Adult Polycystic Kidney Disease and Critical Illness Insurance

Abstract

Adult polycystic kidney disease (APKD) is a single-gene autosomal dominant genetic disorder leading to end-stage renal disease (ESRD, meaning kidney failure). It is associated with mutations in at least two genes, APKD1 and APKD2, but diagnosis is mostly by ultrasonography. We propose a model for critical illness (CI) insurance and estimate rates of onset of ESRD from APKD using two studies. Other events leading to claims under CI policies are included in the model, which we use to study (a) extra premiums under CI policies if the presence of an APKD mutation is known, and (b) the possible costs arising from adverse selection if this information is unavailable to insurers. The extra premiums are typically very high, but because APKD is rare, the possible cost of adverse selection is low. However, APKD is just one of a significant number of single-gene disorders, and this benign conclusion cannot be assumed to apply to all genetic disorders taken together. Moreover, ignoring known genetic risks in underwriting sets a precedent that could have unintended consequences for the underwriting of nongenetic risks of similar magnitude.     

A Model for Coronary Heart Disease and Stroke with Applications to Critical Illness Insurance Underwriting II: Applications

Abstract

In Part I we constructed a model for the development of coronary heart disease (CHD) or stroke that either incorporates, or includes pathways through, the major risk factors of interest when underwriting for critical illness (CI) insurance. In Part II we extend this model to include other critical illnesses, for example, cancers and kidney failure, and describe some applications of the model. In particular, we discuss CI premium ratings for applicants with combinations of some or all of high body mass index, smoking, high blood pressure, high cholesterol, and diabetes. We also consider the possible effect on CI premium ratings of genetic conditions that increase the likelihood of high blood pressure, high cholesterol, diabetes, CHD event, or stroke.     

A Note on Finding the Optimal Allocation Between a Risky Stock and a Risky Bond

The allocation of financial assets among securities with different levels of risk is an essential topic in the study, analysis, and strategic use of derivative securities and markets. In a recent paper, Browne (1999) determined the optimal allocation strategy for dividing investments between a risky stock and a risky bond. In this note, Browne's equation determining the optimal strategy is studied and some methods are described for solving it. In addition, some useful rules‐of‐thumb, computational methods, and approximation techniques are presented. © 2001 John Wiley & Sons, Inc. Jrl Fut Mark 21:1181–1196, 2001     

Employment equity,human resource development and institution building in South Africa

The process of economic and social reconstruction in South Africa (SA) has harnessed capital, organized labour and state agencies in emergent tripartite macro-policy forums; in particular, the National Economic Development and Labour Commission. Public policy on human resource development, affirmative action and diversity issues is increasingly an outcome of negotiations in these structures. However, although significant legislative developments on these issues are envisaged in the near future, institutional adaptation has not been adequately researched. The apartheid state was constructed on the ideological basis of ethnic fragmentation rationalized by ethnic and cultural diversity. At the same time, diversity is a social reality in building common national and organizational goals, symbols and identity.

This paper discusses structural and labour market factors associated with the process of employment equity and diversity management in South African organizations. A research project, the Breakwater Monitor, at the Graduate School of Business, University of Cape Town, has established a national database covering some one million employees, which enables benchmarking of company and sectoral practices in regard to affirmative action, diversity policy, training and development and skills formation. The project has also begun to track diversity representation at all levels across major sectors longitudinally, using a common job evaluation standard for comparability. The project considers both quantitative and qualitative factors in human resource development. Findings from this project are presented and discussed in the context of human resource development.     

The Effect of Off-farm Work on the Intensity of Agricultural Production

Changes in agricultural production methods have been associated with environmental pressure and a loss of natural habitats. This paper explores the extent to which farmer participation in off-farm work (an increasing phenomenon in most developed countries) changes the intensity of agricultural input use focusing, in particular, on fertilizer and crop protection product use. A sample selection model that accounts for both unobserved heterogeneity between farms and the potential simultaneity between farm operations and hours worked off-farm is estimated for 2,419 farms in England and Wales. The econometric evidence indicates that the input intensity of products which have well-established links to environmental damage can increase as well as decrease. The results suggest that that fertilizer intensity may decline as off-farm labor increases while the use of crop protection per hectare increases as off-farm work increases.     

FARM HOUSEHOLD PRODUCTION IN THE PRESENCE OF RESTRICTIONS ON DEBT: THEORY AND POLICY IMPLICATIONS

In this paper a two period life cycle model of the farm household is constructed allowing for production and restrictions on debt in which the consumption and production decisions of the farm household are simultaneous. It is shown that the farm household's production responses to exogenous changes may be qualitatively different to that predicted by the profit-maximising model when all markets are perfect. In particular, when the household is debt constrained, ‘perverse’ output effects are possible with output increasing in response to output price decreases. Further, for such households, compensation payments will have production effects. Finally, the financial situation of the farm has an impact on production for debt constrained farms.     

The impact of voluntary environmental protection instruments on company environmental performance

In the last decade there has been increasing emphasis on the use of voluntary environmental protection tools such as corporate environmental reporting (CER) and environmental management systems (EMSs). There has been relatively little research, however, on the impact of these tools on the actual environmental performance of companies. This paper presents the findings of a survey of 40 companies operating in Western Australia to determine the extent to which the implementation of two voluntary instruments has influenced company environmental performance. The research considered four questions: To what extent have CER and EMSs influenced the environmental performance of companies operating in Western Australia? What are the characteristics of these influences? How does the influence of EMSs on environmental performance compare to that of CER? Have other external factors concurrently influenced environmental performance? In general, most respondents indicated that EMSs had influenced environmental management practices to some extent. On the other hand, CER was seen more as a public relations exercise and had less impact on company practices compared with EMSs. Other factors that influenced environmental performance included pressure from clients, senior management, the public and regulators; corporate culture; and cost savings. Copyright © 2004 John Wiley & Sons, Ltd and ERP Environment.     

Optimising communications for charity brand management

The paper presents recomendations on how to enhance communications planning through new integration and media neutral planning techniques (open planning) linked to Integrated Marketing practice. The paper is based on best practice research in charity and commercial sectors, including NSPCC and National Trust. Copyright © 2005 John Wiley & Sons, Ltd.