Comprehensive Health Care Reform: An Essential Prescription for Women

[Excerpt] The status-quo health insurance system is serving women poorly. An estimated 64 million women lack adequate health insurance. Over half of all medical bankruptcies impact a woman. For too many women and their families today, quality, affordable health care is out of reach. Women are more vulnerable to high health care costs than men. Several factors explain why. First, women’s health needs differ from men’s, so women are obliged to interact more regularly with the health care system – regardless of whether they have adequate insurance coverage or not. Second, women are more likely to be economically vulnerable and therefore face devastating consequences when faced with a mounting pile of medical bills. The inability of the current system to adequately serve women’s health care needs has come at great expense. One recent study estimates that women’s chronic disease conditions cost hundreds of billions of dollars every year. The following brief provides an overview of the basic facts regarding women’s insurance cov-erage, and the consequences of our broken health insurance system on women’s health – both physical and financial. Specifically: &#; Over one million women have lost their health insurance due to a spouse’s job loss during the current economic downturn. &#; As a consequence of single mothers’ job loss, the Joint Economic Committee estimates that at least 276,000 children have lost health insurance coverage. &#; Women between the ages of 55 and 64 are particularly vulnerable to losing their health insurance benefits because of their husbands’ transition from employer-sponsored coverage to Medicare. &#; Younger women are particularly vulnerable to lacking adequate health insur-ance coverage. &#; 39 percent of all low-income women lack health insurance coverage &#; The health consequences of inadequate coverage are more severe for women than for men. &#; While the financial burden of inadequate health insurance coverage weighs heavily on all Americans, uninsured and under-insured women suffer more se-vere economic consequences than do men. The comprehensive health care reform proposals offered by the Obama Administration and currently taking shape under the leadership of Democrats in the House and Senate include numerous provisions that are critical to providing quality, affordable health care for all Americans, both women and men. Many of these solutions are a key part of the prescription for easing the burden on America’s women, for whom the status quo health care system is a failure

Women and the Economy 2010: 25 Years of Progress But Challenges Remain

[Excerpt] This report, which includes annual data from 1984 through 2009, provides a comprehensive overview of women’s economic progress over the last twenty-five years and highlights the additional work left to be done. The role of women in the American economy is of indisputable importance. The future of the American economy depends on women’s work, both inside and outside the home

Addressing Long-Term Unemployment After The Great Recession: The Crucial Role Of Workforce Training

[Excerpt] With almost five unemployed workers for every job opening, the economy is not yet creating enough jobs to make a significant reduction in unemployment. Yet employers report that they are having difficulty finding skilled workers for key positions, despite the high ratio of unemployed workers to job openings. Helping workers build new skills and search more effectively for positions that are a good match for their skillset can help to address the mismatch. But to address the high rate of long-term unemployment, this report finds that policymakers will need to simultaneously spur job creation while also investing in education and training programs that can prepare workers for new employment opportunities

Understanding the Economy: Long-Term Unemployment in the African American Community

[Excerpt] This report provides an in-­‐depth look at unemployment, including long-­‐term unemployment, among African American or black workers. Since 1972, when the Bureau of Labor Statistics started tracking unemployment rates by race, it has become clear that the overall unemployment rate for the United States has masked the depth of the unemployment problem within the African American community. This report is the first in a series of Joint Economic Committee reports examining the unemployment situation among different demographic groups. It shows that while African American workers have historically faced rates of unemployment and long-­‐term unemployment higher than the overall rate, the unemployment problems in the African American community were exacerbated during the Great Recession. Additionally, a larger percentage of African Americans are currently marginally attached or have dropped out of the work force, relative to the population as a whole. Understanding the employment challenges facing the African American community is just one important part of the process of devising effective policies to reduce unemployment for workers in all demographic groups. Longer durations of unemployment and higher unemployment rates could be symptomatic of a mismatch between skills and available jobs and may require more targeted policy actions to correct. Unemployment among teenagers is especially troubling, as economists have found that spells of unemployment among youth may lead to lower future wages and poorer career trajectories. Thus, in addition to reducing the unemployment rate, policymakers must also consider ways of limiting the long-­‐term impact of the recession on workers who have been unemployed for extended periods of time to make sure that these workers can move into employment

