Health Insurance for "Humans": Information Frictions, Plan Choice, and Consumer Welfare.

PubMed

Handel, Benjamin R; Kolstad, Jonathan T

2015-08-01

Traditional models of insurance choice are predicated on fully informed and rational consumers protecting themselves from exposure to financial risk. In practice, choosing an insurance plan is a complicated decision often made without full information. In this paper we combine new administrative data on health plan choices and claims with unique survey data on consumer information to identify risk preferences, information frictions, and hassle costs. Our additional friction measures are important predictors of choices and meaningfully impact risk preference estimates. We study the implications of counterfactual insurance allocations to illustrate the importance of distinguishing between these micro-foundations for welfare analysis.

Development of the Health Insurance Literacy Measure (HILM): Conceptualizing and Measuring Consumer Ability to Choose and Use Private Health Insurance

PubMed Central

Paez, Kathryn A.; Mallery, Coretta J.; Noel, HarmoniJoie; Pugliese, Christopher; McSorley, Veronica E.; Lucado, Jennifer L.; Ganachari, Deepa

2014-01-01

Understanding health insurance is central to affording and accessing health care in the United States. Efforts to support consumers in making wise purchasing decisions and using health insurance to their advantage would benefit from the development of a valid and reliable measure to assess health insurance literacy. This article reports on the development of the Health Insurance Literacy Measure (HILM), a self-assessment measure of consumers' ability to select and use private health insurance. The authors developed a conceptual model of health insurance literacy based on formative research and stakeholder guidance. Survey items were drafted using the conceptual model as a guide then tested in two rounds of cognitive interviews. After a field test with 828 respondents, exploratory factor analysis revealed two HILM scales, choosing health insurance and using health insurance, each of which is divided into a confidence subscale and likelihood of behavior subscale. Correlations between the HILM scales and an objective measure of health insurance knowledge and skills were positive and statistically significant which supports the validity of the measure. PMID:25315595

Development of the Health Insurance Literacy Measure (HILM): conceptualizing and measuring consumer ability to choose and use private health insurance.

PubMed

Paez, Kathryn A; Mallery, Coretta J; Noel, HarmoniJoie; Pugliese, Christopher; McSorley, Veronica E; Lucado, Jennifer L; Ganachari, Deepa

2014-01-01

Understanding health insurance is central to affording and accessing health care in the United States. Efforts to support consumers in making wise purchasing decisions and using health insurance to their advantage would benefit from the development of a valid and reliable measure to assess health insurance literacy. This article reports on the development of the Health Insurance Literacy Measure (HILM), a self-assessment measure of consumers' ability to select and use private health insurance. The authors developed a conceptual model of health insurance literacy based on formative research and stakeholder guidance. Survey items were drafted using the conceptual model as a guide then tested in two rounds of cognitive interviews. After a field test with 828 respondents, exploratory factor analysis revealed two HILM scales, choosing health insurance and using health insurance, each of which is divided into a confidence subscale and likelihood of behavior subscale. Correlations between the HILM scales and an objective measure of health insurance knowledge and skills were positive and statistically significant which supports the validity of the measure.

Reference Pricing with Endogenous or Exogenous Payment Limits: Impacts on Insurer and Consumer Spending.

PubMed

Brown, Timothy T; Robinson, James C

2016-06-01

Reference pricing (RP) theories predict different outcomes when reference prices are fixed (exogenous) versus being a function of market prices (MPs) (endogenous). Exogenous RP results in MPs at both high-price and low-price firms converging towards the reference price from above and below, respectively. Endogenous RP results in MPs at both high-price and low-price firms decreasing, with low-price firms acting strategically to decrease the reference price in order to gain market share. We extend these models to a hospital context focusing on insurer and consumer payments. Under exogenous RP, insurer and consumer payments to low-price hospitals increase, and insurer payments to high-price hospitals decrease, but predictions regarding consumer payments are ambiguous for high-price hospitals. Under endogenous RP, insurer payments to high-price and low-price hospitals decrease, and consumer payments to low-price hospitals decrease, but predictions regarding consumer payments are ambiguous for high-price hospitals. We test these predictions with difference-in-differences specifications using 2008-2013 data on patients undergoing joint replacement. For 2 years following RP implementation, insurer payments to high-price and low-price hospitals moved downward, consistent with endogenous RP. However, when the reference price was not reset to account for changes in MPs, insurer payments to low-price hospitals reverted to pre-implementation levels, consistent with exogenous RP. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Consumer evaluation of complaint handling in the Dutch health insurance market

PubMed Central

2011-01-01

Background How companies deal with complaints is a particularly challenging aspect in managing the quality of their service. In this study we test the direct and relative effects of service quality dimensions on consumer complaint satisfaction evaluations and trust in a company in the Dutch health insurance market. Methods A cross-sectional survey design was used. Survey data of 150 members of a Dutch insurance panel who lodged a complaint at their healthcare insurer within the past 12 months were surveyed. The data were collected using a questionnaire containing validated multi-item measures. These measures assess the service quality dimensions consisting of functional quality and technical quality and consumer complaint satisfaction evaluations consisting of complaint satisfaction and overall satisfaction with the company after complaint handling. Respondents' trust in a company after complaint handling was also measured. Using factor analysis, reliability and validity of the measures were assessed. Regression analysis was used to examine the relationships between these variables. Results Overall, results confirm the hypothesized direct and relative effects between the service quality dimensions and consumer complaint satisfaction evaluations and trust in the company. No support was found for the effect of technical quality on overall satisfaction with the company. This outcome might be driven by the context of our study; namely, consumers get in touch with a company to resolve a specific problem and therefore might focus more on complaint satisfaction and less on overall satisfaction with the company. Conclusions Overall, the model we present is valid in the context of the Dutch health insurance market. Management is able to increase consumers' complaint satisfaction, overall satisfaction with the company, and trust in the company by improving elements of functional and technical quality. Furthermore, we show that functional and technical quality do not

Consumer evaluation of complaint handling in the Dutch health insurance market.

PubMed

Wendel, Sonja; de Jong, Judith D; Curfs, Emile C

2011-11-15

How companies deal with complaints is a particularly challenging aspect in managing the quality of their service. In this study we test the direct and relative effects of service quality dimensions on consumer complaint satisfaction evaluations and trust in a company in the Dutch health insurance market. A cross-sectional survey design was used. Survey data of 150 members of a Dutch insurance panel who lodged a complaint at their healthcare insurer within the past 12 months were surveyed. The data were collected using a questionnaire containing validated multi-item measures. These measures assess the service quality dimensions consisting of functional quality and technical quality and consumer complaint satisfaction evaluations consisting of complaint satisfaction and overall satisfaction with the company after complaint handling. Respondents' trust in a company after complaint handling was also measured. Using factor analysis, reliability and validity of the measures were assessed. Regression analysis was used to examine the relationships between these variables. Overall, results confirm the hypothesized direct and relative effects between the service quality dimensions and consumer complaint satisfaction evaluations and trust in the company. No support was found for the effect of technical quality on overall satisfaction with the company. This outcome might be driven by the context of our study; namely, consumers get in touch with a company to resolve a specific problem and therefore might focus more on complaint satisfaction and less on overall satisfaction with the company. Overall, the model we present is valid in the context of the Dutch health insurance market. Management is able to increase consumers' complaint satisfaction, overall satisfaction with the company, and trust in the company by improving elements of functional and technical quality. Furthermore, we show that functional and technical quality do not influence consumer satisfaction evaluations and

Shopping on the Public and Private Health Insurance Marketplaces: Consumer Decision Aids and Plan Presentation.

PubMed

Wong, Charlene A; Kulhari, Sajal; McGeoch, Ellen J; Jones, Arthur T; Weiner, Janet; Polsky, Daniel; Baker, Tom

2018-05-29

The design of the Affordable Care Act's (ACA) health insurance marketplaces influences complex health plan choices. To compare the choice environments of the public health insurance exchanges in the fourth (OEP4) versus third (OEP3) open enrollment period and to examine online marketplace run by private companies, including a total cost estimate comparison. In November-December 2016, we examined the public and private online health insurance exchanges. We navigated each site for "real-shopping" (personal information required) and "window-shopping" (no required personal information). Public (n = 13; 12 state-based marketplaces and HealthCare.gov ) and private (n = 23) online health insurance exchanges. Features included consumer decision aids (e.g., total cost estimators, provider lookups) and plan display (e.g., order of plans). We examined private health insurance exchanges for notable features (i.e., those not found on public exchanges) and compared the total cost estimates on public versus private exchanges for a standardized consumer. Nearly all studied consumer decision aids saw increased deployment in the public marketplaces in OEP4 compared to OEP3. Over half of the public exchanges (n = 7 of 13) had total cost estimators (versus 5 of 14 in OEP3) in window-shopping and integrated provider lookups (window-shopping: 7; real-shopping: 8). The most common default plan orders were by premium or total cost estimate. Notable features on private health insurance exchanges were unique data presentation (e.g., infographics) and further personalized shopping (e.g., recommended plan flags). Health plan total cost estimates varied substantially between the public and private exchanges (average difference $1526). The ACA's public health insurance exchanges offered more tools in OEP4 to help consumers select a plan. While private health insurance exchanges presented notable features, the total cost estimates for a standardized consumer varied widely on public

Switching benefits and costs in the Irish health insurance market: an analysis of consumer surveys.

PubMed

Keegan, Conor; Teljeur, Conor; Turner, Brian; Thomas, Steve

2018-05-10

Relatively little analysis has taken place internationally on the consumer-reported benefits and costs to switching insurer in multi-payer health insurance markets. Ideally, consumers should be willing to switch out of consideration for price and quality and switching should be able to take place without incurring significant switching costs. Costs to switching come in many forms and understanding the nature of these costs is necessary if policy interventions to improve market competition are to be successful. This study utilises data from consumer surveys of the Irish health insurance market collected between 2009 and 2013 (N [Formula: see text] 1703) to examine consumer-reported benefits and costs to switching insurer. Probit regression models are specified to examine the relationship between consumer characteristics and reported switching costs, and switching behaviour, respectively. Overall evidence suggests that switchers in the Irish market mainly did so out of consideration for price. Transaction cost was the most common switching cost identified, reported by just under 1 in 7 non-switchers. Psychological switching costs may also be impacting behaviour. Moreover, high-risk individuals were more likely to experience switching costs and this was reflected in actual switching behaviour. A recent information campaign launched by the market regulator may prove beneficial in reducing perceived transaction costs in the market, however, a more focused campaign aimed at high-risk consumers may be necessary to reduce inequalities. Policy-makers should also consider the impact insurer behaviour may have on decision-making.

Expanding insurance coverage through tax credits, consumer choice, and market enhancements: the American Medical Association proposal for health insurance reform.

PubMed

Palmisano, Donald J; Emmons, David W; Wozniak, Gregory D

2004-05-12

Recent reports showing an increase in the number of uninsured individuals in the United States have given heightened attention to increasing health insurance coverage. The American Medical Association (AMA) has proposed a system of tax credits for the purchase of individually owned health insurance and enhancements to individual and group health insurance markets as a means of expanding coverage. Individually owned insurance would enable people to maintain coverage without disruption to existing patient-physician relationships, regardless of changes in employers or in work status. The AMA's plan would empower individuals to choose their health plan and give patients and their physicians more control over health care choices. Employers could continue to offer employment-based coverage, but employees would not be limited to the health plans offered by their employer. With a tax credit large enough to make coverage affordable and the ability to choose their own coverage, consumers would dramatically transform the individual and group health insurance markets. Health insurers would respond to the demands of individual consumers and be more cautious about increasing premiums. Insurers would also tailor benefit packages and develop new forms of coverage to better match the preferences of individuals and families. The AMA supports the development of new health insurance markets through legislative and regulatory changes to foster a wider array of high-quality, affordable plans.

The Impact of Consumer Numeracy on the Purchase of Long-Term Care Insurance.

PubMed

McGarry, Brian E; Temkin-Greener, Helena; Chapman, Benjamin P; Grabowski, David C; Li, Yue

2016-08-01

To determine the effect of consumers' numeric abilities on the likelihood of owning private long-term care insurance. The 2010 wave of the Health and Retirement Study, a nationally representative survey of Americans age 50 and older, was used (n = 12,796). Multivariate logistic regression was used to isolate the relationship between numeracy and long-term care insurance ownership. Each additional question answered correctly on a numeracy scale was associated with a 13 percent increase in the likelihood of holding LTCI, after controlling for predictors of policy demand, education, and cognitive function. Poor numeracy may create barriers to long-term care insurance purchase. Policy efforts aimed at increasing consumer decision support or restructuring the marketplace for long-term care insurance may be needed to increase older adults' ability to prepare for future long-term care expenses. © Health Research and Educational Trust.

Consumer Decision-Making Abilities and Long-Term Care Insurance Purchase.

PubMed

McGarry, Brian E; Tempkin-Greener, Helena; Grabowski, David C; Chapman, Benjamin P; Li, Yue

2018-04-16

To determine the impact of consumer decision-making abilities on making a long-term care insurance (LTCi) purchasing decision that is consistent with normative economic predictions regarding policy ownership. Using data from the Health and Retirement Study, multivariate analyses are implemented to estimate the effect of decision-making ability factors on owning LTCi. Stratified multivariate analyses are used to examine the effect of decision-making abilities on the likelihood of adhering to economic predictions of LTCi ownership. In the full sample, better cognitive capacity was found to significantly increase the odds of ownership. When the sample was stratified based on expected LTCi ownership status, cognitive capacity was positively associated with ownership among those predicted to own and negatively associated with ownership among those predicted not to own who could likely afford a policy. Consumer decision-making abilities, specifically cognitive capacity, are an important determinant of LTCi decision outcomes. Deficits in this ability may prevent individuals from successfully preparing for future long-term care expenses. Policy makers should consider changes that reduce the cognitive burden of this choice, including the standardization of the LTCi market, the provision of consumer decision aids, and alternatives to voluntary and private insuring mechanisms.

The cost-effectiveness and consumer acceptability of taxation strategies to reduce rates of overweight and obesity among children in Australia: study protocol.

PubMed

Comans, Tracy A; Whitty, Jennifer A; Hills, Andrew P; Kendall, Elizabeth; Turkstra, Erika; Gordon, Louisa G; Byrnes, Josh M; Scuffham, Paul A

2013-12-14

Childhood obesity is a recognised public health problem and around 25% of Australian children are overweight or obese. A major contributor is the obesogenic environment which encourages over consumption of energy dense nutrient poor food. Taxation is commonly proposed as a mechanism to reduce consumption of poor food choices and hence reduce rates of obesity and overweight in the community. An economic model will be developed to assess the lifetime benefits and costs to a cohort of Australian children by reducing energy dense nutrient poor food consumption through taxation mechanisms. The model inputs will be derived from a series of smaller studies. Food options for taxation will be derived from literature and expert opinion, the acceptability and impact of price changes will be explored through a Citizen's Jury and a discrete choice experiment and price elasticities will be derived from the discrete choice experiment and consumption data. The health care costs of managing rising levels of obesity are a challenge for all governments. This study will provide a unique contribution to the international knowledge base by engaging a variety of robust research techniques, with a multidisciplinary focus and be responsive to consumers from diverse socio-economic backgrounds.

Effects of consumer and provider moral hazard at a municipal hospital out-patient department on Ghana's National Health Insurance Scheme.

PubMed

Yawson, A E; Biritwum, R B; Nimo, P K

2012-12-01

In 2003, Ghana introduced the national health insurance scheme (NHIS) to promote access to healthcare. This study determines consumer and provider factors which most influence the NHIS at a municipal health facility in Ghana. This is an analytical cross-sectional study at the Winneba Municipal Hospital (WHM) in Ghana between January-March 2010. A total of 170 insured and 175 uninsured out-patients were interviewed and information extracted from their folders using a questionnaire. Consumers were from both the urban and rural areas of the municipality. The mean number of visits by insured consumers to a health facility in previous six months was 2.48 +/- 1.007 and that for uninsured consumers was 1.18 +/- 0.387(p-value<0.001). Insured consumers visited the health facility at significantly more frequent intervals than uninsured consumers (χ(2) = 55.413, p-value< 0.001). Overall, insured consumers received more different types of medications for similar disease conditions and more laboratory tests per visit than the uninsured. In treating malaria (commonest condition seen), providers added multivitamins, haematinics, vitamin C and intramuscular injections as additional medications more for insured consumers than for uninsured consumers. Findings suggest consumer and provider moral hazard may be two critical factors affecting the NHIS in the Effutu Municipality. These have implications for the optimal functioning of the NHIS and may affect long-term sustainability of NHIS in the municipality. Further studies to quantify financial/ economic cost to NHIS arising from moral hazard, will be of immense benefit to the optimal functioning of the NHIS.

[Complaints by private health insurance policy-holders to the Consumer Protection Bureau in Argentina, 2000-2008].

PubMed

Luzuriaga, María José; Spinelli, Hugo

2014-05-01

This paper analyzes problems experienced by policy-holders of voluntary private health insurance plans in Argentina when insurance companies fail to comply with the Consumer Protection Code. The sample consisted of consumer complaints filed with the Consumer Protection Bureau and rulings by the Bureau from 2000 to 2008. One striking issue was recurrent non-compliance with services included in the Mandatory Medical Program and the companies' attempts to blame policy-holders. According to the study, the lack of an information system hinders scientific studies to adequately address the problem. Thus, a comparison with studies on health insurance in other Latin American countries highlighted the importance of such research, the relationship to health systems, constraints on use and denial of citizens' rights to healthcare, and the increasing judicialization of healthcare provision.

Optimal non-linear health insurance.

