Health Care Reform: Why Not Best Practices?

The passage of the Affordable Care Act (“ACA” or “Obamacare”) in 2010 promises to bring about significant changes in the way that health care is provided and paid for in the United States of America (USA). Supporters of ACA point to a 2000 WHO study of worldwide health care systems in which the USA ranked 37th as justification for proposed changes, and many of them have expressed a preference for ultimately implementing a single-payer or single-provider system (such as currently exists in Canada or the United Kingdom). Detractors, who generally label the act Obamacare, have expressed concerns about whether the act can achieve its stated objectives, whether it represents a negative step instead of a positive one, and whether the ultimate goal of a single-payer or single-provider system is desirable one or even an achievable one. In the context of the ongoing debate over health care in the USA, this paper reviews the WHO study and subsequent comparative analyses of world health care systems to address the following questions:Does the USA really have the 37th best health care system in the world?Does either a “single-payer” health care system or a “single-provider” health care system offer prospects for significant improvement?What model or models for delivery of health care services represent “best practices” and how can and should they be emulated?

\u3cem\u3eWest Virginia v. Environmental Protection Agency\u3c/em\u3e: The Agency\u27s Climate Authority

On February 28, 2022, the U.S. Supreme Court heard oral arguments for the landmark West Virginia v. EPA case, involving the scope of powers delegated to the U.S. Environmental Protection Agency (EPA) through the Clean Air Act. The Court’s decision will affect administrative law, and could have major consequences for environmental law, particularly the Agency’s power to regulate greenhouse gas emissions and take action on climate change. On March 1, the Environmental Law Institute hosted a panel of leading experts to discuss the case, the arguments, and what form the decision may take. Below, we present a transcript of that discussion, which has been edited for style, clarity, and space considerations

Agri-environmental diversification: Linking environmental, forestry and renewable energy engagement on Scottish farms

AbstractIn this paper we broaden the debate on agri-environmental scheme participation to include farm woodland expansion and renewable energy production, developing a conceptualisation of ‘agri-environmental diversification’. Utilising structural equation modelling, we assess a telephone survey of 2416 Scottish farmers, undertaken in 2013. Findings demonstrate the path dependencies of farming participants, with those already engaged in each of these activities the most likely to plan to be involved in future. Similar factors have influenced the uptake of all three activities since 2005, and intention to increase involvement by 2020. Farmers who are: younger, better educated, information-seeking, certified as organic, receive subsidies, have non-farming income and plan to continue farming in the medium term, are more likely to plan for future engagement in the three activities. Environmental attitudes are also important, but a stronger relationship was found between observation of environmental gains from agri-environmental schemes and the three forms of agri-environmental diversification, suggesting that scheme involvement enables farmers to learn to produce, recognise and value environmental goods. We argue that when assessed within the broader perspective of agri-environmental diversification, agri-environmental scheme participation may represent an initial step on a farming trajectory that involves multiple forms of agri-environmental engagement

Resource use and biophysical constraints of Scottish agriculture

Agriculture is a fundamental sector of economy and society that ensures food supply, classified by the Millennium Ecosystem Assessment among the so-called “provisioning ecosystem services”. Due to the increase of food demand worldwide, farmers are shifting more and more towards intensive agriculture. This trend is connected to the unsustainable consumption of natural resources, most often exceeding the carrying capacity of natural ecosystems. In this paper, the resource use and biophysical constraints of Scottish agriculture were investigated at regional and national levels by means of the Emergy Synthesis method. The study focused on two main agroecosystems: 1) the Cairngorms National Park (CNP) and 2) the national agricultural sector of Scotland as a whole. The evolution of the agricultural sector was explored over time (years 1991, 2001, 2007), accounting for local renewable and non-renewable resources as well as imported resources. Performance and sustainability indicators were then calculated with and without including human labor and economic services (money flows). In the year 2007, the Emergy Yield Ratio (EYR) of the Scottish agricultural sector was about 46% of the same indicator calculated for the CNP (2.65 versus 5.72, respectively). A higher Environmental Loading Ratio (ELR) was calculated for the national sector than for CNP (1.25 versus 1.02, respectively). The Emergy Sustainability Index (ESI) was 2.12 for the national sector and 5.60 for CNP. Such figures were calculated without including the emergy flows supporting labor and services. If the latter are also accounted for, the ESI of the national level and CNP drop by a factor 5.6 and 3.9, respectively. Such variations suggest that larger flows of non-renewable resources strongly affect the environmental performance, increasing the dependence on non-renewable resources supporting the larger economic system in which the agricultural sectors are embedded in

Applying genetic algorithms to multi-objective land use planning.

This paper explores the application of multi-objective genetic algorithms (mGAs) to rural land-use planning, a spatial allocation problem. Two mGAs are proposed. Both share an underlying structure of: fitness assignment using Pareto-dominance ranking, niche induction and an individual replacement strategy. They are differentiated by their representations: a fixed-length genotype composed of genes that map directly to a land parcel's use, and a variable-length, order-dependent representation making allocations indirectly via a greedy algorithm. The latter representation requires additional breeding operators to be defined and post-processing of the genotype structure, to identify and remove duplicate genotypes. The two mGAs are compared on a real land-use planning problem, and the strengths and weaknesses of the underlying framework - and of each representation - are identified

Momentum flow in black-hole binaries: II. Numerical simulations of equal-mass, head-on mergers with antiparallel spins

Research on extracting science from binary-black-hole (BBH) simulations has often adopted a "scattering matrix" perspective: given the binary's initial parameters, what are the final hole's parameters and the emitted gravitational waveform? In contrast, we are using BBH simulations to explore the nonlinear dynamics of curved spacetime. Focusing on the head-on plunge, merger, and ringdown of a BBH with transverse, antiparallel spins, we explore numerically the momentum flow between the holes and the surrounding spacetime. We use the Landau-Lifshitz field-theory-in-flat-spacetime formulation of general relativity to define and compute the density of field energy and field momentum outside horizons and the energy and momentum contained within horizons, and we define the effective velocity of each apparent and event horizon as the ratio of its enclosed momentum to its enclosed mass-energy. We find surprisingly good agreement between the horizons' effective and coordinate velocities. To investigate the gauge dependence of our results, we compare pseudospectral and moving-puncture evolutions of physically similar initial data; although spectral and puncture simulations use different gauge conditions, we find remarkably good agreement for our results in these two cases. We also compare our simulations with the post-Newtonian trajectories and near-field energy-momentum. [Abstract abbreviated; full abstract also mentions additional results.]Comment: Submitted to Phys. Rev.