What Kind of Health Service do we Really Need?. ESRI Memorandum Series No. 140 1980

It is a privilege to be invited by this Association to address such a distinguished audience. Permit me to begin this afternoon by describing the nature and progress of my work at the Economic and Social Research Institute. As some of you know, I spent 1975 and 1976 at the Institute, doing research that in 1978 resulted in my paper on expenditures in education. I returned to the Institute last September, to undertake a project on health care expenditures. I have spent the time since September acquainting myself with the Irish health care system; acting as a consultant to the Oireachtais Joint Committee on state-Sponsored Bodies, on their study of the Voluntary Health Insurance Board; developing a report on "Poverty and Health" for the Irish Team, under the Institute of Public Administration, of a European Community study of poverty; and, as may not surprise you, trying to defend my paper on educational expenditures. Hence I have no results to report to you on health care expenditures. What I will have to say today is based on what is already generally known about the Irish system of health care, together with my understanding of health economics. I reserve the right to modify later the positions I take today. What kind of health care system do we need and want? I will offer the economists' answer: a system which is equitable in its treatment of persons, and efficient in its use of resources. As you will see, these terms are elastic enough to caver the preservation of health and life

The 'CUB' Budget as a Measure of Fiscal Policy. Quarterly Economic Commentary Special Article, January 1976

In a recession or depression, as at present, government budgets tend to be much less expansionary in their effects on the economy than one might infer from the sizes of their overall deficits. In other words, those who try to gauge the effect of the budget on demand in the economy by reference .to the size of the deficit in the overall budget are likely, in a recession, to be wrong. When government budget deficits rise, the usual interpretation is that the budget is more expansionary than theretofore in its influence on the economy, and when budget deficits fall (or surpluses grow), the usual interpretation is that the influence is less expansionary (or more contractionary). But the fact is that increased deficits are not necessarily more expansionary, nor are reduced deficits necessarily more contractionary, even apart from such matters as the types of taxes used, the mix of expenditures, the ways in which deficits are financed, and movements in the supply of money. The sizes of budget deficits and surpluses are influenced not only by the direction and strength of fiscal policy, but by short-term movements of the economy itself

When Job Performance is All Relative: How Family Motivation Energizes Effort and Compensates for Intrinsic Motivation

This is the author accepted manuscript. The final version is available from Academy of Management via the DOI in this record.Supporting one’s family is a major reason why many people work, yet surprisingly little research has examined the implications of family motivation. Drawing on theories of prosocial motivation and action identification, we propose that family motivation increases job performance by enhancing energy and reducing stress, and it is especially important when intrinsic motivation is lacking. Survey and diary data collected across multiple time points in a Mexican maquiladora generally support our model. Specifically, we find that family motivation enhances job performance when intrinsic motivation is low—in part by providing energy, but not by reducing stress. We conclude that supporting a family provides a powerful source of motivation that can boost performance in the workplace, offering meaningful implications for research on motivation and the dynamics of work and family engagement

Inter-Industry Differences in Male Percentage Unemployment Compensation - A Cross Section Analysis for Irish Manufacturing Industry. Quarterly Economic Commentary Special Article, November 1976

It is widely accepted that unemployment rates vary substantially amongst industrial sectors in Ireland. However, it does not appear to be equally recognised that there are substantial inter-industry differences in the percentage of net earnings which an unemployed person receives from Unemployment and Pay-Related Benefits. These differences are accentuated by the non-uniformity of the dependency structure of the labour force in different industries. This paper, therefore, comprises two parts. Part 1 is methodological and consists of an attempt to compute, under fairly restrictive assumptions, for each of 36 manufacturing industries, the proportion of net earnings obtained from unemployment compensation. This is done for persons of differing dependency status. These proportions are then weighted by the dependency distribution of the unemployed in each industry in order to obtain a representative percentage compensation figure for each of the 36 industries. Some space is devoted to an examination of these results. In Part 2 an attempt is made to explore the hypothesis that levels of unemployment compensation may be an important factor in explaining the extent and duration of registered unemployment

Report on Alaska Benefits and Costs of Exporting Alaska North Slope Crude Oil

Prepared for Alaska State Senate Finance CommitteeYe

Hospital competition, resource allocation and quality of care

BACKGROUND: A variety of approaches have been used to contain escalating hospital costs. One approach is intensifying price competition. The increase in price based competition, which changes the incentives hospitals face, coupled with the fact that consumers can more easily evaluate the quality of hotel services compared with the quality of clinical care, may lead hospitals to allocate more resources into hotel rather than clinical services. METHODS: To test this hypothesis we studied hospitals in California in 1982 and 1989, comparing resource allocations prior to and following selective contracting, a period during which the focus of competition changed from quality to price. We estimated the relationship between clinical outcomes, measured as risk-adjusted-mortality rates, and resources. RESULTS: In 1989, higher competition was associated with lower clinical expenditures levels compared with 1982. The trend was stronger for non-profit hospitals. Lower clinical resource use was associated with worse risk adjusted mortality outcomes. CONCLUSIONS: This study raises concerns that cost reductions may be associated with increased mortality

The roles of encoding and retrieval processes in associative and categorical memory illusions

Four experiments investigated the origin of associative and categorical memory illusions by comparing the effects of study and test associations on Deese/Roediger-McDermott (DRM) and categorized lists. Experiments 1 and 2 found that levels of false recognition with both list types were increased by manipulations that facilitated the generation of associates at study (blocked presentation of study lists and explicit instructions to generate associates of studied items). Experiments 3 and 4 showed that manipulations designed to increase test associations (test-induced priming and part-set cuing) did not increase levels of false memory with either list type. These findings indicate that false memories produced by both DRM and categorized lists are influenced by associations activated at study but not by associations activated at test

A computational model of liver iron metabolism

Iron is essential for all known life due to its redox properties; however, these same properties can also lead to its toxicity in overload through the production of reactive oxygen species. Robust systemic and cellular control are required to maintain safe levels of iron, and the liver seems to be where this regulation is mainly located. Iron misregulation is implicated in many diseases, and as our understanding of iron metabolism improves, the list of iron-related disorders grows. Recent developments have resulted in greater knowledge of the fate of iron in the body and have led to a detailed map of its metabolism; however, a quantitative understanding at the systems level of how its components interact to produce tight regulation remains elusive. A mechanistic computational model of human liver iron metabolism, which includes the core regulatory components, is presented here. It was constructed based on known mechanisms of regulation and on their kinetic properties, obtained from several publications. The model was then quantitatively validated by comparing its results with previously published physiological data, and it is able to reproduce multiple experimental findings. A time course simulation following an oral dose of iron was compared to a clinical time course study and the simulation was found to recreate the dynamics and time scale of the systems response to iron challenge. A disease state simulation of haemochromatosis was created by altering a single reaction parameter that mimics a human haemochromatosis gene (HFE) mutation. The simulation provides a quantitative understanding of the liver iron overload that arises in this disease. This model supports and supplements understanding of the role of the liver as an iron sensor and provides a framework for further modelling, including simulations to identify valuable drug targets and design of experiments to improve further our knowledge of this system