PubMed

Blomqvist, A

1997-06-01

Most theoretical and empirical work on efficient health insurance has been based on models with linear insurance schedules (a constant co-insurance parameter). In this paper, dynamic optimization techniques are used to analyse the properties of optimal non-linear insurance schedules in a model similar to one originally considered by Spence and Zeckhauser (American Economic Review, 1971, 61, 380-387) and reminiscent of those that have been used in the literature on optimal income taxation. The results of a preliminary numerical example suggest that the welfare losses from the implicit subsidy to employer-financed health insurance under US tax law may be a good deal smaller than previously estimated using linear models.

Firm strategy and consumer behaviour under a complex tobacco tax system: implications for the effectiveness of taxation on tobacco control.

PubMed

Atuk, Oğuz; Özmen, M Utku

2017-05-01

The current tobacco taxation scheme in Turkey, a mix of high ad valorem tax and low specific tax, contains incentives for firms and consumers to change pricing and consumption patterns, respectively. The association between tax structure and price and tax revenue stability has not been studied in detail with micro data containing price segment information. In this study, we analyse whether incentives for firms and consumers undermine the effectiveness of tax policy in reducing consumption. We calculate alternative taxation scheme outcomes using differing ad valorem and specific tax rates through simulation analysis. We also estimate price elasticity of demand using detailed price and volume statistics between segments via regression analysis. A very high ad valorem rate provides strong incentives to firms to reduce prices. Therefore, this sort of tax strategy may induce even more consumption despite its initial aim of discouraging consumption. While higher prices dramatically reduce consumption of economy and medium price segment cigarettes, demand for premium segment cigarettes is found to be highly price-inelastic. The current tax scheme, based on both ad valorem and specific components, introduces various incentives to firms as well as to consumers which reduce the effectiveness of the tax policy. Therefore, on the basis of our theoretical predictions, an appropriate tax scheme should involve a balanced combination of ad valorem and specific rates, away from extreme ( ad valorem or specific dominant) cases to enhance the effectiveness of tax policy for curbing consumption. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The cost-effectiveness and consumer acceptability of taxation strategies to reduce rates of overweight and obesity among children in Australia: study protocol

PubMed Central

2013-01-01

Background Childhood obesity is a recognised public health problem and around 25% of Australian children are overweight or obese. A major contributor is the obesogenic environment which encourages over consumption of energy dense nutrient poor food. Taxation is commonly proposed as a mechanism to reduce consumption of poor food choices and hence reduce rates of obesity and overweight in the community. Methods/Design An economic model will be developed to assess the lifetime benefits and costs to a cohort of Australian children by reducing energy dense nutrient poor food consumption through taxation mechanisms. The model inputs will be derived from a series of smaller studies. Food options for taxation will be derived from literature and expert opinion, the acceptability and impact of price changes will be explored through a Citizen’s Jury and a discrete choice experiment and price elasticities will be derived from the discrete choice experiment and consumption data. Discussion The health care costs of managing rising levels of obesity are a challenge for all governments. This study will provide a unique contribution to the international knowledge base by engaging a variety of robust research techniques, with a multidisciplinary focus and be responsive to consumers from diverse socio-economic backgrounds. PMID:24330325

The Addiction Benefits Scorecard: A Framework to Promote Health Insurer Accountability and Support Consumer Engagement.

PubMed

Danovitch, Itai; Kan, David

2017-01-01

Health care insurance plans covering treatment for substance use disorders (SUD) offer a wide range of benefits. Distinctions between health plan benefits are confusing, and consumers making selections may not adequately understand the characteristics or significance of the choices they have. The California Society of Addiction Medicine sought to help consumers make informed decisions about plan selections by providing education on the standard of care for SUD and presenting findings from an expert analysis of selected health plans. We developed an assessment framework, based on criteria endorsed by the American Society of Addiction Medicine, to rate the quality of SUD treatment benefits offered by a sample of insurance plans. We convened an expert panel of physicians to rate 16 policies of 10 insurance providers across seven categories. Data from published resources for 2014 insurance plans were extracted, categorized, and rated. The framework and ratings were summarized in a consumer-facing white paper. We found significant heterogeneity in benefits across comparable plans, as well as variation in the characterization and clarity of published services. This article presents findings and implications of the project. There is a pressing need to define requirements for SUD benefits and to hold health plans accountable for offering quality services in accordance with those benefits.

Consumer cost sharing in private health insurance: on the threshold of change.

PubMed

Goff, Veronica

2004-05-14

Employers are asking employees to pay more for health care through higher premium contributions, share of contribution, and out-of-pocket maximums, along with variations in deductibles, co-pays, and coinsurance based on choice of providers, networks, drugs, and other services. This issue brief examines consumer cost-sharing trends in private insurance, discusses the outlook for cost sharing in employment-based benefits, and considers public policies to support health care markets for consumers.

Insurance--a dental viewpoint. Part III: Life assurance, pensions and annuities.

PubMed

Green, A G

1994-09-10

The insurance market is complex and there can be serious taxation implications in many decisions. The tax aspect may be beneficial to the dentist or it can have serious consequences. The advice of independent experts in accountancy and insurance is often vital if catastrophic pitfalls are to be avoided.

The role of product design in consumers' choices in the individual insurance market.

PubMed

Marquis, M Susan; Buntin, Melinda Beeuwkes; Escarce, José J; Kapur, Kanika

2007-12-01

To evaluate the role of health plan benefit design and price on consumers' decisions to purchase health insurance in the nongroup market and their choice of plan. Administrative data from the three largest nongroup insurers in California and survey data about those insured in the nongroup market and the uninsured in California. We fit a nested logit model to examine the effects of plan characteristics on consumer choice while accounting for substitutability among certain groups of products. Product choice is quite sensitive to price. A 10 percent decrease in the price of a product would increase its market share by about 20 percent. However, a 10 percent decrease in prices of all products would only increase overall market participation by about 4 percent. Changes in the generosity of coverage will also affect product choice, but have only small effects on overall participation. A 20 percent decrease in the deductible or maximum out-of-pocket payment of all plans would increase participation by about 0.3-0.5 percent. Perceived information search costs and other nonprice barriers have substantial effects on purchase of nongroup coverage. Modest subsidies will have small effects on purchase in the nongroup market. New product designs with higher deductibles are likely to be more attractive to healthy purchasers, but the new benefit designs are likely to have only small effects on market participation. In contrast, consumer education efforts have a role to play in helping to expand coverage.

New York State oil company gross receipts taxation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, P.E., Jr.

1983-12-01

New York's Governor Cuomo was able to mediate a settlement with 18 major oil companies subject to gross receipts taxation. The compromise was intended to end three years of litigation and to assure a tax revenue flow to the state of hundreds of millions of dollars. It represents New York's effort to single out a handful of large national companies for special burdens and a final resolution of a dispute over the state's attempt to prevent these companies from passing through their tax liabilities to consumers in the prices of petroleum products. This article reviews oil company taxation in Newmore » York State and the effects of the recent accord. 95 references.« less

The Affordable Care Act's plan for consumer assistance with insurance moves states forward but remains a work in progress.

PubMed

Grob, Rachel; Schlesinger, Mark; Davis, Sarah; Cohen, Deborah; Lapps, Joshua

2013-02-01

The Affordable Care Act provides support for state-run consumer assistance programs to help privately insured consumers who experience problems with their coverage. Its provisions signify the first national commitment to such assistance and to using cases aggregated by these state programs to inform policy. We interviewed state-level administrators and analyzed program documents to assess whether federal support for state-run consumer assistance programs achieved certain goals. We found that some federally supported programs made substantial progress in supporting and empowering patients by reorienting state agencies to become active advocates for their citizens. Yet progress across the country was inconsistent, and there was little evidence that programs addressed systemic problems experienced by consumers. On balance, the consumer assistance provisions of health care reform do not yet ensure protection for all privately insured Americans because of uneven implementation-a problem likely to be of further concern as coverage is expanded and health insurance exchanges come on line in 2014. At the same time, the demonstrated impact of consumer assistance programs in the most innovative states is arguably a useful "proof of concept" for this young federal program.

The Role of Product Design in Consumers' Choices in the Individual Insurance Market

PubMed Central

Marquis, M Susan; Buntin, Melinda Beeuwkes; Escarce, José J; Kapur, Kanika

2007-01-01

Objective To evaluate the role of health plan benefit design and price on consumers' decisions to purchase health insurance in the nongroup market and their choice of plan. Data Sources and Study Setting Administrative data from the three largest nongroup insurers in California and survey data about those insured in the nongroup market and the uninsured in California. Study Design We fit a nested logit model to examine the effects of plan characteristics on consumer choice while accounting for substitutability among certain groups of products. Principal Findings Product choice is quite sensitive to price. A 10 percent decrease in the price of a product would increase its market share by about 20 percent. However, a 10 percent decrease in prices of all products would only increase overall market participation by about 4 percent. Changes in the generosity of coverage will also affect product choice, but have only small effects on overall participation. A 20 percent decrease in the deductible or maximum out-of-pocket payment of all plans would increase participation by about 0.3–0.5 percent. Perceived information search costs and other nonprice barriers have substantial effects on purchase of nongroup coverage. Conclusions Modest subsidies will have small effects on purchase in the nongroup market. New product designs with higher deductibles are likely to be more attractive to healthy purchasers, but the new benefit designs are likely to have only small effects on market participation. In contrast, consumer education efforts have a role to play in helping to expand coverage. PMID:17995560

Choice--Chance--Control. That's Life. Learning about Insurance through Secondary School Courses. Insurance Basics for Everyone; Social Sciences; Mathematics; Consumer Economics.

ERIC Educational Resources Information Center

Insurance Education Foundation, Indianapolis, IN.

This guide, which is designed for use with secondary school students, contains four units of activities that teach the fundamentals of insurance within the context of a broad range of subjects, including social sciences, history, civics, government, mathematics, consumer economics, business, economics, life skills, family management, home…

Consumer decision making in the individual health insurance market.

PubMed

Marquis, M Susan; Buntin, Melinda Beeuwkes; Escarce, José J; Kapur, Kanika; Louis, Thomas A; Yegian, Jill M

2006-01-01

This paper summarizes the results from a study of consumer decision making in California's individual health insurance market. We conclude that price subsidies will have only modest effects on participation and that efforts to reduce nonprice barriers might be just as effective. We also find that there is substantial pooling in the individual market and that it increases over time because people who become sick can continue coverage without new underwriting. Finally, we show that people prefer more-generous benefits and that it is difficult to induce people in poor health to enroll in high-deductible health plans.

Taxation of oil and gas revenues: the United States

DOE Office of Scientific and Technical Information (OSTI.GOV)

Verleger, P.K. Jr.

1982-04-01

The taxation of producers of natural resources in the United States is accomplished by a combination of ordinary-income taxation and ad valorem or severence taxes on the removal price of the resource. Taxes are imposed by both the federal and local governments. The federal government imposes both income and ad valorem taxes on the production of resources. State governments generally impose severance taxes based on the value of the resource removed. In addition, some states impose income taxes on the portion of income earned by a producer in the specific state. Recently, there have been serious disputes between resource-producing statesmore » and resource-consuming states over changes in state severance taxes. 3 references.« less

Informal Taxation*

PubMed Central

Olken, Benjamin A.; Singhal, Monica

2011-01-01

Informal payments are a frequently overlooked source of local public finance in developing countries. We use microdata from ten countries to establish stylized facts on the magnitude, form, and distributional implications of this “informal taxation.” Informal taxation is widespread, particularly in rural areas, with substantial in-kind labor payments. The wealthy pay more, but pay less in percentage terms, and informal taxes are more regressive than formal taxes. Failing to include informal taxation underestimates household tax burdens and revenue decentralization in developing countries. We discuss various explanations for and implications of these observed stylized facts. PMID:22199993

Oil taxation and risks

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rodriguez-Padilla, V.

1992-01-01

The relationship between the taxation system and the division of risks between the host country governments and the international companies is discussed. The analysis underscores the effect of taxation on the geological and political risks. These two cases are evaluated in two West-African oil-producing countries. It emerges from this that too heavy and regressive taxes greatly increase the risks supported by the two partners. The progressive character of the taxation is a necessary but not a sufficient condition for the reduction of public and private risks. A taxation burden well-balanced among small and large deposits is the best way tomore » reduce the risk due to taxation. The oil-producing countries of this region had made great advances in developing neutral taxation systems but in most cases they must progress further. 15 refs., 3 figs., 1 tab.« less

Spatial taxation effects on regional coal economic activities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, C.W.; Labys, W.C.

1980-01-01

Spatial taxation effects related to economic activities at the regional level can be directly evaluated using the Kuhn-Tucker system of equations based on a commodity model. In particular, the impacts of a specific tax are predictable within a given set of trade patterns. However, the impacts of an ad valorem tax are difficult to evaluate analytically, mainly because of nonlinearity in the associated response surface. The aspect of spatial-taxation analysis of present relevance for the coal industry related to coal policy, i.e., the share of tax burdens coal producers and consumers are able to bear. Each supplier in a givenmore » market boundary shares the same amount of tax burden, which may eliminate the weakest coal producers, i.e., Southern West Virginia coal mines. The same analogy also applies to the weakest demand region, i.e., Illinois, Wisconsin, and Minnesota utilities. Consequently, a proper policy requires that some preferential tax treatment be given to these regions. Since the taxation effects depend critically on the trade patterns and market boundaries, the successful policy application of present regional energy models will not be possible unless effects of this type are included in the evaluation.« less

Reference Pricing, Consumer Cost-Sharing, and Insurer Spending for Advanced Imaging Tests.

PubMed

Robinson, James C; Whaley, Christopher; Brown, Timothy T

2016-12-01

Fees charged for similar imaging tests often vary dramatically within the same market, leading to wide variation in insurer spending and consumer cost-sharing. Reference pricing is an insurance design that offers good coverage to patients up to a defined contribution limit but requires the patients who select high-priced facilities to pay the remainder out of pocket. To measure the association between implementation of reference pricing and patient choice of facility, test prices, out-of-pocket spending, and insurer spending for advanced imaging (CT and MRI) procedures. Difference-in-differences multivariable analysis of insurance claims data. Study included 4751 employees of a national grocery chain (treatment group) and 23,428 enrollees in the nation's largest private insurance plan (comparison group) that used CT or MRI tests between 2010 and 2013. Patient choice of facility, price paid per test, patient out-of-pocket cost-sharing, and employer spending. Compared with trends in prices paid by insurance enrollees not subject to reference pricing, and after adjusting for characteristics of tests and patients, implementation of reference pricing was associated with a 12.5% (95% CI, -25.0%, 2.1%) reduction in average price paid per test by the end of the second full year of the program for CT scans and a 10.5% (95% CI, -16.9%, 3.6%) for MRIs. Out-of-pocket cost-sharing by patients declined by $71,508 (13.8%). The savings accruing to employees amounted to 45.5% of total savings from reference pricing, with the remainder accruing to the employer. Implementation of reference pricing led to reductions in payments by both employer and employees.

Smart Choice Health Insurance©: A New, Interdisciplinary Program to Enhance Health Insurance Literacy.

PubMed

Brown, Virginia; Russell, Mia; Ginter, Amanda; Braun, Bonnie; Little, Lynn; Pippidis, Maria; McCoy, Teresa

2016-03-01

Smart Choice Health Insurance© is a consumer education program based on the definition and emerging measurement of health insurance literacy and a review of literature and appropriate theoretical frameworks. An interdisciplinary team of financial and health educators was formed to develop and pilot the program, with the goal of reducing confusion and increasing confidence in the consumer's ability to make a smart health insurance decision. Educators in seven states, certified to teach the program, conducted workshops for 994 consumers. Results show statistically significant evidence of increased health insurance literacy, confidence, and capacity to make a smart choice health insurance choice. Discussion centers on the impact the program had on specific groups, next steps to reach a larger audience, and implications for educators, consumers, and policymakers nationwide. © 2015 Society for Public Health Education.

Understanding consumers' preferences and decision to enrol in community-based health insurance in rural West Africa.

PubMed

De Allegri, Manuela; Sanon, Mamadou; Bridges, John; Sauerborn, Rainer

2006-03-01

This paper presents a qualitative investigation of consumers' preferences regarding the single elements of a community-based health insurance (CBI) scheme recently implemented in a rural region in west Africa. The aim is to provide adequate policy-guidance to decision makers in low and middle income countries by producing an in-depth understanding of how consumers' preferences may affect decision to participate in such schemes. Although it has long been suggested that feeble levels of participation may very well be an expression of consumers' dissatisfaction with scheme design, little systematic efforts have so far been channelled towards supporting such argument with empirical evidence. Consumers' preferences were explored through means of 32 individual interviews with household heads. Analysis used the method of constant comparison and was conducted by two independent researchers. Data from 10 focus group discussions provided an additional valuable source of triangulation. Findings suggest that decision to enrol is closely linked to whether the single elements of the scheme match consumers' needs and expectations. In particular, consumers justified decision to join or not to join the insurance scheme in relation to their preference for the unit of enrolment, the premium level and the payment modalities, the benefit package, the health service provider network and the CBI managerial structure. The discussion of the findings focuses on how understanding consumers' preferences and incorporating them in the design of a CBI scheme may result in increased participation rates, ensuring that poor populations gain better access to health services and enjoy greater protection against the cost of illness.

26 CFR 1.61-22 - Taxation of split-dollar life insurance arrangements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... interest in a life insurance contract (or, if later, at the time such transfer is taxable under section 83... the other party that is secured by the life insurance contract; (ii) At least one of the parties to... persons are named as policy owners of a life insurance contract and each person has, at all times, all the...

