ECONOMIC AFFAIRS, Issue 3 2007
Nicholas Eberstadt
The official US ,poverty rate' appears to be a problematic descriptor of poverty trends and levels. Reported results from the ,poverty rate' do not track well with other indicators that would ordinarily be expected to bear directly on living conditions. Over the past 30 years, the relationship between the official poverty rate and these other indicators has been perversely discordant. This article outlines the basis of the poverty rate and the problems it now encounters as a reliable measure of material deprivation. [source]

THE GROWTH OF SOCIAL EXPENDITURE AND POPULATION AGEING

ECONOMIC PAPERS: A JOURNAL OF APPLIED ECONOMICS AND POLICY, Issue 4 2000
JOHN CREEDY
First page of article [source]

THE POSITIVE FINANCIAL CONTRIBUTION OF HOME-BASED PRIMARY CARE PROGRAMS: GENERATING REVENUE OR REDUCING HEALTH EXPENDITURE?

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2008
Jeremy M. Jacobs MBBS
No abstract is available for this article. [source]

PRODUCTIVE GOVERNMENT EXPENDITURE AND ECONOMIC GROWTH

JOURNAL OF ECONOMIC SURVEYS, Issue 4 2009
Andreas Irmen
Abstract We provide a comprehensive survey of the recent literature on the link between productive government expenditure and economic growth. We show that an understanding of the core results and the ensuing contributions can be gained from the study of their respective Euler equations. We argue that the existing literature incorporates many relevant aspects; however, policy recommendations tend to hinge on several knife-edge assumptions. Therefore, future research ought to focus more on idea-based endogenous growth models to check the robustness of policy recommendations. Moreover, the inclusion of hitherto unexplored types of government expenditure, e.g. on the ,rule of law', would be desirable. [source]

GENDER DISCRIMINATION, INTRAHOUSEHOLD RESOURCE ALLOCATION, AND IMPORTANCE OF SPOUSES' FATHERS: EVIDENCE ON HOUSEHOLD EXPENDITURE FROM RURAL INDIA

THE DEVELOPING ECONOMIES, Issue 4 2006
Nobuhiko FUWA
D12; D13; D63; D64 Data collected from rural India was used to examine the rules governing intrahousehold resource allocations. Testing for gender-age discrimination among household members using Deaton's (1989) method, results suggest a general bias favoring boys over girls in allocation of consumption goods, however, the findings are not always statistically significant. Intrahousehold resource allocation rules are then examined to see if such discrimination is based on the unanimous decision of parents. The novelty in our test on allocation rule are: (1) use of grandparental variables as extra-household environmental parameters (EEPs) in expenditure estimation, (2) derivation of a test of the unitary model that only requires EEPs, and (3) semi-formal use of survival status of grandparents in testing collective models. It is interesting that spouse's father characteristics are importantly correlated with greater mother and child goods expenditure shares, and smaller father goods shares. Their survival status matters, and this is stronger evidence for a collective as opposed to unitary model. [source]

WHAT DETERMINES INDUSTRIAL R&D EXPENDITURE IN THE UK?,

THE MANCHESTER SCHOOL, Issue 1 2008
BETTINA BECKER
In this paper we identify some of the factors behind the comparatively poor R&D performance of the UK in the 1990s, when R&D intensity in the business sector declined consistently. We estimate an econometric model of R&D using a panel of UK manufacturing industries. Our results highlight the importance of industry characteristics such as sales and profitability, product market competition, macroeconomic factors such as interest and exchange rates, and the composition of R&D expenditure and funding. A rise in the share of government-funded R&D or the share of foreign R&D is found to have a positive impact on aggregate R&D expenditure. [source]

THE OPTIMAL DIVISION OF GOVERNMENT EXPENDITURE BETWEEN PUBLIC GOODS AND TRANSFER PAYMENTS

AUSTRALIAN ECONOMIC PAPERS, Issue 2 2010
JOHN CREEDY
This paper examines the optimal ratio of transfer payments to expenditure on public goods, for a given income tax rate. The transfer payment is then determined by the government's budget constraint. The optimal ratio of transfers to public good expenditure per person is expressed as a function of the ratio of the median to the arithmetic mean wage, and of the tax rate. Reductions in the skewness of the wage rate distribution are associated with reductions in transfer payments relative to public goods expenditure, at a decreasing rate. Furthermore, increases in the tax rate, from relatively low levels, are associated with increases in the relative importance of transfer payments. But beyond a certain level, further tax rate increases are associated with a lower ratio of transfers to public goods, because of adverse incentive effects. [source]

