Deconstructing health care reform

As health reform is deconstructed, we need to stop and do some deconstructing of our thinking about it, looking at the context of our assumptions or frames. If we think of health as taking the supreme welfare of the people seriously, we will not allow it to be framed only in terms of for-profit interests and the status quo. Nurses have expertise and knowledge regarding what is needed for a quality health care system. We have to join the conversation with as many good questions as ideas. Working from a different frame, one that reflects more of your values, may give you new insights into holding the conversation.     

Comparative effectiveness of standard endotracheal tubes vs. endotracheal tubes with continuous subglottic suctioning on ventilator-associated pneumonia rates

Ventilator-associated pneumonia (VAP) accounts for the majority of nosocomial pneumonias, which may increase intensive care and prolonged hospital stays. Endotracheal tubes allowing continuous subglottic suctioning may reduce VAP; however, they are more expensive than standard endotracheal tubes not allowing continuous suctioning. he objective of this study was to measure the comparative costs associated with continuous subglottic suctioning endotracheal tubes (CSS-ETT) versus standard endotracheal tubes (S-ETT) among intubated patients and whether cost differential is offset by the occurrence of VAP in patients receiving either type of intubation. A retrospective chart review was conducted for 154 intubated adult patients (77 = S-ETT; 77 = CSS-ETT). The S-ETT group had one case of VAP; the CSS-ETT group had none. The mean total hospital charges were higher for the S-ETT group ($103,600; CSS-ETT= $88,500) (p = 0.3). Although the average number of intubation days and ICU days were greater for the CSS-ETT group, there were no cases of VAP compared to the S-ETT group. ased upon the one S-ETT VAP case and the VAP attributable costs, it is cost effective to use the CSS-ETT.     

Women,Ecology and Economics,edited by Ellie Perkins

This paper finds that black women earn 7 percent less than similarly skilled white women because of their race. Even within the same occupational category, black women earn 3 percent less than similarly qualified white women. Black women receive lower pay primarily due to occupational segregation and because they are rewarded with lower earnings than white women for equivalent levels of education and other human capital characteristics.     

Services Offshoring and its Impact on Productivity and Employment: Evidence from Germany, 1995–2006

Economists have recently recognised services offshoring as an important influence on domestic labour market outcomes. Services are of particular interest since their significance has grown in terms of both quantity and quality. Only one and a half decades ago, most services were considered non‐tradable, but the emergence and development of new information and communication technologies has made many services internationally tradable. The liberalisation of international trade in services trade has further accelerated the volume of services trade. Our econometric estimations focus on services offshoring by German manufacturing sectors. We use revised input–output data from 1995 to 2006. We first estimate the impact of services offshoring on labour productivity. We then measure the effects of services offshoring on labour demand. The results show that services offshoring increased sectoral labour productivity, but reduced German manufacturing employment. The overall results suggest that labour demand decreased over 1995–2006, because labour‐reducing productivity and substitution effects dominated labour‐augmenting scale effects from services offshoring.     

Technologies,preferences, and policies for a sustainable use of natural resources

We discuss eight contributions that combine the topics of sustainable natural resource use and economic dynamics. In the first part we consider enhanced oil recovery (EOR), carbon capture and storage (CCS), as well as innovations allowing for energy-efficiency improvements and renewable energy cost reductions. We discuss how to include these technologies and innovations in CGE models, how each of them has different effects on the timing of emissions and abatement and on total emissions, and how (first-best as well as second-best) complementary policies (in particular, emission taxes and innovation subsidies) differ across these technologies. In the second part we compare differences in intergenerational preferences towards resource conservation - altruistic preferences and concern for social status from relative consumption -and also found sharply contrasting effects across the alternative assumptions.     

The effect of information releases on the pricing and timing of equity issues

With time-varying adverse selection in the market for new equityissues, firms will prefer to issue equity when the market ismost informed about the quality of the firm. This implies thatequity issues tend to follow credible information releases.In addition, if the asymmetric in information increases overtime between information releases, the price drop at the announcementof an equity issue should increase in the time since the lastinformation release. Using earning releases as a proxy for informativeevents, we find evidence supporting these propositions.     

Some poor and invisible women: Farm labourers in South Africa

This article presents the results of a prevalence survey carried out in 1994 to assess the socio‐economic significance of waged farmwork in parts of the Eastern Transvaal (now Mpumalanga). The survey was designed to shed light on the question of how many rural households depend for their survival on the availability of wage employment opportunities for women on farms. The results support the view that economists and statisticians in South Africa have paid insufficient attention to the importance of unrecorded, or statistically ‘invisible’ agricultural wage employment to the rural population. In particular, the importance of women's work as waged farm labourers has not received the attention it deserves for policy purposes. Women's wages and working conditions on all types of farms are probably the critical determinants of the standard of living of many tens of thowsands of households in Mhala and Mapulaneng, and of many millions of the poorest households in South Africa as a whole.     

The Impact of Financial Crises on Labor Markets, Household Incomes, and Poverty: A Review of Evidence

The 1990s have witnessed several financial crises, of whichthe East Asia and Mexico tequila crises are perhaps the mostwell known. What impact have these crises had on labor markets,household incomes, and poverty? Total employment fell by muchless than production declines and even increased in some cases.However, these aggregates mask considerable churning in employmentacross sectors, employment status, and location. Economies thatexperienced the sharpest currency depreciations suffered thedeepest cuts in real wages, though deeper cuts in real wagesrelative to GDP were associated with smaller rises in unemployment.To some extent, families smoothed their incomes through increasedlabor force participation and private transfers, though thelimited evidence available suggests that wealthier familieswere better able to smooth consumption. The initial impact ofthe crises was on the urban corporate sector, but rural householdswere affected as well and in some instances suffered deeperlosses than did urban families. School enrollment declined,especially among poorer families, as did use of health facilities,but he impact on children's nutrition levels appears to vary.Crises have typically proved short-lived, but whether householdsplunged into poverty during a crisis are able to recover asthe economy does remains an open question.      

A new contract for welfare: partnership in pensions

The government's Green Paper proposes reducing state pension costs whilst encouraging private sector provision. The success of the proposed ‘stakeholder pension schemes’ depends on regulation. However, regulation can penalise those it is intended to protect. This is a sensitive issue, since stakeholder pension schemes are expected to attract financially vulnerable, lower paid, employees. Whilst the flat rate accrual of the state second pension confers some benefit, certain groups are put in a difficult position by the retention of means-tested benefits.