The Freedom to Spend Your Own Money on Medical Care: A Common Casualty of Universal Coverage

Most people would agree that a patient should always be able to spend his own money on the health care services he desires. Yet that freedom is often threatened or denied when government tries to provide universal health insurance coverage, as in the U.S. Medicare program, which provides health insurance to seniors and people with disabilities. Over the past 20 years, the Medicare bureaucracy -- and to a lesser extent Congress itself -- has limited the freedom of Medicare beneficiaries to purchase medical services with their own money. Those limitations violate beneficiaries' right to privacy, undermine a tool that could reduce the burden Medicare imposes on taxpayers, and may deny care to Medicare beneficiaries outright, or deny them access to the highest quality care available. Ironically, as the U.S. government has restricted the ability of patients to spend their own money on medical care, Canada's socialized health care system is moving in the opposite direction. In a landmark case handed down in 2005, the Supreme Court of Canada ruled that the province of Quebec could not prohibit its citizens from purchasing covered services through private health insurance. That ruling recognized that imposing limits on a patient's freedom to spend his own money can result in his being denied crucial and even life-saving medical services. This threat to patients' rights would grow under many proposals to have the federal or state governments provide universal coverage. Congress and the state legislatures should avoid universal coverage schemes that would undermine this fundamental human right, or tempt future legislatures and bureaucrats to do so. Instead, Congress should restore to American seniors the unfettered right to spend their own money on medical care

"Productivity, Technical Efficiency, and Farm Size in Paraguayan Agriculture"

This essay assesses the relationship between farm size and productivity. Both parametric and nonparametric methods are used to derive efficiency measures. Smaller farms are found to have higher net farm income per hectare, and to be more technically efficient, than larger farms.

"An Empirical Analysis of Gender Bias in Education Spending in Paraguay"

Gender affects household spending in two areas that have been widely studied in the literature. One strand documents that greater female bargaining power within households results in a variety of shifts in household production and consumption. An important source of intrahousehold bargaining power is ownership of assets, especially land. Another strand examines gender bias in spending on children. This paper addresses both strands simultaneously. In it, differences in spending on education are examined empirically, at both the household and the individual level. Results are mixed, though the balance of evidence weighs toward pro-male bias in spending on education at the household level. Results also indicate that the relationship between asset ownership and female bargaining power within the household is contingent on the type of asset.

"Quality of Match for Statistical Matches Used in the 1992 and 2007 LIMEW Estimates for the United States"

The quality of match of four statistical matches used in the LIMEW estimates for the United States for 1992 and 2007 is described. The first match combines the 1992 Survey of Consumer Finances (SCF) with the 1993 March Supplement to the Current Population Survey, or Annual Demographic Supplement (ADS). The second match combines the 1985 American Use of Time Project survey (AUTP) with the 1993 ADS. The third match combines the 2007 SCF with the 2008 March Supplement to the CPS, now called the Annual Social and Economics Supplement (ASEC). The fourth match combines the 2007 American Time Use Survey with the 2008 ASEC. In each case, the alignment of the two datasets is examined, after which various aspects of the match quality are described. Also in each case, the matches are of high quality, given the nature of the source datasets.Statistical Matching; Wealth Distribution; Time Use; Household Production; United States; LIMEW

"Quality of Match for Statistical Matches Used in the 1999 and 2005 LIMEW Estimates for Canada"

The quality of match of four statistical matches used in the LIMEW estimates for Canada for 1999 and 2005 is described. The first match combines the 1999 Survey of Financial Security (SFS) with the 1999 Survey of Labour and Income Dynamics (SLID). The second match combines the 1998 General Social Survey (GSS) with the 1999 SLID. The third match combines the 2005 SFS with the 2005 SLID. The fourth match combines the 2005 GSS with the 2005 SLID. In each case, the alignment of the two datasets is examined, after which various aspects of the match quality are described. Also in each case, the matches are of high quality, given the nature of the source datasets.Statistical Matching; Wealth Distribution; Time Use; Household Production; Canada; LIMEW

"Quality of Match for Statistical Matches Used in the 1995 and 2005 LIMEW Estimates for Great Britain"

The quality of match of four statistical matches used in the LIMEW estimates for Great Britain for 1995 and 2005 is described. The first match combines the fifth (1995) wave of the British Household Panel Survey (BHPS) with the 1995–96 Family Resources Survey (FRS). The second match combines the 1995 time-use module of the Office of Population Censuses and Surveys Omnibus Survey with the 1995-96 FRS. The third match combines the 15th wave (2005) of the BHPS with the 2005 FRS. The fourth match combines the 2000 United Kingdom Time Use Survey with the 2005 FRS. In each case, the alignment of the two datasets is examined, after which various aspects of the match quality are described. In each case, the matches are of high quality, given the nature of the source datasets.Statistical Matching; Wealth Distribution; Time Use; Household Production; United Kingdom; LIMEW