Copayments and Consumer Search: Increasing Competition in Medicare and Other Insured Medical Markets

PubMed Central

Cantwell, James R.

1981-01-01

Between 1950 and 1980, the physician fee component of the Consumer Price Index (CPI) rose 488 percent. In contrast, an index of physician fees adjusted for 1) overall inflation, and 2) the declining proportion which is paid out-of-pocket by the patient, declined over the same 30-year period. This last observation, pointing to the erosion of the market, is important for structuring price competition for physician services. For insured patients, out-of-pocket payments arise from deductibles, coinsurance and limits, each of which is briefly discussed in this article. Following a review of Medicare Part B physician reimbursement, the paper shows that limits can be used to strengthen the incentive which insured patients have to search for less expensive medical care. PMID:10309559

Could a tax on unhealthy products sold for weight loss reduce consumer use? A novel estimation of potential taxation effects.

PubMed

Bryn Austin, S; Liu, Selena Hua; Tefft, Nathan

2018-05-26

Abuse of widely available, over-the-counter (OTC) drugs and supplements such as diet pills, laxatives, and diuretics by adolescents for weight control is well-documented, yet manufacturers and retailers can sell them to minors without restriction. The aim of our study was to estimate the effect of added taxation of OTC drugs and dietary supplements sold for weight loss on household purchases of these products. With data from 60,538 U.S. households in the 2012 waves of the Nielsen/IRi National Consumer Panel (NCP) and the Nielsen/IRi Retail Scanner (NRS) datasets, we conducted analyses in 2017 to tally annual quantities and expenditures on OTC drugs or dietary supplements making weight-loss, cleanse/detox, or diuretic claims. We estimated the percent reduction in household purchases due to a simulated 20% added tax on each category. Among the 14,151 households reporting at least one purchase in the three claims categories, a 20% higher average price of weight-loss products was associated with a 5.2% lower purchases of those products. Among households with children ages 12 to 17 years old present, purchases were 17.5% lower, and among households with a daughter present, purchases were 10.3% lower. Taxation may be an effective public health strategy to reduce purchasing of potentially dangerous OTC drugs and supplements sold for weight loss, especially for households that include children ages 12-17 years old or a daughter. Copyright © 2017. Published by Elsevier Inc.

Consumer-directed health care for persons under 65 years of age with private health insurance: United States, 2007.

PubMed

Cohen, Robin A; Martinez, Michael E

2009-03-01

Data from the National Health Interview Survey. In 2007, 17.3% of persons under 65 years of age with private health insurance were enrolled in a high deductible health plan (HDHP), 4.5% were enrolled in a consumer-directed health plan (CDHP), and 14.8% were in a family with a flexible spending account for medical expenses (FSA); Persons with directly purchased private health insurance were more likely to be enrolled in a high deductible plan than those who obtained their private health insurance through an employer or union; Higher incomes and higher educational attainment were associated with greater uptake and enrollment in HDHPs, CDHPs, and FSAs. National attention to consumer-directed health care has increased following the enactment of the Medicare Prescription Drug Improvement and Modernization Act of 2003 (P.L. 108-173), which established tax-advantaged health savings accounts (1). Consumer-directed health care enables individuals to have more control over when and how they access care, what types of care they use, and how much they spend on health care services. This report includes estimates of three measures of consumer-directed private health care. Estimates for 2007 are provided for enrollment in high deductible health plans (HDHPs), plans with high deductibles coupled with health savings accounts also known as consumer-directed health plans (CDHPs), and the percentage of individuals with private coverage whose family has a flexible spending account (FSA) for medical expenses, by selected sociodemographic characteristics. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

12 CFR 810.5 - Taxation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Taxation. 810.5 Section 810.5 Banks and Banking FEDERAL FINANCING BANK FEDERAL FINANCING BANK BILLS § 810.5 Taxation. All FFB bills shall be subject to Federal taxation to the same extent as obligations of private corporations are taxed. ...

12 CFR 810.5 - Taxation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Taxation. 810.5 Section 810.5 Banks and Banking FEDERAL FINANCING BANK FEDERAL FINANCING BANK BILLS § 810.5 Taxation. All FFB bills shall be subject to Federal taxation to the same extent as obligations of private corporations are taxed. ...

Are Alcohol Taxation and Pricing Policies Regressive? Product-Level Effects of a Specific Tax and a Minimum Unit Price for Alcohol.

PubMed

Vandenberg, Brian; Sharma, Anurag

2016-07-01

To compare estimated effects of two policy alternatives, (i) a minimum unit price (MUP) for alcohol and (ii) specific (per-unit) taxation, upon current product prices, per capita spending (A$), and per capita consumption by income quintile, consumption quintile and product type. Estimation of baseline spending and consumption, and modelling policy-to-price and price-to-consumption effects of policy changes using scanner data from a panel of demographically representative Australian households that includes product-level details of their off-trade alcohol spending (n = 885; total observations = 12,505). Robustness checks include alternative price elasticities, tax rates, minimum price thresholds and tax pass-through rates. Current alcohol taxes and alternative taxation and pricing policies are not highly regressive. Any regressive effects are small and concentrated among heavy consumers. The lowest-income consumers currently spend a larger proportion of income (2.3%) on alcohol taxes than the highest-income consumers (0.3%), but the mean amount is small in magnitude [A$5.50 per week (95%CI: 5.18-5.88)]. Both a MUP and specific taxation will have some regressive effects, but the effects are limited, as they are greatest for the heaviest consumers, irrespective of income. Among the policy alternatives, a MUP is more effective in reducing consumption than specific taxation, especially for consumers in the lowest-income quintile: an estimated mean per capita reduction of 11.9 standard drinks per week (95%CI: 11.3-12.6). Policies that increase the cost of the cheapest alcohol can be effective in reducing alcohol consumption, without having highly regressive effects. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

31 CFR 316.9 - Taxation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Taxation. 316.9 Section 316.9 Money... Taxation. (a) General. For the purpose of determining taxes and tax exemptions, the increment in value..., whether Federal or State, but are exempt from all other taxation now or hereafter imposed on the principal...

31 CFR 346.13 - Taxation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Taxation. 346.13 Section 346.13 Money... BONDS § 346.13 Taxation. The tax treatment provided under section 409 of the Internal Revenue Code of..., inheritance, or other excise taxes, whether Federal or State, but are exempt from all taxation now or...

31 CFR 341.13 - Taxation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Taxation. 341.13 Section 341.13 Money... § 341.13 Taxation. The tax treatment provided under section 405 of the Internal Revenue Code of 1954... taxes whether Federal or State, but are exempt from all taxation now or hereafter imposed on the...

31 CFR 341.13 - Taxation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Taxation. 341.13 Section 341.13 Money... § 341.13 Taxation. The tax treatment provided under section 405 of the Internal Revenue Code of 1954... taxes whether Federal or State, but are exempt from all taxation now or hereafter imposed on the...

31 CFR 346.13 - Taxation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Taxation. 346.13 Section 346.13 Money... BONDS § 346.13 Taxation. The tax treatment provided under section 409 of the Internal Revenue Code of..., inheritance, or other excise taxes, whether Federal or State, but are exempt from all taxation now or...

31 CFR 316.9 - Taxation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Taxation. 316.9 Section 316.9 Money... Taxation. (a) General. For the purpose of determining taxes and tax exemptions, the increment in value..., whether Federal or State, but are exempt from all other taxation now or hereafter imposed on the principal...

31 CFR 340.3 - Taxation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Taxation. 340.3 Section 340.3 Money... COMPETITIVE BIDDING § 340.3 Taxation. The income derived from the bonds will be subject to all taxes imposed... excise taxes, whether Federal or State, but will be exempt from all taxation now or hereafter imposed on...

31 CFR 309.4 - Taxation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Taxation. 309.4 Section 309.4 Money... OF THE TREASURY BUREAU OF THE PUBLIC DEBT ISSUE AND SALE OF TREASURY BILLS § 309.4 Taxation. The... taxes, whether Federal or State, but shall be exempt from all taxation now or hereafter imposed on the...

31 CFR 345.5 - Taxation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Taxation. 345.5 Section 345.5 Money... INDEBTEDNESS-R.E.A. SERIES § 345.5 Taxation. The income derived from the certificates is subject to all taxes... or other excise taxes, whether Federal or State, but are exempt from all taxation now or hereafter...

31 CFR 332.9 - Taxation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Taxation. 332.9 Section 332.9 Money... Taxation. The income derived from Series H bonds is subject to all taxes imposed under the Internal Revenue..., whether Federal or State, but are exempt from all other taxation now or hereafter imposed on the principal...

31 CFR 352.10 - Taxation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Taxation. 352.10 Section 352.10 Money... Taxation. The interest paid on Series HH bonds is subject to all taxes imposed under the Internal Revenue..., whether Federal or State, but are exempt from all taxation now or hereafter imposed on the principal or...

31 CFR 342.6 - Taxation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Taxation. 342.6 Section 342.6 Money... OF THE TREASURY BUREAU OF THE PUBLIC DEBT OFFERING OF UNITED STATES SAVINGS NOTES § 342.6 Taxation..., whether Federal or State, but are exempt from all other taxation now or hereafter imposed on the principal...

31 CFR 352.10 - Taxation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Taxation. 352.10 Section 352.10 Money... Taxation. The interest paid on Series HH bonds is subject to all taxes imposed under the Internal Revenue..., whether Federal or State, but are exempt from all taxation now or hereafter imposed on the principal or...

31 CFR 342.6 - Taxation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Taxation. 342.6 Section 342.6 Money... OF THE TREASURY BUREAU OF THE PUBLIC DEBT OFFERING OF UNITED STATES SAVINGS NOTES § 342.6 Taxation..., whether Federal or State, but are exempt from all other taxation now or hereafter imposed on the principal...

31 CFR 332.9 - Taxation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Taxation. 332.9 Section 332.9 Money... Taxation. The income derived from Series H bonds is subject to all taxes imposed under the Internal Revenue..., whether Federal or State, but are exempt from all other taxation now or hereafter imposed on the principal...

31 CFR 309.4 - Taxation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Taxation. 309.4 Section 309.4 Money... OF THE TREASURY BUREAU OF THE PUBLIC DEBT ISSUE AND SALE OF TREASURY BILLS § 309.4 Taxation. The... taxes, whether Federal or State, but shall be exempt from all taxation now or hereafter imposed on the...

31 CFR 345.5 - Taxation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Taxation. 345.5 Section 345.5 Money... INDEBTEDNESS-R.E.A. SERIES § 345.5 Taxation. The income derived from the certificates is subject to all taxes... or other excise taxes, whether Federal or State, but are exempt from all taxation now or hereafter...

31 CFR 340.3 - Taxation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Taxation. 340.3 Section 340.3 Money... COMPETITIVE BIDDING § 340.3 Taxation. The income derived from the bonds will be subject to all taxes imposed... excise taxes, whether Federal or State, but will be exempt from all taxation now or hereafter imposed on...

Individual insurance: health insurers try to tap potential market growth.

PubMed

November, Elizabeth A; Cohen, Genna R; Ginsburg, Paul B; Quinn, Brian C

2009-11-01

Individual insurance is the only source of health coverage for people without access to employer-sponsored insurance or public insurance. Individual insurance traditionally has been sought by older, sicker individuals who perceive the need for insurance more than younger, healthier people. The attraction of a sicker population to the individual market creates adverse selection, leading insurers to employ medical underwriting--which most states allow--to either avoid those with the greatest health needs or set premiums more reflective of their expected medical use. Recently, however, several factors have prompted insurers to recognize the growth potential of the individual market: a declining proportion of people with employer-sponsored insurance, a sizeable population of younger, healthier people forgoing insurance, and the likelihood that many people receiving subsidies to buy insurance under proposed health insurance reforms would buy individual coverage. Insurers are pursuing several strategies to expand their presence in the individual insurance market, including entering less-regulated markets, developing lower-cost, less-comprehensive products targeting younger, healthy consumers, and attracting consumers through the Internet and other new distribution channels, according to a new study by the Center for Studying Health System Change (HSC). Insurers' strategies in the individual insurance market are unlikely to meet the needs of less-than-healthy people seeking affordable, comprehensive coverage. Congressional health reform proposals, which envision a larger role for the individual market under a sharply different regulatory framework, would likely supersede insurers' current individual market strategies.

Taxation as prevention and as a treatment for obesity: the case of sugar-sweetened beverages.

PubMed

Novak, Nicole L; Brownell, Kelly D

2011-01-01

The contemporary American food environment makes energy-dense, nutrient-poor foods and beverages the "default" option for most consumers. Economic interventions like taxes can shift the relative prices of unhealthy foods to nudge consumers towards healthier options. Beverages with added sugar are a good starting point for food taxation; they constitute over 10 percent of caloric intake nationwide and provide little or no nutritional value. Current levels of taxation on sugar-sweetened beverages (SSBs) are too low to affect consumer behavior, but the implementation of a penny-per-ounce excise tax could lead to substantial public health benefits. Current estimates predict that a tax that raised the cost of SSBs by 20 percent could lead to an average reduction of 3.8 pounds per year for adults, causing the prevalence of obesity to decline from 33 to 30 percent. SSB taxes would also generate considerable revenue for public health and obesity prevention programs. Although the beverage industry is fighting such taxes with massive lobbying and public relations campaigns, support for the policies is increasing, especially when revenue is earmarked for obesity prevention.

Cost-effectiveness of volumetric alcohol taxation in Australia.

PubMed

Byrnes, Joshua M; Cobiac, Linda J; Doran, Christopher M; Vos, Theo; Shakeshaft, Anthony P

2010-04-19

To estimate the potential health benefits and cost savings of an alcohol tax rate that applies equally to all alcoholic beverages based on their alcohol content (volumetric tax) and to compare the cost savings with the cost of implementation. Mathematical modelling of three scenarios of volumetric alcohol taxation for the population of Australia: (i) no change in deadweight loss, (ii) no change in tax revenue, and (iii) all alcoholic beverages taxed at the same rate as spirits. Estimated change in alcohol consumption, tax revenue and health benefit. The estimated cost of changing to a volumetric tax rate is $18 million. A volumetric tax that is deadweight loss-neutral would increase the cost of beer and wine and reduce the cost of spirits, resulting in an estimated annual increase in taxation revenue of $492 million and a 2.77% reduction in annual consumption of pure alcohol. The estimated net health gain would be 21 000 disability-adjusted life-years (DALYs), with potential cost offsets of $110 million per annum. A tax revenue-neutral scenario would result in an 0.05% decrease in consumption, and a tax on all alcohol at a spirits rate would reduce consumption by 23.85% and increase revenue by $3094 million [corrected]. All volumetric tax scenarios would provide greater health benefits and cost savings to the health sector than the existing taxation system, based on current understandings of alcohol-related health effects. An equalized volumetric tax that would reduce beer and wine consumption while increasing the consumption of spirits would need to be approached with caution. Further research is required to examine whether alcohol-related health effects vary by type of alcoholic beverage independent of the amount of alcohol consumed to provide a strong evidence platform for alcohol taxation policies.

A typology of beverage taxation: Multiple approaches for obesity prevention and obesity prevention-related revenue generation

PubMed Central

Chriqui, Jamie F; Chaloupka, Frank J; Powell, Lisa M; Eidson, Shelby S

2013-01-01

Obesity is a global problem. Sugar-sweetened beverages (SSB) are a leading contributor of added sugars in individual diets and thus to obesity. Governments have considered taxing SSBs to prevent obesity and generate revenue, but no ‘one-size-fits-all' taxation approach exists. We describes three key considerations for governments interested in exploring beverage taxation: (i) what type of tax to apply plus how and where the tax is collected and presented to consumers; (ii) what types of beverages to tax; and (iii) the amount of tax needed to affect consumption and/or obesity prevention-related revenue generation. We offer examples of existing beverage taxes in the United States and internationally. The information will be useful to policymakers at all levels of government, as they continue to consider beverage taxation policies. PMID:23698157

A typology of beverage taxation: multiple approaches for obesity prevention and obesity prevention-related revenue generation.

PubMed

Chriqui, Jamie F; Chaloupka, Frank J; Powell, Lisa M; Eidson, Shelby S

2013-08-01

Obesity is a global problem. Sugar-sweetened beverages (SSB) are a leading contributor of added sugars in individual diets and thus to obesity. Governments have considered taxing SSBs to prevent obesity and generate revenue, but no 'one-size-fits-all' taxation approach exists. We describes three key considerations for governments interested in exploring beverage taxation: (i) what type of tax to apply plus how and where the tax is collected and presented to consumers; (ii) what types of beverages to tax; and (iii) the amount of tax needed to affect consumption and/or obesity prevention-related revenue generation. We offer examples of existing beverage taxes in the United States and internationally. The information will be useful to policymakers at all levels of government, as they continue to consider beverage taxation policies.

Association of Reference Payment for Colonoscopy With Consumer Choices, Insurer Spending, and Procedural Complications.

