Home About us Contact
|
Home About us Contact | ||
|
|
||
Public Programs (public + program)
Selected AbstractsAlan Greenspan on the Economic Implications of Population AgingPOPULATION AND DEVELOPMENT REVIEW, Issue 4 2004Article first published online: 15 DEC 200 At the 2004 annual symposium of central bank leaders sponsored by the Federal Reserve Bank of Kansas City at Jackson Hole, Wyoming, Alan Greenspan, Chairman of the US Federal Reserve Board, devoted his opening remarks on 27 August to a discussion of the economic implications of population aging. The full text of his remarks is reproduced below. Greenspan's high prestige and great influence on US economic policy lend special interest to his views on this much-discussed subject (see also the next Documents item in this issue). He outlines the coming demographic shift in the United States in language that is characteristically cautious and qualified. (The elderly dependency ratio will "almost certainly" rise as the baby boom generation retires, Greenspan says, although elsewhere he terms the process, more accurately, inexorable.) The main factor responsible for population aging he identifies as the decline of fertility. Immigration is an antidote, but, to be effective, its size would have to be much larger than is envisaged in current projections. Greenspan's assessment of the economic consequences of the changing age structure highlights the prospect of a deteriorating fiscal situation in the United States: chronic deficits in the Social Security program over the long haul, assuming that existing commitments for benefits per retiree are met, and even greater difficulties for the health care system for the elderly,Medicare,in which the effects of increasing numbers in old age are amplified by advances in medical technology and the bias inherent in the current system of subsidized third-party payments. The sober outline of policy choices imposed by population aging,difficult in the United States, but less so, Greenspan notes, than in Europe and Japan,underlies the need for counteracting the declining growth of the population of labor force age through greater labor force participation and later retirement. Beyond that, growth of output per worker can provide the key "that would enable future retirees to maintain their expected standard of living without unduly burdening future workers." This requires continuation of policies that enhance productivity, such as deregulation and globalization, and greater investment. In turn, the latter presupposes greater domestic saving, both personal and by the government, as the United States cannot "continue indefinitely to borrow saving from abroad." Demographic aging requires a new balance between workers and retirees. Curbing benefits once bestowed is difficult: only benefits that can be delivered should be promised. Public programs should be recalibrated, providing incentives for individuals to adjust to the inevitable consequences of an aging society. [source] BENEFITS AND COSTS OF INTENSIVE FOSTER CARE SERVICES: THE CASEY FAMILY PROGRAMS COMPARED TO STATE SERVICESCONTEMPORARY ECONOMIC POLICY, Issue 3 2009RICHARD O. ZERBE The foster care system attempts to prepare children and youth who have suffered child maltreatment for successful adult lives. This study documents the economic advantages of a privately funded foster care program that provided longer term, more intensive, and more expensive services compared to public programs. The study found significant differences in major adult educational, health, and social outcomes between children placed in the private program and those placed in public programs operated by Oregon and Washington. For the outcomes for which we could find financial data, the estimated present value of the enhanced foster care services exceeded their extra costs. Generalizing to the roughly 100,000 adolescents age 12-17 entering foster care each year, if all of them were to receive the private model of services, the savings for a single cohort of these children could be about $6.3 billion in 2007 dollars. (JEL D61, H75) [source] Issues related to the diagnosis and treatment of autism spectrum disorders,DEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 2 2007Paul T. Shattuck Abstract This paper explores issues and implications for diagnosis and treatment, stemming from the growing number of children identified with autism spectrum disorders (ASDs). Recent developments and innovations in special education and Medicaid programs are emphasized. Eligibility determination policies, innovations in diagnostic practices, the cost and financing of assessment, variability among programs in diagnostic criteria, and racial/ethnic disparities in the timing of diagnosis all influence the capacity of service systems to provide diagnoses in a timely, coordinated, accurate, economical, and equitable manner. There are several barriers to the more widespread provision of intensive intervention for children with ASDs, including lack of strong evidence of effectiveness in scaled-up public programs, uncertainty about the extent of obligations to provide services under the Individuals with Disabilities Education Act, high cost of intervention, and variability among states in their willingness to fund intensive intervention via Medicaid. Innovative policy experiments with respect to financing intensive intervention through schools and Medicaid are being conducted in a number of states. © 2007 Wiley-Liss, Inc. MRDD Research Reviews 2007;13:129,135. [source] IS INEQUALITY