women's status and family planning in Haiti

"The paper argues that women's status in Haiti is a factor favorable to the spread of modern contraception and a potential rapid demographic transition from high to low fertility. After briefly reviewing recent theories on the determining of fertility declines, the paper considers women's status in Haiti. It discusses family patterns, conjugal unions, and economic activities. Finally, it reviews current patterns of contraceptive use and considers how these are related to various aspects of women's status."     

The future of migration

These three papers on the future of migration make up a summary report on the Conference of National Experts held at the OECD in Paris, May 13-15, 1986. The papers concern possible policy options, international migration as a basic element of economic development, and conclusions about migration trends from the present to the long-term future. The author of the concluding paper remarks that "the Conference brought representatives of all of the Organization's Member countries together with eminent economists and social scientists to discuss the possible and probable outlook for migratory movements in the years to come. The purpose was not to define international norms in this respect, nor to draft one or more international agreements or a legal instrument having the force of law, but to review all the problems raised by that outlook."