Government initiatives to expand access to employer-based health insurance

Employer-based health insurance is declining at records rates, which leaves an increasing number of people without access to affordable health insurance. As a result, municipalities are experiencing financial difficulties to provide health care services for their growing uninsured population. In attempt to combat this issue, three health polices have emerged within the last ten years, called Living Wage with a health insurance provision, Pay or Play, and Health Care Preference. These policies are gaining popularity as civic leaders recognize their ability to promote a public health goal by leveraging the power of city and county contracts to include a health insurance component in the competitive bidding practice for government contracts. ^ This is the first paper to conduct a retrospective analysis on whether these three health policies have been able to increase access to employer-based health insurance and/or support the local health care safety net based on the experiences of six municipalities over a 5-year period from 2001-2006. Although there was variation between the effectiveness of the policies, all three demonstrated success in that a number of contractors extended existing health insurance to employees not previously covered and the increased cost of contracting for the local government was, on average, less than 1 percent of the total operating budget. ^

Perceptions of chief executives of Texas Catholic health care institutions regarding the poor and the provision of Catholic health care

Perceptions of chief executive officers (CEOs) of Texas Catholic health care institutions regarding the poor and the provision of Catholic health care were the focus for this study. A total of 40 health care administrators were asked to participate in a survey. Thirty-seven CEOs responded, including seven religious superiors, six health system CEOs and 24 hospital CEOs. Survey items concerning Catholic health for the poor centered on obligations and responsibilities of Catholic hospitals, means of achieving those obligations, and assessment of whether hospitals' objectives were being met. In addition, respondents' attitudes and beliefs about poor people in general were examined. Independent variables were CEO type, gender, religious preference, member of a religious order, and educational preparation. For purposes of analysis, most survey items were classified by level of consensus exhibited by respondents. The respondents to this survey agreed on most issues concerning poor people and the provision of Catholic health care. However, there were areas of disagreement particularly in Part I of the survey which dealt with responsibility/obligation, means/methods, and assessment of health care delivery for the poor. ^

Patient satisfaction in government health facilities in the state of Qatar

This study provides data which can contribute to improving services and delivering quality health care in government health facilities in the state of Qatar. To measure the satisfaction with current care of selected patients who receive care in Hamad General Hospital and the Khalifa Town Health Center in the city of Doha, a cross-sectional survey and a self-administered questionnaire were used.^ Analysis was performed on data from 444 patients on eight dimensions of patient satisfaction with medical care. These include: general satisfaction, availability of services, convenience of services, facilities, humaneness of doctors, quality of care, continuity of care, and aspects of the last visit. Patient satisfaction parameters were compared for males vs. females, for citizens vs. non-citizens, and for patients seen in the hospital vs. those seen in the health center.^ Results indicate that patients seen in the hospital were more satisfied with care than patients seen in the health center, that non-citizens were more satisfied than citizens, and that males were slightly more satisfied than females with medical services. ^

Integration under 'One Country, Two Systems' - The Case of Mainland China and Hong Kong-

Ever since the handover of the territory in 1997, Hong Kong has had its own unique law and its own economic system and international legal personality, and has not been integrated with Mainland China. The Basic Law guarantees the uniqueness of the Hong Kong SAR until 2047. But close economic ties between Hong Kong and the Mainland will promote closer economic integration. The Basic Law limits only a customs union and the introduction of a single currency, but not the formation of a Free Trade Agreement (hereafter FTA) and monetary union. FTA has already been realized in the form of the Closer Economic Partnership Arrangement (hereafter CEPA). The Hong Kong SAR government, including the bureaucrat as well as the Chief Executive Tung Chee Hwa, was opposed to, and hesitant towards, the formation of a regional trade agreement with the Mainland, but the business community made them to adopt a positive attitude towards the CEPA. It is unclear how much integration can been deepened, but it can be argued that the current policy of the Hong Kong SAR is too supportive of business, and an excessive degree of economic integration may threaten the uniqueness of Hong Kong. But if Hong Kong achieves democracy and enjoys complete autonomy, it will be easy for economic integration to co-exist with the 'One Country, Two Systems' approach, in the interests of the business community and of the citizens of the SAR.

