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At least 19 recordsLinked to original sources
PubMed1978

[Economic instruments for promotion of prevention].

The classical economic instruments for influencing individual behaviour are regulatory and sumptuary taxes as well as subsidies. Regulatory taxes are forced payments, which are fixed exclusively to influence a group of individuals in the manner required by the government. Sumptuary taxes are levied in order to eliminate differences between private and societal costs (e.g. with smoking). Here the externality tax takes first place. Subsidies, finally, are a special aid, which should motivate the recipient to behave in a certain way. They can--in the same way as regulatory and sumptuary taxes--, by influencing the price structure, be employed in various ways to partronize preventative behaviour.

Europe↗
PubMedDate not supplied

Hippocrates recycled.

Medical education in the United States has at least three serious deficiencies: its focus on medical under-graduate education rather than on medical education as a continuum throughout the career of a physician; its failure to recognize the basic incompatibility of highly sophisticated medical research and the education of the practicing physician; and its extremely high cost. The Hippocratic concept of preceptor education as an alternative has much to recommend it in replacing the present system, which underwrites the cost of student education through research grants and subsidies, but greatly neglects the continuing education of the practicing physician.

Education, Medical↗
PubMed2026

Antarctic Peninsula soil carbon stock and efflux: A complex interplay of soil properties and heavy metals.

This study establishes a quantitative framework for understanding surface soil carbon dynamics and ecosystem connectivity in Fildes Peninsula and Ardley Island, King George Island, South Shetland Islands, Antarctic Peninsula. The mean soil organic carbon (SOC) stock across all study sites was 1.10 ± 1.93 kg C/m². Restricting net carbon balance analysis to Fildes Peninsula, where soil respiration (Rs) data were available, yielded a site-specific SOC stock of 0.45 ± 0.45 kg C/m². Scaling Rs to a realistic 120-day active season and assuming stable SOC stocks resulted in estimated annual carbon loss of 15 g C/(m2·yr), equivalent to 3.3 % of standing SOC. Comprehensive sensitivity analyses spanning plausible winter respiration (0 %-20 % of summer rates) and annual change in SOC stocks (-1 %-2 %) consistently supported a net carbon sink, with turnover rates constrained to 3.3 %/yr-4.7 %/yr. Principal component analysis showed that ornithogenic processes as the dominant control on SOC, total nitrogen (TN), zinc (Zn), copper (Cu), and cadmium (Cd) provide a clear multivariate signature of marine-derived nutrient, while Pb was decoupled from this gradient and associated instead with fine-particle size controls. These results reveal dual but independent drivers of soil metal enrichment in this region. Despite their limited spatial extent, ornithogenic soils store disproportionately large carbon pools. Overall, this integrated analysis reveals how marine-terrestrial subsidies regulate Antarctic carbon cycling and provides a quantitative and reproducible framework for assessing carbon dynamics under ongoing climate change.

Antarctic Regions↗
PubMed1978

Consumer-Choice Health plan (second of two parts). A national-health-insurance proposal based on regulated competition in the private sector.

Medical costs are straining public finances. Direct economic regulation will raise costs, retard beneficial innovation and be increasingly burdensome to physicians. As an alternative, I suggest that the government change financial incentives by creating a system of competing health plans in which physicians and consumers can benefit from using resources wisely. Main proposals consist of changed tax laws, Medicare and Medicaid to subsidize individual premium payments by an amount based on financial and predicted medical need, as well as subsidies usable only for premiums in qualified health insurance or delivery plans operating under rules that include periodic open enrollment, community rating by actuarial category, premium rating by market area and a limit on each person's out-of pocket costs. Also, efficient systems should be allowed to pass on the full savings to consumers. Finally, incremental changes should be made in the present system to alter it fundamentally, but gradually and voluntarily. Freedom of choice for consumers and physicians should be preserved.

Community Participation↗
PubMed1979

A rationale for continued federal support of medical education.

Changing circumstances and shifting public attitudes are forcing policy makers and educators to reconsider the rationale for a continuing federal role in support of medical education. Federal institutional support programs are criticized as being inappropriate to current and future needs, socially inequitable and subject to abuse by a coercive governmental apparatus. A rationale for federal support can be advanced, but such support must be designed to avoid unwarranted subsidies and to encourage maximum reliance upon private-sector resources, and should be confined to functions for which the federal government in uniquely suited. The appropriate federal role is conceived as being the ultimate guarantor of financial access to the medical-education system by otherwise qualified students, perfecting the market for human-capital investment.

Budgets↗
PubMed1979

Validation of data on demand and need for dental treatment in an elderly population.

