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.     

伍德罗·威尔逊构建世界新秩序的原因初探

伍德罗·威尔逊在其执政时期,利用一战的有利时机提出"十四点"和战后建立国际联盟的构想,妄图以此来领导世界,建立美国的世界霸主地位。威尔逊倡导建立由美国主宰的世界新秩序决非偶然,这是由一战时期美国经济的膨胀和威尔逊思想中根深蒂固的扩张主义思想决定的。     

Psychophysical conditions of air traffic controllers evaluated by the standard shiftwork index

Abstract

In the ambit of a large epidemiological survey on the Italian population of air traffic controllers, an evaluation of their health conditions was carried out using the Standard Shiftwork Index (SSI). The study took into consideration 572 male air traffic controllers, aged between 23 and 59 years, of whom 301 were engaged in three large Regional Centres, 189 in thirteen Airport Towers and 82. formerly active controllers, were working in administrative offices. The former controllers showed worse health levels, in particular minor psychological disorders and chronic fatigue. Sixteen of them had been transferred to administrative jobs because of health impairment, owing to severe diseases of the nervous, gastrointestinal and cardiovascular systems. Such disorders, and musculoskeletal ones, were mostly reported by the active controllers. The controllers engaged in Regional Centres showed more sleep disturbances than those engaged in towers. Beside age, some personal characteristics appeared to influence health and well-being. Neuroticism was correlated with chronic fatigue, digestive and cardiovascular complaints, minor psychological disorders, cognitive and somatic anxiety. On the other hand, morningness was correlated negatively with sleep disturbances on morning shift, and positively with sleep duration both on morning shift and rest days.     

Professional discourse in winning images: objectivity and professional boundaries in environmental news images in the World Press Photo contest, 1992–2011

This article applies the ecological theory of professions to analyze professional discourse in the World Press Photo (WPP) contest, an international photojournalism contest held in Amsterdam, the Netherlands. The article analyzes the content of 148 photojournalism works that received environmental awards in the period 1992 to 2011, the two decades after the 1992 Earth Summit in Rio de Janeiro. The article seeks to understand the representation and negotiation of objectivity and the claims of professional boundaries by the media of both developed and developing countries as well as non-governmental organizations (NGOs). It also seeks to interpret the professional discourse of the WPP in relation to ideologies and power dynamics in both journalism and global environmental politics. The results suggested that the media of developed countries dominated the discourse, and the conventional notion of journalistic objectivity remained intact. However, the results also showed that global environmental politics and the situation of journalism created openings for the media of developing countries and NGOs to enlarge jurisdictional claims in the area of natural disaster reporting and to challenge the conventional notion of objectivity. The results also showed that the conventional notion of objectivity did not necessarily hinder explanations of the complexity of environmental issues, which was made possible by choosing unique angles of storytelling, planning multiple shots, and using richly suggestive, naturalistic images.     

To Leave an Area After Disaster: How Evacuees from the WTC Buildings Left the WTC Area Following the Attacks

How people leave a devastated area after a disaster is critical to understanding their ability to cope with risks they face while evacuating. Knowledge of their needs for communications about these risks is particularly crucial in planning for emergency responses. A convenience sample of 1,444 persons who survived the World Trade Center (WTC) attacks on September 11, 2001 were surveyed to ascertain their initial and ultimate destinations once they had left the buildings, how they arrived there, the role of types of obstacles they encountered, and the need for information and the seeking of other people as potential factors in influencing the process of leaving immediately. This survey was part of a larger, original survey. Results showed differences in how people traveled by mode to initial and ultimate destinations, how immediately they left the area, and factors associated with when they left. How they traveled and when they left were associated with where people lived, their tendency in times of stress to seek out other people including who they knew in the immediate area (e.g., co‐workers or friends), the physical conditions surrounding them, and the importance to some of waiting for more information. Many people indicated they did not leave immediately because they had no information about where to go or what services would be available to them. Perceptions and communications about risks they were facing were reflected in the choices they considered in how and when to leave the area. These findings have numerous ramifications for understanding and guiding personal behavior in catastrophic situations.     

Does work during childhood affect the health of Guatemalan adults?

The diversity of potential relationships between child labor and health makes the empirical disentanglement of the causal relationship a difficult exercise. This paper examines the long run impact of child labour on health by controlling for unobserved household specific characteristics. In order to control for the unobserved households specific effect, we estimate a conditional fixed effect model using data on siblings constructed from the Guatemalan National Survey of Living Condition. The estimation results reinforce the conventional wisdom that child labor is harmful for health in the long run. The results can be interpreted as a lower bound of the true impact since healthier children are most likely to offer themselves for employment and to be appointed. The views expressed in this paper are those of the authors and do not necessarily represent those of IMF and IMF policy.     

Healthcare in India: Changing the Financing Strategy

The way in which healthcare is financed is critical for equity in access to healthcare. At present the proportion of public resources committed to healthcare in India is one of the lowest in the world, with less than one‐fifth of health expenditure being publicly financed. India has large‐scale poverty and yet the main source of financing healthcare is out‐of‐pocket expenditure. This is a cause of the huge inequities we see in access to healthcare. The article argues for strengthening public investment and expenditure in the health sector and suggests possible options for doing this. It also calls for a reform of the existing healthcare system by restructuring it to create a universal access mechanism which also factors in the private health sector. The article concludes that it is important to over‐emphasize the fact that health is a public or social good and so cannot be left to the vagaries of the market.     

中国农业在加入WTO后面临的主要问题及对策

中国加入WTO后 ,农业将是受到冲击最大的行业之一。中国农业的发展条件、生产力水平与主要发达国家和一部分发展中国家还有一定的差距。因此 ,针对中国农业的现状 ,分析加入WTO后面临的主要问题 ,并提出中国农业发展的基本对策 ,很有必要     

Chinese and Americans Agree on What Is Fair,but Disagree on What Is Best in Societal Decisions Affecting Health and Safety Risks

Through surveys of students and junior professionals and interviews with business and government executives, we studied Chinese choices and fairness perceptions in risky health and safety decisions. The survey responses were compared with American responses from an earlier study by Keller and Sarin.The survey results show that the American and Chinese respondents had similar fairness perceptions, but the Chinese did not make decisions that were consistent with their fairness perceptions, whereas the Americans did. We found that the middle-age Chinese professionals tended to make choices that were more different from the Americans than were the choices of the young Chinese management students. It is likely that these discrepancies were caused by cultural differences, with the younger Chinese tending to face a stronger Western influence.The insights from the survey results were enriched by interviews that revealed fairness perceptions of Chinese business and government executives. A framework to interpret cultural influences on decision making was also proposed.     

Brand alliance and event management for social causes: Evidence from New Zealand

This paper uses findings from research on the effectiveness of a New Zealand health promotion program to make two arguments. The first is that, in appropriate cases such as this program, event management can play a key role in a social marketing health promotion campaign. In showing how event management added value to achieving that particular program's goals, it argues that event management could often be a valid and effective part of the mix for other campaigns promoting social causes. The second highlights important issues that can arise in relationships between non-profit organizations and the commercial sponsors of their events. It contends that organisers of campaigns for social causes need to be alert to the risks in brand alliances between such organizations and need to consider not only the appropriateness of the fit but also the need for an appropriate balance between the sponsor's commercial interests and the non-profit organization's goal.