卫生投入结构、健康发展与经济增长

卫生投入通过促进健康发展进而影响经济增长,而这种影响既有数量效应,更有结构效应,本文侧重分析了卫生投入结构因素对健康发展及经济增长影响的理论机制;在此基础上运用1993—2007年中国30个省级行政单位(以下简称省份)面板数据协整模型进行实证研究。结果表明:当前中国卫生投入主体存在结构失衡问题,个人比例过高,而公共比例偏低,这不仅短期内直接降低了民众健康保障能力和福利水平,构成了对区域经济增长的负效应,而且对长期经济增长能力和增长方式转型也构成深远影响。所以,基于改善民生健康福利与实施人力资本发展战略的双重目标要求,新医改应重视卫生投入结构的优化发展,当前特别要减轻过重的个人医疗负担。     

Health planning rationality

Health planning theory has failed to operationalize the concept of rationality into terms useful for theory building. The concept of rationality has also generally not been translated into a useful tool for the health planning practitioner. In order to decrease the mystique associated with rationality and to aid in refinement of the concept, four attributes of health planning rationality are proposed:

1. Health planning rationality is “bounded” due to the magnitude of problems and man's limited problem-solving abilities;
2. Health planning rationality has multiple dimensions (technical, social, legal, political and economic);
3. The multiple dimensions of health planning rationality interact as complements and substitutes; and
4. Health planning rationality may be conceived of as the exposure of problems to cognitive processes.

     

爱尔兰共和国90年代医疗政策综述

一、医疗体制介绍 爱尔兰共和国实行公费和自费并存的医疗体制.公费医疗服务分为两类:全部免费和部分免费.     

Health care reform now

He has written articles on war and public opinion, research methodology, and computer simulations of urban and political processes. He is editor of A Handbook of Social Science Methods.     

Health care reform now

The online version of the original article can be found at     

Understanding the Relationship between Health PACs and Health Lobbying in the American States

We examine how health PAC activity in the states is connectedto lobbying. Is the political money that health interest organizationsbring to the policy process a powerful, independent means ofinfluence or is it better understood narrowly as a tactic usedto support lobbying? We examine the relationship between campaigncontributions and lobby activity and the limited work that hasbeen conducted on them and raise a number of questions aboutthe process by which they are connected. We utilize 1998 dataon state lobbying and PAC activity, allowing us to answer causalresearch questions generated from existing studies at the nationallevel. We conclude that PAC activity is best viewed as an adjunctof lobbying rather than an independent form of political activity.     

Changing the Culture of Health: One Public Health Misstep at a Time

In this article, I argue that public health regulations are a necessary component of changing the culture of health in the US. After considering libertarian critiques of public health interventions, I maintain that many of the interventions critiqued are not in fact coercive. Looking forward, I do not envision an either/or between the nanny state vs. a libertarian polity. Instead, a middle ground will emerge that respects individual choice and personal responsibility while accepting that government has a legitimate interest in securing the population’s health. Better health helps people make better choices and enjoy freedom; being free from poor health status is as important to liberty as free choice.     

The Effect of Safety Net Generosity on Maternal Mental Health and Risky Health Behaviors

Single mothers are more likely to experience mental health problems and stress-related negative health behaviors than their married counterparts, but a more generous safety net may improve these outcomes. We use a simulated safety net eligibility approach that accounts for interactions across safety net programs and relies on changing policies across states and time to identify causal effects of safety net generosity on psychological distress and risky behaviors of single mothers. Results suggest that a more generous safety net is protective of maternal mental health: a $1,000 increase to the simulated potential combined cash and food benefit package reduces severe psychological distress by 8.4 percent. Breaking out effects by individual programs while still controlling for potential benefits from other programs, we find protective effects of tax credits, cash benefits provided by Temporary Assistance for Needy Families, and food benefits provided by Supplemental Nutritional Assistance, but no effects of Medicaid eligibility. The effects are primarily driven by single mothers with the lowest levels of education. We find no significant effects of generosity on daily smoking, but we find evidence that benefits reduce the likelihood of heavy drinking. Results suggest that government investments in resources available to low-income families can be effective at improving well-being.     

Health and Health Services Access Among Adults With Disabilities Who Receive Federal Housing Assistance

Using newly available U.S. Department of Housing and Urban Development (HUD) administrative data linked with National Health Interview Survey data, this study estimates the prevalence of disability among HUD-assisted adults and examines health disparities for this population. The linked data suggest a much higher prevalence of disability among HUD-assisted adults than previously suggested by HUD administrative data. Controlling for individual characteristics and HUD program type, assisted-housing residents who have disabilities experienced higher rates of self-reported fair or poor health, asthma, diabetes, hypertension, obesity, and cigarette smoking. Adults with disabilities had more frequent use of emergency rooms and increased concerns with affording the necessary health care. HUD-assisted adult residents with disabilities were more likely than residents without disabilities to be connected to the health-care system, having higher rates of insurance coverage and more frequent contact with specialists, general doctors, and mental health-care providers. Policy implications are discussed.