Health care costs in general, and prescription drug costs in particular, are rapidly rising. Between 1996 and 2007 the average annual per capita health care cost is projected to increase from dollar 3,781 to dollar 7,100. [AQ1] The single leading component of health care cost is the cost of prescription drugs (currently 10% of total health care spending, projected to become 18% in 2008). The average cost per drug increased 40% during the 1993-1998 period. Forty-one million Americans have no health insurance, and those who have, have inadequate prescription drug coverage. [AQ2] To cope with this situation, many consumers are trying to economize by doing without the prescriptions or the appropriate doses, buying generics or medicines from Canada or Mexico, or splitting pills of higher doses to take advantage of the pricing policy of drug manufacturers. Some of these approaches are medically and/or legally acceptable, while some are dubious. Most adversely affected are the seniors and poor; for certain groups of seniors prescription drugs account for 30% of their health care spending. The problem must receive prompt concerted attention from consumers, insurers, pharmaceutical companies, and lawmakers before it gets out of hand.
The community health center movement, begun in Saskatchewan, is central to successsfully reforming the Canadian health care system. The arguments of 30 years ago are relevant today. Canadian Medicare is at the crossroads. The evidence shows that the provision of primary health care through community health centers is cost effective and that the quality of care is at least as high in these settings as in traditional fee-for-service settings. Each province must encourage the development of a network of community health centers capable of providing services to every resident who wishes to receive all of his or her primary care "under one roof."
Between the 1890s and 1930s, anglophone politicians, journalists, novelists, and other commentators living in western, central, and eastern Canada drew upon established connections among greed, luxury, hysteria, and femininity to describe women who went shopping as irrational. Their motivations for doing so included their desires to assuage feelings of guilt about increased abundance; articulate anger caused by spousal conflicts over money; assert the legitimacy of male authority; and assign blame for the decline of small communities’ sustainability, the degradation of labour standards, and the erosion of independent shopkeeping. By calling upon stock stereotypes of femininity, and by repositioning them to fit the current capitalist moment, English-Canadian commentators constructed disempowering representations of women to alleviate their anxieties about what they perceived as the ills of modernization.
Adequate policy of price formation is one condition for effective development of public health under conditions of market economy. The authors present the fundamentals of price formation in public health under conditions of state financing, insurance, and self-support. Price formation should promote the activities of public health institutions, aimed at improving the quality of medical aid to the population and at the creation of conditions for the welfare of medical workers.
In a model incorporating uncertainty and state-dependent utility of health services, as well as information asymmetry between patients/buyers and physicians/sellers, two types of equilibria are compared: (1) when consumers have conventional third-party insurance and doctors are paid on the basis of fee-for-service; and (2) when insurance is through an HMO which provides health services through its own doctors. Conditions are found under which contractual or legal incentives can overcome the information asymmetry problem and bring about an efficient allocation of resources to health services provision.
This article demonstrates a novel application of propensity score matching techniques: to estimate nonexperimental impacts on program participants within the context of an experimental research design. The author examines the relationship between program participation, defined as qualifying for an earnings supplement by working full-time, and marital union formation among low-income mothers in two Canadian provinces. The author finds that receipt of an earnings supplement substantially increased union formation in one province but not the other. A subgroup analysis based on propensities of program participation revealed that the positive effect on unions was concentrated among relatively disadvantaged participants. The techniques demonstrated in the article are broadly applicable to studies in which take-up is less than 100% among those randomly assigned to a program group.
A vast majority of the journeys made by children with disabilities in Sweden are in the family car, which usually is bought and adapted for the child with governmental subsidies. Despite the important philosophical views about accessible vehicles, little is known about the impact of vehicle adaptations on families' lives. The aim of the study was to investigate parent views about the impact of vehicle grants and vehicle adaptation grants on their children's transport mobility and community access.
In total, 434 parents of children with disabilities in Sweden who had received vehicle grants and/or vehicle adaptation grants between 1998-2007 responded to a questionnaire comprising questions with both pre-selected and open-ended answers. A non-responder analysis was performed.
Children with disabilities were found to increase their transport mobility and community access in society as vehicle grants and/or vehicle adaptation grants were given to their parents. Their travel patterns and their travel priorities with their family car indicated that family friends and relatives and leisure activities were frequently visited and prioritised destinations. The grants were linked to access to social and family activities, provided environmental gains and led to increased experienced security. The results also showed that the potential to make spontaneous trips had increased substantially and that families experienced feelings of freedom and enhanced community access. The non-responder analysis confirmed these results.
According to parents, vehicle grants and vehicle adaptation grants for children with disabilities have a positive impact on the children's transport mobility and community access.
This paper examines consumer brand categorization in view of price-quality evaluations. In particular it examines the relationship of the Brisoux and Laroche (1980) brand categorization process and the Bliemel (1984) conceptualization of consumers' price-quality evaluations, in a pharmaceutical marketing context. The findings suggest that: the Brisoux-Laroche conceptualization is supported in a pharmaceutical/industrial marketing scenario; and, the pharmacists' categorization of brands (i.e., into the evoked, hold, foggy, and reject sets) can be partially explained as an outcome of a price-quality evaluation process.