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Current Expenditures (current + expenditure)
Selected AbstractsPreservation of sight in diabetes: developing a national risk reduction programmeDIABETIC MEDICINE, Issue 9 2000L. Garvican SUMMARY Background Early treatment for diabetic retinopathy is effective at saving sight, but dependent on pre-symptomatic detection. Although 60% of people with diabetes have their eyes examined annually, few UK health authorities have systematic programmes that meet the British Diabetic Association's standards for sensitivity (> 80%) and specificity (> 95%). Screening is generally performed by general practitioners and optometrists, with some camera-based schemes, operated by dedicated staff. The National Screening Committee commissioned a group to develop a model and cost estimates for a comprehensive national risk-reduction programme. Ophthalmoscopy Evidence indicates that direct ophthalmoscopy using a hand-held ophthalmoscope does not give adequate specificity and sensitivity, and should be abandoned as a systematic screening technique. Indirect ophthalmoscopy using a slit lamp is sensitive and specific enough to be viable, and widespread availability in high street optometrists is an advantage, but the method requires considerable skill. Photographic schemes The principal advantage of camera-based screening is the capturing of an image, for patient education, review of disease progression, and quality assurance. Digital cameras are becoming cheaper, and are now the preferred option. The image is satisfactory for screening and may be transmitted electronically. With appropriate training and equipment, different professional groups might participate in programme delivery, based on local decisions. Cost issues Considerable resources are already invested in ad hoc screening, with inevitable high referral rates incurring heavy outpatient costs. Treatment for advanced disease is expensive, but less likely to be effective. The costs of a new systematic screening and treatment programme appear similar to current expenditure, as a result of savings in treatment of late-presenting advanced retinopathy. Conclusion A systematic national programme based on digital photography is proposed. [source] Long-Term Effects of Fiscal Policy on the Size and Distribution of the Pie in the UK,FISCAL STUDIES, Issue 3 2008Xavier Ramos C5; E6; H3 Abstract. This paper provides a joint analysis of the output and distributional long-term effects of various fiscal policies in the UK, using a vector autoregression (VAR) approach. Our findings suggest that the long-term impact on GDP of increasing public spending and taxes is negative, and especially strong in the case of current expenditure. We also find significant distributional effects associated with fiscal policies, indicating that an increase in public spending reduces inequality while a rise in indirect taxes increases income inequality. [source] Fiscal Policy, Business Cycles and Economic Stabilisation: Evidence from Industrialised and Developing Countries,FISCAL STUDIES, Issue 4 2007Young Lee This paper empirically investigates the responsiveness of fiscal policy to business cycles and the effectiveness of fiscal policy in reducing economic fluctuations. From regressions on the responsiveness of fiscal policy to business cycles, we find that the government's current expenditures and subsidies & transfers move counter-cyclically, whereas taxes and capital expenditures move pro-cyclically. Using economic fluctuations in neighbouring countries as an instrumental variable, we show that ordinary least squares (OLS) estimates understate the responsiveness of fiscal policy to economic fluctuations. We also find that fiscal policy responds asymmetrically over economic fluctuations. In investigating the effectiveness of fiscal policy in reducing economic fluctuations, we mitigate omitted variable bias by adding four important factors - military expenditures, oil production, economic fluctuations in neighbouring countries and fiscal policy responsiveness to business cycles. The results of effectiveness regressions are consistent with the responsiveness regressions, highlighting the importance of current expenditures, especially subsidies and transfers, in responding to business cycles and stabilising the economy. [source] Publicly funded medical savings accounts: expenditure and distributional impacts in Ontario, CanadaHEALTH ECONOMICS, Issue 10 2008Jeremiah Hurley Abstract This paper presents the findings from simulations of the introduction of publicly funded medical savings accounts (MSAs) in the province of Ontario, Canada. The analysis exploits a unique data set linking population-based health survey information with individual-level information on all physician services and hospital services utilization over a four-year period. The analysis provides greater detail along three dimensions than have previous analyses: (1) the distributional impacts of publicly funded MSAs across individuals of differing health statuses, incomes, ages, and current expenditures; (2) the impact of differing degrees of risk adjustment for MSA contributions; and (3) the impact of MSA funding over multiple years, incorporating year-to-year variation in spending at the individual level. In addition, it analyses more plausible designs for publicly funded MSAs than the existing studies. Government uses information available from year t,,,1 to allocate its budget for year t in a manner that is ex ante fiscally neutral for the public sector: the government first withholds funds equal to expected catastrophic insurance payments under the MSA plan, and then allocates only the balance to individual MSA accounts. The government captures the savings associated with reduced health-care utilization under MSAs and we examine deductibles that vary by income rather than by current health-care expenditures. The impacts on public expenditures under these designs are more modest than in the previous studies and under plausible assumptions MSAs are predicted to decrease public expenditures. MSAs, however, are also predicted to have unavoidable negative distributional consequences with respect to both public expenditures and out-of-pocket spending. Copyright © 2007 John Wiley & Sons, Ltd. [source] Examining Factors that Impact Mississippi Counties' Unreserved Fund Balance during Relative Resource Abundance and Relative Resource ScarcityPUBLIC BUDGETING AND FINANCE, Issue 4 2009LA SHONDA M. STEWART Although using some of the same organizational and financial factors examined by prior researchers to build and test models that explain factors influencing change in the general fund unreserved balance for smaller, rural, and less affluent counties in Mississippi, the rationale of this study is to build additional support that applying the recommended 5,15 percent savings benchmark across all jurisdictions is not a sufficient guide. Overall, Mississippi counties maintain unreserved fund balances ranging from a negative balance to over one hundred percent of their current expenditures. Counties also increase reserves during times of relative resource abundance and decrease them during relative resource scarcity. Moreover, they tend to address short-term needs and resident demands when revenues are plentiful. During relative resource scarcity, however, they are more cost-conscious and focus on maintaining rather than expanding current expenditures. This research shows that counties using the Beat system, a political form of government, are more likely to behave more frugally than counties using a Unit system, an administrative form of government. [source] | |||||||||||||