Are people in the SADC region willing to pay more tax to fund public healthcare?

ABSTRACT

For Africa to develop and achieve sustainable development, African governments have to prioritise spending on public health. However, the current spending data shows that health spending is a continuing struggle for African countries. Many researchers have the view that African governments have to collect more tax to spend enough on public healthcare. The question here is what extent people are willing to pay more tax to increase spending on public healthcare? Employing a multilevel regression model on Afrobarometer survey data, this paper examined to what extent individual and country level factors influence people’s willingness to pay more tax to increase spending on public healthcare in 12 Southern African Development Community (SADC) member states. This study found that peoples’ trust in their government is an important determinant of willingness to pay more tax, while factors such as the country’s quality of democracy, economic condition, and current per capita health expenditure have no influence.     

Understanding Urban Inequality: A Model Based on Existing Theories and an Empirical Illustration

In the debate on urban inequality, Sassen’s theory on social polarization and Wilson’s theory on spatial mismatch have received much attention. Where Sassen highlights the decline of the middle classes, Wilson focuses on the upgrading of urban labour markets. In this article we argue that both theories may be valid, but that they have to be put in a more extended theoretical framework. Of central importance are national institutional arrangements, membership of different ethnic groups and networks, and place–specific characteristics rooted in local socio–economic histories. As a first empirical illustration of our model, we use data on the labour markets of Amsterdam and Rotterdam and show that different forms of inequality can be found both in economic sectors and within ethnic groups. The model we present could be used both to reinterébatpret existing data and as an analytical framework for the analysis of different forms of urban inequality. Dans le d& sur l’inégalitéurbaine, la théorie de la polarisation sociale de Sassen et celle de la disparité spatiale de Wilson ont retenu l’attention. Alors que Sassen souligne le déclin des classes moyennes, Wilson s’attache à la revalorisation des marchés du travail urbains. Cet article soutient que, si ces deux théories sont admissibles, elles doivent étre placées dans un cadre théorique plus large. En effet, sont essentielles les dispositions institutionnelles nationales, l’adhésion de différents réseaux et groupes ethniques, et les spécificités du lieu enracinées dans les histoires socio–économiques locales. Comme première illustration empirique de notre modèle, nous utilisons des données relatives aux marchés du travail d’Amsterdam et de Rotterdam pour montrer qu’il y existe différentes formes d’inégalitéà la fois dans les secteurs économiques et les groupes ethniques. Le modèle présenté pourrait servir à réinterpréter les données existantes et fournir un cadre à l’analyse des diverses formes d’inégalité urbaine.     

Institutional design and the closure of public facilities in transition economies

As part of the reforms of their systems for financing and delivering health care, many transition economies, particularly in central and eastern Europe, have adopted national insurance funds that are institutionally separate from ministries of health. Most of these countries have also grappled with the problem of restructuring the delivery system, especially the need to reduce hospital capacity. Although improving the performance of medical care providers through a shift from passive budgeting to explicitly incentive mechanisms is important, why this change in financial relations between the government and providers could not be implemented simply by reforming the role of health ministries is not obvious. This paper presents an explicit rationale for the separation of powers between the regulator (the ministry of health) and the financing body (the insurance fund), based on the inability of a single agency to commit to closing hospitals. JEL classification: L51, P20, P35, I18.     

The Dangers of Misclassifying “Employees”: Microsoft Litigation Emphasizes Distinctions Between Employees and Nontraditional Workers

In the past decade, businesses, for reasons such as greater flexibility and lower total costs, have increased their use of nontraditional workers such as independent contractors and temporary agency employees. The Internal Revenue Service's crackdown on misclassifying employees slowed this growth. Additionally, recent lawsuits by nontraditional workers against employers such as Microsoft Corporation have resulted in some client employers being forced to pay more benefits to nontraditional employees because of employment misclassification and coemployment rulings. Such rulings might reduce or even eliminate the use of some types of nontraditional employees. This paper analyzes the vast array of types of workers that have evolved into the nontraditional work force and the difficulty of defining employee with respect to entitlement to employer benefits. Possible recommendations for employers include auditing present use of nontraditional workers, accurately classifying employees, and taking proper actions to minimize problems in the future.     

A diffusion model with application to evolving medical technologies

This paper reports on a system dynamics simulation model which was developed to study the diffusion of medical technologies but which should be applicable to other sorts of technologies as well. The model addresses both the adoption and the changing extent of use of an evolving, product-based technology and also endogenously accounts for changes in actual and perceived performance. Two specific medical case studies provide background to the model and are used for testing the model's ability to reproduce various aspects of historical behavior. The model's relatively complex structure is presented in the form of influence diagrams showing major flows and relationships. The paper concludes with a discussion of contributions and possible future uses and modifications of the model.     

PRICES AND PRICE ANALYSIS IN THE FRAMEWORK OF THE NATIONAL ACCOUNTS

The paper discusses the role of prices in the framework of the new System of National Accounts (SNA) in terms of three major uses: (1) deflation, (2) price indicators, and (3) price analysis. Following a brief review of the price and quantity measures required by the new SNA with its emphasis on deflation of commodity flows and input-output accounts, in addition to the more conventional deflation of final demand categories, the paper discusses some of the conceptual, methodological and data problems involved in implementing the various uses of prices in the new SNA. Implementing the use of prices as deflators depends, in part, on the concept of output selected (national versus domestic; gross versus net), and which of six concepts of valuation, ranging from purchasers'value to true factor cost, is used. Some of the difficulties in deflating nonmarket flows (e.g., interplant transfers) and industry value added, based on the double deflation method, are discussed. In concept price deflators, which have shifting weights, cannot be used as price indicators, which should have fixed weights. In practice, this is often disregarded and the deflators are used as price indicators. The paper support the SNA recommendation for the development of price indexes with fixed weights to be used as price indicators, in addition to the implicit price deflators. Research in the United States indicates that differences in weights can result in different price measures for various subperiods, components of demand and sector output. Periodic revisions in weights to provide more current fixed weights for price and quantity indexes in each subperiod may minimize the problem but it introduces a new problem—lack of comparability with the constant price tables in the SNA which have fixed weights for the entire period. The new SNA provides a comprehensive and integrated framework for price analysis including the analysis of the structure of aggregate price changes, the industrial origin of final demand prices, and the impact of price change in one sector of the economy on the rest of the economy. Some major gaps which need to be overcome in order to implement the use of the new SNA for price analysis include the development of industry capital stock estimates, separate estimates of proprietors’income, reconciliation of value added and distribution share estimates, and the development of a wide variety of information to supplement the conventional input-output tables in the SNA. Implementing the various objectives of price measures within the framework of the accounts will require a number of improvements in existing price measures and expanding the scope of coverage. “List” prices should be superseded by “transactions” prices and better techniques and data need to be developed to provide for quality adjustment of prices. Coverage will need to be expanded to include services, freight rates, trade margins, government expenditures, and also fill in gaps for many manufactured products. Finally, where possible, use of unit values as price indexes or deflators, e.g., imports and exports, should be replaced by direct price measures.