PubMed

Robinson, James C; Brown, Timothy T; Whaley, Christopher; Finlayson, Emily

2015-11-01

Regulatory limits on consumer cost sharing permit wide variation in the prices charged for screening and diagnostic tests such as colonoscopy. Employers are experimenting with reference payment initiatives that offer full insurance coverage at low-priced facilities but require substantial cost sharing if patients select high-priced alternatives. To ascertain the effect of reference payment on facility choice, insurer spending, consumer cost sharing, and procedural complications for colonoscopy. The California Public Employees' Retirement System (CalPERS) implemented reference payment in January 2012. We obtained data on 21 644 CalPERS enrollees who underwent colonoscopy in the 3 years prior to implementation and on 13 551 patients in the 2 years after implementation. Control group data were obtained on 258 616 Anthem Blue Cross enrollees who underwent colonoscopy and who were not subject to reference payment initiatives during this 5-year period. Consumer choice of facility, price paid per procedure, total insurer spending, consumer cost sharing, and procedural complications. Choices, prices, and complications were compared for CalPERS and Anthem patients before and after implementation of reference payments, using difference-in-difference multivariable regressions to adjust for patient demographic characteristics and comorbidities, procedure indications, and geographic location. Utilization of low-priced facilities for CalPERS members increased from 68.6% in 2009 to 90.5% in 2013. After adjusting for patient demographic characteristics, comorbidities, and other factors, the implementation of reference payment increased use of low-priced facilities by 17.6 percentage points (95% CI, 11.8 to 23.4; P < .001). The mean price paid for colonoscopy for the CalPERS population increased from $1587 (95% CI, $1555-$1618) in 2009 to $1716 (95% CI, $1678-$1753) in 2011 and then decreased to $1508 (95% CI, $1469-$1548) in 2013 for patients subject to reference payment

Consumer Health Insurance Shopping Behavior and Challenges: Lessons From Two State-Based Marketplaces.

PubMed

Sinaiko, Anna D; Kingsdale, Jon; Galbraith, Alison A

2017-07-01

Selecting a health plan in a health insurance exchange is a critical decision, yet consumers are known to face challenges with health plan choice. We surveyed new enrollees in two state-based exchanges in 2015 to investigate how a nonelderly, primarily low-income population chose their health plans and the implications of shopping behavior for early experiences in their plans. Financial considerations were most important to enrollees. Prior Medicaid enrollees and the uninsured were more likely to have multiple shopping challenges (e.g., difficulty identifying the best or most affordable plan, fair/poor experience, unmet need for help) than enrollees with prior employer coverage (42.9% vs. 32.5% vs. 16.4%, respectively, p < .01). Shopping challenges were associated with difficulty finding a doctor, understanding coverage, and getting questions answered. Assistance targeting enrollees who previously had Medicaid or lacked insurance could improve both shopping experiences and downstream outcomes in plans.

Diabetes in employer-sponsored health insurance.

PubMed

Peele, Pamela B; Lave, Judith R; Songer, Thomas J

2002-11-01

To examine medical and mental health care expenditures for large numbers of individuals with diabetes enrolled in employment-sponsored insurance plans. Health insurance billing data for approximately 1.3 million individuals enrolled in health insurance plans sponsored by 862 large self-insured employers nationwide were used to examine employer expenditures and consumer out-of-pocket payments for 20,937 people identified with diabetes. These expenditures were compared with expenditures for individuals with other chronic illnesses. Main outcome measures were covered charges, insurance plan reimbursements, and estimated consumer out-of-pocket payments for both medical and mental health services. A total of 1.7% of enrollees were identified as having diabetes and approximately 11% of those used at least one mental health service during 1996. Health care expenditures were three times higher for those with diabetes compared with all health care consumers in these insurance plans, but when compared with individuals with other chronic illnesses such as heart disease, HIV/AIDS, cancer, and asthma, those with diabetes were not more expensive for employers' insurance plans. Diabetes accounts for 6.5% of total health plan expenditures. Diabetes is not more expensive for either consumers or their employer-sponsored insurance plans than other chronic illnesses.

Taxation and the American Indian

ERIC Educational Resources Information Center

Brunt, David

1973-01-01

The article explores American Indian tribal rights to tax exemptions and self-imposed taxation; general recommendations on possible tribal tax alternatives; and evaluation of the probable economic effect of taxation. (FF)

State insurance exchanges face challenges in offering standardized choices alongside innovative value-based insurance.

PubMed

Corlette, Sabrina; Downs, David; Monahan, Christine H; Yondorf, Barbara

2013-02-01

Value-based insurance is a relatively new approach to health insurance in which financial barriers, such as copayments, are lowered for clinical services that are considered high value, while consumer cost sharing may be increased for services considered to be of uncertain value. Such plans are complex and do not easily fit into the simplified, consumer-friendly comparison tools that many state health insurance exchanges are formulating for use in 2014. Nevertheless some states and plans are attempting to strike the right balance between a streamlined health exchange shopping experience and innovative, albeit complex, benefit design that promotes value. For example, agencies administering exchanges in Vermont and Oregon are contemplating offering value-based insurance plans as an option in addition to a set of standardized plans. In the postreform environment, policy makers must find ways to present complex value-based insurance plans in a way that consumers and employers can more readily understand.

Progressive taxation, income inequality, and happiness.

PubMed

Oishi, Shigehiro; Kushlev, Kostadin; Schimmack, Ulrich

2018-01-01

Income inequality has become one of the more widely debated social issues today. The current article explores the role of progressive taxation in income inequality and happiness. Using historical data in the United States from 1962 to 2014, we found that income inequality was substantially smaller in years when the income tax was more progressive (i.e., a higher tax rate for higher income brackets), even when controlling for variables like stock market performance and unemployment rate. Time lag analyses further showed that higher progressive taxation predicted increasingly lower income inequality up to 5 years later. Data from the General Social Survey (1972-2014; N = 59,599) with U.S. residents (hereafter referred to as "Americans") showed that during years with higher progressive taxation rates, less wealthy Americans-those in the lowest 40% of the income distribution-tended to be happier, whereas the richest 20% were not significantly less happy. Mediational analyses confirmed that the association of progressive taxation with the happiness of less wealthy Americans can be explained by lower income inequality in years with higher progressive taxation. A separate sample of Americans polled online (N = 373) correctly predicted the positive association between progressive taxation and the happiness of poorer Americans but incorrectly expected a strong negative association between progressive taxation and the happiness of richer Americans. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Health Insurance as a Two-Part Pricing Contract *

PubMed Central

Lakdawalla, Darius; Sood, Neeraj

2013-01-01

Monopolies appear throughout health care. We show that health insurance operates like a conventional two-part pricing contract that allows monopolists to extract profits without inefficiently constraining quantity. When insurers are free to offer a range of insurance contracts to different consumer types, health insurance markets perfectly eliminate deadweight losses from upstream health care monopolies. Frictions limiting the sorting of different consumer types into different insurance contracts restore some of these upstream monopoly losses, which manifest as higher rates of uninsurance, rather than as restrictions in quantity utilized by insured consumers. Empirical analysis of pharmaceutical patent expiration supports the prediction that heavily insured markets experience little or no efficiency loss under monopoly, while less insured markets exhibit behavior more consistent with the standard theory of monopoly. PMID:23997354

26 CFR 509.120 - Double taxation claims.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 19 2010-04-01 2010-04-01 false Double taxation claims. 509.120 Section 509.120... CONVENTIONS SWITZERLAND General Income Tax § 509.120 Double taxation claims. (a) General. Under Article XVII... United States or Switzerland has resulted, or will result, in double taxation contrary to the provisions...

26 CFR 509.120 - Double taxation claims.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 19 2011-04-01 2010-04-01 true Double taxation claims. 509.120 Section 509.120... CONVENTIONS SWITZERLAND General Income Tax § 509.120 Double taxation claims. (a) General. Under Article XVII... United States or Switzerland has resulted, or will result, in double taxation contrary to the provisions...

Energy taxation: an analysis of selected taxes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1980-01-01

Taxation is a key instrument by which governments affect economic decision making and outcomes. Not surprisingly, energy taxation has received considerable attention in recent years with the mounting concern over national energy policy. As with other policy instruments, the taxation of energy production and use spans a wide array of topics. It also cuts across other instruments because it affects the entire spectrum of economic variables - prices, outputs, investments, uses, and so on. As a result, the subject of energy taxation constitutes a highly complex set of issues for public policy. This report examines the principal components of thatmore » set of issues. In the process, it points out the most-important interrelations among the various taxes and between taxation and other policy instruments.« less

Medicalization, markets and consumers.

PubMed

Conrad, Peter; Leiter, Valerie

2004-01-01

This paper examines the impact of changes in the medical marketplace on medicalization in U.S. society. Using four cases (Viagra, Paxil, human growth hormone and in vitro fertilization), we focus on two aspects of the changing medical marketplace: the role of direct-to-consumer advertising of prescription drugs and the emergence of private medical markets. We demonstrate how consumers and pharmaceutical corporations contribute to medicalization, with physicians, insurance coverage, and changes in regulatory practices playing facilitating roles. In some cases, insurers attempt to counteract medicalization by restricting access. We distinguish mediated and private medical markets, each characterized by differing relationships with corporations, insurers, consumers, and physicians. In the changing medical environment, with medical markets as intervening factors, corporations and insurers are becoming more significant determinants in the medicalization process.

12 CFR 343.50 - Where insurance activities may take place.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF GENERAL POLICY CONSUMER PROTECTION IN SALES OF INSURANCE § 343.50 Where insurance activities may... consumer who seeks to purchase an insurance product or annuity to a qualified person who sells that product...

The global context for public health nutrition taxation.

PubMed

Thow, Anne Marie; Heywood, Peter; Leeder, Stephen; Burns, Lee

2011-01-01

To assess critically the scope for public health nutrition taxation within the framework of the global tax reform agenda. Review of the tax policy literature for global policy priorities relevant to public health nutrition taxation; critical analysis of proposals for public health nutrition taxation judged against the global agenda for tax reform. The global tax reform agenda shapes decisions of tax policy makers in all countries. By understanding this agenda, public health nutritionists can make feasible taxation proposals and thus improve the development, uptake and implementation of recommendations for nutrition-related taxation. The priorities of the global tax reform agenda relevant to public health nutrition taxation are streamlining of taxes, adoption of value-added tax (VAT), minimisation of excise taxes (except to correct for externalities) and removal of import taxes in line with trade liberalisation policies. Proposals consistent with the global tax reform agenda have included excise taxes, extension of VAT to currently exempted (unhealthy) foods and tariff reductions for healthy foods. Proposals for public health nutrition taxation should (i) use existing types and rates of taxes where possible, (ii) use excise taxes that specifically address externalities, (iii) avoid differential VAT on foods and (iv) use import taxes in ways that comply with trade liberalisation priorities.

Taxation of mineral resources

DOE Office of Scientific and Technical Information (OSTI.GOV)

Conrad, R.F.; Hool, R.B.

1980-01-01

There has been a substantial increase in recent years in the level of taxation imposed on mining firms by state and local governments. This increase can be attributed to three factors: (1) a heightened awareness that resources are limited in quantity; (2) environmental damage resulting from mining operations has brought demands for just compensations; and (3) significant price increases for some minerals have often been viewed by states as an opportunity to collect additional tax revenue. The broad aim of this book is to provide a comprehensive economic analysis of the effects of mining taxation on the extraction of mineralmore » resources and to offer a set of recommendations for tax policy. The primary objective of this design is to minimize the distortionary incentives created by the taxation. From a practical standpoint, however, one must also recognize the degrees of difficulty in the administration of the various taxes. 90 references, 1 figure, 14 tables.« less

Taxation and Its Effect Upon Public and Private Health Insurance and Medical Demand

PubMed Central

Greenspan, Nancy T.; Vogel, Ronald J.

1980-01-01

Multiple tax subsidies are available to many buyers and sellers of health insurance. These subsidies have the potential of creating excess demand for health insurance, which in turn can create excess demand for health services. A review of the literature on the effects of the tax subsidies on the price of health care shows that these subsidies, by raising prices in the medical sector, constrain the Medicare and Medicaid programs' ability to provide access to care for their beneficiaries. PMID:10309222

Influence of simplified nutrition labeling and taxation on laboratory energy intake in adults.

PubMed

Temple, Jennifer L; Johnson, Karena M; Archer, Kelli; Lacarte, Allison; Yi, Christina; Epstein, Leonard H

2011-08-01

The purpose of these studies was to test the hypotheses that simplified nutrition labeling and taxation alter food selection and intake. In Experiment 1, participants consumed lunch in the laboratory three times with no labels, standard nutrition labels, or traffic light diet labels at each visit. In Experiment 2, participants were given $6.00 with which to purchase lunch in the laboratory twice with standard pricing on one visit and a 25% tax on "red" foods on another visit. Participants received a brief education session on the labeling systems being used. Total energy intake and energy intake and number of foods purchased from each traffic light category were measured. Nutrition labeling decreased energy intake in lean females, but had no effect in men or in obese females. Traffic light labels increased consumption of "green" foods and decreased consumption of "red" foods. Taxation decreased the purchasing of "red" foods in obese, but not non-obese participants. There were no interactions between taxation and simplified nutrition labeling. Although generalization to real-world purchasing and consumption is limited by the laboratory study design, our findings suggests that taking multiple, simultaneous approaches to reduce energy intake may have the greatest impact on food purchases and/or nutrient consumption. Copyright © 2011 Elsevier Ltd. All rights reserved.

Regulated Medicare Advantage And Marketplace Individual Health Insurance Markets Rely On Insurer Competition.

PubMed

Frank, Richard G; McGuire, Thomas G

2017-09-01

Two important individual health insurance markets-Medicare Advantage and the Marketplaces-are tightly regulated but rely on competition among insurers to supply and price health insurance products. Many local health insurance markets have little competition, which increases prices to consumers. Furthermore, both markets are highly subsidized in ways that can exacerbate the impact of market power-that is, the ability to set price above cost-on health insurance prices. Policy makers need to foster robust competition in both sectors and avoid designing subsidies that make the market-power problem worse. Project HOPE—The People-to-People Health Foundation, Inc.

Supplementary insurance as a switching cost for basic health insurance: Empirical results from the Netherlands.

PubMed

Willemse-Duijmelinck, Daniëlle M I D; van de Ven, Wynand P M M; Mosca, Ilaria

2017-10-01

Nearly everyone with a supplementary insurance (SI) in the Netherlands takes out the voluntary SI and the mandatory basic insurance (BI) from the same health insurer. Previous studies show that many high-risks perceive SI as a switching cost for BI. Because consumers' current insurer provides them with a guaranteed renewability, SI is a switching cost if insurers apply selective underwriting to new applicants. Several changes in the Dutch health insurance market increased insurers' incentives to counteract adverse selection for SI. Tools to do so are not only selective underwriting, but also risk rating and product differentiation. If all insurers use the latter tools without selective underwriting, SI is not a switching cost for BI. We investigated to what extent insurers used these tools in the periods 2006-2009 and 2014-2015. Only a few insurers applied selective underwriting: in 2015, 86% of insurers used open enrolment for all their SI products, and the other 14% did use open enrolment for their most common SI products. As measured by our indicators, the proportion of insurers applying risk rating or product differentiation did not increase in the periods considered. Due to the fear of reputation loss insurers may have used 'less visible' tools to counteract adverse selection that are indirect forms of risk rating and product differentiation and do not result in switching costs. So, although many high-risks perceive SI as a switching cost, most insurers apply open enrolment for SI. By providing information to high-risks about their switching opportunities, the government could increase consumer choice and thereby insurers' incentives to invest in high-quality care for high-risks. Copyright © 2017 Elsevier B.V. All rights reserved.

12 CFR 208.85 - Where insurance activities may take place.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SYSTEM MEMBERSHIP OF STATE BANKING INSTITUTIONS IN THE FEDERAL RESERVE SYSTEM (REGULATION H) Consumer Protection in Sales of Insurance § 208.85 Where insurance activities may take place. (a) General rule. A bank... transactions are routinely conducted in the bank may refer a consumer who seeks to purchase an insurance...

12 CFR 536.50 - Where insurance activities may take place.

Code of Federal Regulations, 2010 CFR

2010-01-01

....50 Section 536.50 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY CONSUMER PROTECTION IN SALES OF INSURANCE § 536.50 Where insurance activities may take place. (a) General rule. A... savings association may refer a consumer who seeks to purchase an insurance product or annuity to a...

Health Insurance Literacy: How People Understand and Make Health Insurance Purchase Decisions

ERIC Educational Resources Information Center

Vardell, Emily Johanna

2017-01-01

The concept of health insurance literacy, which can be defined as "the extent to which consumers can make informed purchase and use decisions" (Kim, Braun, & Williams, 2013, p. 3), has only recently become a focus of health literacy research. Though employees have been making health insurance decisions for many years, the Affordable…

Insuring Your Property. The CIRcular: Consumer Information Report 29.

ERIC Educational Resources Information Center

Bank of America NT & SA, San Francisco, CA.

This report presents guidelines to help homeowners, renters, and condominium owners purchase and maintain adequate insurance coverage for their residences and personal property. Types of property coverage discussed include the following: (1) standard policies and exclusions; (2) special programs (earthquake insurance, federal programs for…

Dynamics of social health insurance development: examining the determinants of Chinese basic health insurance coverage with panel data.

PubMed

Liu, Jun-Qiang

2011-08-01

Social health insurance (SHI) is gaining popularity in many developing countries, but there are few systematic empirical studies on the dynamics of SHI development. This study investigates the determinants of coverage of the Basic Healthcare Insurance for Urban Employees (BHI) in China. Using a panel database ranging from 1999 to 2007, the study finds that: (1) economic development plays a valuable role in BHI development; (2) strong financial capacity and administrative capacity in the government contributes to BHI progress; (3) higher trade union density is closely related to more rapid BHI expansion; and (4) taxation agencies are better at collecting SHI premiums. These findings provide evidence-based lessons for new and ongoing SHI programs. In addition, this article aims to make a more general contribution to the study of social policy development by expanding the scope of current theories on social policy development. Copyright © 2011 Elsevier Ltd. All rights reserved.

Property Taxation. National Education Association Search.

ERIC Educational Resources Information Center

National Education Association, Washington, DC. Research Div.