The present paper intended (1) to validate some key variables employed in a survey of a representative sample of 241 persons aged 65-79 in Troms in Northern Norway, and (2) to discuss aspects of social policy related to dental programs for pensioners. The participants were asked questions focused on potential demand for dental services, and oral problems. Treatment need was assessed professionally. It was explained to the subjects that pensioners were entitled to dental care at half price, and referral to a dentist was arranged if wanted. Validity was studied in terms of sensitivity and specificity. Using referral as a criterion, the question related to potential demand displayed a sensitivity of only 53%, probably because of the imprecise wording, while the specificity appeared to be 82%. Ninety-five persons reported oral problems. The existing subsidy arrangements operating in a traditional service setting did not seem to cope adequately with this problem group. Treatment need was a sensitive (88%), but not a specific (43%), indicator of oral problems. Viewed socio-politically, these findings may be interpreted as a need for visiting services and for an upgrading of the value of self-assessment. It was concluded that this method of validation provided additional information on the practical usefulness of the test methods employed.

Aged↗
PubMed1978

A national food policy for prevention of CHD?

There is an increasing recognition of the importance of diet in the prevention of CHD. Dietary recommendations of various authoritative bodies are summarized. There is now a concensus of opinion concerning certain nutritional changes needed. These have important implications for education, agriculture, food labelling and food subsidies. It is concluded that a national food policy is needed, but that this should come from education and persuasion and not from compulsion.

Coronary Disease↗
PubMed1979

Response of low income women and abortion facilities to restriction of public funds for abortion: a study of a large metropolitan area.

During the first five months after the restriction of public funds for abortion, a large percentage of low-income women seeking abortions in a metropolitan area in Texas obtained abortion that were partially subsizied using a combination of reduced clinic fees and public funds for ancillary non-abortion services. Their own personal funds made up the difference between the subsidy and the full cost of the procedure.

Abortion, Induced↗
PubMed1979

What's inside the black box: a case study of allocative politics in the Hill-Burton program.

This paper explores the political and bureaucratic determinants of grant allocations within the Hospital Survey and Construction Act of 1946 (the Hill-Burton Act), which established the major hospital construction subsidy program in the United States. Resource allocation within the Hill-Burton Program was neither purely a function of external political forces impinging on the state nor purely a result of internal organizational factors. Instead, as shown in the analysis which follows, external political forces shaped program structure, operating routines, and rules and regulations at the time of the Program's formation. Rules and regulations depoliticized the grant allocation process while institutionalizing the interests of hospitals and other producers into the program structure. Consumer interests and influence are excluded from program decision making. Once established, the rules and regulations and a set of bureaucratic behaviors play a critical role in determining resource allocation. Rules and regulations facilitate distributing divisible benefits to producer interests in a politically predi-table way. Yet rules and regulations must also regulate the supply of hospital beds in accordance with local and national market conditions. The mode of operations required for distributing benefits in a politically predictable way limited the Program's ability to regulate hospital bed supply. This was a critical factor which led the Hill-Burton Program to subsidize excess capacity in the U.S. hospital system and is a useful way of explaning many similar dysfunctions within allocative programs such as Hill-Burton.

Facility Regulation and Control↗
PubMed1979

The export of hazardous factories to developing nations.

The export of hazardous industrial plants to developing nations is examined for a number of industries. As hazardous and polluting industries come under increasing regulation in industrial nations, some of the affected processes are exported, without improvements to make them less hazardous, to nonregulating countries where cheap and uninformed labor is abundant. "Runaway shops" then market their products in industrial nations with the competitive advantage of not having had to comply with costly workplace and pollution-control regulations. The international trade impacts of hazard export include: export of jobs from regulating to nonregulating countries; shift of international balance of payments in favor of nonregulating countries; export of mortal health hazards and environmental destruction to workers and communities in nonregulating nations, in order to produce goods for consumption by the regulating countries; weakened competitive position of reputable manufacturers who incur control costs and complete in domestic and would markets against less scrupulous companies; prolonged widespread use of discredited, extremely hazardous technologies, arising from the continuing "subsidy" of certain industries by workers and communities exposed to uncontrolled, well-recognized, mortal health hazards; and aggravated international relations resulting from developing nations' awareness and concern over becoming dumping grounds for hazard export from industrial nations.

Air Pollutants↗
PubMed1976

[On the problem complex of the new act on the severely handicapped with respect to the workshop for the disabled (author's transl)].

One group of the disabled, i.e., the most severely handicapped, will not be able to benefit from the improvements brought about by the new Act on the Severely Handicapped, if the statutory orders of the Federal Government and the provisions of the Federal Employment Office are implemented as planned. In this event it would become extremely difficult for the severely physically handicapped to participate in the life of the community. The article demonstrates how a sheltered workshop for the disabled which, in part, looks after the most severely handicapped needing special care: - will not achieve recognition under 55 of the Act on the Severely Handicapped, - will not benefit from either institutional or individual support provided by the organisations of - the labour administration, - will not obtain contracts from either industrial or public enterprises because the orders cannot be set off against the equalisation payment, - cannot help their disabled employees to become eligible for social security benefits. This development which for the most severely handicapped represents a step backwards must be removed from those who are the most afflicted. It must not happen that efforts made at school to promote and integrate the disabled terminate in segregated facilities (nursing homes), which are run under different subsidy regulations. What is needed is a concept for appropriate care and support of the most severely handicapped and their integration into suitably equipped small groups within workshops for the disabled.

Persons with Disabilities↗