HARMFUL FOR THE ENVIRONMENT IN A GROWING ECONOMY?ECONOMICS & POLITICS, Issue 1 2007HUBERT KEMPF In this paper, we investigate the relationship between inequality and the environment in a growing economy from a political-economy perspective. We consider an endogenous growth economy, where growth generates pollution and a deterioration of the environment. Public expenditures may either be devoted to supporting growth or abating pollution. The decision over the public programs is made in a direct democracy, with simple majority rule. We prove that the median voter is decisive and show that inequality is harmful for the environment: the poorer the median voter relative to the average individual, the less she will tax and devote resources to the environment, preferring to support growth. [source] Accessibility of Addiction Treatment: Results from a National Survey of Outpatient Substance Abuse Treatment OrganizationsHEALTH SERVICES RESEARCH, Issue 3 2003Peter D. Friedmann Objectives This study examined organization-level characteristics associated with the accessibility of outpatient addiction treatment. Methods Program directors and clinical supervisors from a nationally representative panel of outpatient substance abuse treatment units in the United States were surveyed in 1990, 1995, and 2000. Accessibility was measured from clinical supervisors' reports of whether the treatment organization provided "treatment on demand" (an average wait time of 48 hours or less for treatment entry), and of whether the program turned away any patients. Results In multivariable logistic models, provision of "treatment on demand" increased two-fold from 1990 to 2000 (OR, 1.95; 95 percent CI, 1.5 to 2.6), while reports of turning patients away decreased nonsignificantly. Private for-profit units were twice as likely to provide "treatment on demand" (OR, 2.2; 95 percent CI, 1.3 to 3.6), but seven times more likely to turn patients away (OR, 7.4; 95 percent CI, 3.2 to 17.5) than public programs. Conversely, units that served more indigent populations were less likely to provide "treatment on demand" or to turn patients away. Methadone maintenance programs were also less likely to offer "treatment on demand" (OR, .65; 95 percent CI, .42 to .99), but more likely to turn patients away (OR, 2.4; 95 percent CI, 1.4 to 4.3). Conclusions Although the provision of timely addiction treatment appears to have increased throughout the 1990s, accessibility problems persist in programs that care for indigent patients and in methadone maintenance programs. [source] SUCCESSFUL AND UNSUCCESSFUL PARTICIPATORY ARRANGEMENTS: WHY IS THERE A PARTICIPATORY MOVEMENT AT THE LOCAL LEVEL?JOURNAL OF URBAN AFFAIRS, Issue 3 2010LAURENCE BHERER ABSTRACT:,The objective of this article is to explore some of the reasons for the growing number of participatory arrangements at the local level. An approach in terms of governance allows us to examine the underlying patterns of logic that induce public authorities to develop new policy tools such as participatory arrangements. Our study focuses on a medium-sized French city, Bordeaux, where eight types of relatively weak participatory arrangements have been implemented since 1995. The article shows that the French government and European Union have fostered this type of arrangement through a complex series of public programs and policies with the aim of rebuilding their political legitimacy by encouraging participation at the municipal level. This approach is relevant to understanding the origin of the reforms affecting local governments over the past decade. [source] Political Resources for Policy TerminatorsPOLICY STUDIES JOURNAL, Issue 1 2002Janet E. Frantz Scholars of policy termination have long understood that there are tremendous difficulties associated with closing down public programs and facilities. This examination of one closure begins with that understanding and then, using Deborah Stone's conceptualization of politics in the policy arena, moves to categorize and analyze those difficulties. The case involves the U.S. government's policy of providing lifelong, residential care to victims of Hansen's Disease (leprosy). The investigation documents the government's decision in the 1950s to end the policy and follows the ensuing battle. The government terminators, despite the rationality of their position, were held at bay for nearly fifty years by politically savvy opponents including patients, staff, and the community that housed the leprosarium. Only when government officials reached into their own bag of political resources and skillfully employed those resources, was it possible to end the policy. [source] Lessons Learned from Two Decades of Alternative Dispute Resolution Programs and Processes at the U.S. Environmental Protection AgencyPUBLIC ADMINISTRATION REVIEW, Issue 6 2001Rosemary O'Leary Mediation, facilitation, and other alternative dispute resolution (ADR) techniques are being used in federal agencies, state and local governments, private-sector organizations, and among private citizens in an effort to prevent and resolve disputes in a timely, cost-effective, and less adversarial manner. The U.S. Environmental Protection Agency (EPA), one of the pioneers in the application of ADR processes and techniques to public policy disputes, recently announced that it plans to in-crease the use of ADR techniques and practices across all agency programs. This article reports the results of a four-part evaluation of the use of ADR in enforcement actions at the EPA