The role of the sickness funds in the Belgian health care market

This article reviews some of the salient features of the Belgian health care finance and delivery system. Special attention is paid to the role played by the third-party payers, i.e. the Health Insurance Associations (HIAs) in administering the compulsory national health insurance program. It is shown how, despite extensive government regulation, the markets for GP, specialist and hospital services exhibit fierce competition of the non-price variety. Next, the paper considers the three problems perceived to be the most pressing ones at present: (i) the problem of raising sufficient revenues to cover the public share of health expenditures; (ii) the (related) cost containment problem; and (iii) the problem of ensuring efficiency through appropriate incentive mechanisms. Finally, two recently proposed options for reform are discussed and complemented with a third proposal based on the ideas of regulated competition. It is concluded that strengthening the role of the third-party payers remains crucial in any attempt to reshape the system to make it efficient and affordable while keeping it equitable

Governance, Human Rights, and the Case for Political Adaptation in the Gulf: Issues in the EU-GCC Political Dialogue

democratization; globalization; NGOs; WTO

Experimental investigation of direct contact baseplate cooling for electric vehicle power electronics

An experimental setup has been built to investigate the thermo-hydraulic performance of the direct contact baseplate cooling technique for power electronics in electric vehicles, to improve the design and to validate the modelling of this technique. The setup consists of an electrical heater to emulate the heat dissipation of the power electronics and which is cooled by a 60/40% mixture by mass of water-glycol. It is equipped with a flow rate sensor, absolute and differential pressure sensors and temperature measurements at the inlet, outlet and baseplate over the channel length, to determine the performance parameters used in the comparison: thermal resistance and pumping power. Three fluid inlet temperatures, four power levels and four flow rates have been tested for three channel heights (1.5mm, 3mm and 7.6mm). Increasing the fluid temperature and/or heating power, results in a lower thermal resistance and pumping power, due to a lower viscosity of the fluid. The performance of the 1.5mm and 7.6mm channel was found to be quite similar, while the 3mm channel results on average in a 5.8% lower thermal resistance compared to the other two channel heights. The heat transfer in terms of the Nusselt number was also evaluated in function of the Reynolds number. By analyzing the hydraulic and thermal entrance lengths it could be concluded that the flow in all measurements is simultaneously developing. A comparison with two correlations from scientific literature for simultaneously developing flow did not show a good agreement, possibly due to the specific inlet and outlet effect, which is more pronounced for a bigger channel height than a smaller channel height

Combined conduction and natural convection cooling of offshore power cables in porous sea soil

The power that can be carried by offshore power cables is often restricted by the temperature limit of the materials inside the cable. It is therefore essential to predict the heat transfer behavior of the dissipated power from the cable to the environment. Offshore cables are buried in the seabed, which is a porous structure of sea soil saturated with water. Both conduction of heat through the soil, as well as natural convection due to the flow of water through the porous soil, are possible ways of heat transfer. Most cases are best described as a combination of these heat transfer effects. In this paper, a numerical model is made to predict the heat transfer from the cable to the environment by modeling the surrounding soil as a porous medium. The influence of soil parameters such as conductivity, heat capacity and permeability, as well as geometrical parameters, such as burial depth and cable diameter, are tested. An analytical expression, which can estimate the heat transfer rate for conduction dominated heat flows, is used. For convection dominated heat flows, a correlation in function of the Darcy-modified Rayleigh number is used. For heat flows which are a combination of conduction and convection effects, an algebraic summation of the thermal conductance due to convection and conduction is found not to give adequate agreement with the simulations. It is shown that an asymptotic expansion of the limiting equations for conductive and convective heat transfer rate can be used to determine the total heat flow effectively. Several soil samples in the North Sea are analyzed, and the thermal properties are used as inputs for the model. These calculations show that conduction is the main heat transfer effect and that convection has a limited effect on the heat transfer

Development of a dynamic model for ice-on-coil external melt storage systems

Ice storage systems are commonly used to balance the intermittency of renewable energy and decrease the peak load by switching to off-peak hours. An adequate model is necessary to predict the behaviour of these systems. However, there is a scarce in detailed models available used to describe the performance of an ice storage evaporator and its use in a refrigeration cycle. Most existing models approximate the working principles with a steady analysis, not considering the sub cooling of ice and thickness distribution along the length. The developed model in this article uses a discretisation in length and radial direction together with an adapted thermal resistance matrix method to limit the calculation time. It has a great variability of boundary conditions and the ability to implement different types of refrigerants. The simulation results are in good agreement with the data of the manufacturer. The model shows that switching from R404A to R449A reduces the total electricity consumption

Ruling Families and Business Elites in the Gulf Monarchies: Ever Closer?

Project: Middle East and North Africa Programme, Future Trends in the GCCThis is the final version of the article. Available from Chatham House via the URL in this record.Summary The pre-eminent role of nationalized oil and gas resources in the six Gulf monarchies has resulted in a private sector that is highly dependent on the state. This has crucial implications for economic and political reform prospects. All the ruling families – from a variety of starting points – have themselves moved much more extensively into business activities over the past two decades. Meanwhile, the traditional business elites’ socio-political autonomy from the ruling families (and thus the state) has diminished throughout the Gulf region – albeit again from different starting points and to different degrees today. The business elites’ priority interest in securing and preserving benefits from the rentier state has led them to reinforce their role of supporter of the incumbent regimes and ruling families. In essence, to the extent that business elites in the Gulf engage in policy debate, it tends to be to protect their own privileges. This has been particularly evident since the 2011 Arab uprisings. The overwhelming dependence of these business elites on the state for revenues and contracts, and the state’s key role in the economy – through ruling family members’ personal involvement in business as well as the state’s dominant ownership of stocks in listed companies – means that the distinction between business and political elites in the Gulf monarchies has become increasingly blurred. Under current uncertain political and economic conditions, existing patterns of clientelism and the business sector’s dependence on the state will not undergo significant changes. In these circumstances, the business elites are unlikely to become drivers of political reform. In the context of persistently low oil prices, growing tensions related to the definition of the new social contract and the content of structural reforms in the Gulf monarchies are likely to provoke renewed popular frustrations and considerable turmoil.This research was supported by the UK Economic and Social Research Council (grant no. ES/J012696/1)

Advanced lumped parameter model for switched reluctance motors with high performance cooling

In this paper an advanced thermal lumped parameter model for a switched reluctance electric motor (SRM) is constructed, based on a 2D thermal finite element simulation of a radial cross section of the motor. When applying and combining advanced cooling methods such as direct coil cooling, end winding cooling (radial stretched) and spray cooling on an SRM, the conventional lumped parameter models can no longer be used due to the 3D and complex temperature gradients in the motor. In standard LP models, mostly one simple cooling method is implemented by which the thermal gradients are also quite simple (1D or 2D). When combining different cooling methods, the gradients become highly 3D and these LPM are no longer valid. To improve the accuracy of this problem, a fully 3D thermal finite element simulation could be performed, but this would unnecessarily increase effort, complexity and computational time. To avoid this an advanced lumped parameter model is constructed in this paper, such that the high thermal gradients are modeled in more detail. The results from one 2D finite element simulation of a radial cross section of half of a stator tooth are reduced to a simpler lumped parameter model with more nodes in the most crucial parts, i.e., where the highest thermal gradients are expected. The 2D thermal model is then expanded to a 3D lumped parameter model, including the gradients in axial direction. Using this model, various cooling configurations and geometry parameters can be varied easily such that the design of an SRM with advanced cooling can be optimized efficiently