Recent trends in health care expenditure and utilization in OECD countries

Conclusions High unemployment and low economic growth continue to plague many OECD countries, putting strong pressures on governments to reduce social spending. Health is the second largest social expenditure program and has been one of the fastest growing. Health care financing and delivery systems which were designed to achieve access have not proven themselves effective in ensuring efficient production and consumption of services.The inability to measure the effects of health expenditures on health outcomes, the lack of clinical standards of appropriateness of treatment, and indeed the sensitivity of health status to non-medical systems' aspects of society further confound the problems of developing policies to promote efficiency and equity. Moreover, future demographic and technological changes could place substantial new budgetary pressures on governments.Understanding the nature of the problem, effective measures taken, and the transferability of such measures to particular situations or systems are essential for preserving access while assuring efficiency under current as well as future economic and demographic constraints.Invited address at the Twenty-Third International Atlantic Economic Conference and the International Health Economics and Management Conference, April 20–27, 1987, Munich, West Germany. The views expressed in this paper are those of the author and do not necessarily represent those of the OECD.     

Determinants of environmental management systems standards implementation: evidence from Greek industry

This paper employs logistic regression analysis to test a model that predicts the implementation or non‐implementation of Environmental Management Systems Standards (EMSSs) by considering various factors as explanatory variables. The dependent variable is dichotomous: industrial firms either implementing or not implementing EMSSs. From past experience we identify 15 major variables contributing to implementation of EMSSs. A sample of 259 respondents (84 implementing and 175 not) is used to estimate the parameters of the logistic regression model employing maximum likelihood. The results show an overall significant model with four of the 15 variables significant. The significance of management perception of environmental issues on their decision to implement EMSS was confirmed with regards to their perception on win–win possibilities. Pressure on companies to improve their environmental performance does not result in higher uptake of the standards. Company image and size are important factors in its decision to implement EMSS. Copyright © 2002 John Wiley & Sons, Ltd. and ERP Environment     

Culture rules OK: class and culture in Brazilian cities

Cet article considère comment la culture dans les villes brésiliennes représente un reflet ainsi qu'une voie de médiation de la domination des classes. On analysera ici les pratiques et les orientations des différentes classes sociales par l'examen des stratégies employées pour répondre aux besoins materiels et culturels. On montrera comment les comportements formels et informels s'entrecoupent et comment, malgré le fait qu'ils semblent souvent ětre en conflit avec les formes ‘rationnelles’ de confronter un problème, en réalité, ils proviennent des péculiarités de l'ordre social et économique actuel, se conformant bien à la logique du processus brésilien de l'accumulation du capital.     

Introduction and Overview

As one of globalisation's most visible dimensions, foreign direct investment (FDI) is central to the prospects for developing countries in the world economy. Key issues include the direction of causation between FDI and growth, the potential role of the new information and communication technologies in attracting FDI flows (as well as the role of FDI in building such infrastructure), the process of skill acquisition associated with FDI, and the specific problems that Africa faces in attracting more FDI. Achievement of the Millennium Development Goals requires very fast growth in output and employment if global poverty is to be halved, and FDI could play a very positive role if its development benefits are maximised.