Recent data show wide disparity between Japan and the United States in the effectiveness of their health care systems. Japan spends close to the lowest percentage of its gross domestic product on health care among OECD countries, the United States spends the highest, yet life expectancies in Japan are among the world’s longest. Clearly, a great deal can be learned from a comprehensive comparative analysis of health care issues in these two countries.
In Health Care Issues in the United States and Japan, contributors explore the structural characteristics of the health care systems in both nations, the economic incentives underlying the systems, and how they operate in practice. Japan’s system, they show, is characterized by generous insurance schemes, a lack of gatekeepers, and fee-for-service mechanisms. The United States’ structure, on the other hand, is distinguished by for-profit hospitals, privatized health insurance, and managed care. But despite its relative success, an aging population and a general shift from infectious diseases to more chronic maladies are forcing the Japanese to consider a model more closely resembling that of the United States.
In an age when rising health care costs and aging populations are motivating reforms throughout the world, this timely study will prove invaluable.
Popular anger against the financial system has never been higher, yet the practical workings of the system remain opaque to many people. The Heretic's Guide to Global Finance aims to bridge the gap between protest slogans and practical proposals for reform.
Brett Scott is a campaigner and former derivatives broker who has a unique understanding of life inside and outside the financial sector. He builds up a framework for approaching it based on the three principles of 'Exploring', 'Jamming' and 'Building', offering a practical guide for those who wish to deepen their understanding of, and access to, the inner workings of financial institutions.
Scott covers aspects frequently overlooked, such as the cultural dimensions of the financial system, and considers major issues such as agricultural speculation, carbon markets and tar-sands financing. Crucially, it also showcases the growing alternative finance movement, showing how everyday people can get involved in building a new, democratic, financial system.
The cost of hospital care has grown so rapidly in the past thirty years that it is threatening to bend our economy completely out of shape. A hospital bed that cost $16 per day in 1950 cost $214 per day by 1978—an increase of more than 1200 per cent! What is the cause of this fantastic inflation, which has been far higher than for any other major good or service? In this pathbreaking book, Martin Feldstein sets forth a novel explanation, provides empirical support for it, and suggests some remedies for the problem.
Feldstein demonstrates a complex relationship between the growing sophistication of hospital care, physician and patient demand, third-party insurance payments, and the tax treatment of insurance premiums. This last, he argues, is the key to the problem in that government policies stimulate the purchase of excessive insurance by a tax deduction and exclusion that cost the Treasury about $10 billion a year. To mitigate the increasingly severe burden of hospital costs, Feldstein recommends that this preferential tax treatment be ended. In its place, he proposes a new national health insurance plan that would give incentives to physicians and their patients to economize on costs and at the same time provide adequate coverage for major illnesses.
This book assesses the effects of spatially concentrated programs for housing and neighborhood improvement. These programs provide direct assistance to low–income property owners in an attempt to arrest neighborhood decline and encourage revitalization.
The authors used the Harvard Urban Development Simulation Model (HUDS) in evaluating these programs. HUDS, a large–scale computer model, represents the process of housing rehabilitation, the production and consumption of housing services, household moving decisions, and other determinant of neighborhood change. The model simulates the behavior of approximately 80,000 individual households in two hundred residential neighborhoods of various quality levels. Unlike more aggregate models of urban development, HUDS has the capacity to identify how specific housing policies affect individual households as well as particular neighborhoods.
Since program evaluations are no better than the models on which they are based, the authors provide sufficient detail to permit those readers primarily interested in the policy analysis to assess the methodology and to understandhow the policies are represented in the model; a more technical discussion of the model is then presented in appendixes.
Although the simulations focus on policies that induce central–city property owners to upgrade their properties and thus stimulate revitalization, many of the authors' findings are relevant to larger issues of urban development. For example, the analysis of how housing rehabilitation subsidies affect the investment behavior of nonsubsidized property owners provides insights about the link between initial upgrading and sustained neighborhood improvement. The analysis also demonstrates how differences in location, household, and housing stock characteristics affect a particular neighborhood’s responsiveness to a common policy initiative.
Victor Fuchs, author of Who Shall Live?, cuts through the hand wringing and the “pop” panaceas for America's current social crises in a brilliant analysis of the way we live. The facts are familiar. A doubled rate of divorce. A birth rate cut nearly in half while the percentage of illegitimate births nearly tripled. The young face dismal job prospects, and many of the old are totally dependent on the federal government.
Fuchs's economic approach shows us that the societal upheaval of American life is not created by fiat but rather emerges as millions of men and women make seemingly small choices that are constrained by their circumstances: “Should I go back to school?” “How many children should we have?” “When should I retire?” In a masterly synthesis, he shows the interrelatedness of our choices regarding family, work, health, and education throughout the life cycle. He uses the latest facts of American life to explore three major themes—the fading family, the impact of simple demographics on individual destiny, and the effect of weighing present and future costs and benefits on individual choice.
Fuchs concludes by offering innovative solutions to many contemporary problems: social security, health insurance, child care, youth unemployment, and illegitimate births. Moving beyond the outworn orthodoxies of liberalism and conservatism, he offers a clearer view of our circumstances so that readers from all walks of life can make better private choices, and contribute to more effective public policies.
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