EFSA CEF Penal (EFSA Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids), 2014. Scientific Opinion on Flavouring Group Evaluation 212, Revision 2 (FGE.212Rev2): α,β-Unsaturated alicyclic ketones and precursors from chemical subgroup 2.6 of FGE.19

International audienc

Counter-intelligence in a command economy

This article provides the first thick description of the counter-intelligence function in a command economy of the Soviet type. Based on documentation from Soviet Lithuania, the article considers the KGB (secret police) as a market regulator, commissioned to prevent the disclosure of secret government business and forestall the disruption of government plans. Where market regulation in open societies is commonly intended to improve market transparency, competition, and fair treatment of consumers and employees, KGB regulation was designed to enforce secrecy, monopoly, and discrimination. One consequence of KGB regulation of the labour market may have been adverse selection for talent. Here it is argued that the Soviet economy was designed to minimize costs

The Dark Side of Transfer Pricing: Its Role in Tax Avoidance and Wealth Retentiveness

In conventional accounting literature, ?transfer pricing? is portrayed as a technique for optimal allocation of costs and revenues amongst divisions, subsidiaries and joint ventures within a group of related entities. Such representations of transfer pricing simultaneously acknowledge and occlude how it is deeply implicated in processes of wealth retentiveness that enable companies to avoid taxes and facilitate the flight of capital. A purely technical conception of transfer pricing calculations abstracts them from the politico-economic contexts of their development and use. The context is the modern corporation in an era of globalized trade and its relationship to state tax authorities, shareholders and other possible stakeholders. Transfer pricing practices are responsive to opportunities for determining values in ways that are consequential for enhancing private gains, and thereby contributing to relative social impoverishment, by avoiding the payment of public taxes. Evidence is provided by examining some of the transfer prices practices used by corporations to avoid taxes in developing and developed economies

Automated imaging technologies for the diagnosis of glaucoma: a comparative diagnostic study for the evaluation of the diagnostic accuracy, performance as triage tests and cost-effectiveness (GATE study)

BACKGROUND: Many glaucoma referrals from the community to hospital eye services are unnecessary. Imaging technologies can potentially be useful to triage this population. OBJECTIVES: To assess the diagnostic performance and cost-effectiveness of imaging technologies as triage tests for identifying people with glaucoma. DESIGN: Within-patient comparative diagnostic accuracy study. Markov economic model comparing the cost-effectiveness of a triage test with usual care. SETTING: Secondary care. PARTICIPANTS: Adults referred from the community to hospital eye services for possible glaucoma. INTERVENTIONS: Heidelberg Retinal Tomography (HRT), including two diagnostic algorithms, glaucoma probability score (HRT-GPS) and Moorfields regression analysis (HRT-MRA); scanning laser polarimetry [glaucoma diagnostics (GDx)]; and optical coherence tomography (OCT). The reference standard was clinical examination by a consultant ophthalmologist with glaucoma expertise including visual field testing and intraocular pressure (IOP) measurement. MAIN OUTCOME MEASURES: (1) Diagnostic performance of imaging, using data from the eye with most severe disease. (2) Composite triage test performance (imaging test, IOP measurement and visual acuity measurement), using data from both eyes, in correctly identifying clinical management decisions, that is 'discharge' or 'do not discharge'. Outcome measures were sensitivity, specificity and incremental cost per quality-adjusted life-year (QALY). RESULTS: Data from 943 of 955 participants were included in the analysis. The average age was 60.5 years (standard deviation 13.8 years) and 51.1% were females. Glaucoma was diagnosed by the clinician in at least one eye in 16.8% of participants; 37.9% of participants were discharged after the first visit. Regarding diagnosing glaucoma, HRT-MRA had the highest sensitivity [87.0%, 95% confidence interval (CI) 80.2% to 92.1%] but the lowest specificity (63.9%, 95% CI 60.2% to 67.4%) and GDx had the lowest sensitivity (35.1%, 95% CI 27.0% to 43.8%) but the highest specificity (97.2%, 95% CI 95.6% to 98.3%). HRT-GPS had sensitivity of 81.5% (95% CI 73.9% to 87.6%) and specificity of 67.7% (95% CI 64.2% to 71.2%) and OCT had sensitivity of 76.9% (95% CI 69.2% to 83.4%) and specificity of 78.5% (95% CI 75.4% to 81.4%). Regarding triage accuracy, triage using HRT-GPS had the highest sensitivity (86.0%, 95% CI 82.8% to 88.7%) but the lowest specificity (39.1%, 95% CI 34.0% to 44.5%), GDx had the lowest sensitivity (64.7%, 95% CI 60.7% to 68.7%) but the highest specificity (53.6%, 95% CI 48.2% to 58.9%). Introducing a composite triage station into the referral pathway to identify appropriate referrals was cost-effective. All triage strategies resulted in a cost reduction compared with standard care (consultant-led diagnosis) but with an associated reduction in effectiveness. GDx was the least costly and least effective strategy. OCT and HRT-GPS were not cost-effective. Compared with GDx, the cost per QALY gained for HRT-MRA is £22,904. The cost per QALY gained with current practice is £156,985 compared with HRT-MRA. Large savings could be made by implementing HRT-MRA but some benefit to patients will be forgone. The results were sensitive to the triage costs. CONCLUSIONS: Automated imaging can be effective to aid glaucoma diagnosis among individuals referred from the community to hospital eye services. A model of care using a triage composite test appears to be cost-effective

