Health Reform, Health Insurance, and Selection: Estimating Selection into Health Insurance Using the Massachusetts Health Reform

We implement an empirical test for selection into health insurance using changes in coverage induced by the introduction of mandated health insurance in Massachusetts. Our test examines changes in the cost of the newly insured relative to those who were insured prior to the reform. We find that counties with larger increases in insurance coverage over the reform period face the smallest increase in average hospital costs for the insured population, consistent with adverse selection into insurance before the reform. Additional results, incorporating cross-state variation and data on health measures, provide further evidence for adverse selection.

Health Reform, Health Insurance, and Selection: Estimating Selection into Health Insurance Using the Massachusetts Health Reform

We implement an empirical test for selection into health insurance using changes in coverage induced by the introduction of mandated health insurance in Massachusetts. Our test examines changes in the cost of the newly insured relative to those who were insured prior to the reform. We find that counties with larger increases in insurance coverage over the reform period face the smallest increase in average hospital costs for the insured population, consistent with adverse selection into insurance before the reform. Additional results, incorporating cross-state variation and data on health measures, provide further evidence for adverse selection.Adverse selection, Massachusetts, Health reform

Reconfigurable Computing for Speech Recognition: Preliminary Findings

Continuous real-time speech recognition is a highly computationally-demanding task, but one which can take good advantage of a parallel processing system. To this end, we describe proposals for, and preliminary findings of, research in implementing in programmable logic the decoder part of a speech recognition system. Recognition via Viterbi decoding of Hidden Markov Models is outlined, along with details of current implementations, which aim to exploit properties of the algorithm that could make it well-suited for devices such as FPGAs. The question of how to deal with limited resources, by reconfiguration or otherwise, is also addressed

The Ethical Lacunae in Friedman\u27s Concept of the Manager

This article challenges along two lines Milton Friedman\u27s injunction that the sole role of the business manager is to maximize profits for shareholders using all legal and ethical means. First, it shows how Friedman overly narrows the manager\u27s moral duties to consequentialist profit maximization and thereby fails to account for a wide range of values and virtues necessary for good management. Second, it illustrates how more oblique approaches to management as well as Adam Smith\u27s virtue-based model better capture the moral imagination and relational aspects of leadership that are critical to good management today. In the end, this article suggests that a subtler version of Friedman\u27s directive should be considered in which maximizing shareholder wealth provides a powerful business goal but not an exclusive one to direct or to motivate managers

Do carbonate karst terrains affect the global carbon cycle?

Carbonate minerals comprise the largest reservoir of carbon in the earth’s lithosphere, but they are generally assumed to have no net impact on the global carbon cycle if rapid dissolution and precipitation reactions represent equal sources and sinks of atmospheric carbon. Observations of both terrestrial and marine carbonate systems indicate that carbonate minerals may simultaneously dissolve and precipitate within different portions of individual hydrologic systems. In all cases reported here, the dissolution and precipitation reactions are related to primary production, which fixes atmospheric CO2 as organic carbon, and the subsequent remineralization in watersheds of the organic carbon to dissolved CO2. Deposition of carbonate minerals in the ocean represents a flux of CO2 to the atmosphere. The dissolution of oceanic carbonate minerals can act either as a sink for atmospheric CO2 if dissolved by carbonic acid, or as a source of CO2 if dissolved through sulfide oxidation at the freshwater-saltwater boundary. Since dissolution and precipitation of carbonate minerals depend on ecological processes, changes in these processes due to shifts in rainfall patterns, earth surface temperatures, and sea level should also alter the potential magnitudes of sources and sinks for atmospheric CO2 from carbonate terrains, providing feedbacks to the global carbon cycle that differ from modern feedbacks.Keywords: Global carbon cycle, carbonate terrains, organic carbon fixation, remineralization, carbonate mineral dissolution, carbonate mineral precipitation.DOI: 10.3986/ac.v42i2-3.66

OCEANIC FLUXES FROM PROGLACIAL AND DEGLACIAL WATERSHEDS IN WESTERN GREENLAND

Weathering in western Greenland occurs in two distinct environments: proglacial watersheds that extend from the margin of the Greenland Ice Sheet (GIS) and derive water from ice melt, and deglacial watersheds that develop on terrains unconnected to the GIS and derive water from annual precipitation. Proglacial and deglacial watersheds currently provide equal amounts of runoff in western Greenland. These watersheds may contribute different solute fluxes to the oceans depending on exposure age, climate, and weathering environment. We test this hypothesis by comparing chemical compositions of streams in four deglacial watersheds (Sisimiut, Nerumaq, Qorlortoq, Kangerlussuaq) and one proglacial watershed (Watson River Akuliarusiarsuup Kuua River; AKR) along a ~160 km transect from the coast to the GIS. Recent work found that weathering reactions in the deglacial watersheds shift from being dominated by carbonate dissolution inland to sulfide oxidation near the coast. Silicate weathering, based on increased Si, Na and K concentrations, is a minor source of solutes to deglacial streams and is less extensive near the GIS than the coast, where older moraines experience greater precipitation. In general, specific conductivity (SpC: 48-301 μS/cm) and pH (7.0-8.2) increase inland as precipitation decreases and fresh mineral surfaces become more common. The AKR, in contrast, has lower average SpC (11.9 uS/cm) and pH (6.86) than the deglacial streams. Low SpC reflects dilution by ice melt and short residence time of water in the subglacial system. Proglacial flow is enriched in Si compared to deglacial flow particularly near headwaters, indicating higher silicate weathering rates in the pro- and sub-glacial systems. Low pH values indicate: 1) equilibration with atmospheric CO2 in the supraglacial system near headwaters, and 2) acid production generated by sulfide oxidation in the hyporheic zone identified by elevated SO4 concentrations. However, Ca, Mg and HCO3 are the dominant ions over the length of the AKR indicating that dissolution of carbonate is the predominant form of weathering. Our results indicate the two types of watersheds provide distinct fluxes of solutes to the oceans that are likely to change as ice sheets retreat and advance with changing climate

