95 research outputs found
An Economic Analysis of the Diet, Growth, and Health of Young Children in the United States
No full textThe purpose of this paper is to investigate the extent to which family income and education are obstacles to the provision of adequate diets for young children in the United States. An examination of the Health and Nutrition Examination Survey reveals the following: 1. Average nutrient intakes of young children are well above recommended dietary standards, with the exception of iron. 2. Average nutrient intakes for children in households of lower economic status are very similar to intakes of children in households of higher economic status. Rates of children's growth are also similar in these households. 3. Family income and education of the household head have statistically significant but very small positive effects on the nutrient intake levels of young children. 4. There are substantial effects of protein intakes on children's height and head growth, even though protein is consumed in excess of dietary standards. This finding and the apparent correlation between children's growth and their intellectual development brings to question the adequacy of present protein standards. Could American mothers, who provide very high protein diets for their children in households at all levels of socioeconomic status know more about what constitutes an adequate diet for their children than the experts do?
A pay-for-performance system for civil service doctors: The Indonesian experiment
No full textIn 1980 the Government of Indonesia proposed the introduction of a pay-for-performance system, the Functional Position System (FPS), for certain occupational categories of civil servants to provide a career development path and stimulate productivity (Government of Indonesia. Government Ordinance No. 3, 1980 Concerning Appointment to Civil Service Rank. Jakarta, 1980). The FPS, a bold pay concept in the civil service, links pay to skills and performance. In 1987, instructions were issued for doctors to be included in the system (Government of Indonesia. Credit Scores for Doctors. Circular Issued by the Ministry of Health and the Agency for Administration of the Civil Service No. 614/MENKES/E/VIII/1987 and No. 16/SE/1987). In this paper we evaluate how well the system--which in principle could be applicable to both developed and developing economies--can meet its stated objectives for Indonesian doctors working in the community, and for Indonesian health policy objectives as stated in the country's last five-year development plan "Repelita V" (Government of Indonesia. The Fifth Five-year Development Plan (Repelita V) 1989-1994. Jakarta, Indonesia, 1989). The FPS is particularly innovative in the Indonesian environment where wages are low and comparatively uniform, reflecting a philosophy of 'shared poverty', and vary primarily by seniority. The FPS has, however, several conceptual and practical shortcomings. The design of the reward system disregards effort or time inputs, as well as other inputs needed per unit of reward. Consequently, the FPS can not be used as an effective incentive system promoting professional excellence and health policy objectives. Practically, the system hardly provides an effective alternative for career development among community physicians. Nor does the system provide enough resources to induce physicians to spend more effort in their civil service activity and less effort in private practice. An improved FPS taking these and other comparatively more technical shortcomings into account has promise as a viable substitute or a supplement to wage, capitation and fee-for-service systems to compensate physicians in both developed and developing economies (Chernichovsky D. The Emerging Financial Mechanism of Health Systems: Capitation and its Organizational Consequences. Ben-Gurion University, Israel; Chernichovsky D. Physicians' Pay--A Synthetic Approach. Ben-Gurion University, Israel, 1994).doctors' pay incentives performance health policy
Microeconomic theory of the household and nutrition programs
No full textLack of food is no longer the major cause of malnutrition. Many households and individuals remain malnourished when income and supplies of food are adequate. Nutrition policy and programs must be based on a sound knowledge of household behaviour patterns. The microeconomic theory of the household focuses on the household's decisionmaking about scarce food resources based upon such considerations as: (i) the size of the family; (ii) the purchasing power of the family; (iii) the availability of healthful foods; (iv) the family's food preferences; (v) environmental variables (such as ethnic traditions and the homemaker's level of education); and finally (vi) family health (disease can limit the absorption of nutrients). Such determinants should be monitored to anticipate malnutrition problems unrelated to the food.Environmental Economics&Policies,Economic Theory&Research,Poverty Lines,Health Economics&Finance,Inequality
Pluralism, Public Choice, and the State in the Emerging Paradigm in Health Systems
No full textToday in developed nations, the public pays for most medical care, with the state and the medical profession or providers determining its nature, form, and level. But there is no well-defined institutional framework for revealing consumer preferences and enabling client choice about the nature and form of public entitlement. This thwarts the efforts of health system reformers to satisfy their clients and consequently promote equity and control costs--the raison d'etre of publicly supported care. Consumers can be empowered in the emerging paradigm, however, in which the publicly financed system also contains competing fund-holding institutions that organize and manage the consumption of care (OMCC), such as HMOs and sickness funds. In a system in which individuals are entitled to health coverage, OMCC institutions can play an essential role in both shaping the entitlement and in expressing members' preferences. To do this, the OMCCs need to be financed through capitation and endowed with appropriate constitutional rights on how to use the funds
La desagregación de los gastos privados en atención médica en Colombia; Implicaciones políticas
No full textEl documento hace un análisis descriptivo y comparativo entre distintos elementos de tres escenarios (un modelo estatizado, privatizado o combinado) hacia los cuals puede evolucionar el Sistema general de Seguridad Sociel en Salud (SGSSS) de Colombia. La presentación de estas distintas perspectivas tiene el objetivo de fundamentar un debate público informado sobre las dificultades presentes en el sistema de salud actual y qué se puede hacer al respecto. Dentro de los elementos de cada escenario, se hace mención a mecanismos de financiación, vigilancia (regulación), qué beneficios abarca la afiliación al sistema, entre otros
La desagregación de los gastos privados en atención médica en Colombia; Implicaciones políticas
No full textEl documento hace un análisis descriptivo y comparativo entre distintos elementos de tres escenarios (un modelo estatizado, privatizado o combinado) hacia los cuals puede evolucionar el Sistema general de Seguridad Sociel en Salud (SGSSS) de Colombia. La presentación de estas distintas perspectivas tiene el objetivo de fundamentar un debate público informado sobre las dificultades presentes en el sistema de salud actual y qué se puede hacer al respecto. Dentro de los elementos de cada escenario, se hace mención a mecanismos de financiación, vigilancia (regulación), qué beneficios abarca la afiliación al sistema, entre otros
Demand-side strategies to deal with moral hazard in public insurance for long-term care
No full textMoral hazard in public insurance for long-term care may be counteracted by strategies influencing supply or demand. Demand-side strategies may target the patient or the insurer. Various demand-side strategies and how they are implemented in four European countries (Germany, Belgium, Switzerland and the Netherlands) are described, highlighting the pros and cons of each strategy. Patient-oriented strategies to counteract moral hazard are used in all four countries but their impact on efficiency is unclear and crucially depends on their design. Strategies targeted at insurers are much less popular: Belgium and Switzerland have introduced elements of managed competition for some types of long-term care, as has the Netherlands in 2015. As only some elements of managed competition have been introduced, it is unclear whether it improves efficiency. Its effect will depend on the feasibility of setting appropriate financial incentives for insurers using risk equalization and the willingness of governments to provide insurers with instruments to manage long-term care
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