The first of a series on school finance and the role of the state/local community, this document examines recent trends and developments in property taxation. The setting for property taxation and the state and local share of tax revenues for financing education are discussed. Two charts illustrate: (1) school district property tax collections…

12 CFR 14.50 - Where insurance activities may take place.

Code of Federal Regulations, 2010 CFR

2010-01-01

....50 Section 14.50 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY CONSUMER PROTECTION IN SALES OF INSURANCE § 14.50 Where insurance activities may take place. (a) General rule. A bank... transactions are routinely conducted in the bank may refer a consumer who seeks to purchase an insurance...

78 FR 53758 - Agency Information Collection Activities: Submission for OMB Review; Comment Request: Insurance...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-30

... Review; Comment Request: Insurance Sales Consumer Protections AGENCY: Federal Deposit Insurance... comment for 60 days on renewal of its Insurance Sales Consumer Protections information collection, which... Sales Consumer Protections. OMB Number: 3064-0140. Frequency of Response: Once--reviewing/updating...

Natural resource theory of unitary taxation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Johnston, J.L.; Reynolds, A.

1985-01-01

Empirical evidence supports the tentative hypothesis that unitary taxation encourages natural resource recovery in states well endowed with timber, fuels, and nonfuel minerals. Consequently, if combined apportionment is a stable institution in any state, it will remain so while extractive industries, with higher upstream than downstream profitability, continue to dominate the state's economy. Over time, however, nonproducing states will abandon unitary taxation to prevent integrated firms from disinvesting within their borders and expanding operations in states with a hospitable investment climate. Since states, like firms, must compete with one another, unitary taxation will become less important as state economies becomemore » less dependent on the recovery of natural resources. 43 references, 1 figure, 4 tables.« less

Switching benefits and costs in competitive health insurance markets: A conceptual framework and empirical evidence from the Netherlands.

PubMed

Duijmelinck, Daniëlle M I D; Mosca, Ilaria; van de Ven, Wynand P M M

2015-05-01

Competitive health insurance markets will only enhance cost-containment, efficiency, quality, and consumer responsiveness if all consumers feel free to easily switch insurer. Consumers will switch insurer if their perceived switching benefits outweigh their perceived switching costs. We developed a conceptual framework with potential switching benefits and costs in competitive health insurance markets. Moreover, we used a questionnaire among Dutch consumers (1091 respondents) to empirically examine the relevance of the different switching benefits and costs in consumers' decision to (not) switch insurer. Price, insurers' service quality, insurers' contracted provider network, the benefits of supplementary insurance, and welcome gifts are potential switching benefits. Transaction costs, learning costs, 'benefit loss' costs, uncertainty costs, the costs of (not) switching provider, and sunk costs are potential switching costs. In 2013 most Dutch consumers switched insurer because of (1) price and (2) benefits of supplementary insurance. Nearly half of the non-switchers - and particularly unhealthy consumers - mentioned one of the switching costs as their main reason for not switching. Because unhealthy consumers feel not free to easily switch insurer, insurers have reduced incentives to invest in high-quality care for them. Therefore, policymakers should develop strategies to increase consumer choice. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Coal leasing and taxation. Coal policy paper

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brody, S.E.; DeVries, A.H.

1981-01-01

The paper presents background information on current and proposed approaches to coal leasing and taxation, at both the State and federal levels. In addition, it discusses both the governmental objectives and probable economic effects of various combinations of leasing and taxation policies.

Knowledge and understanding of health insurance: challenges and remedies.

PubMed

Barnes, Andrew J; Hanoch, Yaniv

2017-07-13

As coverage is expanded in health systems that rely on consumers to choose health insurance plans that best meet their needs, interest in whether consumers possess sufficient understanding of health insurance to make good coverage decisions is growing. The recent IJHPR article by Green and colleagues-examining understanding of supplementary health insurance (SHI) among Israeli consumers-provides an important and timely answer to the above question. Indeed, their study addresses similar problems to the ones identified in the US health care market, with two notable findings. First, they show that overall-regardless of demographic variables-there are low levels of knowledge about SHI, which the literature has come to refer to more broadly as "health insurance literacy." Second, they find a significant disparity in health insurance literacy between different SES groups, where Jews were significantly more knowledgeable about SHI compared to their Arab counterparts.The authors' findings are consistent with a growing body of literature from the U.S. and elsewhere, including our own, presenting evidence that consumers struggle with understanding and using health insurance. Studies in the U.S. have also found that difficulties are generally more acute for populations considered the most vulnerable and consequently most in need of adequate and affordable health insurance coverage.The authors' findings call attention to the need to tailor communication strategies aimed at mitigating health insurance literacy and, ultimately, access and outcomes disparities among vulnerable populations in Israel and elsewhere. It also raises the importance of creating insurance choice environments in health systems relying on consumers to make coverage decisions that facilitate the decision process by using "choice architecture" to, among other things, simplify plan information and highlight meaningful differences between coverage options.

Health Care and Services for Consumers.

ERIC Educational Resources Information Center

Daugherty, Mabel

This module, consisting of materials for use in conducting a consumer education mini-course, deals with health care and services for consumers. Covered in the individual lessons are the following topics: understanding what is and is not covered by Medicare, assessing the need for private health insurance, purchasing private health insurance,…

Spatial taxation effects on regional coal economic activities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, C.W.; Labys, W.C.

1982-01-01

Taxation effects on resource production, consumption and prices are seldom evaluated especially in the field of spatial commodity modeling. The most commonly employed linear programming model has fixed-point estimated demands and capacity constraints; hence it makes taxation effects difficult to be modeled. The second type of resource allocation model, the interregional input-output models does not include a direct and explicit price mechanism. Therefore, it is not suitable for analyzing taxation effects. The third type or spatial commodity model has been econometric in nature. While such an approach has a good deal of flexibility in modeling political and non-economic variables, itmore » treats taxation (or tariff) effects loosely using only dummy variables, and, in many cases, must sacrifice the consistency criterion important for spatial commodity modeling. This leaves model builders only one legitimate choice for analyzing taxation effects: the quadratic programming model which explicitly allows the interplay of regional demand and supply relations via a continuous spatial price constructed by the authors related to the regional demand for and supply of coal from Appalachian markets.« less

Tribal and state taxation of natural resources on Indian reservations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Whiteing, J.S.

1993-12-31

Development of natural resources, including primarily energy resources, on Indian reservations has been significantly hampered by dual taxation - by tribes and states. The focus of tribes, states and industry has turnbed to potential legislative and other possible solutions. Discussed in the article are the following topics: Tribal taxation: tribal members, nonmembers on trust lands, nonmembers on fee lands; State taxation - Indian property, nonmembers; Alternatives to dual taxation - litigation, state-tribal cooperative agreements, new agreements for development, legislation.

Taxation in Public Education. Analysis and Bibliography Series, No. 12.

ERIC Educational Resources Information Center

Ross, Larry L.

Intended for both researchers and practitioners, this analysis and bibliography cites approximately 100 publications on educational taxation, including general texts and reports, statistical reports, taxation guidelines, and alternative proposals for taxation. Topics covered in the analysis section include State and Federal aid, urban and suburban…

Progressive taxation and the subjective well-being of nations.

PubMed

Oishi, Shigehiro; Schimmack, Ulrich; Diener, Ed

2012-01-01

Using data from the Gallup World Poll, we examined whether progressive taxation is associated with increased levels of subjective well-being. Consistent with Rawls's theory of justice, our results showed that progressive taxation was positively associated with the subjective well-being of nations. However, the overall tax rate and government spending were not associated with the subjective well-being of nations. Furthermore, controlling for the wealth of nations and income inequality, we found that respondents living in a nation with more-progressive taxation evaluated their lives as closer to the best possible life and reported having more positive and less negative daily experiences than did respondents living in a nation with less-progressive taxation. Finally, we found that the association between more-progressive taxation and higher levels of subjective well-being was mediated by citizens' satisfaction with public goods, such as education and public transportation.

20 CFR 243.4 - Taxation of benefits.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Taxation of benefits. 243.4 Section 243.4 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT TRANSFER, ASSIGNMENT, OR WAIVER OF PAYMENTS § 243.4 Taxation of benefits. (a) Annuities paid by the Board are subject...

20 CFR 243.4 - Taxation of benefits.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Taxation of benefits. 243.4 Section 243.4 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT TRANSFER, ASSIGNMENT, OR WAIVER OF PAYMENTS § 243.4 Taxation of benefits. (a) Annuities paid by the Board are subject...

20 CFR 243.4 - Taxation of benefits.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Taxation of benefits. 243.4 Section 243.4 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT TRANSFER, ASSIGNMENT, OR WAIVER OF PAYMENTS § 243.4 Taxation of benefits. (a) Annuities paid by the Board are subject...

20 CFR 243.4 - Taxation of benefits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Taxation of benefits. 243.4 Section 243.4 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT TRANSFER, ASSIGNMENT, OR WAIVER OF PAYMENTS § 243.4 Taxation of benefits. (a) Annuities paid by the Board are subject...

Switching insurer in the Irish voluntary health insurance market: determinants, incentives, and risk equalization.

PubMed

Keegan, Conor; Teljeur, Conor; Turner, Brian; Thomas, Steve

2016-09-01

The determinants of consumer mobility in voluntary health insurance markets providing duplicate cover are not well understood. Consumer mobility can have important implications for competition. Consumers should be price-responsive and be willing to switch insurer in search of the best-value products. Moreover, although theory suggests low-risk consumers are more likely to switch insurer, this process should not be driven by insurers looking to attract low risks. This study utilizes data on 320,830 VHI healthcare policies due for renewal between August 2013 and June 2014. At the time of renewal, policyholders were categorized as either 'switchers' or 'stayers', and policy information was collected for the prior 12 months. Differences between these groups were assessed by means of logistic regression. The ability of Ireland's risk equalization scheme to account for the relative attractiveness of switchers was also examined. Policyholders were price sensitive (OR 1.052, p < 0.01), however, price-sensitivity declined with age. Age (OR 0.971; p < 0.01) and hospital utilization (OR 0.977; p < 0.01) were both negatively associated with switching. In line with these findings, switchers were less costly than stayers for the 12 months prior to the switch/renew decision for single person (difference in average cost = €540.64) and multiple-person policies (difference in average cost = €450.74). Some cost differences remain for single-person policies following risk equalization (difference in average cost = €88.12). Consumers appear price-responsive, which is important for competition provided it is based on correct incentives. Risk equalization payments largely eliminated the profitable status of switchers, although further refinements may be required.

26 CFR 25.2701-5 - Adjustments to mitigate double taxation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Adjustments to mitigate double taxation. 25....2701-5 Adjustments to mitigate double taxation. (a) Reduction of transfer tax base—(1) In general. This... − $187,500). (g) Double taxation otherwise avoided. No reduction is available under this section if— (1...

26 CFR 25.2701-5 - Adjustments to mitigate double taxation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 14 2011-04-01 2010-04-01 true Adjustments to mitigate double taxation. 25.2701... Adjustments to mitigate double taxation. (a) Reduction of transfer tax base—(1) In general. This section... − $187,500). (g) Double taxation otherwise avoided. No reduction is available under this section if— (1...

12 CFR Appendix A to Part 343 - Consumer Grievance Process

Code of Federal Regulations, 2010 CFR

2010-01-01

... POLICY CONSUMER PROTECTION IN SALES OF INSURANCE Pt. 343, App. A Appendix A to Part 343—Consumer... Consumer Protection (DSC), Federal Deposit Insurance Corporation, at the following address: 550 17th Street... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Consumer Grievance Process A Appendix A to Part...

Are increases in cigarette taxation regressive?

PubMed

Borren, P; Sutton, M

1992-12-01

Using the latest published data from Tobacco Advisory Council surveys, this paper re-evaluates the question of whether or not increases in cigarette taxation are regressive in the United Kingdom. The extended data set shows no evidence of increasing price-elasticity by social class as found in a major previous study. To the contrary, there appears to be no clear pattern in the price responsiveness of smoking behaviour across different social classes. Increases in cigarette taxation, while reducing smoking levels in all groups, fall most heavily on men and women in the lowest social class. Men and women in social class five can expect to pay eight and eleven times more of a tax increase respectively, than their social class one counterparts. Taken as a proportion of relative incomes, the regressive nature of increases in cigarette taxation is even more pronounced.

26 CFR 521.117 - Claims in cases of double taxation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 19 2010-04-01 2010-04-01 false Claims in cases of double taxation. 521.117...) REGULATIONS UNDER TAX CONVENTIONS DENMARK General Income Tax Taxation of Nonresident Aliens Who Are Residents of Denmark and of Danish Corporations § 521.117 Claims in cases of double taxation. Under Article XX...

26 CFR 521.117 - Claims in cases of double taxation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 19 2011-04-01 2010-04-01 true Claims in cases of double taxation. 521.117...) REGULATIONS UNDER TAX CONVENTIONS DENMARK General Income Tax Taxation of Nonresident Aliens Who Are Residents of Denmark and of Danish Corporations § 521.117 Claims in cases of double taxation. Under Article XX...

75 FR 81612 - The Consumer Operated and Oriented Plan (CO-OP) Advisory Board; Office of Consumer Information...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-28

... Operated and Oriented Plan (CO-OP) Advisory Board; Office of Consumer Information and Insurance Oversight... and Insurance Oversight (OCIIO) on the Department's strategy to foster the creation of qualified... and Insurance Oversight (OCIIO) on the Department's strategy to foster the creation of qualified...

Health Considerations in Regulation and Taxation of Electronic Cigarettes.

PubMed

Mainous, Arch G; Tanner, Rebecca J; Mainous, Ryan W; Talbert, Jeffery

2015-01-01

The use of electronic cigarettes (e-cigarettes) is experiencing unprecedented growth. This can be contrasted to the use of conventional cigarettes which showed a decrease among adults with the current smoker prevalence dropping from 20.9% in 2005 to 17.8% in 2013. There is some data that e-cigarettes are attracting both former smokers and never smokers, and in particular, young people as users. Currently most states do not tax e-cigarettes. Taxation and regulation may have a similar overall goal of decreasing smoking but regulation tends to focus reduced availability of products. In terms of tobacco control, taxation focuses on the demand side of the equation. Taxation is a distinct strategy from regulation and has been shown to decrease new adopters of conventional cigarettes. A variety of potential taxation strategies can be considered by policymakers based on different assumptions about e-cigarettes and their utility, ranging from untaxed to taxation at moderate levels compared to conventional cigarettes to taxation equal to conventional cigarettes. Until more evidence for the benefits of e-cigarettes is presented, it seems prudent to view them as a potentially harmful and addictive product that ought to be regulated and taxed in an equivalent manner to conventional cigarettes. © Copyright 2015 by the American Board of Family Medicine.

Exploring health insurance services in Sudan from the perspectives of insurers.

PubMed

Salim, Anas Mustafa Ahmed; Hamed, Fatima Hashim Mahmoud

2018-01-01

It has been 20 years since the introduction of health insurance in Sudan. This study was the first one that explored health insurance services in Sudan from the perspectives of the insurers. This was a qualitative, exploratory, interview study. The sampling frame was the list of Social Health Insurance and Private Health Insurance institutions in Sudan. Participants were selected from the four Social Health Insurance institutions and from five Private Health Insurance companies. The study was conducted in January and February 2017. In-depth individual interviews were conducted with a convenient sample of key executives from the different health insurers. Ideas and themes were identified and analysed using thematic analysis. The result showed that universal coverage was not achieved despite long time presence of Social Health Insurance and Private Health Insurance in Sudan. All participants described their services as comprehensive. All participants have good perception of the quality of the services they provide, although none of them investigated customer satisfaction. The main challenges facing Social Health Insurance are achieving universal coverage, ensuring sustainability and recruitment of the informal sector and self-employed population. Consumers' affordability of the premiums is the main obstacle for Private Health Insurance, while rising healthcare cost due to economic inflation is a challenge facing both Social Health Insurance and Private Health Insurance. In spite of the presence of Social Health Insurance and Private Health Insurance in Sudan, the country is still far from achieving universal coverage. Moreover, the sustainability of health insurance is questionable. The main reasons include low governmental financial resources and lack of affordability by beneficiaries especially for Private Health Insurance. This necessitates finding solutions to improve them or trying other types of health insurance. The quality of services provided by Social

Tobacco, taxation, and fairness

PubMed Central

McLachlan, H

2002-01-01

The author defends himself against an attack by Smith and Bopp on his views on smoking and taxation. The theory that, on the grounds of equity and/or fairness, smokers should pay via taxation on tobacco for the health care costs of treating smoking-related medical conditions is discussed and shown to be defective. It is argued that the fundamental mistake that Smith and Bopp make is to confuse and conflate the separate issues of whether particular taxes are fair and whether they are justifiable. The conclusion is reached that an excise duty on tobacco is a good tax. It is a non-fair or even an unfair tax but it is justified on grounds other than fairness. PMID:12468659

Incentive-compatible guaranteed renewable health insurance premiums.

PubMed

Herring, Bradley; Pauly, Mark V

2006-05-01

Theoretical models of guaranteed renewable insurance display front-loaded premium schedules. Such schedules both cover lifetime total claims of low-risk and high-risk individuals and provide an incentive for those who remain low-risk to continue to purchase the policy. Questions have been raised of whether actual individual insurance markets in the US approximate the behavior predicted by these models, both because young consumers may not be able to "afford" front-loading and because insurers may behave strategically in ways that erode the value of protection against risk reclassification. In this paper, the optimal competitive age-based premium schedule for a benchmark guaranteed renewable health insurance policy is estimated using medical expenditure data. Several factors are shown to reduce the amount of front-loading necessary. Indeed, the resulting optimal premium path increases with age. Actual premium paths exhibited by purchasers of individual insurance are close to the optimal renewable schedule we estimate. Finally, consumer utility associated with the feature is examined.