THE ECONOMICS OF HOMELAND SECURITY EXPENDITURES: FOUNDATIONAL EXPECTED COST-EFFECTIVENESS APPROACHES

CONTEMPORARY ECONOMIC POLICY, Issue 1 2007
SCOTT FARROW
While most economists expect some marginal conditions to result from basic expected value models involving government expenditures and homeland security investments, such models are not readily found in the literature. The article presents six basic models that all incorporate uncertainty; they also capture various problems involving technological limits, behavioral interactions, false negatives and false positives, and decision making with uncertainty and irreversibility. Recent reviews of homeland security programs by the U.S. Government Accountability Office are used to illustrate the relevance of the models.(JEL H100) [source]

EXPENDITURES ON CHILDREN AND VISITATION TIME

FAMILY COURT REVIEW, Issue 2 2004
A Reply to Garfinkel, McLanahan, Wallerstein
In their critique, Garfinkel, McLanahan, and Wallerstein raise concerns about the representativeness of the authors' sample, benchmark approach methodology, and historical review of guidelines, all of which lead them to discount the evidence presented opposing the cliff-model assumption of father expenditures on children, and to laud instead child support guidelines that give little monetary credit or adjustment for visitation. This article presents evidence that (a) this sample is at most little biased, and remains trustworthy for the main implications presented; (b) although only a beginning, the benchmark approach is highly useful and most of the concerns raised about it are ill founded or implausible; and (c) the historical review suggesting that current guidelines assume zero visitation expenses is indeed accurate for the vast majority of states, according to the foremost authority. Thus, notwithstanding the critique, these findings have merit and importance and should be considered by policy makers. The authors also comment on the additional arguments against continuous and generous adjustments for visitation, finding them based on a weak foundation of evidence and reasoning. [source]

The size and mix of government spending on illicit drug policy in Australia

DRUG AND ALCOHOL REVIEW, Issue 4 2008
TIMOTHY J. MOORE
Abstract Aim. To estimate how much governments in Australia spend on reducing and dealing with illicit drug problems. Methods. Government documents and supplementary information sources were used to estimate drug-related expenditure for the financial year 2002,03, in Australian dollars. Public sector expenditure on reducing drug problems (,proactive expenditure') was classified into four policy functions: prevention, treatment, harm reduction and enforcement. Expenditure related to the consequences of drug use (,reactive expenditure') was included as a separate category. Results. Spending by Australian governments in financial year 2002,03 on all drug-related activities was estimated to be $3.2 billion. Proactive expenditure was estimated to be $1.3 billion, comprising 55% on enforcement, 23% on prevention, 17% on treatment, 3% on harm reduction and 1% on activities that span several of these functions. Expenditure on dealing with the consequences of drug use was estimated to be $1.9 billion, with the majority the result of crime-related consequences. Conclusion. Several insights result from estimating these expenditures. First, law enforcement is the largest drug policy component, with Australian governments also spending significant amounts on treatment and prevention programmes. Secondly, apart from the prevention component, Australia's drug policy mix is strikingly similar to recent international estimates. Finally, expenditures associated with dealing with the consequences of illicit drugs are large and important for assessing drug-related public sector expenditure. [source]

Expenditure on the NHS in Perspective

ECONOMIC OUTLOOK, Issue 3 2000
Martin Chalkley
In the wake of the recently-announced increases in health spending, Martin Chalkley reviews the record of health spending in the UK both historically and comparatively. It is clear that prices paid by the NHS have increased more than prices in general, and once this is allowed for then it appears that real health spending today is only twice that of 50 years ago as compared with the fourfold increase suggested when using a general price deflator. Such differential inflation is obviously not a problem which is confined to the UK, and it does add considerably to problems in making proper comparisons between levels of health spending in different countries. In spite of these difficulties, it seems that compared with many other developed countries, health spending in the UK as a proportion of GDP is modest. So, looking ahead, there is some way to go before the UK attains the levels of spending achieved in many other countries. But understanding the reasons for relative price changes is vital if any proposed increases in spending is to be translated into increases in the quantity and quality of services provided. [source]

When do the Costs of Spermatogenesis Constrain Sperm Expenditure?

