28th out of 30: Poor medicine and unhealthy Americans

In 1970 the USA spent 7% of its GNP on healthcare, in 200716%. Whereas the OECD average per capita expenditure on healthcare in 2007 was $2,964, the USA spent$7,290. Yet in that same period, the health of America’s citizens relative to those of other developed countries declined dramatically, so much so that the CIA lists 49 countries whose citizens now can look forward to on average living longer than Americans. This paper looks for the causes of this colossal disparity between expenditure and results. It argues that they are due to the unique economic institutions that, beginning during WWII, have grown up around healthcare in the USA. Because the magnitude of the relative decline in healthcare in the USA is poorly appreciated, especially by Americans, this paper begins with a set of OECD data tables documenting that decline. The main body of the paper is an historical analysis of the institutional economics of American healthcare from 1940 to the present. The paper concludes with a brief consideration of the possibilities for serious reform.USA; health expenditure; health indicators; life expectancy; OECD; obesity; healthcare; American healthcare; HMOs; healthcare reform; medicine; heath insurance; pharmaceutical industry; Obama

To observe or not to observe: Complementary pluralism in physics and economics

This quotation from Einstein expresses the essence of what this paper hopes to say. "Whether you can observe a thing or not depends on the theory which you use. It is theory which decides what can be observed." There exists in economics a malaise more fundamental than its theories themselves. The malaise concerns how economics regards and uses its theories, and it is this and its relation to the teaching of economics that this paper addresses

Ammonia uptake and release in the MnX₂–NH₃ (X = Cl, Br) systems and structure of the Mn(NH₃)nX₂ (n = 6, 2) ammines

Hexa-ammine complexes, Mn(NH<sub>3</sub>)<sub>6</sub>X<sub>2</sub> (X = Cl, Br), have been synthesized by ammoniation of the corresponding transition metal halide and characterized by Powder X-ray diffraction (PXRD) and Raman spectroscopy. The hexa-ammine complexes are isostructural (Cubic,Fm-3m, Z = 4; a = 10.2742(6) Å and 10.527(1) Å for X = Cl, Br respectively). Temperature programmed desorption (TPD) demonstrated that ammonia release from Mn(NH<sub>3</sub>)<sub>6</sub>X<sub>2</sub> complexes occurred in three stages corresponding to the release of 4, 1 and 1 NH<sub>3</sub> equivalents respectively. The chloride and bromide both exhibit a deammoniation onset temperature below 323 K. The di-ammoniates from the first desorption step were isolated during TPD measurements and their crystal structures determined by Rietveld refinement against PXRD data (X = Cl: orthorhombicCmmm, a = 8.1991(9) Å, b = 8.2498(7) Å, c = 3.8212(4) Å, Z = 2; X = Br: orthorhombic Pbam, a = 6.0109(5) Å, b = 12.022(1) Å, c = 4.0230(2) Å, Z= 2)

28th out of 30: Poor medicine and unhealthy Americans

In 1970 the USA spent 7% of its GNP on healthcare, in 200716%. Whereas the OECD average per capita expenditure on healthcare in 2007 was $2,964, the USA spent$7,290. Yet in that same period, the health of America’s citizens relative to those of other developed countries declined dramatically, so much so that the CIA lists 49 countries whose citizens now can look forward to on average living longer than Americans. This paper looks for the causes of this colossal disparity between expenditure and results. It argues that they are due to the unique economic institutions that, beginning during WWII, have grown up around healthcare in the USA. Because the magnitude of the relative decline in healthcare in the USA is poorly appreciated, especially by Americans, this paper begins with a set of OECD data tables documenting that decline. The main body of the paper is an historical analysis of the institutional economics of American healthcare from 1940 to the present. The paper concludes with a brief consideration of the possibilities for serious reform

28th out of 30: Poor medicine and unhealthy Americans

In 1970 the USA spent 7% of its GNP on healthcare, in 200716%. Whereas the OECD average per capita expenditure on healthcare in 2007 was $2,964, the USA spent$7,290. Yet in that same period, the health of America’s citizens relative to those of other developed countries declined dramatically, so much so that the CIA lists 49 countries whose citizens now can look forward to on average living longer than Americans. This paper looks for the causes of this colossal disparity between expenditure and results. It argues that they are due to the unique economic institutions that, beginning during WWII, have grown up around healthcare in the USA. Because the magnitude of the relative decline in healthcare in the USA is poorly appreciated, especially by Americans, this paper begins with a set of OECD data tables documenting that decline. The main body of the paper is an historical analysis of the institutional economics of American healthcare from 1940 to the present. The paper concludes with a brief consideration of the possibilities for serious reform