Hydrologic exchange and chemical weathering in a proglacial watershed near Kangerlussuaq, west Greenland

The exchange of proglacial river water with active layer pore water could alter water chemical compositions in glacial outwash plains and oceanic solute fluxes. To evaluate effects of this exchange, we sampled Watson River and adjacent pore water during the 2013 melt season at two sandurs in western Greenland; one in Sandflugtdalen and the other near the confluence with Søndre Strømfjord. We measured temperature, specific conductivity, and head gradients between the river and bank over a week-long period at Sandflugtdalen, as well as sediment hydraulic conductivity and chemical compositions of waters from both sites. Specific conductivity of pore water is four to ten times greater than river water as solutes are concentrated from weathering reactions, cryoconcentration, and evaporation. Pore water compositions are predominantly altered by carbonate dissolution and sulfide mineral oxidation. High concentrations of HCO3 and SO4 result from solute recycling and dissolution of secondary Ca-Mg carbonate/sulfate salts initially formed by near-surface evaporation in the summer and at depth by freeze-in of the active layer and cryoconcentration in the winter. High hydraulic conductivity (10−5 to 10−4 m/s) and diurnal fluctuations of river stage during our study caused exchange of river and pore water immediately adjacent to the river channel, with a net loss of river water to the bank. Pore water \u3e6 m from the river continuously flowed away from the river. Approximately 1–8% of the river discharge through the Sandflugtdalen was lost to the river bank during our 6.75 day study based on calculations using Darcy’s Law. Although not sampled, some of this water should discharge to the river during low river stage early and late in the melt season. Elevated pore water solute concentrations in sandurs and water exchange at diurnal and seasonal frequency should impact fluxes of solutes to the ocean, although understanding the magnitude of this effect will require long-term evaluation throughout the melt season

Adverse Selection and an Individual Mandate: When Theory Meets Practice

We develop a model of selection that incorporates a key element of recent health reforms: an individual mandate. We identify a set of key parameters for welfare analysis, allowing us to model the welfare impact of the actual policy as well as to estimate the socially optimal penalty level. Using data from Massachusetts, we estimate the key parameters of the model. We compare health insurance coverage, premiums, and insurer average health claim expenditures between Massachusetts and other states in the periods before and after the passage of Massachusetts health reform. In the individual market for health insurance, we find that premiums and average costs decreased significantly in response to the individual mandate; consistent with an initially adversely selected insurance market. We are also able to recover an estimated willingness-to-pay for health insurance. Combining demand and cost estimates as sufficient statistics for welfare analysis, we find an annual welfare gain of $335 dollars per person or$71 million annually in Massachusetts as a result of the reduction in adverse selection. We also find evidence for smaller post-reform markups in the individual market, which increased welfare by another $107 dollars per person per year and about$23 million per year overall. To put this in perspective, the total welfare gains were 8.4% of medical expenditures paid by insurers. Our model and empirical estimates suggest an optimal mandate penalty of $2,190. A penalty of this magnitude would increase health insurance to near universal levels. Our estimated optimal penalty is higher than the individual mandate penalty adopted in Massachusetts but close to the penalty implemented under the ACA

A Calibration Scheme for Non-Line-of-Sight Imaging Setups

The recent years have given rise to a large number of techniques for "looking around corners", i.e., for reconstructing occluded objects from time-resolved measurements of indirect light reflections off a wall. While the direct view of cameras is routinely calibrated in computer vision applications, the calibration of non-line-of-sight setups has so far relied on manual measurement of the most important dimensions (device positions, wall position and orientation, etc.). In this paper, we propose a semi-automatic method for calibrating such systems that relies on mirrors as known targets. A roughly determined initialization is refined in order to optimize a spatio-temporal consistency. Our system is general enough to be applicable to a variety of sensing scenarios ranging from single sources/detectors via scanning arrangements to large-scale arrays. It is robust towards bad initialization and the achieved accuracy is proportional to the depth resolution of the camera system. We demonstrate this capability with a real-world setup and despite a large number of dead pixels and very low temporal resolution achieve a result that outperforms a manual calibration

Health Reform, Health Insurance, and Selection: Estimating Selection Into Health Insurance Using the Massachusetts Health Reform

We implement an empirical test for selection into health insurance using changes in coverage induced by the introduction of mandated health insurance in Massachusetts. Our test examines changes in the cost of the newly insured relative to those who were insured prior to the reform. We find that counties with larger increases in insurance coverage over the reform period face the smallest increase in average hospital costs for the insured population, consistent with adverse selection into insurance before the reform. Additional results, incorporating cross-state variation and data on health measures, provide further evidence for adverse selection