ETHOLOGY, Issue 1 2009
Remarks on the Pattern of the Spermatogenic Cycle
The costs of spermatogenesis constrain sperm expenditure when sperm production per day is limited. Thus, males are challenged to allocate available resources to sperm production and other life history functions. However, this prevailing assumption is not applicable to species in which spermatogenesis becomes quiescent during the breeding season. Males of these species prepare large quantities of sperm before the breeding season. Among these species, constraints on ejaculates have been intensively investigated in salamanders that deposit spermatophores. Although it is predicted that sperm expenditure should not be limited because of abundantly prepared sperm, spermatophore deposition is often limited during the breeding season when vas deferens are full of sperm. We tested a hypothesis regarding limited spermatophore deposition by measuring sperm quantity and volume of spermatophores sequentially deposited by male eastern newts Notophthalmus viridescens. A male newt rarely deposits more than three spermatophores per mating. If depletion of non-sperm components of spermatophores limits spermatophore deposition, we predicted that spermatophore volume decreases while sperm quantity remains constant as a male deposits more spermatophores. Alternatively, some regulative mechanisms allow a limited portion of available sperm to be expended per mating, in which sperm quantity is predicted to decrease while the spermatophore volume remains constant. Finally, depletion of non-sperm components may regulate sperm expenditure, which predicted that both spermatophore volume and sperm quantity decrease. We found that both sperm quantity and the spermatophore volume decreased as a male deposited more spermatophores during a single mating. Sperm expenditure was constrained without the costs involved in active spermatogenesis, and depletion of non-sperm components likely regulate sperm quantity loaded in spermatophores. In dissociated spermatogenesis, constrained sperm expenditure do not mean that costly spermatogenesis is directly limiting male mating capacity but rather suggest that the evolution of physiological mechanisms regulating sperm expenditure per mating maximizes male reproductive success. [source]

Using Scanner Technology to Collect Expenditure Data,

FISCAL STUDIES, Issue 3-4 2009
Andrew Leicester
C81; C83; C33; C41 Abstract In terms of collecting panel expenditure data, there are trade-offs between the demands imposed on respondents and the detail and coverage of data collected. Comprehensive spending data tend to be cross-sectional whilst panel studies include only limited, aggregated expenditure questions. Recently, economists have begun to use detailed, bar-code-level spending data from household panels collected by market research companies. However, there has not been a detailed assessment of the strengths and weaknesses of this collection method or its implications for the recorded data. This paper seeks to fill this gap by providing an in-depth examination of data from one company, Taylor Nelson Sofres (TNS), recording grocery purchases over five years. We assess how far the ongoing demands of participation lead to ,fatigue' in respondents' recording of their spending and the implications for household attrition, and we provide a detailed comparison of the expenditure data collected by TNS and the well-established Expenditure and Food Survey (EFS). Broadly, we suggest that problems of fatigue and attrition may not be particularly severe, though there are differences in expenditures that cannot be attributed to demographic or time effects and may be suggestive of survey mode effects. [source]

Expenditure Reform in Industrialised Countries: A Case-Study Approach,

FISCAL STUDIES, Issue 3 2007
Sebastian Hauptmeier
This study examines reforms of public expenditure in industrialised countries over the past two decades. We distinguish ambitious and timid reformers and analyse in detail reform experiences in eight case studies of ambitious reform episodes. We find that ambitious reform countries reduce spending on transfers, subsidies and public consumption. Such expenditure retrenchment is also typically part of a comprehensive reform package that includes improvements in fiscal institutions as well as structural and other macroeconomic reforms. The study finds that ambitious expenditure retrenchment and reform coincides with large improvements in fiscal and economic growth indicators. [source]