32 CFR 643.56 - Taxation of lessee's interest.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Taxation of lessee's interest. 643.56 Section 643.56 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE Leases § 643.56 Taxation of lessee's interest. The lessee's interest in leased...

32 CFR 643.56 - Taxation of lessee's interest.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 4 2011-07-01 2011-07-01 false Taxation of lessee's interest. 643.56 Section 643.56 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE Leases § 643.56 Taxation of lessee's interest. The lessee's interest in leased...

Insurance Consumer Protection and Solvency Act of 2012

THOMAS, 112th Congress

Rep. Posey, Bill [R-FL-15

2012-09-14

House - 10/01/2012 Referred to the Subcommittee on Insurance, Housing and Community Opportunity. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Petroleum taxation and efficiency: the Canadian system in question

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wahby, M.J.

1983-08-01

The question considered in this article is whether it is possible to have a tax that appropriates resource rents without imposing a penalty on potential petroleum production. It is submitted that a system of income taxes exists which partially fulfills the above requirements. The Canadian government has been moving towards this system of taxation since 1962 but its historical development has been slow. Topics discussed include: the efficient taxation of resource rents, a history of Canadian petroleum taxation, and the efficiency of the present petroleum tax system.

26 CFR 1.403(b)-7 - Taxation of distributions and benefits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Taxation of distributions and benefits. 1.403(b... Taxation of distributions and benefits. (a) General rules for when amounts are included in gross income... arrangements and other eligible retirement plans—(1) Timing of taxation of rollovers. In accordance with...

26 CFR 1.403(b)-7 - Taxation of distributions and benefits.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 5 2011-04-01 2011-04-01 false Taxation of distributions and benefits. 1.403(b.... § 1.403(b)-7 Taxation of distributions and benefits. (a) General rules for when amounts are included...) Rollovers to individual retirement arrangements and other eligible retirement plans—(1) Timing of taxation...

Insurance Consumer Protection and Solvency Act of 2013

THOMAS, 113th Congress

Rep. Posey, Bill [R-FL-8

2013-02-08

House - 05/20/2014 Hearings Held by the Subcommittee on Housing and Insurance Prior to Referral. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Taxation of foreign oil and gas income: a primer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lashbrooke, E.C. Jr.

1983-06-01

The United States, just like many other countries of the world, uses the source of income, residence, citizenship, or a combination thereof as its bases of taxation. This makes double taxation, the result of a home and host countries both taxing the same income, an obstacle in the way of international investment and technology. Allowing a tax credit for certain taxes paid to foreign sovereigns is the American approach to help alleviate the double taxation problem. Special effort is taken to define foreign oil and gas extraction income (FOGEI) and foreign oil-related income (FORI) as they pertain to taxation. Severalmore » examples illustrate the latest means for calculating FOGEI and FORI taxable income based on the 1982 and 1983 limitations and provisions which were set forth in the Internal Revenue Code. 175 references.« less

Insurance Curriculum Guide for High School Consumer Education and Various Other Courses.

ERIC Educational Resources Information Center

Mason, Kathy

The Insurance Department and the Department of Education of the Commonwealth of Pennsylvania collaborated on the insurance guide intending to present basic information about the insurance industry and its regulations in Pennsylvania. Presented in a format appropriate to existing curriculum needs and students' skills at the secondary level, the…

26 CFR 1.995-1 - Taxation of DISC income to shareholders.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 10 2010-04-01 2010-04-01 false Taxation of DISC income to shareholders. 1.995...) INCOME TAX (CONTINUED) INCOME TAXES Domestic International Sales Corporations § 1.995-1 Taxation of DISC... to taxation on the earnings and profits of the DISC in accordance with the provisions of chapter 1 of...

26 CFR 1.995-1 - Taxation of DISC income to shareholders.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 10 2011-04-01 2011-04-01 false Taxation of DISC income to shareholders. 1.995... Taxation of DISC income to shareholders. (a) In general. (1) Under § 1.991-1(a), a corporation which is a... DISC, are subject to taxation on the earnings and profits of the DISC in accordance with the provisions...

Taxation of oil and gas revenues: Norway

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stauffer, T.R.

1982-04-01

Fiscalization of petroleum in Norway is a multidimensional process, which includes the conventional components of explicit taxation but also involves implicit nontax economic burdens. The latter are often even more important than the taxes themselves. The multidimensional fiscal structure reflects the multiple purposes of petroleum taxation in Norway, of which revenue collection appears to be but one. Given the multiple objectives, it is therefore not surprising that the components are partly inconsistent and contradictory.

Canadian oil and gas taxation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Watkins, C.; Scarfe, B.

1985-01-01

The taxation of Canadian oil and gas production has occasioned significant conflict between the federal government and the provinces, which own most of the petroleum resources. During the upheaval of the world oil market in the 1970s, such conflict became overt, with claims and counterclaims on perceived economic rents. In contrast, the 1950s and 1960s had been relatively quiet, with quite straightforward taxation regimes requiring only a little federal-provincial policy coordination. Federal policies were then preoccupied with encouraging market growth, with scant attention to pricing and revenue shares, the issues that have dominated federal and provincial energy policy in themore » 1970s and the 1980s. The authors begin by outlining the tax and royalty systems imposed by the federal government and by the government of Alberta, which accounts for some 85% of Canadian oil and gas output. They use the term system here in a broad sense to include all revenue-collecting devices and direct subsidies. Then they analyze the nature, problems, and efficiency of these regimes, especially as devices to collect economic rent. A final section speculates about the future evolution of Canadian oil and gas taxation. 13 references, 4 tables.« less

Theory of health insurance.

PubMed

Nyman, J A

1998-01-01

The conventional explanation for purchasing insurance is to transfer risk. Psychologists, however, have shown that this explanation does not match actual behavior. They find that people generally prefer the risk of no loss at all to the certainty of a smaller actuarially equivalent loss, a situation exactly opposite to the one represented by the purchase of insurance. Nevertheless, people do purchase insurance, so there must be an explanation other than risk transfer for purchasing it. Of the explanations so far advanced, however, none have yet developed a wide acceptance. Regardless of risk issues, people will be more likely to purchase insurance when the premium is low compared to the value of the coverage to the consumer. Moral hazard raises the premium, as does adverse selection. The presence of either makes the purchase of insurance less likely. With health insurance, the tax subsidy can reduce the effective premium to less than the actuarially fair cost of insurance. This would increase the likelihood that health insurance is purchased. Finally, because of the value we place on our health, we desire access to a full range of health care. Health insurance is often the only affordable way of gaining access to this care, given the high costs of many of these procedures.

Stakeholders' perceptions of ways to support decisions about health insurance marketplace enrollment: a qualitative study.

PubMed

Housten, A J; Furtado, K; Kaphingst, K A; Kebodeaux, C; McBride, T; Cusanno, B; Politi, M C

2016-11-08

Approximately 29 million individuals are expected to enroll in health insurance using the Patient Protection and Affordable Care Act (ACA) Marketplace by 2022. Those seeking health insurance struggle to understand insurance options and choose a plan that best suits their needs. We interviewed stakeholders to identify the challenges associated with the ACA Marketplace health insurance enrollment and elicited feedback about what to include in health insurance decision support tools. Interviews were transcribed and themes were identified using inductive thematic analysis. Stakeholders stated that consumers felt frustrated by unclear terminology, high plan costs, and complex calculations required to assess costs. Consumers felt anxious about making the wrong choice and being unable to change plans within a calendar year. Stakeholders recommended using plain language tables defining complex terms, grouping information, and using engaging graphics to communicate information about health insurance. Stakeholders thought that narratives of how others made decisions about insurance might be helpful to consumers, but recommended that they be tailored to the needs of specific consumers. Strategies that clarify health insurance terms using plain language and graphics, acknowledge concern associated with making the wrong choice, calculate and enable cost comparison, and tailor information to consumers' unique needs could benefit those enrolling in ACA Marketplace plans, Narratives developed should be simple and inclusive enough for diverse populations.

Worth of Geophysical Data in Natural-Disaster-Insurance Rate Setting.

NASA Astrophysics Data System (ADS)

Attanasi, E. D.; Karlinger, M. R.

1982-04-01

Insurance firms that offer natural-disaster insurance base their rates on available information. The benefits from collecting additional data and incorporating this information to improve parameter estimates of probability distributions that are used to characterize natural-disaster events can be determined by computing changes in premiums as a function of additional data. Specifically, the worth of data can be measured by changes in consumer's surplus (the widely applied measure of benefits to consumers used in benefit-cost analysis) brought about when the premiums are adjusted. In this paper, a formal model of the process for setting insurance rates is hypothesized in which the insurance firm sets rates so as to trade off penalties of overestimation and underestimation of expected damages estimated from currently available hydrologic data. A Bayesian preposterior analysis is performed which permits the determination of the expected benefits of collecting additional geophysical data by examining the changes in expected premium rates as a function of the longer record before the data are actually collected. An estimate of the expected benefits associated with collecting more data for the representative consumer is computed using an assumed demand function for insurance. In addition, a sensitivity analysis of expected benefits to changes in insurance demand and firm rate-setting procedures is carried out. From these results, conclusions are drawn regarding aggregate benefits to all flood insurance purchasers.

26 CFR 1.852-2 - Method of taxation of regulated investment companies.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Method of taxation of regulated investment... Trusts § 1.852-2 Method of taxation of regulated investment companies. (a) Imposition of normal tax and... for partially tax-exempt interest provided by section 242. (b) Taxation of capital gains—(1) In...

26 CFR 1.852-2 - Method of taxation of regulated investment companies.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 9 2011-04-01 2011-04-01 false Method of taxation of regulated investment... Investment Trusts § 1.852-2 Method of taxation of regulated investment companies. (a) Imposition of normal... for partially tax-exempt interest provided by section 242. (b) Taxation of capital gains—(1) In...

Consumers, health insurance and dominated choices.

PubMed

Sinaiko, Anna D; Hirth, Richard A

2011-03-01

We analyze employee health plan choices when the choice set offered by their employer includes a dominated plan. During our study period, one-third of workers were enrolled in the dominated plan. Some may have selected the plan before it was dominated and then failed to switch out of it. However, a substantial number actively chose the dominated plan when they had an unambiguously better choice. These results suggest limitations in the ability of health reform based solely on consumer choice to achieve efficient outcomes and that implementation of health reform should anticipate, monitor and account for this consumer behavior. Copyright © 2011 Elsevier B.V. All rights reserved.

International taxation of multinational enterprises in developed countries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Adams, J.D.R.; Whalley, J.

1977-01-01

The authors, specialists in law and economics, respectively, adopt an interdisciplinary approach to the international taxation of multinational corporations in developed countries, with particular emphasis on the EEC and the United States, integrating both legal and economic aspects of the subject. Since the international nature of the activities of multinational companies brings them within the scope of the domestic tax provisions of different countries, the authors outline the principles behind the domestic tax treatment of companies, and then assess the economic impact of this treatment. They subsequently examine the international taxation of multinationals, paying special attention to the OECD modelmore » treaty which seeks to remove the problem of international double taxation; reactions of governments to each other's fiscal policies are also examined, with special attention being paid to tax havens. Finally, they look at the EEC proposals for the harmonization of corporate tax systems within the Community and postulate how these proposals would operate if put into effect. There are numerous examples throughout the book of international taxation at work, and these together with the clear text provide a readily comprehensible account of a subject that can seem highly complicated to the uninitiated.« less

Alcohol taxation policy in Thailand: implications for other low- to middle-income countries.

PubMed

Sornpaisarn, Bundit; Shield, Kevin D; Rehm, Jürgen

2012-08-01

  Prevention of drinking initiation is a significant challenge in low- and middle-income countries that have a high prevalence of abstainers, including life-time abstainers. This paper aims to encourage a debate on an alternative alcohol taxation approach used currently in Thailand, which aims specifically to prevent drinking initiation in addition to reduce alcohol-attributable harms.   Theoretical evaluation, simulation and empirical analysis.   The taxation method of Thailand, 'Two-Chosen-One' (2C1) combines specific taxation (as a function of the alcohol content) and ad valorem taxation (as a function of the price), resulting in an effective tax rate that puts a higher tax both on beverages which are preferred by heavy drinkers and on beverages which are preferred by potential alcohol consumption neophytes, compared to either taxation system alone. As a result of these unique properties of the 2C1 taxation system, our simulations indicate that 2C1 taxation leads to a lower overall consumption than ad valorem or specific taxation alone. In addition, it puts a relatively high tax on beverages attractive to young people, the majority of whom are currently abstaining. Currently, the abstention rates in Thailand are higher than expected based on its economic wealth, which could be taken as an indication that the taxation strategy is successful.   'Two-chosen-one' (2C1) taxation has the potential to simultaneously reduce alcohol consumption and prevent drinking initiation among youth; however, additional empirical evidence is needed to assess its effectiveness in terms of the public health impact in low- and middle-income countries. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Switching health insurers: the role of price, quality and consumer information search.

PubMed

Boonen, Lieke H H M; Laske-Aldershof, Trea; Schut, Frederik T

2016-04-01

We examine the impact of price, service quality and information search on people's propensity to switch health insurers in the competitive Dutch health insurance market. Using panel data from annual household surveys and data on health insurers' premiums and quality ratings over the period 2006-2012, we estimate a random effects logit model of people's switching decisions. We find that switching propensities depend on health plan price and quality, and on people's age, health, education and having supplementary or group insurance. Young people (18-35 years) are more sensitive to price, whereas older people are more sensitive to quality. Searching for health plan information has a much stronger impact on peoples' sensitivity to price than to service quality. In addition, searching for health plan information has a stronger impact on the switching propensity of higher than lower educated people, suggesting that higher educated people make better use of available health plan information. Finally, having supplementary insurance significantly reduces older people's switching propensity.

22 CFR 40.105 - Former citizens who renounced citizenship to avoid taxation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... avoid taxation. 40.105 Section 40.105 Foreign Relations DEPARTMENT OF STATE VISAS REGULATIONS PERTAINING... Miscellaneous § 40.105 Former citizens who renounced citizenship to avoid taxation. An alien who is a former... avoid United States taxation, is ineligible for a visa under INA 212(a)(10)(E). [62 FR 67568, Dec. 29...

22 CFR 40.105 - Former citizens who renounced citizenship to avoid taxation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... avoid taxation. 40.105 Section 40.105 Foreign Relations DEPARTMENT OF STATE VISAS REGULATIONS PERTAINING... Miscellaneous § 40.105 Former citizens who renounced citizenship to avoid taxation. An alien who is a former... avoid United States taxation, is ineligible for a visa under INA 212(a)(10)(E). [62 FR 67568, Dec. 29...

26 CFR 1.405-3 - Taxation of retirement bonds.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Taxation of retirement bonds. 1.405-3 Section 1.405-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.405-3 Taxation of retirement...

26 CFR 26.2653-1 - Taxation of multiple skips.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Taxation of multiple skips. 26.2653-1 Section 26.2653-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) ESTATE...-1 Taxation of multiple skips. (a) General rule. If property is held in trust immediately after a GST...

26 CFR 1.501(a)-1 - Exemption from taxation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 7 2010-04-01 2010-04-01 true Exemption from taxation. 1.501(a)-1 Section 1.501(a)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Exempt Organizations § 1.501(a)-1 Exemption from taxation. (a) In...

26 CFR 1.501(a)-1 - Exemption from taxation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 7 2011-04-01 2009-04-01 true Exemption from taxation. 1.501(a)-1 Section 1.501(a)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Exempt Organizations § 1.501(a)-1 Exemption from taxation. (a) In...

26 CFR 1.405-3 - Taxation of retirement bonds.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 5 2011-04-01 2011-04-01 false Taxation of retirement bonds. 1.405-3 Section 1.405-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.405-3 Taxation of...

Taxation and Sugar-Sweetened Beverages: Position of Dietitians of Canada.

PubMed

2016-06-01

Dietitians of Canada recommends that an excise tax of at least 10-20% be applied to sugar-sweetened beverages sold in Canada given the negative impact of these products on the health of the population and the viability of taxation as a means to reduce consumption. For the greatest impact, taxation measures should be combined with other policy interventions such as increasing access to healthy foods while decreasing access to unhealthy foods in schools, daycares, and recreation facilities; restrictions on the marketing of foods and beverages to children; and effective, long-term educational initiatives. This position is based on a comprehensive review of the literature. The Canadian population is experiencing high rates of obesity and excess weight. There is moderate quality evidence linking consumption of sugar-sweetened beverages to excess weight, obesity, and chronic disease onset in children and adults. Taxation of sugar-sweetened beverages holds substantiated potential for decreasing its consumption. Based on economic models and results from recent taxation efforts, an excise tax can lead to a decline in sugar-sweetened beverage purchase and consumption. Taxation of up to 20% can lead to a consumption decrease by approximately 10% in the first year of its implementation, with a postulated 2.6% decrease in weight per person on average. Revenue generated from taxation can be used to fund other obesity reduction initiatives. A number of influential national organizations support a tax on sugar-sweetened beverages.

26 CFR 1.61-21 - Taxation of fringe benefits.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 2 2013-04-01 2013-04-01 false Taxation of fringe benefits. 1.61-21 Section 1... § 1.61-21 Taxation of fringe benefits. (a) Fringe benefits—(1) In general. Section 61(a)(1) provides... includes compensation for services, including fees, commissions, fringe benefits, and similar items. For an...

26 CFR 26.2653-1 - Taxation of multiple skips.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 14 2011-04-01 2010-04-01 true Taxation of multiple skips. 26.2653-1 Section 26.2653-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) ESTATE AND... Taxation of multiple skips. (a) General rule. If property is held in trust immediately after a GST, solely...

