Medical Marijuana Knowledge and Attitudes: A Survey of the California Pharmacists Association

Views on the medical efficacy and acceptability of marijuana have changed over the years. California was the first state permitting individuals to use medical marijuana. Even with a long history of use and widespread agreement around the effectiveness of medical marijuana, the literature is sparse about the role health care providers, including pharmacists, play in this interaction. The purpose of this article is to shed light on knowledge and attitudes of pharmacists regarding medical marijuana. We developed a survey for pharmacists about their level of knowledge and attitudes toward medical marijuana. The survey was distributed using SurveyMonkey. It consisted of 44 questions and an opportunity to provide comments. We collaborated with the California Pharmacists Association who provided a link to the survey in October 2017 to their members. Results from 474 responses indicate a majority of providers believe that marijuana has medical efficacy. Yet most providers report that they neither have much information about medical marijuana nor do they know where to get such information. One area of particular concern is the potential for drug interactions. Pharmacists would feel more comfortable discussing medical marijuana if it was approved by the Food and Drug Administration. Moreover, they believe more research needs to occur. The variance between California and federal policy leads to dysfunction among pharmacists providing information to patients. We believe federal policy should change

Ethics and Economics of the COVID-19 Pandemic in the United States

The Covid-19 experience provides a natural experiment in personal and social ethics. Difficult decisions are routinely made to optimize lives and livelihoods. This commentary provides background and insight into the ethical and economic foundations underpinning dilemmas of this historic pandemic

Organization and Finance of China\u27s Health Sector: Historical Antecedents for Macroeconomic Structural Adjustment

China has exploded onto the world economy over the past few decades and is undergoing rapid transformation toward relatively more services. The health sector is an important part of this transition. This article provides a historical account of the development of health care in China since 1949. It also focuses on health insurance and macroeconomic structural adjustment to less saving and more consumption. In particular, the question of how health insurance impacts precautionary savings is considered. Multivariate analysis using data from 1990 to 2012 is employed. The household savings rate is the dependent variable in 3 models segmented for rural and urban populations. Independent variables include out-of-pocket health expenditures, health insurance payouts, housing expenditure, education expenditure, and consumption as a share of gross domestic product (GDP). Out-of-pocket health expenditures were positively correlated with household savings rates. But health insurance remains weak, and increased payouts by health insurers have not been associated with lower levels of household savings so far. Housing was positively correlated, whereas education had a negative association with savings rates. This latter finding was unexpected. Perhaps education is perceived as investment and a substitute for savings. China’s shift toward a more service-oriented economy includes growing dependence on the health sector. Better health insurance is an important part of this evolution. The organization and finance of health care is integrally linked with macroeconomic policy in an environment constrained by prevailing institutional convention. Problems of agency relationships, professional hegemony, and special interest politics feature prominently, as they do elsewhere. China also has a dual approach to medicine relying heavily on providers of traditional Chinese medicine. Both of these segments will take part in China’s evolution, adding another layer of complexity to policy

Merger & Acquisition and Capital Expenditure in Health Care: Information Gleaned From Stock Price Variation

Investment, especially through merger and acquisition (M&A), is a leading topic of concern among health care managers. In addition, the implications of this activity for organization and market concentration are of great interest to policy makers. Using a sample of 2256 firm-year observations in the health care industry during the period from 1985 to 2011, this article provides novel evidence that managers learn from financial markets in making capital expenditure (CAPEX) and M&A investment decisions. Within the industry, managers in the Drugs subsector are most likely to do so, whereas managers in the Medical Equipment and Supplies are least likely to do so. We find informative stock prices improve firm financial performance. This article highlights the importance of financial markets for real economic activity in the health care industry

Palestinian Health Institutions: Finding a Way Forward in the Wake of the Second Intifada

The strength of Hamas in Palestinian elections in early 2006 reshuffled the cards in the game of Middle East politics. Many astonished observers have sought an explanation for this political change. But the election result should not have been so surprising. Hamas has earned a reputation of clean governance and compassion for the poor, unlike the Fatah-led Palestinian Authority. Hamas has had a strong presence in the health sector which helped establish its legitimacy and popularity. This paper reviews bilateral and multilateral aid to Palestinians following the second intifada and argues that not enough was done by the international community to bolster health services of the Palestinian Authority. This left a void that Hamas and other charitable organizations have filled. The health sector remains strategic and its assimilation with the Palestinian Authority should be sought. Comprehensive policy toward the Middle East and other developing regions should integrate social welfare programs with global security interests