The Distribution of Public Expenditure across the UK Regions

FISCAL STUDIES, Issue 1 2003
Iain McLean
Abstract The distribution of UK revenue to the regional and territorial governments, administrations and authorities that spend the money is based on a hotchpotch of badly designed formulae. This is widely recognised. The Barnett formula, which allocates money to the devolved territories, has been attacked from all sides, its consequences described as ,terribly unfair' by its progenitor, Lord Barnett. The mechanism by which resources are distributed to local authorities within the English regions has been abandoned by the government, although its replacement has not yet been determined. This paper argues that a common basis for government spending across the regions and territories of the UK will be more equitable and efficient, and may even depoliticise the financial framework of the UK. [source]

The Distributional Effects of Public Expenditure

JOURNAL OF ECONOMIC SURVEYS, Issue 3 2000
Gerd Schwartz
It is commonly agreed that economic policies, including budgetary policies, can have potentially strong distributional effects. Traditional economic analysis held that economic policies affected the income distribution primarily through their impact on the rate of growth. More recently, it has come to be recognised that qualitative aspects of economic growth are probably more important than the rate of growth itself. While recent research has confirmed the potential role of expenditure policies as a redistributive tool, it has also shown that redistribution does not necessarily have to come at the expense of economic growth and efficiency. Although there are substantial analytical and technical problems to be faced in the design of equitable and cost-effective public expenditure programmes, unfavourable distributional outcomes of these programmes can usually be traced more to political and institutional pressures than to purely technical factors. JEL Classification number: H5 [source]

Infrastructure Investment and Maintenance Expenditure: Optimal Allocation Rules in a Growing Economy

JOURNAL OF PUBLIC ECONOMIC THEORY, Issue 2 2009
PIERRE-RICHARD AGÉNOR
This paper studies the allocation of public expenditure between infrastructure investment and maintenance in an endogenous growth framework. In the basic model, maintenance spending affects both the durability and efficiency of public capital. The balanced growth path is derived and transitional dynamics associated with a revenue-neutral increase in expenditure on maintenance are analyzed. The model is then extended to account for the possibility that public spending on maintenance affects also the durability of private capital. The growth-maximizing tax rate and share of infrastructure investment are calculated in both cases. First- and second-best welfare-maximizing solutions are also discussed. [source]

The Value of Life and Health for Public Policy

THE ECONOMIC RECORD, Issue SpecialIssue 2003
Peter Abelson
Expenditure on health and safety is a substantial part of GDP, but public agencies in many countries, including Australia, have only qualitative views about the value of life and health. Also, despite considerable work by economists on the value of life and health in recent years, some important issues, such as the value of a healthy life-year, remain unresolved. This paper presents a framework for valuing life and health. It then draws on international and Australian research to estimate possible values for life, healthy life-years, and various chronic and acute health states for public policy purposes in Australia. [source]

Output Taxation, Human Capital and Growth

THE MANCHESTER SCHOOL, Issue 2 2000
Rosa Capolupo
In this paper we investigate the long-run effects of government spending and taxation in an endogenous growth setting. The model is a variant of Barro's model (,Government Expenditure in a Simple Model of Endogenous Growth', Journal of Political Economy, Vol. 98, 1990, pp. S103,S125) and Lucas's model (,On the Mechanics of Economic Development', Journal of Monetary Economics, Vol. 22, 1988, pp. 3,42) in which human capital accumulation is driven by government spending on public education. To balance the budget the government levies a tax on output in two alternative specifications of the human capital accumulation equation. The results consolidate some recent findings that taxation, when it is used for productive purposes, may lead to faster growth. Growth rates increase with taxes up to a level around 60,70 per cent. [source]

Switching statins in Norway after new reimbursement policy , a nationwide prescription study

BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 4 2007
Solveig Sakshaug
What is already known about this subject ,,Use of statins is growing worldwide and costs represent a burden to public budgets. ,,The introduction of simvastatin generics, generic substitution and price regulations have contributed to price reductions and resulted in overall cost reductions of statin use in Norway. What this study adds ,,New reimbursement regulations for statins in Norway in June 2005, making simvastatin the drug of choice, had a great impact on physicians' prescribing of statins. ,,Nearly 40% of the atorvastatin users switched to simvastatin during the 13-month period after implementation of the new regulations. ,,Among the new users of statins the proportion receiving simvastatin increased from 48% in May 2005 to 92% in June 2006. ,,The new regulations have reduced costs of statins, even though the prevalence of statin use has increased. Aims To assess the changes in prescribing of statins in Norway after implementation of the new reimbursement regulations for statins in June 2005. Methods Data were retrieved from the Norwegian Prescription Database covering the total population in Norway (4.6 million). Outcome measures were the proportion of atorvastatin users switching to simvastatin and changes in the proportion of new statin users receiving simvastatin. Based on retail costs for all statin prescriptions dispensed in Norway, expenditure was measured in Norwegian currency. Results One-year prevalences of statin use increased from 6.3 to 6.8% for women and from 7.5 to 8.1% for men from the year before to the year after the new statin regulations. Of atorvastatin users (N = 131 222), 39% switched to simvastatin during the 13-month period after the implementation. The proportion of switching was higher in women (41%) than in men (36%). In May 2005, 48% of the new statin users received simvastatin. The proportion of new users receiving simvastatin increased rapidly after implementation of the new regulations to 68% in June 2005 and reached 92% in June 2006. Expenditure was reduced from ,120 million to ,95 million when comparing the year before with the year after the new statin regulations. Conclusions The new reimbursement policy for statins has had a great impact on physicians' prescribing of statins in Norway. Physicians in Norway acknowledge the importance of contributing to cost containment. [source]

A Censored Quantile Regression Analysis of Vegetable Demand: The Effects of Changes in Prices and Total Expenditure

CANADIAN JOURNAL OF AGRICULTURAL ECONOMICS, Issue 4 2006
Geir Wæhler Gustavsen
Many diseases are linked to dietary behavior. One major diet-related risk factor is a low consumption of vegetables. The consumption may be increased through public policies. The effects on vegetable purchases of either removing the value added tax on vegetables or a general income support are investigated. Adverse health effects are most serious in households consuming low quantities of vegetables. Therefore, the effects on high- and low-consuming households are estimated by using quantile regressions (QRs). Since many households did not purchase any vegetable during each survey period, censored as well as ordinary QRs are used. Our results suggest that the effects of the policy variables differ in different parts of the conditional distribution of vegetable purchases. None of the proposed policy options is likely to substantially increase vegetable purchases among low-consuming households. Bon nombre de maladies découlent des habitudes alimentaires. La faible consommation de légumes constitue un important facteur de risque liéà l'alimentation. Cette consommation pourrait être accrue par l'instauration de politiques gouvernementales. Nous avons examiné les effets de l'abolition de la taxe sur la valeur ajoutée ou d'un soutien du revenu sur les achats de légumes. Les effets néfastes sur la santé sont plus graves chez les ménages qui consomment de faibles quantités de légumes. Nous avons donc estimé les effets chez les ménages à forte et à faible consommation de légumes à l'aide de régressions par quantile. Comme de nombreux ménages n'ont pas acheté de légumes au cours des périodes sondées, nous avons utilisé des régressions par quantile censurées et des régressions par quantile ordinaires. Nos résultats ont indiqué que les effets des variables concernant les politiques diffèrent dans différentes parties de la distribution conditionnelle des achats de légumes. Aucune des options politiques proposées ne semble susceptible d'accroître substantiellement les achats de légumes chez les ménages qui en consomment peu. [source]

Complementary and alternative medicine: the move into mainstream health care

CLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 2 2004
Kylie O'Brien BSc (Optometry) BAppSc (Chinese Medicine) MPH
The use of complementary and alternative medicine (CAM) in Australia is extensive with over 50 per cent of the Australian population using some form of complementary medicine and almost 25 per cent of Australians visiting CAM practitioners. Expenditure on CAM by Australians is significant. The scope of CAM is extremely broad and ranges from complete medical systems such as Chinese medicine to well-known therapies, such as massage and little known therapies, such as pranic healing. There is a growing focus on CAM in Australia and worldwide by a range of stakeholders including government, the World Health Organization, western medical practitioners and private health insurance companies. CAM practices may offer the potential for substantial public health gains and challenge the way that we view human beings, health and illness. Several issues are emerging that need to be addressed. They include safety and quality control of complementary medicines, issues related to integration of CAM with western medicine and standards of practice. The evidence base of forms of CAM varies considerably: some forms of CAM have developed systematically over thousands of years while others have developed much more recently and have a less convincing evidence base. Many forms of CAM are now being investigated using scientific research methodology and there are increasing examples of good research. Certain forms of CAM, including Chinese medicine in which ophthalmology is an area of clinical speciality, view the eye in a unique way. It is important to keep an open mind about CAM and give proper scrutiny to new evidence as it emerges. [source]

