Realizing Health Reform's Potential: Will the Affordable Care Act Make Health Insurance Affordable?

Examines the percentage of low-income families, by income, family structure, and out-of-pocket healthcare costs, unable to afford insurance even with the premium and cost-sharing subsidies provided under the 2010 reform. Explores implications

Efficiency and Equity in the Use of Eminent Domain, with Local Externalies

In Shapiro and Pincus (2008), we proposed a method for arriving at just compensation of private owners of urban land, in cases like Kelo v New London, in which government has plans to use eminent domain to `take' private properties, to be assembled into a single parcel for some public purpose. The required quantum of just compensation can be discovered when the public purpose is to be pursued via private use of the assembled land parcel, and when the private user can be selected through an auction of the assembled land. This paper extends the auction mechanism to include properties which lie outside the area `taken' or resumed by government, but which will be affected by the new use made of the assembled area. The auction provides an efficiency test: does the proposed change in use increase the aggregate value of the land to be resumed plus the affected properties? Local externalities are internalised through the auction. We briefly discuss the political economy of the mechanism.

The L2H2 Auction: Efficiency and Equity in the Assemblage of Land for Public Use

The burden of redevelopment projects, whether or not they ultimately benefit the communities in which they are undertaken, is borne disproportionately by those displaced. Neighborhoods are destroyed and residents are made to leave a home they love, compensated only by its market value. The benefits and costs of redevelopment can only be estimated since there are no direct market tests. Here a mechanism, developed as an extension of two recent papers, by Lehavi and Lichts (L2) and by Heller and Hill (H2), provides a market-based efficiency test for a proposed project and a compensation rule that alleviates the disproportionate burden on displaced residents. Assembled property is sold at an auction. The reserve price (the lowest price at which the assembled property will be sold) is set so that all displaced residents receive at least their personal value of their property. A successful bid, one that claims the assembled property, is sufficient proof of efficiency.

What is the probability of a thermodynamical transition?

If the second law of thermodynamics forbids a transition from one state to another, then it is still possible to make the transition happen by using a sufficient amount of work. But if we do not have access to this amount of work, can the transition happen probabilistically? In the thermodynamic limit, this probability tends to zero, but here we find that for finite-sized systems, it can be finite. We compute the maximum probability of a transition or a thermodynamical fluctuation from any initial state to any final state, and show that this maximum can be achieved for any final state which is block-diagonal in the energy eigenbasis. We also find upper and lower bounds on this transition probability, in terms of the work of transition. As a bi-product, we introduce a finite set of thermodynamical monotones related to the thermo-majorization criteria which governs state transitions, and compute the work of transition in terms of them. The trade-off between the probability of a transition, and any partial work added to aid in that transition is also considered. Our results have applications in entanglement theory, and we find the amount of entanglement required (or gained) when transforming one pure entangled state into any other.Comment: 15+6 pages, 7+1 figures V3: Added discussion on heralded probability and relation to fluctuation theorems. V2: Emphasized that X can be any state and that the achievability of our result in the full thermodynamics case, holds only when the target state is block-diagonal in the energy eigenbasi

Land Grant Application- Perry, Jonathan (Amhearst)

Land grant application submitted to the Maine Land Office for Jonathan Perry for service in the Revolutionary War.https://digitalmaine.com/revolutionary_war_mass/1267/thumbnail.jp

User Involvement in Mental Health Nurse Education: A study of the effect on the interpersonal skills of student nurses

This study makes an original contribution to the evidence base for service user involvement in the teaching of interpersonal skills. The study is a synthesis of three different types of research activity. Firstly a systematic review which reviews the evidence base for service user involvement in interpersonal skills teaching. This review used inclusion criteria that restricted its scope to research that included elements that used outcomes, either qualitative or quantitative related to mental health service users involvement in teaching interpersonal skills. Four quantitative and eight qualitative studies met the criteria for inclusion. All the quantitative studies were methodologically weak. Qualitative studies lacked clear statements of qualitative methods used. Overall the studies reviewed provided some evidence of the efficacy of service user involvement. Qualitative findings included some negative effects of involvement. The second research approach used was reliability and validity testing of the Observed Assessment of Interpersonal Skills Scale (OAISS) using Factor Analysis and Cronbach’s Alpha. The OAISS is an observational instrument intended to measure an observer’s impression of another’s interpersonal skills during simulated interviews. Two factors were retained that accounted for 34% of the variance within the scale. Internal consistency of the scale was good. Two factors were interpreted to produce subscales called feedback and collaborative reflection and listening. The final study used mixed methods including a quasi-experiment and interview based qualitative data gathering. The quasi-experimental part of the study examined the effects on the student nurses (n = 75) interpersonal skills of a teaching intervention run by mental health service users. The experiment used a pre-test post-test design with a teaching as normal control group compared with the service user-teaching group. No significant difference was found between the two groups on measures of interpersonal skills. Qualitative results indicated that students had been affected by the service user teaching. Evidence was found of changes in empathic responses, attitudes and deep reflection on practice. Some polarization of views was also found particularly regarding the shocking nature of some of the personal accounts used in service user teaching and student concerns related to the representativeness of service users involved in teaching

Mending Invisible Wounds: The Efficacy and Legality of MDMA-Assisted Psychotherapy in United States\u27 Veterans Suffering with Post-Traumatic Stress Disorder

Though Veteran Affairs has provided crucial life sustaining—and often lifesaving—treatments to returning soldiers, the substantial and ever-increasing rates of veteran suicides, drug addictions, and criminal behavior indicate a need for broader options in treatment. One of the most profound discoveries uncovered through MDMA-assisted psychotherapy research is MDMA’s facilitation of the alleviation of addictive behavior in subjects, and, as a result, an alleviation of addictions in general. Addiction is one of the key symptoms of post-traumatic stress disorder (PTSD) and drug abuse plays a large role in the other afflictions suffered by veterans, namely criminal activity and a high rate of suicide. If there is any hope of treating this debilitating psychotic phenomenon—or at least containing its rapid growth and addressing its profound depth—alternative remedies as a means must not be ignored for a normative end. Accordingly, this note argues that physicians must be able to treat PTSD victims through MDMA-assisted psychotherapy, an alternative remedy to PTSD treatment that has shown overwhelming promise in domestic and international medical research. In doing so, it first discusses 21 U.S.C.A. § 812, which labels MDMA as a Schedule I substance and prohibits healthcare professionals from using MDMA-assisted psychotherapy to treat PTSD victims. Next, the note asserts that the Drug Enforcement Agency (DEA) erroneously categorized MDMA as a substance lacking an accepted medical use and lack of safety under medical supervision. The note sets out studies, domestic and international, where clinical testing of MDMA-assisted therapy to treat PTSD have been met with overwhelmingly positive results. Finally, the note argues that MDMA’s accepted medical use, low physical and psychological dependence, and known safety under medical supervision support its classification as a Schedule III under the CSA, and that the 1986 classification of MDMA as a Schedule I narcotic was, and continues to be, an arbitrary and capricious agency interpretation of an otherwise viable piece of congressional legislation