The First Universal Suffrage Election, at County (Gewog) Level, in Bhutan

Following a Royal Edict to adopt universal suffrage in election for local government institutions, maiden elections were held in 199 gewogs (counties) in Bhutan in 2002 to elect their chief executives. This paper gives an account of this first time event in a country where most villagers had never seen secret ballots and poll booths. It synthesizes detailed data, mostly qualitative, collected soon after the election was over, and assesses aspects of electoral participation that His Majesty the King of Bhutan has introduced steadily to deepen democracy. Beginning with a glance at the territorial organization of the Bhutanese state within which the counties are embedded, the paper compares the electoral results with the relevant election rules.

Crowding-out and Crowding-in Effects of Government Bonds Market on Private Sector Investment (Japanese Case Study)

This paper reviews the relationship between public sector investment and private sector investment through government expenditures financed by government bonds in the Japanese economy. This study hypothesizes that deficit financing by bond issues does not crowd out private sector investment, and this finance method may crowd in. Thus the government increases bond issues and sells them in the domestic and international financial markets. This method does not affect interest rates because they are insensitive to government expenditures and they depend on interest rates levels in the international financial market more than in the domestic financial market because of globalization and integration among financial markets.

Myanmar Sugar SMEs: History, Technology, Location and Government Policy

Small and medium enterprises (SMEs) engaged in sugar processing in Myanmar appeared in the last decade of the socialist era. An acute sugar deficit, restricted trade in white sugar, and high demand from the conventional dairy business led to the growth of sugar SMEs by appropriate blending of semi-finished products (syrup) in the fields, which were then processed in vacuum pans and centrifugals to obtain white sugar. This became a tradable commodity and sugar SMEs grew in clusters in big cities. They are family-owned businesses. However, they lack the bagasse-based power generation. In recent years, large modern sugar factories operated by private and military companies have emerged as key players. The current shortage of fuel feedstock and competition for raw materials have become driving forces that shift sugar SMEs from market-oriented to raw material-oriented locations. Internal competition among key players made sugar price highly volatile, too. Being placed on a level playing field, the whole industry should be upgraded in terms of price and quality to become export-oriented.

Determinants of government consumption expenditure in developing countries : a panel data analysis

The paper focuses on the recent pattern of government consumption expenditure in developing countries and estimates the determinants which have influenced government expenditure. Using a panel data set for 111 developing countries from 1984 to 2004, this study finds evidence that political and institutional variables as well as governance variables significantly influence government expenditure. Among other results, the paper finds new evidence of Wagner's law which states that peoples' demand for service and willingness to pay is income-elastic hence the expansion of public economy is influenced by the greater economic affluence of a nation (Cameron1978). Corruption is found to be influential in explaining the public expenditure of developing countries. On the contrary, size of the economy and fractionalization are found to have significant negative association with government expenditure. In addition, the study finds evidence that public expenditure significantly shrinks under military dictatorship compared with other form of governance.

Myanmar's two decades of partial transition to a market economy : a negative legacy for the new government

Despite more than two decades of transition from a centrally planned to a market-oriented economy, Myanmar’s economic transition is still only partly complete. The government’s initial strategy for dealing with the swelling deficits of the state economic enterprises (SEEs) was to put them under direct control in order to scrutinize their expenditures. This policy change postponed restructuring and exacerbated the soft budget constraint problem of the SEEs. While the installation of a new government in March 2011 has increased prospects for economic development, sustainable growth still requires full-scale structural reform of the SEEs and institutional infrastructure building. Myanmar can learn from the gradual approaches to economic transition in China and Vietnam, where partial reforms weakened further impetus for reforms.

Changing local elite selection in Thailand : emergence of new local government presidents after direct elections and their capabilities

Before rural local government units were established in Thailand, reform debates within the country faced a crucial issue: Candidates at the rural sub-district levels might adopt electioneering methods such as vote buying and the patronage system of the local political and economic elite, the methods that had been used in the national elections. In fact, the results of the 2006 survey in this paper, which followed the introduction of direct elections in rural local government units in 2003, contrast with the result anticipated during the debates on political reform. The preliminary data of the survey shows that the decentralization process and the introduction of the direct election system in the rural areas had some effect in changing the selection process of the local elite in Thailand.