Effort/gains dynamics in heterogeneous networks

INTERNATIONAL JOURNAL OF COMMUNICATION SYSTEMS, Issue 4 2008
L. Mamatas
Abstract We investigate the behaviour of TCP(,, ,) protocols in the presence of wireless networks. We seek an answer to strategic issues of maximizing energy and bandwidth exploitation, without damaging the dynamics of multiple-flow equilibrium. We take a fresh perspective on protocol design: What is the return of the effort that a protocol expends? Can we achieve more gains with less effort? We study first the design assumptions of TCP(,, ,) protocols and discuss the impact of equation-based modulation of , and , on protocol efficiency. We introduce two new measures to capture protocol behaviour: the ,Extra Energy Expenditure' and the ,Unexploited Available Resource Index'. We confirm experimentally that, in general, smoothness and responsiveness constitute a tradeoff; however, we show that this tradeoff does not graft its dynamics into a conservative/aggressive behaviour, as it is traditionally believed. We uncover patterns of unjustified tactics; our results suggest that an adaptive congestion control algorithm is needed to integrate the dynamics of heterogeneous networks into protocol behaviour. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Income Smoothing and Discretionary R&D Expenditures of Japanese Firms,

CONTEMPORARY ACCOUNTING RESEARCH, Issue 2 2000
VIVEK MANDE
Abstract During the recent recession (1991 to present), Japanese firms decreased their spending on R&D for the first time since World War II. The decreases have raised concerns that Japanese managers may be making suboptimal allocations to R&D. We test whether Japanese managers adjust R&D based on short-term performance. Our results show that Japanese firms in several industries adjust their R&D budgets to smooth profits. Interestingly, adjustments to R&D are larger in expansion years. These results, similar to those documented with U.S. managers, point to myopic decision making by Japanese managers. [source]

Household Composition and Housing Expenditures in Rental-Occupied and Owner-Occupied Markets

FAMILY & CONSUMER SCIENCES RESEARCH JOURNAL, Issue 3 2008
Aydogan Ulker
This article examines the relationship between household compositions and housing expenditures in rental-occupied and owner-occupied markets. The author finds that renters allocate their budget proportionately between housing and nonhousing goods for an additional household member, leaving the budget share of housing expenditures unchanged. For homeowners, nevertheless, an extra member implies a reduction in housing expenditures as a share of total budget. Although age and gender compositions turn out to be significant in determining the budget share of housing expenditures for renters, they play no major role for homeowners. And although an increase in the number of working members for renters significantly reduces the share of budget spent on housing, it has no significant impact for their owner counterparts. Moreover, keeping total expenditures constant, the main income source of the head of the household does not make any difference in terms of resource allocation across housing and nonhousing goods for both renters and owners. [source]

Lottery Expenditures in Canada: Regional Analysis of Probability of Purchase, Amount of Purchase, and Incidence

FAMILY & CONSUMER SCIENCES RESEARCH JOURNAL, Issue 1 2001
Mohamed Abdel-Ghany
This article has two purposes: First, to examine the effect of household characteristics on lottery expenditures in six regions of Canada using a double hurdle model to distinguish between the decision to play and the decision of how much to spend. Second, to estimate the incidence of lottery expenditures. Using the 1996 Canadian Family Expenditure Survey, the results portray the profile of households that have the probability of becoming participants in lottery play as well as the profile of households that spend more on lottery purchases. Lottery expenditures are found to be regressive in all regions. [source]

The Use of Tax Regulations as Covert Political Policy Variables: A Case Study of Tax Expenditures During the Thatcher Years

