Strategies for pricing publicly provided health services

The authors examine how governments finance and allocate public spending, with an eye to developing strategies for pricing publicly provided health services. They also examine the implications of current policy and the possibility for rationalizing competing government priorities. Because governments face budget constraints and cannot fully subsidize all programs and activities, the authors argue the following: a) Public spending on health can (1) improve health outcomes, (2) promote nonhealth aspects of well-being (for example, reducing individuals'risk of economic losses from random health crises), and (3) finance redistribution to the poor. Optimal subsidy and fee policy will depend on how much relative weight government places on those competing objectives. Subsidies need to be reallocated toward the poor and toward public health sector can financed by increasing public subsidies. b) Prices for curative services (user fee) have two distinct roles. They can raise revenue, freeing public resources to be reallocated to public health activities and for limited cofinancing to improve the quality of curative care. More important, they can improve efficiency in the use of public facilities and the health care system as a whole. But those gains must be weighed against evidence that increased fees can compromise public health's three main goals. The literature has focused largely on how raising revenue affects the poor, but the more important effect is likely to be the guidance of resources. User fees are important in cofinancing health care but shouldn't be the primary means of finance. c) Revenue generated from user fees is sometimes used to improve the quality of, and access to, curative medical care. There is some evidence that people are willing to pay some of the cost of improving health care (especially for drugs), but the wealthy are willing to pay a lot more than the poor. If governments charge the average"willingness to pay,"the wealthy will use the services more, the poor, less. d) Prepayment social insurance plans hold promise, but there is evidence that they may introduce inefficient inflation of medical care costs that lower- and middle- income countries cannot afford.Public Sector Economics&Finance,Health Systems Development&Reform,Environmental Economics&Policies,Payment Systems&Infrastructure,Health Economics&Finance,Environmental Economics&Policies,Public Sector Economics&Finance,Health Systems Development&Reform,Health Economics&Finance,Urban Economics

On the origin of <i>Halipeurus heraldicus</i> on Round Island petrels: cophylogenetic relationships between petrels and their chewing lice

Lice phylogenetic relationships have often been used to elucidate host relationships and vice versa. In this study, we investigate the louse genus Halipeurus which parasitizes bird hosts in the families Procellariidae, Hydrobatidae and Pelecanoididae. The presence of two lice species on Pterodroma arminjoniana in different breeding grounds (Halipeurus heraldicus on Round Island, off Mauritius in the Indian Ocean and Halipeurus kermadecensis on Trindade Island in the Atlantic Ocean) has led to some confusion in the distribution of Pt. arminjoniana and its close relatives Pt. heraldica and Pt. neglecta. By using a cophylogenetic approach that incorporates uncertainties in phylogenetic reconstructions, we show significant overall coevolution between Halipeurus lice and their hosts. However, the study also indicates that the presence of H. heraldicus on Pt. arminjoniana and Pt. neglecta on Round Island and on Pt. heraldica on Gambier Island are the result of a host switch whereas H. kermadecensis is the ancestral parasite of Pt. arminjoniana. This suggests that H. kermadecensis was lost during or after colonisation of Round Island by Pt. arminjoniana. We conclude that cophylogenetic analyses are central to inferring the evolutionary history and biogeographical patterns of hosts and their parasites

THE CANADA-FRANCE REDSHIFT SURVEY V: Global Properties of the Sample

The photometric and spectroscopic data of the CFRS survey of objects with 17.5 < I_{AB} < 22.5 are combined and analysed. The overall completeness is 85%. The redshift histogram of the sample is presented for 591 field galaxies with secure redshifts. The median redshift is z = 0.56, and the highest redshift observed is z = 1.3; 25 galaxies have z > 1 The distributions of magnitudes and colors demonstrate that galaxies at these high redshifts have very similar colors to those observed locally. The survey thus represents a major improvement in our knowledge of field galaxies at large look-back times. Only ~1% of the galaxies are as compact as stars (on images with FWHM ~ 0.9") and comparisons of the photometric and spectroscopic data show that only one galaxy was initially incorrectly classified spectroscopically as a star, and only two stars were misclassified as galaxies. It is demonstrated that the redshift distributions in the five fields are statistically consistent with each other, once the reduction in the effective number of independent galaxies due to small-scale clustering in redshift is taken into account. The photometric properties of the spectroscopically-unidentified objects indicate that most are likely to be galaxies rather than stars. At least half of these must have the same redshift distribution as the identified galaxies, and a combination of magnitudes, colors and compactness of the remaining unidentified galaxies is used to predict their redshifts. The majority are probably ordinary galaxies at the high redshift end of our sample, including some quiescent galaxies at z > 1.0, rather than some new or unusual population.Comment: 20 uuencoded postscript pages (first part) with 12 figures (second part). Also available at http://www.dao.nrc.ca/DAO/SCIENCE/science.html and coming soon on a CFRS homepage. Accepted June 19, scheduled for Dec 10 issue of Ap

Redshifts of the Gravitational Lenses MG1131+0456 and B1938+666

The redshifts of the gravitational lens galaxies in MG1131+0456 and B1938+666 are 0.844 and 0.881 respectively. Both are early-type galaxies lying at the redshifts predicted by assuming that they are early-type galaxies with old stellar populations lying on the fundamental plane. We also find evidence for a foreground group of galaxies at z=0.343 near MG1131+0456. The source redshifts are predicted to be >1.8 in both systems, but they are so red that infrared spectra will be required to determine their redshifts.Comment: 10 pages, AASTeX Latex, including 1 JPEG and 2 postscript figures, submitted to Astronomical Journal Minor typos fixe

