Analyzing the effects of insuring health risks : on the trade-off between short run insurance benefits vs. long run incentive costs

This paper constructs a dynamic model of health insurance to evaluate the short- and long run effects of policies that prevent firms from conditioning wages on health conditions of their workers, and that prevent health insurance companies from charging individuals with adverse health conditions higher insurance premia. Our study is motivated by recent US legislation that has tightened regulations on wage discrimination against workers with poorer health status (Americans with Disability Act of 2009, ADA, and ADA Amendments Act of 2008, ADAAA) and that will prohibit health insurance companies from charging different premiums for workers of different health status starting in 2014 (Patient Protection and Affordable Care Act, PPACA). In the model, a trade-off arises between the static gains from better insurance against poor health induced by these policies and their adverse dynamic incentive effects on household efforts to lead a healthy life. Using household panel data from the PSID we estimate and calibrate the model and then use it to evaluate the static and dynamic consequences of no-wage discrimination and no-prior conditions laws for the evolution of the cross-sectional health and consumption distribution of a cohort of households, as well as ex-ante lifetime utility of a typical member of this cohort. In our quantitative analysis we find that although a combination of both policies is effective in providing full consumption insurance period by period, it is suboptimal to introduce both policies jointly since such policy innovation induces a more rapid deterioration of the cohort health distribution over time. This is due to the fact that combination of both laws severely undermines the incentives to lead healthier lives. The resulting negative effects on health outcomes in society more than offset the static gains from better consumption insurance so that expected discounted lifetime utility is lower under both policies, relative to only implementing wage nondiscrimination legislation

Heart-Lung Interactions in Aerospace Medicine

Few of the heart-lung interactions that are discussed have been studied in any detail in the aerospace environment, but is seems that many such interactions must occur in the setting of altered accelerative loadings and pressure breathing. That few investigations are in progress suggests that clinical and academic laboratory investigators and aerospace organizations are further apart than during the pioneering work on pressure breathing and acceleration tolerance in the 1940s. The purpose is to reintroduce some of the perennial problems of aviation physiology as well as some newer aerospace concerns that may be of interest. Many possible heart-lung interactions are pondered, by necessity often drawing on data from within the aviation field, collected before the modern understanding of these interactions developed, or on recent laboratory data that may not be strictly applicable. In the field of zero-gravity effects, speculation inevitably outruns the sparse available data

ECONOMIC AND ENVIRONMENTAL BENEFITS OF SOIL/WATER NITROGEN TESTING: THE CASE OF CENTRAL NEBRASKA

This research presents a competitive dynamic model to evaluate the economic and groundwater quality benefits resulting from the adoption of soil/water nitrogen testing. The model is applied to an irrigated corn production county in the Nebraska Mid-State area where the groundwater contamination level from nitrates is reported to be, on average, 18.7 parts per million (ppm). Adoption of nutrient management practices would result in increased economic benefits to farmers and reduced nitrate stocks in groundwater.Environmental Economics and Policy,

Cellular factors that interact with the negative regulatory element of the 5'-long terminal repeat of human immunodeficiency virus type 1

Transcriptional regulation of HlV-1 gene expression has been shown to be regulated by a combination of viral and cellular proteins which bind to regulatory elements in the viral 5' long terminal repeat (5'LTR) Functionally the LTR can be divided into three regulatory regions: the TAR region, extending from nucleotides 1 to 60 relative to the start site of transcription, contains sequences with which the viral trans-activator Tat interacts. The adjacent region from nucleotides -1 to -78 contains the core promoter with elements crucial for both basal and Tat-induced expression. The third region, extending from -79 to -454, contains numerous elements with which a variety of cellular factors may interact, resulting in either positive or negative modulation of LTR-driven transcription. The work contained within this thesis describes the discovery and delineation of two new transcription factor binding sites, designated as site A and site B, within the 5'-LTR of HIV-1. The majority of the work focused on site B itself, involving the characterisation of cellular proteins that specifically interacted with the nucleotide sequences in this site. Site B was found to contain a palindromic sequence TGACC involved in protein-DNA contact separated by a 9 base-pair spacer sequence that was not important for protein binding. This palindrome resembles the consensus binding site for members of the nuclear hormone receptor super-family of transcription factors. Although several members of this super-family of transcription factors were shown to interact in vitro with site B, the predominant protein present in T-lymphocyte nuclear extracts did not correspond to any of those previously characterised. The T-cell protein was shown to have a relative molecular size of 100-110 kD for the monomeric polypeptide and bound to site B as a dimer. Maximal binding to site B required both halves of the palindrome. Functionally site B was shown to act as a repressor element of both basal transcription and of transcription activated by phorbol ester in T- lymphocytes. Site B was also shown to function as a retinoic acid response element (RARE) in a heterologous promoter. The ability to function as either a positive or negative regulatory element is a recognised characteristic of nuclear hormone response elements and in part is a function of the relative abundance of factors able to interact with the site or to form complexes with one another. The overall effect of site B upon LTR-directed transcription may similarly depend upon the complex interaction of multiple factors which themselves depend on the cell type, cell activation state and degree of differentiation