FINANCIAL ACCOUNTABILITY & MANAGEMENT, Issue 2 2003
Paul Collier
First page of article [source]

Immigration, Migration, and State Redistributive Expenditures

GROWTH AND CHANGE, Issue 1 2001
Katherine Hempstead
The effect of immigration on state and local budgets is a frequent topic of both political and academic conversations. A controversial issue among scholars is whether or not immigration induces outmigration of low income native born residents, a population movement which would potentially have implications for the jurisdictional distribution of immigration's fiscal impact. It is hypothesized here that if interstate poverty migration occurred, it should cause fiscal spillovers by distributing some of the public sector burden of immigration from immigrant "host" states to neighboring states. This paper uses cross-sectional state data from 1988,1995 to explore the relationship between immigration in neighbor states and state redistributive expenditures. The results suggest that there is a positive relationship between immigration to neighboring states and redistributive expenditures. While most discussion of the fiscal impact of immigration has focused on the effects on host states and localities, the implications of these findings are that there are fiscal spillovers to neighboring states, suggesting that fiscal impacts on host states have been over-estimated and effects on neighboring states have been underestimated. Additionally, the implications of recent welfare reform, which gives states the opportunity to use citizenship as a criterion for program eligibility, are discussed. [source]

Utilization and Expenditures on Chiropractic Care in the United States from 1997 to 2006

HEALTH SERVICES RESEARCH, Issue 3 2010
Matthew A. Davis
Objective. To investigate national utilization and expenditures on chiropractic care between 1997 and 2006. Data Source. The nationally representative Medical Expenditure Panel Survey (MEPS). Study Design. We performed descriptive analyses and generated national estimates from data obtained from U.S. adult (,18 years) MEPS respondents who reported having visited a chiropractor (annual sample size between 789 and 1,082). For each year, we examined the estimated total national expenditure, the total number of U.S. adults who received chiropractic care, the total number of ambulatory visits to U.S. chiropractors, and the inflation-adjusted charges and expenditures per U.S. adult chiropractic patient. Principal Findings. The total number of U.S. adults who visited a chiropractor increased 57 percent from 7.7 million in 2000 to 12.1 million in 2003. From 1997 to 2006, the inflation-adjusted national expenditures on chiropractic care increased 56 percent from U.S.$3.8 billion to U.S.$5.9 billion. Inflation-adjusted total mean expenditures per patient and expenditures per office visit remained unchanged. Conclusion. The large increase in U.S. adult expenditures on chiropractic care between 1997 and 2006 was due to a 57 percent increase in the total number of U.S. adult chiropractic patients that occurred from 2000 to 2003. From 2003 to 2006, the total number of U.S. adult chiropractic patients has remained stable. [source]

Evaluation of the Effect of a Consumer-Driven Health Plan on Medical Care Expenditures and Utilization

HEALTH SERVICES RESEARCH, Issue 4p2 2004
Stephen T. Parente§
Objective. To compare medical care costs and utilization in a consumer-driven health plan (CDHP) to other health insurance plans. Study Design. We examine claims and employee demographic data from one large employer that adopted a CDHP in 2001. A quasi-experimental pre,post design is used to assign employees to three cohorts: (1) enrolled in a health maintenance organization (HMO) from 2000 to 2002, (2) enrolled in a preferred provider organization (PPO) from 2000 to 2002, or (3) enrolled in a CDHP in 2001 and 2002, after previously enrolling in either an HMO or PPO in 2000. Using this approach we estimate a difference-in-difference regression model for expenditure and utilization measures to identify the impact of CDHP. Principal Findings. By 2002, the CDHP cohort experienced lower total expenditures than the PPO cohort but higher expenditures than the HMO cohort. Physician visits and pharmaceutical use and costs were lower in the CDHP cohort compared to the other groups. Hospital costs and admission rates for CDHP enrollees, as well as total physician expenditures, were significantly higher than for enrollees in the HMO and PPO plans. Conclusions. An early evaluation of CDHP expenditures and utilization reveals that the new health plan is a viable alternative to existing health plan designs. Enrollees in the CDHP have lower total expenditures than PPO enrollees, but higher utilization of resource-intensive hospital admissions after an initially favorable selection. [source]