Taxation and regulation of uranium mining in Canada

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1990-11-01

Government taxation and regulation have a profound influence on mineral operations. In Canada, taxation occurs both on the federal and provincial levels. In addition, both federal and provincial regulations also affect mine operations, sometimes with overlapping, or conflicting, legislation and jurisdiction. Three broad areas of regulation affect the mine production of uranium in Canada: (1) mining law or mineral rights; (2) the licensing procedures; and (3) regulation of occupational health and safety.

Energy taxation: An analysis of selected taxes: Energy policy study, Volume 14

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1980-09-05

Taxation is a key instrument by which governments affect economic decision making and outcomes. Not surprisingly, energy taxation has received considerable attention in recent years with the mounting concern over national energy policy. As with other policy instruments, the taxation of energy production and use spans a wide array of topics. It also cuts across other instruments because it affects the entire spectrum of economic variables/endash/prices, outputs, investments, uses, and so on. As a result, the subject of energy taxation constitutes a highly complex set of issues for public policy. This report examines the principal components of that set ofmore » issues. In the process, it points out the most important interrelations among the various taxes and between taxation and other policy instruments. Passing mention is made of areas that in the committee's opinion warrant further research. 61 refs., 15 tabs.« less

Teaching Aids in Consumer Economics, 1970-71.

ERIC Educational Resources Information Center

New York State Council on Economic Education, Albany.

The document consists of 12 consumer education units for grade 12: Consumer Purchasing; Purchasing Food, Clothing, Furniture, and Appliances; Purchasing and Maintaining an Automobile; Housing; Consumer Credit; Money Management; Fraud, Quackery, and Deception; Banking and Savings; Investments; Life Insurance; Security Programs (Social Security,…

26 CFR 1.852-1 - Taxation of regulated investment companies.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Regulated Investment Companies and Real Estate Investment Trusts § 1.852-1 Taxation of regulated investment companies. (a) Requirements applicable thereto—(1) In... 26 Internal Revenue 9 2012-04-01 2012-04-01 false Taxation of regulated investment companies. 1...

26 CFR 1.852-1 - Taxation of regulated investment companies.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Regulated Investment Companies and Real Estate Investment Trusts § 1.852-1 Taxation of regulated investment companies. (a) Requirements applicable thereto—(1) In... 26 Internal Revenue 9 2013-04-01 2013-04-01 false Taxation of regulated investment companies. 1...

26 CFR 1.852-1 - Taxation of regulated investment companies.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Regulated Investment Companies and Real Estate Investment Trusts § 1.852-1 Taxation of regulated investment companies. (a) Requirements applicable thereto—(1) In... 26 Internal Revenue 9 2014-04-01 2014-04-01 false Taxation of regulated investment companies. 1...

26 CFR 1.852-1 - Taxation of regulated investment companies.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Taxation of regulated investment companies. 1.852-1 Section 1.852-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED....852-1 Taxation of regulated investment companies. (a) Requirements applicable thereto—(1) In general...

Urban Property Taxation: II. Land and Location. Exchange Bibliography 480.

ERIC Educational Resources Information Center

White, Anthony G.

This is one of three related bibliographies listing publications dealing with the broad topic of property taxation. This particular volume concerns some specialized fields of study, including locational theory, land use and taxation, property markets and valuation, housing, and urban renewal and redevelopment. Citations are listed alphabetically…

Consumer-directed health plans: enrollee views, early employer experience.

PubMed

Frates, Janice; Severoni, Ellen

2005-06-01

Consumer-directed health plans (CDHPs) are a new health insurance product that is of growing interest to employers who are struggling to cope with rising health insurance premium costs and to consumers who are desiring more choice and engagement in their health care. This paper presents the results of a study of California consumer awareness of, and attitudes toward, CDHPs in the context of several national surveys and the experiences of some early-adopting employers. California Health Decisions conducted a telephone survey of 800 insured adult California residents in November 2002. Few respondents had heard of CDHPs. They appealed more to younger, single, less educated, and healthier respondents and those who did not understand them well. The most attractive CDHP features were greater provider choice and health savings accounts' portability and flexibility. Concerns centered on personal financial exposure. While CDHPs' commercial market penetration is increasing, their greatest potential future contributions might be to reduce the number of uninsured Americans by offering an affordable health insurance product and to fund additional health services for retirees. As CDHPs further evolve, more consumer involvement in their refinement, implementation, and evaluation is essential.

26 CFR 1.852-1 - Taxation of regulated investment companies.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 9 2011-04-01 2011-04-01 false Taxation of regulated investment companies. 1.852-1 Section 1.852-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED... Trusts § 1.852-1 Taxation of regulated investment companies. (a) Requirements applicable thereto—(1) In...

Consumer choice among Mutual Healthcare Purchasers: a feasible option for China?

PubMed

Xu, Weiwei; van de Ven, Wynand P M M

2013-11-01

In its 2009 blue print of healthcare reform, the Chinese government aimed to create a competitive health insurance market in order to increase efficiency in the health insurance sector. A major advantage of a competitive health insurance market is that insurers are stimulated to act as well-motivated prudent purchasers of healthcare on behalf of their enrolees, and that consumers can choose among these purchasers. To emphasize the insurers' role of purchasers of care we denote them, as well as other entities that can fulfil this role (e.g. fundholding community health centres), as 'Mutual Healthcare Purchasers' (MHPs). As feasible proposals for creating competition in China's health insurance sector have yet to be made, we suggest two potential approaches to create competition among MHPs: (1) separating finance and operation of social health insurance and allowing consumer choice among operators of social health insurance schemes; (2) allowing consumer choice among fund-holding community health centres. Although the benefits of competition are widely accepted in China, the problematic consequences of a free competitive health insurance market - especially in relation to affordability and accessibility - are generally neglected. To solve the problems of lack of affordability and inaccessibility that would occur in the case of unregulated competition among MHPs, at least the following regulations are proposed to the Chinese policy makers: a 'standard benefit package' for basic health insurance, a 'risk-equalization scheme', and 'open enrolment'. Potential obstacles for implementing a risk equalization scheme are examined based on theoretical arguments and international experiences. We conclude that allowing consumer choice among MHPs and implementing a risk equalization scheme in China is politically and technically complex. Therefore, the Chinese government should prepare carefully for a market-oriented reform in its healthcare sector and adopt a strategic approach

Basic taxation of natural resources

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1986-01-01

This book contains 19 selections. Some of the titles are: Introduction to taxation and natural resources; The economic interest concept; Oil and gas exploration and development expenditures; Percentage depletion for oil and gas; and Mine reclamation and closing expenses.

26 CFR 1.597-2 - Taxation of Federal financial assistance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 7 2010-04-01 2010-04-01 true Taxation of Federal financial assistance. 1.597-2 Section 1.597-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Mutual Savings Banks, Etc. § 1.597-2 Taxation of Federal...

26 CFR 1.83-7 - Taxation of nonqualified stock options.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Taxation of nonqualified stock options. 1.83-7 Section 1.83-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Items Specifically Included in Gross Income § 1.83-7 Taxation...

Oil and gas taxation in Algeria: exploration and production activities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Frilet, M.

1982-09-01

The Algerian taxation scheme for foreign companies involved in the petroleum sector is profoundly different depending on whether the company is directly involved in exploration and production or is merely acting as a service company or contractor. This article discusses Algerian taxation of foreign companies directly involved in production and exploration.

26 CFR 1.597-2 - Taxation of Federal financial assistance.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 7 2011-04-01 2009-04-01 true Taxation of Federal financial assistance. 1.597-2 Section 1.597-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Mutual Savings Banks, Etc. § 1.597-2 Taxation of Federal...

26 CFR 1.83-7 - Taxation of nonqualified stock options.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 2 2011-04-01 2011-04-01 false Taxation of nonqualified stock options. 1.83-7 Section 1.83-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Items Specifically Included in Gross Income § 1.83-7 Taxation...

Innovation and The Welfare Effects of Public Drug Insurance*

PubMed Central

Lakdawalla, Darius; Sood, Neeraj

2010-01-01

Rewarding inventors with inefficient monopoly power has long been regarded as the price of encouraging innovation. Prescription drug insurance escapes that trade-off and achieves an elusive goal: lowering static deadweight loss, without reducing incentives for innovation. As a result of this feature, the public provision of drug insurance can be welfare-improving, even for risk-neutral and purely self-interested consumers. The design of insurers’ cost-sharing schedules can either reinforce or mitigate this result. Schedules that impose higher consumer cost-sharing requirements on more expensive drugs help ensure that insurance subsidies translate into higher utilization, rather than pure increases in manufacturer profits. Moreover, some degree of price-negotiation with manufacturers is likely to be welfare-improving, but the optimal degree depends on the size of such transactions costs, as well as the social cost of weakening innovation incentives by lowering innovator profits. These results have practical implications for the evaluation of public drug insurance programs like the US Medicaid and Medicare Part D programs, along with European insurance schemes. PMID:20454467

Development of taxation system for oil production companies in Russia

NASA Astrophysics Data System (ADS)

Salmina, S. V.; Sboeva, I. M.; Selivanovskaya, J. I.; Khafizova, A. R.; Fomin, V. P.

2018-01-01

The present article is devoted to the taxation system for oil production companies in Russia. The role of oil production companies in the realization of the fiscal function of the state is shown. Tax and due receipts at the consolidated budget of the Russian Federation from major economic sectors in the years 2013-2015 are presented and analysed. An investigation of oil production taxation peculiarities is carried out. In particular, mineral extraction tax analysis is made, the said tax being one of the basic taxes paid by oil production companies. The authors come to a conclusion that mineral extraction tax in Russia needs reforming. Based on the investigation realized possible ways of taxation system development in respect of oil production companies in Russia are proposed. Thus, taking into account the fact that oil industry is very important for budget revenue formation, initially it is planned to test the new taxation system principles in a limited number of deposits, so called ‘pilot projects’. For highly profitable minefield deposits it is planned to introduce progressive and regressive index, varying depending on oil prices. Within the framework of the investigation the authors come to a conclusion that it is necessary to introduce gradually the taxation system based on the definition of surplus profit depending on the cost effectiveness and taking into account oil prices.

Pigouvian taxation of energy for flow and stock externalities and strategic, noncompetitive energy pricing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wirl, F.

1994-01-01

The literature on energy and carbon taxes is by and large concerned about the derivation of (globally) efficient strategies. In contrast, this paper considers the dynamic interactions between cartelized energy suppliers and a consumers' government that collectively taxes energy carriers for Pigouvian motives. Two different kinds of external costs are associated with energy consumption: flow (e.g., acid rain) and stock externalities (e.g., global warming). The dynamic interactions between a consumers' government and a producers' cartel are modeled as a differential game with a subgame perfect Nash equilibrium in linear and nonlinear Markov strategies. The major implications are that the nonlinearmore » solutions are Pareto-inferior to the linear strategies and energy suppliers may preempt energy taxation and thereby may raise the price at front; however, this effect diminishes over time because the producers' price declines, while taxes increase. 22 refs., 5 figs., 1 tab.« less

Consumer Health: Products and Services.

ERIC Educational Resources Information Center

Haag, Jessie Helen

This book presents a general overview of consumer health, its products and services. Consumer health is defined as those topics dealing with a wise selection of health products and services, agencies concerned with the control of these products and services, evaluation of quackery and health misconceptions, health careers, and health insurance.…

Taxation of Small Business Corporations

PubMed Central

Flynn, W. Rand

1980-01-01

On December 6 1979, new legislation substantially changed the taxation of business income from Canadian-controlled private corporations. The new rules will be of particular interest to corporations providing personal, financial or management services, and to professionals contemplating the use of such corporations. PMID:21293665

Pattern of state coal taxation. [Review

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gulley, D.A.

1981-01-01

This paper reviews the recent history of state coal taxation and reports an empirically-based effort at defining the key determinants of state and local coal taxation. A pattern emerges but the analysis is complicated by the empirical and conceptual difficulties typical of such studies. Perhaps as important a result as the detection of a pattern is the recognition that many seemingly important variables do not appear to have consistently influenced tax levels. For policy makers and for industry, it appears that the present concern over a coal-states cartel is excessive. One can speculate that draconian tax adjustments on the basismore » of a crude-indicator-like reserve base will ultimately transfer less wealth than would skillful preemption of rent. It is also noteworthy that the sign of the tax effort variable is positive, indicating that coal tax rates are consistent with other tax efforts, not a substitute for them. Accepting impacts and general tax effort variables as the best explanations of interstate variations in tax effort is a somewhat different matter than determining what any given state's tax rate ought to be; such a question lies beyond the scope of this paper. This tax-determinant study can not define the right level of coal taxation, but it can suggest that no trend is yet evident toward entrepreneurial tax rates. 20 references, 4 figures.« less

Let's put consumers in charge of health care.

PubMed

Herzlinger, Regina E

2002-07-01

Businesses spend billions on health insurance. And what do they get for their money? A lot of unhappy employees. Workers fret about the quality of the care they receive, the burden of their out-of-pocket expenses, and the gaps in their coverage. For businesses, health care has become a lose-lose proposition: They pay way too much, and they get way too little. The problem is that the health care industry has been shielded from consumer pressure--by employers, insurers, and the government. As a result, costs have exploded even as choices have narrowed. But if companies embrace a new model of health coverage--one that places control over both costs and care directly into the hands of employees--the competitive forces that spur productivity and innovation in consumer markets can be loosed upon the inefficient, tradition-bound health care system. Moving to consumer-driven health care requires that companies revamp their health benefits in six ways: Give employees incentives to shop intelligently; offer a real choice of insurance plans; charge employees prices that accurately reflect the company's costs; let providers set their own prices; adjust payments for each enrollee based on need; and provide relevant information. Putting consumers in charge of health care may seem like a radical approach. But individuals are highly motivated to educate themselves about their health, their insurance, and their care, and they want to seek the most value for their money. Promoting that economic dynamic--the same that fuels consumer markets everywhere--is the best way to enhance the health care industry's productivity and quality.

12 CFR 343.60 - Qualification and licensing requirements for insurance sales personnel.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Qualification and licensing requirements for insurance sales personnel. 343.60 Section 343.60 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF GENERAL POLICY CONSUMER PROTECTION IN SALES OF INSURANCE § 343.60 Qualification...

Do individuals respond to cost-sharing subsidies in their selections of marketplace health insurance plans?

PubMed

DeLeire, Thomas; Chappel, Andre; Finegold, Kenneth; Gee, Emily

2017-12-01

The Affordable Care Act (ACA) provides assistance to low-income consumers through both premium subsidies and cost-sharing reductions (CSRs). Low-income consumers' lack of health insurance literacy or information regarding CSRs may lead them to not take-up CSR benefits for which they are eligible. We use administrative data from 2014 to 2016 on roughly 22 million health insurance plan choices of low-income individuals enrolled in ACA Marketplace coverage to assess whether they behave in a manner consistent with being aware of the availability of CSRs. We take advantage of discontinuous changes in the schedule of CSR benefits to show that consumers are highly sensitive to the value of CSRs when selecting insurance plans and that a very low percentage select dominated plans. These findings suggest that CSR subsidies are salient to consumers and that the program is well designed to account for any lack of health insurance literacy among the low-income population it serves. Copyright © 2017 Elsevier B.V. All rights reserved.

Health insurance coverage, income distribution and healthcare quality in local healthcare markets.

PubMed

Damianov, Damian S; Pagán, José A

2013-08-01

We develop a theoretical model of a local healthcare system in which consumers, health insurance companies, and healthcare providers interact with each other in markets for health insurance and healthcare services. When income and health status are heterogeneous, and healthcare quality is associated with fixed costs, the market equilibrium level of healthcare quality will be underprovided. Thus, healthcare reform provisions and proposals to cover the uninsured can be interpreted as an attempt to correct this market failure. We illustrate with a numerical example that if consumers at the local level clearly understand the linkages between health insurance coverage and the quality of local healthcare services, health insurance coverage proposals are more likely to enjoy public support. Copyright © 2012 John Wiley & Sons, Ltd.

Using contingent choice methods to assess consumer preferences about health plan design.

PubMed

Marquis, M Susan; Buntin, Melinda Beeuwkes; Kapur, Kanika; Yegian, Jill M

2005-01-01

American insurers are designing products to contain health care costs by making consumers financially responsible for their choices. Little is known about how consumers will view these new designs. Our objective is to examine consumer preferences for selected benefit designs. We used the contingent choice method to assess willingness to pay for six health plan attributes. Our sample included subscribers to individual health insurance products in California, US. We used fitted logistic regression models to explore how preferences for the more generous attributes varied with the additional premium and with the characteristics of the subscriber. High quality was the most highly valued attribute based on the amounts consumers report they are willing to pay. They were also willing to pay substantial monthly premiums to reduce their overall financial risk. Individuals in lower health were willing to pay more to reduce their financial risk than individuals in better health. Consumers may prefer tiered-benefit designs to those that involve overall increases in cost sharing. More consumer information is needed to help consumers better evaluate the costs and benefits of their insurance choices.

75 FR 45013 - Pre-Existing Condition Insurance Plan Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-30

... provided (an important protection for a program designed to offer coverage to those with a pre-existing... Part II Department of Health and Human Services 45 CFR Part 152 Pre-Existing Condition Insurance... [OCIIO-9995-IFC] RIN 0991-AB71 Pre-Existing Condition Insurance Plan Program AGENCY: Office of Consumer...