Development and evaluation of an intervention providing insight into the tobacco industry to prevent smoking uptake: a mixed-methods study

Background Smokers who start smoking at an early age are less likely to quit and more likely to die from their habit. Evidence from the US Truth® campaign suggests that interventions focusing on tobacco industry practices and ethics may be effective in preventing smoking uptake. Objectives In an exploratory study, to develop, pilot and provide preliminary evidence of the acceptability and effectiveness of Operation Smoke Storm, a school-based intervention based on the premise of the Truth® campaign, to prevent smoking uptake. Design Mixed-methods, non-randomised controlled study. Component 1 was delivered to Year 7 students, and student focus groups and teacher interviews were conducted to refine the lessons and to develop components 2 and 3. The revised Year 7 lessons and accompanying family booklet were delivered to new Year 7 students 1 year later in one school only; Year 8 students in both schools received the booster session. Setting and participants Students in Years 7–8 (aged 11–13 years) in two UK schools. Intervention A three-component intervention comprising (1) three 50-minute classroom-based sessions in Year 7 in which students acted as secret agents to uncover industry practices through videos, quizzes, discussions and presentations; (2) an accompanying family booklet containing activities designed to stimulate discussions about smoking between parents and students; and (3) a 1-hour interactive classroom-based booster session for Year 8 students, in which students learnt about tobacco marketing strategies from the perspectives of an industry executive, a marketing company and a health campaigner. Main outcome measures Odds ratios to compare the self-reported prevalence of ever smoking and susceptibility to smoking in Year 8 students after the delivery of the booster session in study schools compared with students in local control schools. Qualitative data on acceptability of the intervention. Results The combined prevalence of ever smoking and susceptibility increased from 18.2% in Year 7 to 33.8% in Year 8. After adjusting for confounders there was no significant difference in the odds of a Year 8 student in an intervention school being an ever smoker or susceptible never smoker compared with controls [adjusted odds ratio (aOR) 1.28, 95% confidence interval (CI) 0.83 to 1.97; p = 0.263] and no significant difference in the odds of ever smoking (aOR 0.82, 95% CI 0.42 to 1.58; p = 0.549). Students mostly enjoyed the intervention and acquired new knowledge that appeared to strengthen their aversion to smoking. Teachers liked the ‘off-the-shelf’ nature of the resource, although they highlighted differences by academic ability in the extent to which students understood the messages being presented. Use of the family component was low but it was received positively by those parents who did engage with it. Limitations Logistical difficulties meant that students’ responses in Year 7 and Year 8 could not be linked; however, baseline smoking behaviours differed little between intervention and control schools, and analyses were adjusted for confounders measured at follow-up. Conclusions Operation Smoke Storm is an acceptable resource for delivering smoking-prevention education but it does not appear to have reduced smoking and susceptibility. Future work The lack of a strong signal for potential effectiveness, considered alongside logistical difficulties in recruiting and working with schools, suggests that a fully powered cluster randomised trial of the intervention is not warranted