Solving identity delegation problem in the e-government environment

At present, many countries allow citizens or entities to interact with the government outside the telematic environment through a legal representative who is granted powers of representation. However, if the interaction takes place through the Internet, only primitive mechanisms of representation are available, and these are mainly based on non-dynamic offline processes that do not enable quick and easy identity delegation. This paper proposes a system of dynamic delegation of identity between two generic entities that can solve the problem of delegated access to the telematic services provided by public authorities. The solution herein is based on the generation of a delegation token created from a proxy certificate that allows the delegating entity to delegate identity to another on the basis of a subset of its attributes as delegator, while also establishing in the delegation token itself restrictions on the services accessible to the delegated entity and the validity period of delegation. Further, the paper presents the mechanisms needed to either revoke a delegation token or to check whether a delegation token has been revoked. Implications for theory and practice and suggestions for future research are discussed.

The facility manager architect : the social responsability as an added value.

From the very first steps to execute a building, it is essential to analyze its life cycle. Similarly, we should consider the life cycle when projecting an urban intervention. Professionals of the Facility Management take part in construction projects, developing and managing DBFMO projects (Design, Build, Finance, Maintenance & Operate). Whatever the nature of the promoter is – private or public – promoters are leaders in projects of responsible management of spaces, whether these are work spaces, leisure spaces or residential spaces. They know and identify with the company and its performance, its values and its needs. These professionals give sustainable solutions in the life cycle of buildings (offices and housing), new ways to work and initiatives of innovations linked to current social changes: technology, social networks, and new habits. Concepts where innovation is essential should consider responsible values. Social, economic and sustainable aspects have to associate with the management performed by a Facilities Manager when considering the three groups of stakeholders with which it is linked: economic (shareholders), contractual (users), non-contractual (neighborhoods, organizations, etc.). Marcus Vitruvius Pollio, at the beginning of his book "The Ten Books on Architecture" describes and argues how the distribution in buildings must always adapt to their inhabitants. Let us build cities and buildings with responsible criteria, bearing in mind all its users and the needs of each one of them. Not to mention the need to adapt to future requirements with minimum cost and maximum profitability. These needs, under responsible management, are competencies developed by a Facilities Manager in his day to day. He cares and takes over the entire life cycle of buildings and their surroundings. This work is part of the PhD project whose main aim is to study the added value to the architectural profession when social responsibility criteria are applied in his/her role as Facility Manager.

Luciano Kulczewski, arquitecto: Eclecticismo y procesos modernizadores en el Chile de la primera mitad del siglo XX

