Unemployment Insurance Savings Accounts

We examine a system of Unemployment Insurance Saving Accounts (UISAs) as an alternative to the traditional unemployment insurance system. Individuals are required to save up to 4 percent of wages in special accounts and to draw unemployment compensation from these accounts instead of taking state unemployment insurance benefits. If the accounts are exhausted, the government lends money to the account. Positive accounts earn the return on commercial paper and negative accounts are charged that rate. Positive UISA balances are converted into retirement income or bequeathed if the individual dies before retirement age. Negative account balances are forgiven at retirement age. Money taken by an unemployed individual from a UISA with a positive balance reduces the individual's personal wealth by an equal amount. In this case, individuals fully internalize the cost of unemployment compensation. UISAs provide the same protection to the unemployed as the current UI system but with less of the adverse incentives. The key empirical question is whether accounts based on a moderate saving rate can finance a significant share of unemployment payments or whether the concentration of unemployment among a relatively small number of individuals implies that the UISA balances would typically be negative, forcing individuals to rely on government benefits with the same adverse effects that characterize the current UI system. To resolve this issue we use the Panel Study on Income Dynamics to simulate the UISA system over a 25 year historic period. Our analysis indicates that almost all individuals have positive UISA balances and therefore remain sensitive to the cost of unemployment compensation. Even among individuals who experience unemployment, most have positive account balances at the end of their unemployment spell. Although about half of the benefit dollars would go to individuals whose accounts are negative at the end of their working life, less than one third of the benefits go to individuals who also have negative account balances when unemployed. These facts suggest a substantial potential improvement in the incentives of the unemployed. The cost to taxpayers of forgiving the negative balances is substantially less than half of the taxpayer cost of the current UI system. Our analysis of the distribution of lifetime UISA payments and taxes of household heads shows the top quintile gaining a small cumulative amount while those in the bottom quintile lose a very small cumulative amount. Other quintiles are small net gainers.

Are International Differences in Living Standards Really So Hard to Explain?

A cross-country regression using only a handful of deeply rooted explanatory variables accounts for 80 percent of the variation in living standards across countries. Most of the biggest residuals from the regression can also be explained, at least partially, with rudimentary facts about the associated countries. What remains may be a useful indicator of a country’s openness and innovative capacity throughout its economic history

Enrollee Mix, Treatment Intensity, and Cost in Competing Indemnity and HMO Plans

We examine why managed care plans are less expensive than traditional indemnity insurance plans. Our database consists of the insurance experiences of over 200,000 state and local employees in Massachusetts and their families, who are insured in a single pool. Within this group, average HMO costs are 40 percent below those of the indemnity plan. We evaluate cost differences for 8 conditions representing over 10 percent of total health expenditures. They are: heart attacks, cancers (breast, cervical, colon, prostate), diabetes (type I and II), and live births. For each condition, we identify the portions of the cost differential arising from differences in treatment intensity, enrollee mix, and prices paid for the same treatment. Surprisingly, treatment intensity differs hardly at all between the HMOs and the indemnity plan. That is, relative to their fee-for-service competitor, HMOs do not curb the use of expensive treatments. Across the 8 conditions, roughly half of the HMO cost savings is due to the lower incidence of the diseases in the HMOs. Virtually all of the remaining savings come because HMOs pay lower prices for the same treatment.

Forever Young: Aging Control For Smartphones In Hybrid Networks

The demand for Internet services that require frequent updates through small messages, such as microblogging, has tremendously grown in the past few years. Although the use of such applications by domestic users is usually free, their access from mobile devices is subject to fees and consumes energy from limited batteries. If a user activates his mobile device and is in range of a service provider, a content update is received at the expense of monetary and energy costs. Thus, users face a tradeoff between such costs and their messages aging. The goal of this paper is to show how to cope with such a tradeoff, by devising \emph{aging control policies}. An aging control policy consists of deciding, based on the current utility of the last message received, whether to activate the mobile device, and if so, which technology to use (WiFi or 3G). We present a model that yields the optimal aging control policy. Our model is based on a Markov Decision Process in which states correspond to message ages. Using our model, we show the existence of an optimal strategy in the class of threshold strategies, wherein users activate their mobile devices if the age of their messages surpasses a given threshold and remain inactive otherwise. We then consider strategic content providers (publishers) that offer \emph{bonus packages} to users, so as to incent them to download updates of advertisement campaigns. We provide simple algorithms for publishers to determine optimal bonus levels, leveraging the fact that users adopt their optimal aging control strategies. The accuracy of our model is validated against traces from the UMass DieselNet bus network.Comment: See also http://www-net.cs.umass.edu/~sadoc/agecontrol

Streaming primary urgent care: a prospective approach

Aim: To identify the appropriate service provider attendees of emergency departments (EDs) and walk-in centres (WiCs) in North East London and to match this to local service provision and patient choice. Design: An anonymous patient survey and a retrospective analysis of a random sample of patient records were performed. A nurse consultant, general practitioner (GP) and pharmacist used the presenting complaints in the patients’ records to independently stream the patient to primary care services, non-National Health Services or ED. Statistical analysis of level of agreement was undertaken. A stakeholder focus group reviewed the results. Subjects and setting Adult health consumers attending ED and urgent care services in North East London. Results The health user survey identified younger rather than older users (mean age of 35.6 years – SD 15.5), where 50% had not seen a health professional about their concern, with over 40% unable to obtain a convenient or emergency appointment with their GP. Over a third of the attendees were already receiving treatment and over 40% of these saw their complaint as an emergency. Over half of respondents expected to see a doctor, one-quarter expected to see a nurse and only 1% expected to see a pharmacist across both services, although WiCs are nurse-led services. More respondents expected a prescription from a visit to a WiC, whereas in the ED a third of respondents sought health advice or reassurance. Conclusion: A number of unscheduled care strategies are, or have just been, developed with the emphasis on moving demand into community-based services. Plurality of services provides service users with a range of alternative access points but can cause duplication of services and repeat attendance. Managing continued increase in emergency and unscheduled care is a challenge. The uncertainties in prospective decision making could be used to inform service development and delivery