THE CANADA-FRANCE REDSHIFT SURVEY II: Spectroscopic Program; Data for the 0000-00 and 1000+25 Fields

This paper describes the methods used to obtain the spectroscopic data and construct redshift catalogs for the Canada-France deep Redshift Survey (CFRS). The full data set consists of more than one thousand spectra, of objects with 17.5 < I_{AB} < 22.5, obtained from deep multi-slit data with the MARLIN and MOS-SIS spectrographs at the CFHT. The final spectroscopic catalog contains 200 stars, 591 galaxies with secure redshifts in the range 0 < z < 1.3, 6 QSOs, and 146 objects with very uncertain or unknown redshifts, leading to an overall success rate of identification of 85%. Additionally, 67 objects affected by observational problems have been placed in a supplemental list. We describe here the instrumental set up, and the observing procedures used to efficiently gather this large data set. New optimal ways of packing spectra on the detector to significantly increase the multiplexing gain offered by multi-slit spectroscopy are described. Dedicated data reduction procedures have been developed under the IRAF environment to allow for fast and accurate processing. Very strict procedures have been followed to establish a reliable list of final spectroscopic measurements. Fully independent processing of the data has been carried out by three members of the team for each data set associated with a multi-slit mask, and final redshifts were assigned only after the careful comparison of the three independent measurements. A confidence class scheme was established. We strongly emphasize the benefits of such procedures. Finally, we present the spectroscopic data obtained for 303 objects in the 0000-00 and 1000+25 fields. The success rate in spectroscopic identification isComment: 16 uuencoded postcript pages with figures 4,5,8,9 and 12. Other (large) figures available from the authors. Large data table not yet released. Also available at http://www.dao.nrc.ca/DAO/SCIENCE/science.html and coming soon on a CFRS homepage. Accepted June 19, scheduled for the Dec 10 issue of Ap

Signatures of few-body resonances in finite volume

We study systems of bosons and fermions in finite periodic boxes and show how the existence and properties of few-body resonances can be extracted from studying the volume dependence of the calculated energy spectra. Using a plane-wave-based discrete variable representation to conveniently implement periodic boundary conditions, we establish that avoided level crossings occur in the spectra of up to four particles and can be linked to the existence of multi-body resonances. To benchmark our method we use two-body calculations, where resonance properties can be determined with other methods, as well as a three-boson model interaction known to generate a three-boson resonance state. Finding good agreement for these cases, we then predict three-body and four-body resonances for models using a shifted Gaussian potential. Our results establish few-body finite-volume calculations as a new tool to study few-body resonances. In particular, the approach can be used to study few-neutron systems, where such states have been conjectured to exist.Comment: 13 pages, 10 figures, 2 tables, published versio

The CANADA-FRANCE REDSHIFT SURVEY I: Introduction to the Survey, Photometric Catalogs and Surface Brightness Selection Effects

The Canada-France Redshift Survey has been undertaken to provide a large well-defined sample of faint galaxies at high redshift in which the selection criteria match as closely as possible those of samples of nearby galaxies. The survey is designed to have a median redshift of z ~ 0.6 corresponding to a look-back time of half the present age of the Universe for Omega ~ 1. Such a survey can then be used for studying many different aspects of the evolution of galaxies over the interval 0 < z < 1. In this paper we describe the selection of the fields, the multicolor imaging observations and the construction and validation of the photometric catalogs. Particular attention is paid to quantifying the unavoidable selection effects in surface brightness and their impact on the survey is assessed in the context of the properties of known populations of galaxies. The photometric catalogs contain several thousand objects brighter than I_{AB}< 22.5 and are essentially complete for central surface brightnesses as faint as $\mu_{AB}(I)$ $\sim$ 24.5 mag arcsec$^{-2}$. This should be sufficient to include both normal surface brightness galaxies and prototypes of extreme low surface brightness galaxies.Comment: 17 pages, 2 tables, 10 postscript figures (in 2 parts), uses aaspp.sty Also available at http://www.dao.nrc.ca/DAO/SCIENCE/science.html and coming soon on a CFRS homepag

Is a Trineutron Resonance Lower in Energy than a Tetraneutron Resonance?

We present quantum Monte Carlo calculations of few-neutron systems confined in external potentials based on local chiral interactions at next-to-next-to-leading order in chiral effective field theory. The energy and radial densities for these systems are calculated in different external Woods-Saxon potentials. We assume that their extrapolation to zero external-potential depth provides a quantitative estimate of three- and four-neutron resonances. The validity of this assumption is demonstrated by benchmarking with an exact diagonalization in the two-body case. We find that the extrapolated trineutron resonance, as well as the energy for shallow well depths, is lower than the tetraneutron resonance energy. This suggests that a three-neutron resonance exists below a four-neutron resonance in nature and is potentially measurable. To confirm that the relative ordering of three- and four-neutron resonances is not an artifact of the external confinement, we test that the odd-even staggering in the helium isotopic chain is reproduced within this approach. Finally, we discuss similarities between our results and ultracold Fermi gases.Comment: 6 pages, 5 figures, version compatible with published lette