The financial burden of health care

Because nearly 46 million Americans have no health insurance, medical debt has been behind many of today’s foreclosures. The author offers potential solutions.Medically uninsured persons ; Foreclosure ; Medical care, Cost of

Fiscal Decentralization and Peasants' Financial Burden in China

This paper sheds light on the heavy financial burden on peasants in China's fiscal decentralization system. Using a political economy framework, this paper explores the tax-farming nature of China's fiscally decentralized system and examines why the system incurs a particularly heavy financial burden on peasants. Specifically, it points out that a political hierarchy financed by a tax-farming system in China, fails to contain the exploitative behavior of local officials, which results in the expenditure devolution and revenue centralization within the hierarchy. Ultimately, peasants bear the brunt of the tax burden. As the financial pressure of excessive levies and fees reaches a perilous point, peasants are resorting to violent protests. Unless a fiscally decentralized system with horizontal accountability mechanisms evolves, the country's ability to sustain a centralized polity may become increasingly undermined. A case study of township finance is used to exemplify the exploitative nature of China's fiscal decentralization system.Fiscal Decentralization, Corruption, Financial Burden, China

To what extent does the interest burden affect firm survival? Evidence from a panel of UK firms during the recent financial crisis

Using a panel of mainly unquoted UK firms over the period 2000–09, we document a significant effect of changes in the interest burden from debt-servicing on firm survival. The effect is found to be stronger during the recent financial crisis compared with more tranquil periods. Furthermore, the survival chances of bank-dependent, younger, and non-exporting firms are most affected by changes in the interest burden, especially during the crisis. Our results are robust to using different estimation methods and different interest burden measures They suggest that one way for policymakers to mitigate the effects of financial crises by limiting firm failures would be to prevent financing costs from rising, especially for those firms more likely to face liquidity constraints

Out-of-pocket spending and financial burden among low income adults after Medicaid expansions in the United States: quasi-experimental difference-in-difference study.

OBJECTIVE:To examine the association between expansion of the Medicaid program under the Affordable Care Act and changes in healthcare spending among low income adults during the first four years of the policy implementation (2014-17). DESIGN:Quasi-experimental difference-in-difference analysis to examine out-of-pocket spending and financial burden among low income adults after Medicaid expansions. SETTING:United States. PARTICIPANTS:A nationally representative sample of individuals aged 19-64 years, with family incomes below 138% of the federal poverty level, from the 2010-17 Medical Expenditure Panel Survey. MAIN OUTCOMES AND MEASURES:Four annual healthcare spending outcomes: out-of-pocket spending; premium contributions; out-of-pocket plus premium spending; and catastrophic financial burden (defined as out-of-pocket plus premium spending exceeding 40% of post-subsistence income). P values were adjusted for multiple comparisons. RESULTS:37 819 adults were included in the study. Healthcare spending did not change in the first two years, but Medicaid expansions were associated with lower out-of-pocket spending (adjusted percentage change -28.0% (95% confidence interval -38.4% to -15.8%); adjusted absolute change -122 (£93; €110); adjusted P<0.001), lower out-of-pocket plus premium spending (-29.0% (-40.5% to -15.3%); -442; adjusted P&lt;0.001), and lower probability of experiencing a catastrophic financial burden (adjusted percentage point change -4.7 (-7.9 to -1.4); adjusted P=0.01) in years three to four. No evidence was found to indicate that premium contributions changed after the Medicaid expansions. CONCLUSION:Medicaid expansions under the Affordable Care Act were associated with lower out-of-pocket spending and a lower likelihood of catastrophic financial burden for low income adults in the third and fourth years of the act's implementation. These findings suggest that the act has been successful nationally in improving financial risk protection against medical bills among low income adults

Common Capital: A Thought Experiment in Cross-Border Resolution

Cross-border bank resolution efforts focus on burden-sharing between bank owners, private creditors and the public. There is little talk of burden-sharing among governments, despite the rich history of governments trying to stick one another with the cost of financial conglomerate failures. There is an unspoken fear that acknowledging the need to allocate losses among governments would undermine post-crisis pledges of No More Bailouts. This symposium essay argues for making government stakes in private financial firms more transparent, and for using the contingent public share as a key to loss allocation among governments in cross-border banking crises

