Equality of opportunity and the expansion of higher education in the UK

Using nine waves of data from Understanding Society (UKHLS), we study the expansion of higher education in the UK and its consequences for levels of and inequalities in income, physical and mental health. University expansion was characterized by a large increase in the proportion of graduates, with higher rates of graduation among individuals from more advantaged socioeconomic backgrounds. Having controlled for birth cohort and lifecycle effects, there is evidence of significant inequality of opportunity (IOp) in the actual outcomes. However, comparing actual outcomes with counterfactual projections, that freeze the likelihood of university graduation and the joint distribution of graduation and circumstances to the pre-1963 levels, we do not detect an impact of the expansion of higher education on IOp in income and only small reductions in IOp in physical and mental health.     

Information Asymmetries and Risk Management in Healthcare Markets: The U.S. Affordable Care Act in Retrospect

This article critically examines the pertinent issues in ex ante and ex post moral hazard in healthcare markets, with the U.S. Affordable Care Act (ACA) as its focal point of inquiry. First, it compares the various types of information asymmetries resulting from the production, allocation, and utilization of health insurance. Second, it reviews the literature on adverse selection, moral hazard, and risk mitigation against which salient ACA reforms are analyzed. In contrasting conventional moral hazard from an alternative theory of welfare maximization, it suggests that healthcare (over)utilization cannot necessarily be considered wasteful, even if it ends up costing insurers more on a short-term basis. Costs and savings attributable to healthcare spending under the ACA will vary between the consumer, insurer, and regulator-subsidizer. Despite the ambiguities surrounding definitions of “health,” the challenge of containing inefficient moral hazard, and encouraging its desirable counterpart, lies in the tradeoffs that arise between consumer access to affordable and quality healthcare and the market competitiveness of health insurers. The new Trump administration will have to address these tradeoffs in repealing and replacing the ACA, particularly in light of escalating insurance premiums and deductibles, narrower provider networks, and technical implementation issues.     

Parental Compensatory Behaviors and Early Child Health Outcomes in Cebu, Philippines()

A dynamic optimization model of parents choosing investments in their children's health motivates an empirical model of parents' choices of health inputs for their children and the impacts of these decisions on their children's subsequent health. Estimates of the child health input demand functions and the child health production functions from the Cebu Longitudinal Health and Nutrition Survey accord with the prediction that optimizing behavior results in higher levels of aggregate child health. Observable parental behaviors respond to the physical developmental status of their children. These parental responses appear to yield large and statistically significant improvements in children's early physiological outcomes. However, because some health inputs choices are not observable, it is impossible to ascertain whether these measured effects are due solely to variations in the observed input choices.     

我国卫生防疫体系制度变迁中的政府责任分析

卫生防疫所涉及内容的利益外溢性和单个人的无力作为决定了卫生防疫这一产品的纯公共品性质。我国政府作为卫生防疫管制者的身份在不断地加强,而作为生产者的身份则一直在弱化。这样一种状况造成在卫生防疫中政府责任的缺失,其直接后果就是各种解放后几近绝迹的传染病的死灰复燃和各种突发性公共卫生事件的频发。因此,强调政府特别是中央政府在卫生防疫中的财政责任和管制责任就显得较为迫切。     

Using data envelopment analysis approach to estimate the health production efficiencies in China

By using Data Envelopment Analysis approach, we treat the health production system in a certain province as a Decision Making Unit (DMU), identify its inputs and outputs, evaluate its technical efficiency in 1982, 1990 and 2000 respectively, and further analyze the relationship between efficiency scores and social-environmental variables. This paper has found several interesting findings. Firstly, provinces on frontier in different year are different, but provinces far from the frontier keep unchanged. The average efficiency of health production has made a significant progress from 1982 to 2000. Secondly, all provinces in China can be divided into six categories in terms of health production outcome and efficiency, and each category has specific approach of improving health production efficiency. Thirdly, significant differences in health production efficiencies have been found among the eastern, middle and western regions in China, and among the eastern and middle regions. At last, there is significant positive relationship between population density and health production efficiency but negative relationship (not very significant) between the proportions of public health expenditure in total expense and efficiency. Maybe it is the result of inappropriate tendency of public expenditure. The relationship between abilities to pay for health care services and efficiency in urban areas is opposite to that in rural areas. One possible reason is the totally different income and public services treatments between rural and urban residents. Therefore, it is necessary to adjust health policies and service provisions which are specifically designed to different population groups. __________ Translated from Jingji Yanjiu 经济研究 (Economic Research Journal), 2006, (7): 92–105     

城市化对健康的影响研究评述：利弊分析与未来展望

快速的城市化对健康产生双重影响,既有积极的一面,也有消极的一面。城市化使城市人群能够分享现代医疗技术的最新成果,从而使城市人群的预期寿命更长,婴儿死亡率、孕产妇死亡率等更低;但同时城市化的过程也伴随着城市环境的污染和城市生活方式的改变,从而又使城市人群在许多疾病的发病率上高于农村。城市化对健康的影响到底是利大于弊还是弊大于利,目前在学术界还没有达成共识。文章尝试对此问题做一评述性研究。     

中日农村医疗保险制度比较研究

纵向比较分析中日两国农村医疗保险制度的发展历程,从覆盖范围、筹资方式、补偿方式、资金收支情况等方面横向比较中日两国的农村医疗保险制度,探讨中日两国农村医疗保险制度的优缺点,为我国完善新型农村合作医疗制度提供相关建议。     

Does Medical Equipment Expansion Lead to More Diagnostic Services? Evidence from China’s Sichuan Province

A major goal of China’s healthcare reform is to control the increasing healthcare spending, much of which can be attributed to the overuse of diagnostic tests and has been relatively less studied in the literature. This article analyzes the correlation between medical equipment expansion and the increase in diagnostic test expenditure in China, using Sichuan Province as an example. County-level data aggregated from hospitals’ annual reports in Sichuan Province from 2008 to 2012 were used. The results show a positive correlation between the expansion of medical equipment and the increase in diagnostic test expenditure. Our study provides implications on reforming China’s healthcare delivery system and medical equipment regulation policies.     

电子健康发展中的障碍及对策初探

电子健康是包括电子健康档案、数字化医疗及卫生保健集于一体的新型医疗保健模式。但在电子健康发展的过程中,存在着观念、技术、法律、道德等方面的障碍,文章就其发展过程中遇到的障碍进行分析,并提出了相应的对策。     

You should know better! Do health students have different risk attitudes to unplanned pregnancy and sexually transmitted diseases?

Because healthcare professionals are in the best position to assess, assist and educate those participating in risky sexual behaviour, understanding if (and how) their risk attitudes differ from the wider population is of vital importance. In this study, we explore university health students’ risk attitudes towards unplanned pregnancy and sexually transmitted diseases (STDs). We examine whether university students pursuing health-related degrees, who hypothetically should have more exposure to and understanding of the risks associated with unplanned pregnancy and STD, have more risk averse attitudes to sexual behaviour. We find that health students’ sexual attitudes are significantly more risk averse than those of their nonhealth peers in relation to STDs but not unplanned pregnancy. In line with previous research, age and no previous sexual history (virginity) appear to increase risk-averse attitudes to both unplanned pregnancy and STDs. Moreover, males and singles are more risk seeking in their sexual attitudes. These findings suggest that, because unplanned pregnancy and STDs are ongoing global issues, further research is warranted into the risk attitudes of those healthcare professionals most able to provide education and support for individuals participating in risky sexual behaviour.