Non-invasive cerebellar stimulation in dystonia

Primary isolated dystonia is a hyperkinetic movement disorder whereby involuntary muscle contractions cause twisted and abnormal postures. Dystonia of the cervical spine and upper limb may present as sustained muscle contractions or task-specific activity when using the hand or upper limb. There is little understanding of the pathophysiology underlying dystonia and this presents a challenge for clinicians and researchers alike. Emerging evidence that the cerebellum is involved in the pathophysiology of dystonia using network models presents the intriguing concept that the cerebellum could provide a novel target for non-invasive brain stimulation. Non-invasive stimulation to increase cerebellar excitability improved aspects of handwriting and circle drawing in a small cohort of people with focal hand and cervical dystonia. Mechanisms underlying the improvement in function are unknown, but putative pathways may involve the red nucleus and/or the cervical propriospinal system. Furthermore, recent understanding that the cerebellum has both motor and cognitive functions suggests that non-invasive cerebellar stimulation may improve both motor and non-motor aspects of dystonia. We propose a combination of motor and non-motor tasks that challenge cerebellar function may be combined with cerebellar non-invasive brain stimulation in the treatment of focal dystonia. Better understanding of how the cerebellum contributes to dystonia may be gained by using network models such as our putative circuits involving red nucleus and/or the cervical propriospinal system. Finally, novel treatment interventions encompassing both motor and non-motor functions of the cerebellum may prove effective for neurological disorders that exhibit cerebellar dysfunction. © Versita Sp. z o.o

The Economics of Tax Compliance: Fact and Fantasy

This paper reviews the current state of theoretical and empirical knowledge regarding compliance with the federal income tax laws. We focus on the validity of certain myths that have come to dominate tax compliance discussions. Toward that end, we discuss three general categories--empirical work, theoretical methodology and fiscal policy recommendations--that seem to require more careful assessment and formulation

Constitutional Uncertainty and the Design of Social Insurance: Reflections on the Obamacare Case

In 2010, Barack Obama signed the Patient Protection and Affordable Care Act (the ACA), a complex statute of more than nine hundred pages that fulfilled his goal of extending health-insurance coverage to virtually all Americans – an objective that previous U.S. presidents had sought and failed to achieve for a century. This legislation was hotly contested in the Congress, passing with the support of very few Republicans in the Senate and none in the House. To broaden access to health insurance, the ACA relies primarily on two devices: (1) an expansion to Medicaid – a joint federal-state health-insurance program for – to cover adults with incomes up to 133% of the poverty level, and (2) refundable tax credits for families earning up to 400% of the poverty level to subsidize purchases of private health insurance. The Medicaid expansion includes a federal requirement that states expand their coverage to meet the new, higher income threshold or face the potential withdrawal of all federal Medicaid funds. Private insurers are required to take all applicants, regardless of their health, and are prohibited from increasing premiums based on preexisting medical conditions. The ACA also contains an individual mandate, which requires adults not covered by government-sponsored or employer-provided health insurance to purchase health-insurance coverage or pay a penalty. Seven minutes after the President had put down his pen signing the ACA into law, thirteen states filed lawsuits challenging the constitutionality of both the individual mandate and the Medicaid expansion. Another thirteen states and several individuals and organizations, including the National Federation of Independent Businesses (NFIB), soon joined as plaintiffs. After decisions had been rendered by several courts of appeals, the case came to the Supreme Court in an appeal from the decision of the Eleventh Circuit Court of Appeals. The Eleventh Circuit had struck down the individual mandate as exceeding Congress\u27s powers under the Commerce Clause and failing to qualify as a tax authorized by Congress\u27s power to tax and spend for the general welfare. That court upheld the Medicaid expansion, rejecting a claim that it was an unconstitutional attempt to coerce states into implementing and helping finance a federal program. The court found that the individual mandate was severable from the rest of the statute, which it upheld. The Fourth, Sixth, and District of Columbia Circuits had reached different conclusions

Constitutional Uncertainty and the Design of Social Insurance: Reflections on the Obamacare Case

The gravamen of the constitutional complaint against the individual mandate is its supposed intrusion on personal freedom. But, when all was said and done, no one attacked a state government’s requirement that individuals must purchase health insurance, nor advanced any constitutional limitation on the states doing so. All we have is a holding that if the federal government wishes to do the same, it must exercise its powers to tax and spend, not its power to regulate. The ACA case then is best understood as a legal attack on the means but not the goals of the health care legislation. This emphasis on means rather than ends and on state over federal powers potentially poses significant risks for the complex institutional arrangements for social insurance that now exist and may imply harmful constraints on how Congress can restructure these programs to better meet the needs of the American people in our 21st Century economy. Not coincidentally, the new constitutional framework announced in the ACA decision favors those who want to dismantle rather than strengthen our nation’s social insurance protections. We explain why this is so with regard not only to health insurance, but also unemployment insurance and social security

State Income Tax Amnesties 1: Causes

The purpose of this paper is to analyze empirically for the years 1980-88 the factors which led states with state income taxes to run tax amnesty programs. We find a principal factor to be the level of IRS auditing; in particular, we find that states have tended to "free-ride" on the IRS-if the IRS is active in a state, then that state is less likely to run a tax amnesty program. Indeed, our estimates indicate that had the IRS audit rate remained constant during the 1980-88 period (instead of falling by almost one-half) , then the cumulative probability that an average state would have a tax amnesty by 1988 would have fallen by almost one-half compared to its actual level

The Report of the United States to the International Fiscal Association on the Costs of Tax Administration and Compliance

This is a report prepared for the International Fiscal Association on the costs of tax administration and compliance in the United States. At the federal level, we present comprehensive data on administrative costs and review recent estimates of compliance costs. At the state level, we present new data on the administrative costs of state income taxes and general sales taxes, and review the very limited data on state level compliance costs. We also discuss the growing role of tax preparers, including new empirical results of our own. Finally, we review the recently enacted "Taxpayer Bill of Rights.

The Effect of Tax and Audit Rates on Compliance with the Federal Income Tax, 1977-85

This paper develops a game-theoretic model of the effects of state and federal income tax rates and audit rates on compliance with the federal income tax. Using data drawn primarily from the Annual Reports of the Commissioner of Internal Revenue for the years 1977-85, we find empirical confirmation of the model's prediction that increases in the tax rates increase compliance. We also investigate the overall performance of the federal revenue collection process and find that the entire IRS estimate of the increase in individual noncompliance during 1977-85 is more than accounted for by the decrease in auditing over the same period