during the last two decades. Funded by the Hewlett Foundation, this effort utilized in-depth telephone interviews, government statistics, and archival records. The four groups interviewed were EPA's alternative dispute resolution specialists, potentially responsible parties (defendants) to EPA enforcement lawsuits, mediators and facilitators to EPA cases, and agency enforcement attorneys who had participated in agency enforcement ADR processes. Concluding that there are generally high levels of satisfaction with the EPA's enforcement ADR program, this article examines the sources of obstacles and assistance to ADR efforts at the EPA, suggests ways in which the EPA might improve its ADR programs, and draws lessons from the EPA's experiences that may be helpful to other public programs or organizations. [source] Exploring Explanations of State Agency Budgets: Institutional Budget Actors or Exogenous Environment?PUBLIC BUDGETING AND FINANCE, Issue 3 2008JAY EUNGHA RYU Budgetary incrementalism argues that three institutional actors,agencies, executive budget offices, and legislative committees,dominate budget outcomes. The complexity and interdependency of public programs expands this expectation to include the influence of exogenous budget factors. Findings from a survey of state agency heads reveal that budget environments do influence state agency budget outcomes. However, the institutional budgetary participants, especially governors and legislatures, envisioned in classical incrementalism retain their principal and primary influence on state agency budgets. A significant departure from classical incrementalism is that agencies are not as influential as previously depicted. [source] Public Preferences for Program Tradeoffs: Community Values for Budget PrioritiesPUBLIC BUDGETING AND FINANCE, Issue 1 2004Glenn C. Blomquist A growing literature concerns techniques to improve community-based reforms and citizen-centered governance in order to reinforce the trust in democratic government. We analyze a contingent choice technique that systematically collects information about individual citizens' relative values of a set of state public programs. Individual citizens are asked to allocate a fixed increment of public funds. Individuals reveal their marginal willingness to trade off (MWTTO) additions in one program for additions in another. MWTTO values provide program rankings and information concerning the relative strength of citizen preferences. An example of a contingent choice survey is described. [source] Inside the Sausage Factory: Improving Estimates of the Effects of Health Insurance Expansion ProposalsTHE MILBANK QUARTERLY, Issue 4 2002Sherry Glied Many policy proposals address the lack of insurance coverage, with the most commonly discussed being tax credits to individuals, expansions of existing public programs, subsidies for employers to offer coverage to their workers, and mandates for employers and individuals. Although some policy options may be favored (or disfavored) on theoretical or ideological grounds, many debates about policy center on empirical questions: How much will this option cost? How many people will obtain insurance coverage? Estimates of costs and consequences influence policy in three ways. First, the Office of Management and Budget, the Congressional Budget Office, the Centers for Medicare and Medicaid Services, the Treasury Department, and other government agencies incorporate estimates of the costs of proposals in their budget calculations. Particularly in times of fiscal restraint, the cost of a proposal is central to its legislative prospects. Second, recognizing the importance of final budget numbers, policy advocates include estimates in their advocacy. The fate of a proposal to expand health insurance is influenced by predictions of the proposal's effects on the number of newly insured and the cost of new coverage. Estimates vary widely, for reasons that are often hard to discern and evaluate. This article describes and compares the frameworks and parameters used for insurance modeling. It examines conventions and controversies surrounding a series of modeling parameters: how individuals respond to a change in the price of coverage, the extent of participation in a new plan by those already privately insured, firms' behavior, and the value of public versus private coverage. The article also suggests ways of making models more transparent and proposes "reference case" guidelines for modelers so that consumers can compare modeling results. [source] Effects of Alcohol Consumption on Disability among the Near Elderly: A Longitudinal AnalysisTHE MILBANK QUARTERLY, Issue 4 2001Jan Ostermann Data from four waves of the Health and Retirement Study are used to analyze the effects of alcohol use on disability, mortality, and income transfers from public programs. Cross-sectional analysis reveals a complex relationship, with a history of problem drinking clearly leading to higher rates of limitations, and a nonmonotonic relationship between current drinking and disability. In longitudinal analysis, problem drinking was predictive of disability onset, but not of transfer receipt or mortality. Heavy drinkers and problem drinkers, if anything, were less likely to receive public income support than abstainers or moderate drinkers. The likelihood that heavy drinkers received public transfers did not decrease relative to others following statutory changes in 1996 that sought to limit eligibility of alcoholics and drug abusers. [source] | ||||||||||||||||