Esta investigación tiene por fin poner en valor la obra del arquitecto chileno Luciano Kulczewski, profesional que cumplió un rol clave y distintivo en la primera mitad del siglo XX, considerado como un período crucial para el desarrollo de la arquitectura nacional, ya que es el momento en que se produce el advenimiento de la modernidad en el país. Si bien su figura goza de un gran reconocimiento, solamente una parte de su obra es (re)conocida por la historiografía nacional. Su labor en el libre ejercicio de la profesión, como asimismo los distintos cargos administrativos y políticos que desempeñó en su vida, hacían suponer un corpus más amplio, como finalmente se pudo constatar en este estudio. El amplio catastro documentado permitió fehacientemente identificar el rol y el significado que esta obra cumpliera en la transición que hizo posible dejar atrás los valores impuesto por el Academicismo, para incorporar los procesos de modernización en los distintos ámbitos de la arquitectura. Por tanto, el quehacer de Kulczewski se reveló como ejemplar y paradigmático. Una de las ilustraciones más elocuentes a este respecto fue la precursora realización de edificios en altura para uso residencial. Esta tipología lo obligó a trabajar con nuevos materiales y técnicas constructivas, junto a la necesidad de introducir las modernas tecnologías que estos portentos arquitectónicos requerían para su funcionamiento, como era el uso de ascensores y los sistemas de calefacción centralizada. El estudio del contexto urbano de sus obras permitió dar cuenta también de los procesos que estaban convirtiendo a las principales ciudades del país en urbes ‘modernas’. En este ámbito, destaca la nueva concepción urbanística que llegaba vinculada a los barrios-jardín, que contrariamente a lo establecido por el urbanismo tradicional, implicó inéditas maneras de articular la ciudad y el empleo de nuevas tipologías residenciales. Estas concepciones de ciudad encontraron eco principalmente en las urbanizaciones que se estaban realizando en las nuevas comunas de la capital, contexto elegido por el arquitecto para llevar a cabo algunos innovadores conjuntos habitacionales, hoy considerados modélicos, y que estaban destinados a un nuevo estrato social empoderado y demandante: la clase media. Su particular preocupación por las cuestiones sociales, las que entraron en crisis con el devenir del siglo XX, lo llevaron a desarrollar una activa vida política, que culminó con un importante puesto administrativo en el primer Gobierno Radical que tuvo lugar en el país. Desde esa posición, pudo gestionar y dar solución apropiada a la urgente necesidad de viviendas obreras que requería el país, creando los primeros edificios colectivos destinados a este grupo social. Esto a la vez supuso un acercamiento más sustancial a las nuevas propuestas vinculadas al Movimiento Moderno. En conclusión, su quehacer hizo eco de los estilos vanguardistas y modernos que arribaron provenientes de Europa, pero reconociendo las realidades propias del país, de tal forma que la apropiación, y no la reproducción, fue su sello. En este proceso de adecuación al medio local, los modelos foráneos se desprenderán de muchas de sus principios rectores originales, lo que sumado a la impronta de un imaginario propio y original, convierten a sus creaciones en un caso singular en el contexto del la arquitectura chilena. ABSTRACT This research aims to add value to the work of Chilean architect Luciano Kulczewski, a professional who accomplished a key and distinctive role in the first half of the twentieth century, which is considered as a crucial period for the development of the Chilean architecture, since it corresponds to the arrive of Modernity in this country. While his figure is widely recognized, only a portion of his oeuvre is known (or acknowledged) by national historiography. Because of his work as a freelance professional and another administrative and political position he held in his life, it is possible to assume a larger corpus, as it was finally confirmed by this study. The copious documented cadastre allowed convincingly to identify the role and significance that this work fulfilled in the transition that made possible leaving behind the values imposed by Academicism, and thus to incorporate the modernization processes in the different fields of architecture. Therefore, the work of Kulczewski revealed itself as exemplary and paradigmatic. One of the most eloquent illustrations to this regard was the pioneering construction of high-rise buildings with a residential purpose. This typology drove him to work with new materials and constructive techniques, alongside with the need of introducing new modern technologies required by these architectonical advances for its operations, like the use of elevators and central heating systems. The study of the urban context of his work allowed also accounting the processes the major cities of the country went through in order to become 'modern' cities. In this context, it stands out the new urban conception linked to the idea of garden city, which was contrary to the practices of the traditional urbanism, and that implied new ways of articulating the city and that the use of new residential typologies. These urban notions were mainly echoed in the urbanizations that were made in the new districts of the city, scenario chosen by the architect for the concretion of innovative housing projects, nowadays thought as paradigmatic, and that were oriented for a new empowered and demanding social group: the middle class. His particular concern for social issues, which ones came into crisis with the arrival of the twentieth century, led him to take an active political role, culminating with an important administrative position in the first Radical Government that took place in the country. From that position, he could manage and provide adequate solutions to the urgent worker’s housing needs that required the country, creating the first collective buildings for this social group. This supposed a more substantial approach to new proposals of the Modern Movement. To conclude, his oeuvre was influenced by the avant-garde and modern styles that arrived from Europe, but with the proper adjustments to the local requirements, so that it is possible to say that appropriation more than reproduction was his hallmark. In this process, these features were transformed in order to get more flexibility for their adaptation to the Chilean needs that added to a personal and peculiar imaginary, which transformed his works into a unique case in the national architecture history.