Generating structural diversity in α,α-difluoromethyl ketones

This thesis describes attempts to use palladium-catalysed cross-coupling methodology in the synthesis of α,α-difluoroketones contained within a diverse array of molecular motifs. 1-(N,N-Diethylcarbamoyloxy)-2,2-difluoro-1-(tributylstannyl)ethene undergoes Stille cross coupling with a variety of aryl, heteroaryl, vinyl and allyl organic electrophiles. Conditions, which promote in situ transmetallation to a more reactive copper intermediate, were essential for obtaining significant quantities of product. 1-(N,N-Diethylcarbamoyloxy)-2,2-difluoro-1-iodoethene also underwent coupling with a range of aryl, heteroaryl and vinyl stannanes. Due to the difficulties with cleavage of this protecting group, the synthesis and potential application of an N-ethyl-N-(2-methylallyl)carbamate has been studied. A 2-methoxyethoxymethyl (MEM) protecting group strategy proved very successful for the synthesis of a range of difluoromethyl aryl ketones. Two consecutive coupling reactions were possible from a difluoroenol stannane, in which coupling of initial styrene products bearing a triflate group afforded a range of biarylethenes. Cleavage occurred under mild electrophilic conditions with protic, halogen, sulfur and carbon electrophiles. Diene products have been tested for reactivity in Sharpless Asymmetric Dihydroxylation. A 1,4-diene has been converted through to a fluorinated analogue of a dideoxyxylulose. A 1,3-diene has been successfully converted through to a difluorodeoxyxylulose of current interest. Key points involve regioselective and highly enantioselective dihydroxylation of the non-fluorinated olefin. Application of a special protecting group for the allylic alcohol was essential, as was control of the pH of the reaction medium.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Direct extraction of oil from sunflower seeds by twin-screw extruder according to an aqueous extraction process: Feasibility study and influence of operating conditions

The objective of this study was to evaluate the feasibility of an aqueous process to extract sunflower seed oil using a co-rotating twin-screw extruder. Aqueous extraction was carried out using whole seeds and the influence of the operating conditions on oil yield was examined. Operating conditions included screw profile, screw rotation speed, and input flow rates of sunflower seeds and water. Liquid/solid separation required the addition of a lignocellulosic residue upstream from the filtration zone. However, even with maximum fiber input flow, drying of the cake meal did not improve. The lixiviation of the sunflower seeds was also incomplete. The aqueous extraction of the oil was more efficient in the twin-screw extruder than the reference trial conducted in a batch reactor. The best oil extraction yield obtained was approximately 55% and the residual oil content of the cake meal was approximately 30%. The hydrophobic phases produced were oil-in-water emulsions. These emulsions were stabilized by phospholipids and proteins at the interface, which are natural surface-active agents co-extracted during the process

The political economy of Public Employment Services: measurement and disempowered empowerment?

Active Labour Market Policies (ALMPs) and Public Employment Services (PES) are related components of the European Union and member state labour market policy. Typically, PES are analysed in terms of a narrow concern with efficiency and effectiveness of service. In this paper, we argue that PES are constituents in broader processes. They are not just means to facilitate employment, they are also part of transmission mechanisms for a political economy of competitiveness. They play a particular role in governance processes, and so serve to produce and reproduce power relations that are intrinsic to those processes. We argue that the technical ways that PES have been managed over recent decades has contributed to broader processes of disempowering labour, through depoliticized management practices. We argue that attempts at even limited re-empowerment of labour would require a repoliticization of these management practices

Towards an economics of well-being

There is growing concern that presently dominant frameworks in economics no longer provide a way of adequately addressing and analysing the problems of today’s globalising and rapidly changing world. This article makes a number of fundamental proposals about how we might reframe economics to move it towards a clearer focus on human well-being. It develops arguments for a change in the basic ontological proposition and for the need to see ‘the economy’ as an instituted process of resource allocation. From this viewpoint, economics is then the study of resource allocation decisions and processes and the forces that guide these: from a human perspective it is about understanding who gets what, under what conditions and why? The paper argues that a pluralist approach to understanding the economy is necessary for political, analytical and technical reasons. Drawing on a range of contributions to heterodox economics, the paper argues that if we are to understand current crises and challenges, then our understanding of resource allocation in society must have a broader scope than is present in mainstream economics; it proposes a rethinking of economic agency and provides a critique of rational behaviour that is founded in shifting the emphasis from a narrow conception of welfare to well-being. Acknowledging human well-being as a multidimensional concept, the relationship between the well-being of the person and the collective is reconsidered and the methodological implications for the issue of aggregation are discussed. The article seeks to serve as a point of departure for formulating new research questions, exploring the relationships between human well-being and economic development and analysing economic behaviour and interactions in such a way as to bring us closer to peoples’ realities on the ground