The Distribution and Dispersion of Debt Burden Ratios Among Households in Poland and its Implications for Financial Stability

Debt burden ratio as measured on the aggregate level does not give an adequate assessment of the ability of the household sector to repay its debt. The low level of financial deepening in Poland is primarily reflected in a low percentage of households that have been granted a loan. Therefore, the average debt burden for households, which have any debt outstandings could be much higher than the one measured on the aggregate level. If the debt is concentrated among groups of households with lower incomes, it can threat the financial stability in case of FX or interest rate shocks. Using the data from Polish Households Budget Survey we first define three different measures of debt burden and calculate its dispersion in time and distribution among income groups. We find that (1) the total debt service burden and loan service burden ratios are on lower levels than in other European countries and recently have not risen substantially, (2) the mortgage debt service burden ratio has been rapidly increasing in the last four years especially in lower income groups of households reaching in 2004 the 3/4 of the level noted in EU-15. In comparison with EU it seems that the level of indebtedness of house- holds in Poland is on a secure level. However, we notice that the secure level of debt burden ratio is on a lower level in emerging market countries than in wealthier countries because of the higher share of basic living costs in total consumption expenditure. Therefore, the increasing levels of mortgage debt service ratios in lower-income groups could pose a potential threat to the financial stability in case of FX or interest rate shock.Financial stability; debt burden; sebt service burden; haousehold indebtedness

Tax burden - the tax evasion generator

The economic globalization has emphasized and elaborated the existing inter-dependencies between the national economies, favouring the development of the world economy, but at the same time, of the underground economy - a tax evasion generator. In the context of debating the tax evasion which is currently present in all the countries of the world, it is not possible to ignore one of the most important generating factors of this phenomenon, i.e. the tax burden. In our opinion, the tax burden in Romania is more current than ever, firstly, due to the fact that our country is in the phase of harmonizing the financial system with the community acquis and secondly, due to the fact that the Romanian economy is confronted with the lack of capital in the context of the world financial crisis, the incomes of the taxpayers are insufficient to be governed by an excessive tax policy, without giving birth to the evasion phenomena. This is the reason why I think it is convenient to perform an analysis of the implications of the tax burden over the tax evasion in the Romanian economy.tax burden, globalization, financial crisis

Bank Bail-Outs, International Linkages and Cooperation

Financial institutions are increasingly linked internationally and engaged in cross-border operations. As a result, financial crises and potential bail-outs by governments have important international implications. Extending Allen and Gale (2000) we provide a model of international contagion allowing for bank bail-outs financed by distortionary taxes. In the sequential game between governments, there are inefficiencies due to spillovers, free-riding and limited burden-sharing. When countries are of equal size, an increase in cross-border deposit holdings improves, in general, the non-cooperative outcome. For efficient crisis managment, ex-ante fiscal burden sharing is essential as ex-post contracts between governments do not achieve the same global welfare.bail-out, contagion, financial crisis, international institutional arrangements

How Much "Skin in the Game" Is Enough? The Financial Burden of Health Spending for People on Medicare

Examines trends in the financial burden of out-of-pocket healthcare expenses relative to income among Medicare beneficiaries between 1997 and 2006, including the composition of expenses and contributing factors. Includes projections for 2025

Statistics and society: a study on the burden experienced by caregivers of patients with Alzheimer

The cost of caring for people with Alzheimer-type diseases is enormous. Caregivers experience emotional, physical and financial stress, and their demands are central to decisions on patient institutionalization. We hereby investigate the burden experienced by caregivers of Alzheimer patients in Cyprus. We explore whether burden is related to variables such as patient psychopathology, caregiver gender, income and level of education. Moreover, we examine if there is a significant difference in the level of burden, depression, or reaction to memory and behavior problems when patients live in the community or in institutions and if the level of burden is associated with the use of different coping strategies by caregivers. Various statistical techniques are implemented for the analysis and all the conclusions are discussed. This work was partially funded by the Cyprus Research Promotion Foundation