Obesity-related costs and the economic impact of laparoscopic adjustable gastric banding procedures: benefits in the Texas Employees Retirement System

Objective: To assess the return on investment (ROI) and economic impact of providing insurance coverage for the laparoscopic adjustable gastric banding (LAGB) procedure in classes II and III obese members of the Texas Employees Retirement System (ERS) and their dependents from payer, employer, and societal perspectives.

Methods: Classes II and III obese employee members and their adult dependents were identified in a Texas ERS database using self-reported health risk assessment (HRA) data. Direct health costs and related absenteeism and mortality losses were estimated using data from previous research. A dynamic input–output model was then used to calculate overall economic effects by incorporating direct, indirect, and induced impacts. Direct health costs were inflation-adjusted to 2008 US dollars using the Consumer Price Index for Medical Care and other spending categories were similarly adjusted using relevant consumer and industrial indices. The future cost savings and other monetary benefits were discounted to present value using a real rate of 4.00%.

Results: From the payer perspective (ERS), the payback period for direct health costs associated with the LAGB procedure was 23–24 months and the annual return (over 5 years) was 28.8%. From the employer perspective (State of Texas), the costs associated with the LAGB procedure were recouped within 17–19 months (in terms of direct, indirect, and induced gains as they translated into State revenue) and the annual return (over 5 years) was 45.5%. From a societal perspective, the impact on total business activity for Texas (over 5 years) included gains of $195.3 million in total expenditures, $93.8 million in gross product, and 1354 person-years of employment.

Limitations: The analysis was limited by the following: reliance on other studies for methodology and use of a control sample; restriction of cost savings to 2.5 years which required out-of-sample forecasting; conservative assumptions related to the cost of the procedure; exclusion of presenteeism; and no sensitivity analyses performed.

Conclusion: This analysis indicates that providing benefits for the LAGB procedure to eligible members of the Texas ERS and their dependents is worthy of support from payer, employer, and societal perspectives.     

SAVINGS IN TIMES OF DEMOGRAPHIC CHANGE: LESSONS FROM THE GERMAN EXPERIENCE

Pension reforms in many developed countries make individuals shoulder a bigger share of longevity and income risks. The desired response is that individuals accumulate private assets for retirement. Whether this actually takes place, is of paramount relevance for scientists and policy makers. We take Germany as an example: Twenty years of pension reform have transformed the monolithic German pension system into a multipillar system. Formerly generous public pension benefits are gradually being reduced, whereas substantial incentives are granted to occupational and private saving schemes. Has this transition worked out? We survey the reform steps and households’ reactions: How did individuals adjust their labor market behavior? How did private and occupational pension plans take off? How do behavioral adjustments vary in the population? Most Germans adapted to the new situation. Both actual and expected retirement decisions changed and the share of households without supplementary pensions decreased from 73% to 39% in little more than a decade. This is a remarkable success. Nonetheless, households with low education, low income and less financial education did neither adjust their retirement behavior nor pick up supplementary pension plans and are thus likely to face difficulties in bridging the gap arising in future pension income.     

Reconceptualising home in seasonal Chinese tourism mobilities

This article has sought to contribute to the study of home in tourism studies by conceptualising how Chinese seasonal tourists to Sanya make sense of their own practices of home in doing health-related tourism mobilities. Qualitative research was conducted with 43 retired ‘snowbirds’ over three years in Sanya. It is found that the interplay of both mobile and located homes and identities has destabilized the singularity in understandings of home. This paper suggests examining home in Chinese tourism mobilities as a juxtaposition of three related dimensions – the physical, the social and the personal. The interactions between the multiple affordances of home are fostered through continual corporeal, material and imaginative mobilities, through which a sense of belonging is sustained.     

Pension reforms and saving gains in the United Kingdom

The empirical validity of the effect of pension reforms on domestic savings in the UK has been investigated using an Auto‐regressive Distributed Lag (ARDL) model capable of testing for the existence of a long‐run relationship regardless of whether the underlying time series are individually I(1) or I(0). The total savings response to change in pension savings is positive and significant, but an increase in occupational pension saving appears offset by a decrease in other forms of saving. This paper concludes that there is no firm evidence that aggregate savings increase considerably because of privately funded pension schemes.     

树立五种意识 做好新形势下的离退休管理工作

文章从树立大局意识、责任意识、细致意识、服务意识和创新意识等五方面入手,对作好新形势下的离退休管理工作进行探讨。     

Retirement,home production and labor supply elasticities

A standard life cycle model with home production implies a tight relationship between key preference parameters and the changes in time allocated to home production and leisure at retirement. We derive this relationship and use data from the ATUS to explore its quantitative implications. The key finding is that the intertemporal elasticity of substitution for leisure and the elasticity of substitution between time and goods in home production are approximately equal, in contrast to what is commonly assumed.     

I.J. Bienaymé [1796–1878]: Criticality,Inequality, and Internationalization*

Two striking contributions of Bienaymé to mathematical statistics: (1) a completely correct statemet of the Criticality Theorem for simple branching processes in 1845; and (2) the derivation of the Bienaymé-Chebyshev Inequality, are revisited on the 200th anniversary of his birth. We use writings and archival materials available since the note of Heyde & Seneta (1972) to present a fuller biographical picture. Bienaymé's connections with Buniakovsky and Chebyshev are elucidated, and this role in furthering Chebyshev's international contacts outlined. A concluding section illuminates Bienaymé's understanding of the linear regression of one random variable on another in an actuarial context of random shocks.     

Social security and cross-country differences in hours: A general equilibrium analysis

I develop a general equilibrium life cycle model with an intensive and extensive margin of labor supply and endogenous human capital accumulation. I use the model to assess the effects of changes to various features of social security on labor supply outcomes. Of particular interest are changes to the scale of the program and to the relevant eligibility rules. I find that the cross-country differences in social security programs account for at least 79% of the differences in employment rates of people aged 55–64 and 17–31% of the differences in aggregate hours worked between the US and continental Europe.     

寿命延长与延迟退休：国际比较与我国实证

基于国际比较的视角,探讨人口寿命延长与延迟退休之间的机制关系,分析国际上人口寿命延长与延迟退休的实践。通过对我国人口寿命延长趋势的研究,在一定的精算假设下,测算延迟退休对我国养老金支付压力的影响,并分析经济、制度等因素变动对测算结果的敏感性。结论表明,我国人口寿命延长趋势显著,延迟退休能够有效缓解老金支付压力,但在不同的性别之间有所差异。经济、制度等因素与延迟退休之间具有一定的替代效应,尽管延迟退休是未来我国应对人口寿命延长的必然选择,但目前建立二者的调整机制条件尚未成熟。     

Minutes of Business Meeting,December 30, 1953

Corporations institutionalize managerial and professional positions in a hierarchical pyramid in which many young professionals begin work at a lower and wider level of the pyramid where positions are numerous. However, as the professionals start climbing up the pyramid in their careers, the number of positions rapidly declines at higher levels. The pyramid gets narrower as the professionals climb up into fewer and fewer positions. Since they usually either move up or out in their career climb, as the young professionals begin aging, more and more of them are forced out to look for jobs elsewhere or eventually, to retire. This article develops a simple model that shows how this particular way of organizing work results in premature retirement and aging for many workers. Alternative ways of organizing work are discussed in which premature aging and retirement do not take place. Furthermore, a number of implications are explored and various projections made all of which show that the so-called future crisis in the Social Security and Medicare Systems in the United States is exaggerated. If reform is really needed, what is called for is adjustment in the way work is organized, not abandonment of security for the elderly.