The Case of South African and Chilean Health Systems: Comparison of Financial, Economic and Health Indicators

The purpose of this study is to identify similarities and differences between healthcare systems of South Africa and Chile. The World Health Report 2000, the Human Development Index, and financial indicators were used for comparison. Chile showed better performance than South Africa in most of the measures used. Significant progress has been made in South Africa, bringing better education, healthcare and housing to the deprived black majority. However, the HIV/AIDS epidemic, weighs heavily on health indicators. Chile decentralized its health services and implemented economic reforms during the 1980\u27s and has had steady improvement in its healthcare indicators. Finally, these counties share: World Bank classification as middle income economies, dual public/private health systems, skewed income distribution and allocation towards the private sector, with relatively high private health expenditures as a percentage of total health expenditures, focus in primary health care in their public health system and implementation of new healthcare reforms

The Chilean Pension System at 25 Years: The Evolution of a Revolution

The 1981 reform of the Chilean pension system was revolutionary at its time. It was the first instance of a mature public Pay-As-You-Go social security system being converted into a mandatory defined contribution system managed by the private sector. This paper contends that a unique confluence of events were responsible for this change. The rise of a dictatorship in Chile, a struggling public retirement system, and a cadre of Chicago oriented economists determined to make Chile a model free market neoliberal economy. This was later followed by the Washington Consensus and the promotion of Chilean reform by the World Bank. This paper analyzes the Chilean reform and its subsequent development; evaluating it on both efficiency and equity grounds. While the evidence for efficiency gains is mixed there is little doubt that equity has suffered under the new system. Nevertheless, it continues to evolve and equity concerns are increasingly being addressed

The Chilean Pension System at 25 Years: The Evolution of a Revolution

The 1981 reform of the Chilean pension system was revolutionary at its time. It was the first instance of a mature public Pay-As-You-Go social security system being converted into a mandatory defined contribution system managed by the private sector. This paper contends that a unique confluence of events were responsible for this change. The rise of a dictatorship in Chile, a struggling public retirement system, and a cadre of Chicago oriented economists determined to make Chile a model free market neoliberal economy. This was later followed by the Washington Consensus and the promotion of Chilean reform by the World Bank. This paper analyzes the Chilean reform and its subsequent development; evaluating it on both efficiency and equity grounds. While the evidence for efficiency gains is mixed there is little doubt that equity has suffered under the new system. Nevertheless, it continues to evolve and equity concerns are increasingly being addressed

Rising gasoline prices increase new motorcycle sales and fatalities

Background: We examined whether sales of new motorcycles was a mechanism to explain the relationship between motorcycle fatalities and gasoline prices. Methods: The data came from the Motorcycle Industry Council, Energy Information Administration and Fatality Analysis Reporting System for 1984–2009. Autoregressive integrated moving average (ARIMA) regressions estimated the effect of inflation-adjusted gasoline price on motorcycle sales and logistic regressions estimated odds ratios (ORs) between new and old motorcycle fatalities when gasoline prices increase. Results: New motorcycle sales were positively correlated with gasoline prices (r = 0.78) and new motorcycle fatalities (r = 0.92). ARIMA analysis estimated that a US$1 increase in gasoline prices would result in 295,000 new motorcycle sales and, consequently, 233 new motorcycle fatalities. Compared to crashes on older motorcycle models, those on new motorcycles were more likely to be young riders, occur in the afternoon, in clear weather, with a large engine displacement, and without alcohol involvement. Riders on new motorcycles were more likely to be in fatal crashes relative to older motorcycles (OR 1.14, 95 % confidence interval (CI) 1.02–1.28) when gasoline prices increase. Conclusions: Our findings suggest that, in response to increasing gasoline prices, people tend to purchase new motorcycles, and this is accompanied with significantly increased crash risk. There are several policy mechanisms that can be used to lower the risk of motorcycle crash injuries through the mechanism of gas prices and motorcycle sales such as raising awareness of motorcycling risks, enhancing licensing and testing requirements, limiting motorcycle power-to-weight ratios for inexperienced riders, and developing mandatory training programs for new riders