Medicaid as a Platform for Broader Health Reform: Supporting High-Need and Low-Income Populations

Outlines how policy makers can build on Medicaid to expand health coverage for low-income, high-need people by basing eligibility on income, boosting provider participation, increasing federal funding, and containing costs as a step toward broader reform

The 2008 Presidential Candidates' Health Reform Proposals: Choices for America

Looks at key differences in the 2008 presidential candidates' health insurance reforms and evaluates them against the Commonwealth Fund Commission on a High Performance Health System's principles. Estimates each plan's impact on the number of uninsured

Health Care Cost Containment and Coverage Expansion

Examines the relationship between expanding insurance coverage and controlling medical costs. Analyzes combinations of cost containment options and coverage expansion models for their compatibility and implications for the feasibility of proposed reforms

Competition in Rail Transport: A New Opportunity for Railways?

Throughout Europe, and in many other parts of the world, railways are suffering from declining market share and deteriorating financial performance; consequently there is renewed interest in deregulation and the introduction of competition into rail transport as a way of improving performance. An EC Directive now provides for access to rail infrastructure for third parties to run their own international trains in some circumstances. After a long debate, the British Government in July 1992 published a White Paper (New Opportunities for the Railways) which aimed to go much further. It would both open access to the infrastructure for any licensed operator and franchise out existing passenger services via a competitive bidding process; all freight services would be privatised outright. Draft legislation to implement these proposals, as well as a string of consultation documents on details have also been published, and an Interim Report from the Select Committee of Members of Parliament examining the proposals has appeared. This paper review the debate that is currently raging over the British government proposals. It considers the potential for innovation and cost savings which they offer, as well as the problems of increased transactions costs, lack of competitive bidding and other potential inefficiencies of the new system. The key issue of the charging regime for access to the infrastructure is also addressed. It is concluded that competition in the provision of freight services is desirable, but that passenger services present many more problems, and that the proposals need modification if they are to meet their objectives

Contract Farming for Better Farmer-Enterprise Partnerships: ADB\u27s Experience in the People\u27s Republic of China

[Excerpt] Agriculture should provide safe and nutritious food to people. In the People’s Republic of China (PRC ) and many other developing members of the Asian Development Bank (ADB), agriculture is also the main source of income for rural residents. Yet as compared with the total labor force absorption, the contribution of agriculture to gross domestic product is very small, suggesting lower productivity, often resulting in poverty. Recognizing the invaluable contribution of agriculture to the PRC ’s development, the government has been prioritizing agricultural modernization in its policy agenda with an aim to further improve the agricultural sector’s productivity and efficiency. ADB’s support to the sustainable development of agriculture in the PRC covers broad areas ranging from irrigation infrastructure and farmland upgrading to agribusiness development and food safety. The Dryland Sustainable Agriculture project commenced in 2009 with ADB assistance supports the development of partnerships between private agro-enterprises and farmers using contract farming arrangements to strengthen farm productivity, food production, and processing capacity in 27 counties in Gansu, Henan, and Shandong provinces. After 6 years, the project has delivered considerable amount of outputs in terms of facilities established and farmers engaged, showing promise in achieving its outcome. Concurring with the request from the Ministry of Agriculture, the project executing agency, ADB provided a grant to study the experiences arising from the project with respect to developing sustainable farmer–enterprise partnerships particularly contract farming models. Equally important, the study examines the issues involved in current contract farming practices and recommends policies that may help resolve them