26 CFR 1.457-7 - Taxation of Distributions Under Eligible Plans.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 6 2010-04-01 2010-04-01 false Taxation of Distributions Under Eligible Plans. 1.457-7 Section 1.457-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY...-7 Taxation of Distributions Under Eligible Plans. (a) General rules for when amounts are included in...

Images of health insurance in popular film: the dissolving critique.

PubMed

Pendo, Elizabeth A

2004-01-01

Several recent films have villainized the health-insurance industry as a central element of their plots. This Article examines three of those films: Critical Care, The Rainmaker, and John Q. It analyzes these films through the context of the consumer backlash against managed care that began in the 1990s and shows how these films reflect the consumer sentiment regarding health-insurance companies and the cost controlling strategies they employ. In addition, the Article identifies three key premises about health insurance in the films that, although exaggerated and incomplete, have significant factual support. Ultimately, the author argues that, despite their passionately critical and liberal tone, these films actually put forward solutions that are highly individualist and conservative, rather than inclusive and systemic.

Institute on oil and gas law and taxation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ernst, A.C.

1979-01-01

This volume contains discussions, by acknowledged authorities, of important legal and tax problems of the oil and gas industries. The articles were delivered in condensed form as lectures during the Thirtieth Annual Institute on Oil and Gas Law and Taxation held by the Southwest Legal Foundation. The following topics are discussed: crude oil issues; natural gas liquid-selected problems in regulation; recent developments in DOE audits of refiners and marketers; contrasting administrative procedures before the DOE, DOE organization - the limit of regulatory power, current major developments in federal natural gas legislation and regulation; dedication and abandonment - problems under sectionmore » 7(b) of the Natural Gas Act; Natural gas pipelines - their regulation and their current problems, current antitrust developments in oil and gas exploration and production; developments in nonregulatory oil and gas law; recent developments in oil and gas taxation; entity selection - an experience in alchemy - a comparison of corporations, partnerships, and joint ventures; foreign money and US oil and gas - tax considerations; 1978 legislative developments in oil and gas taxation; and recapture of intangibles under section 1254. (DC)« less

An evaluation of independent consumer assistance centers on problem resolution and user satisfaction: the consumer perspective.

PubMed

Nascimento, Lori Miller; Cousineau, Michael R

2005-04-01

Individuals who wish to receive independent assistance to resolve access to care health problems have limited options. The Health Consumer Alliance (HCA) is an independent, coordinated effort of nine legal services organizations that provide free assistance to low-income health consumers in 10 California counties. The need for the HCA stems from the vast number of health consumers with unanswered questions and unresolved problems relating to access to care issues, among both insured and uninsured populations. However, little is known about the effectiveness of independent consumer assistance centers. This paper examines the effectiveness of a network of independent consumer assistance programs in resolving consumer problems and consumers' level of satisfaction with services received. As the project evaluators, we conducted telephone surveys with 1,291 users of the HCA to assess if this independent program resolved consumer problems, and to measure the level of satisfaction among HCA users. Specifically, we asked questions about the HCA's influence on problem resolution, consumer satisfaction, health insurance status and use of preventive care services. From 1997 to 2001, more than 46,000 consumers contacted the seven health consumer centers (HCCs). According to our sample of respondents, results show that the HCCs are an important resource for low-income Californians trying to access health care. After contacting the HCCs, 62 percent of the participants report that their problems were resolved. In addition, 87 percent of the participants said the HCCs were helpful and 95 percent said they would be likely to contact the HCC again if necessary.

26 CFR 1.857-1 - Taxation of real estate investment trusts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Taxation of real estate investment trusts. 1.857-1 Section 1.857-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Real Estate Investment Trusts § 1.857-1 Taxation of real estate...

26 CFR 1.457-7 - Taxation of Distributions Under Eligible Plans.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 6 2011-04-01 2011-04-01 false Taxation of Distributions Under Eligible Plans. 1.457-7 Section 1.457-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY... Included § 1.457-7 Taxation of Distributions Under Eligible Plans. (a) General rules for when amounts are...

26 CFR 1.857-1 - Taxation of real estate investment trusts.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 9 2011-04-01 2011-04-01 false Taxation of real estate investment trusts. 1.857-1 Section 1.857-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Real Estate Investment Trusts § 1.857-1 Taxation of real...

Taxation of exhaustible resources. [Monograph

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dasgupta, P.; Heal, G.; Stiglitz, J.

1980-01-01

This paper analyzes the effect of taxation on the intertemporal allocation of an exhaustible resource. A general framework within which a large variety of taxes can be analyzed is developed and then applied to a number of specific taxes. It is shown that there exists a pattern of taxation which can generate essentially any desired pattern of resource usage. Many tax policies, however, have effects markedly different both from the effects that these policies would have in the case of produced commodities and from those which they are designed (or widely thought) to have. For instance, if extraction costs aremore » zero, a depletion allowance at a constant rate (widely thought to encourage the extraction of resources) has absolutely no effect; its gradual removal (usually thought to be preferable to a sudden removal) leads to faster rates of depletion (and lower prices) now, but higher prices in the future; which its sudden and unanticipated removal has absolutely no distortionary effect on the pattern of extraction. More generally, it is shown that the effects of tax structure on the patterns of extraction are critically dependent on expectations concerning future taxation. The changes in tax structure that have occurred in the past fifty years are of the kind that, if they were anticipated, (or if similar further changes are expected to occur in the future) lead to excessively fast exploitation of natural resources. However, if it is believed that current tax policies (including rates) will persist indefinitely, the current tax structure would lead to excessive conservationism. Thus, whether in fact current tax policies have lead to excessive conservationism is a moot question.« less

12 CFR 536.60 - Qualification and licensing requirements for insurance sales personnel.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF THE TREASURY CONSUMER PROTECTION IN SALES OF INSURANCE § 536.60 Qualification and licensing... for sale any insurance product or annuity in any part of the savings association's office or on its...

A behavioral economics perspective on tobacco taxation.

PubMed

Cherukupalli, Rajeev

2010-04-01

Economic studies of taxation typically estimate external costs of tobacco use to be low and refrain from recommending large tobacco taxes. Behavioral economics suggests that a rational decision-making process by individuals fully aware of tobacco's hazards might still lead to overconsumption through the psychological tendency to favor immediate gratification over future harm. Taxes can serve as a self-control device to help reduce tobacco use and enable successful quit attempts. Whether taxes are appropriately high depends on how excessively people underrate the harm from tobacco use and varies with a country's circumstances. Such taxes are likely to be more equitable for poorer subgroups than traditional economic analysis suggests, which would strengthen the case for increased tobacco taxation globally.

American Indian tribal taxation of energy resources

DOE Office of Scientific and Technical Information (OSTI.GOV)

Redhorse, D.; Smith, T.R.

1982-07-01

Whether a tribe can tax is now but old rhetoric. How to tax has become the more crucial question. Tribes must develop taxing schemes that are reasonable and competitive. How public services are linked to taxation, as well as who are the recipients of those services, is weighed heavily in considering whether other taxing entities interfere with tribal governments. The Merrion Decision, which upheld the authority of a tribe to impose taxes on minerals extracted from tribal lands, serves as a milestone in Indian taxation; however, the decision itself pointed to possible pitfalls unless tribes judiciously exercise judgement in theirmore » use of the power to tax. 39 references.« less

26 CFR 1.857-1 - Taxation of real estate investment trusts.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 9 2012-04-01 2012-04-01 false Taxation of real estate investment trusts. 1.857...) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Real Estate Investment Trusts § 1.857-1 Taxation of real... real estate investment trust for a taxable year unless— (1) The deduction for dividends paid for the...

26 CFR 1.857-1 - Taxation of real estate investment trusts.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 9 2014-04-01 2014-04-01 false Taxation of real estate investment trusts. 1.857...) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Real Estate Investment Trusts § 1.857-1 Taxation of real... real estate investment trust for a taxable year unless— (1) The deduction for dividends paid for the...

26 CFR 1.857-1 - Taxation of real estate investment trusts.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 9 2013-04-01 2013-04-01 false Taxation of real estate investment trusts. 1.857...) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Real Estate Investment Trusts § 1.857-1 Taxation of real... real estate investment trust for a taxable year unless— (1) The deduction for dividends paid for the...

Can universal access be achieved in a voluntary private health insurance market? Dutch private insurers caught between competing logics.

PubMed

Vonk, Robert A A; Schut, Frederik T

2018-05-07

For almost a century, the Netherlands was marked by a large market for voluntary private health insurance alongside state-regulated social health insurance. Throughout this period, private health insurers tried to safeguard their position within an expanding welfare state. From an institutional logics perspective, we analyze how private health insurers tried to reconcile the tension between a competitive insurance market pressuring for selective underwriting and actuarially fair premiums (the insurance logic), and an upcoming welfare state pressuring for universal access and socially fair premiums (the welfare state logic). Based on primary sources and the extant historiography, we distinguish six periods in which the balance between both logics changed significantly. We identify various strategies employed by private insurers to reconcile the competing logics. Some of these were temporarily successful, but required measures that were incompatible with the idea of free entrepreneurship and consumer choice. We conclude that universal access can only be achieved in a competitive individual private health insurance market if this market is effectively regulated and mandatory cross-subsidies are effectively enforced. The Dutch case demonstrates that achieving universal access in a competitive private health insurance market is institutionally complex and requires broad political and societal support.

The problem of choice: From the voluntary way to Affordable Care Act health insurance exchanges.

PubMed

Mulligan, Jessica

2017-05-01

This article takes a genealogical and ethnographic approach to the problem of choice, arguing that what choice means has been reworked several times since health insurance first figured prominently in national debates about health reform. Whereas voluntary choice of doctor and hospital used to be framed as an American right, contemporary choice rhetoric includes consumer choice of insurance plan. Understanding who has deployed choice rhetoric and to what ends helps explain how offering choices has become the common sense justification for defending and preserving the exclusionary health care system in the United States. Four case studies derived from 180 enrollment observations at the Rhode Island health insurance exchange conducted from March 2014-January 2017 and interviews with enrollees show how choice is experienced in this latest iteration of health reform. The Affordable Care Act (ACA) of 2010 created new pathways to insurance coverage in the United States. Insurance exchanges were supposed to unleash the power of consumer decision-making through marketplaces where health plans compete on quality, coverage, and price. Consumers, however, contended with confusing insurance terminology and difficult to navigate websites. The ethnography shows that consumers experienced choice as confusing and overwhelming and did not feel "in charge" of their decisions. Instead, unstable employment, changes in income, existing health needs, and bureaucratic barriers shaped their "choices." Copyright © 2017 Elsevier Ltd. All rights reserved.

Taxation and Welfare: A Revision Exercise.

ERIC Educational Resources Information Center

Boden, Andrew

1992-01-01

Offers a revision exercise intended to remind students of some economic terminology associated with taxation and welfare. Provides a set of definitions for which students are to supply matching terms. Includes an answer list and suggests related exercises. (SG)

Insurance: Teacher's Guide. IIC.

ERIC Educational Resources Information Center

University of the South Pacific, Suva (Fiji).

The document presents a guide for teaching insurance protection based on the needs of students in the South Pacific. It is presented as a unit of study within the area of consumer education. Suggestions for unit objectives, student activities, time allocation, teaching methods, and reference materials are offered. A lesson plan is outlined based…

Reduction of Systemic Risk by Means of Pigouvian Taxation

PubMed Central

Zlatić, Vinko; Gabbi, Giampaolo; Abraham, Hrvoje

2015-01-01

We analyze the possibility of reduction of systemic risk in financial markets through Pigouvian taxation of financial institutions, which is used to support the rescue fund. We introduce the concept of the cascade risk with a clear operational definition as a subclass and a network related measure of the systemic risk. Using financial networks constructed from real Italian money market data and using realistic parameters, we show that the cascade risk can be substantially reduced by a small rate of taxation and by means of a simple strategy of the money transfer from the rescue fund to interbanking market subjects. Furthermore, we show that while negative effects on the return on investment (ROI) are direct and certain, an overall positive effect on risk adjusted return on investments (ROI RA) is visible. Please note that the taxation is introduced as a monetary/regulatory, not as a _scal measure, as the term could suggest. The rescue fund is implemented in a form of a common reserve fund. PMID:26177351

Reduction of Systemic Risk by Means of Pigouvian Taxation.

PubMed

Zlatić, Vinko; Gabbi, Giampaolo; Abraham, Hrvoje

2015-01-01

We analyze the possibility of reduction of systemic risk in financial markets through Pigouvian taxation of financial institutions, which is used to support the rescue fund. We introduce the concept of the cascade risk with a clear operational definition as a subclass and a network related measure of the systemic risk. Using financial networks constructed from real Italian money market data and using realistic parameters, we show that the cascade risk can be substantially reduced by a small rate of taxation and by means of a simple strategy of the money transfer from the rescue fund to interbanking market subjects. Furthermore, we show that while negative effects on the return on investment (ROI) are direct and certain, an overall positive effect on risk adjusted return on investments (ROIRA) is visible. Please note that the taxation is introduced as a monetary/regulatory, not as a _scal measure, as the term could suggest. The rescue fund is implemented in a form of a common reserve fund.

Do excise taxes save lives? The Irish experience with alcohol taxation.

PubMed

Walsh, B M

1987-12-01

This paper studies the effects of changes in the level of indirect taxation of alcoholic beverages on alcohol-related problems. Using time series data for Ireland the following topics are explored: (1) the effect of changes in taxation on the retail price of alcohol; (2) the effect of changes in the retail price on the consumption of alcohol; and (3) the association between changes in alcohol consumption and the incidence of certain alcohol-related problems, such as deaths from liver cirrhosis and fatal road accidents. The evidence is that a relatively small number of alcohol-related deaths would be averted by higher alcohol taxes. The effect of heavier taxation on the distribution of purchasing power is discussed.

Consumer-directed health care and the courts: let the buyer (and seller) beware.

PubMed

Jacobson, Peter D; Tunick, Michael R

2007-01-01

In consumer-directed health care, patients will be expected to exert greater control over their spending decisions than before. As consumer-directed care gains market acceptance, courts will inevitably be involved in resolving challenges to the new arrangements. We anticipate that courts will be generally favorable toward consumer-directed care, but the new legal doctrine will not uniformly favor medical professionals and insurers. The information demands inherent in consumer-directed care will present particular legal challenges to physicians and insurers. Even as courts provide flexibility to reflect the new market realities, they will closely monitor how consumer-directed care is implemented.

Medical Underwriting In Long-Term Care Insurance: Market Conditions Limit Options For Higher-risk Consumers

PubMed Central

2016-01-01

A key feature of private long-term care insurance is that medical underwriters screen out would-be buyers who have health conditions that portend near-term physical or cognitive disability. We applied common underwriting criteria based on data from two long-term care insurers to a nationally representative sample of individuals in the target age range for long-term care insurance (50–71 years of age). The screening criteria put upper bounds on the current proportion of Americans who could gain coverage in the individual market without changes to medical underwriting practice. Specifically, our simulations show that, for the target age range, approximately 30% of individuals whose wealth meets minimum industry standards for the suitability of long-term care insurance would have their long-term care insurance application rejected for medical reasons. Among the general population–without considering restrictions on wealth–we estimate that 40% would be disqualified. In evaluating long-term care financing reforms and their potential to increase private insurance rates, as well as to reduce financial pressure on public safety-net programs, policymakers need to consider the role of underwriting in the market for long-term care insurance. PMID:27503976

Insurance choice and tax-preferred health savings accounts.

PubMed

Cardon, James H; Showalter, Mark H

2007-03-01

We develop an infinite horizon utility maximization model of the interaction between insurance choice and tax-preferred health savings accounts. The model can be used to examine a wide range of policy options, including flexible spending accounts, health savings accounts, and health reimbursement accounts. We also develop a 2-period model to simulate various implications of the model. Key results from the simulation analysis include the following: (1) with no adverse selection, use of unrestricted health savings accounts leads to modest welfare gains, after accounting for the tax revenue loss; (2) with adverse selection and an initial pooling equilibrium comprised of "sick" and "healthy" consumers, introducing HSAs can, but does not necessarily, lead to a new pooling equilibrium. The new equilibrium results in a higher coinsurance rate, an increase in expected utility for healthy consumers, and a decrease in expected utility for sick consumers; (3) with adverse selection and a separating equilibrium, both sick and healthy consumers are better off with a health savings account; (4) efficiency gains are possible when insurance contracts are explicitly linked to tax-preferred health savings accounts.

A Behavioral Economics Perspective on Tobacco Taxation

PubMed Central

2010-01-01

Economic studies of taxation typically estimate external costs of tobacco use to be low and refrain from recommending large tobacco taxes. Behavioral economics suggests that a rational decision-making process by individuals fully aware of tobacco's hazards might still lead to overconsumption through the psychological tendency to favor immediate gratification over future harm. Taxes can serve as a self-control device to help reduce tobacco use and enable successful quit attempts. Whether taxes are appropriately high depends on how excessively people underrate the harm from tobacco use and varies with a country's circumstances. Such taxes are likely to be more equitable for poorer subgroups than traditional economic analysis suggests, which would strengthen the case for increased tobacco taxation globally. PMID:20220113

26 CFR 1.852-2 - Method of taxation of regulated investment companies.

Code of Federal Regulations, 2012 CFR

2012-04-01

... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Regulated Investment Companies and Real Estate Investment Trusts § 1.852-2 Method of taxation of regulated investment companies. (a) Imposition of normal... 26 Internal Revenue 9 2012-04-01 2012-04-01 false Method of taxation of regulated investment...

26 CFR 1.852-2 - Method of taxation of regulated investment companies.

Code of Federal Regulations, 2014 CFR

2014-04-01

... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Regulated Investment Companies and Real Estate Investment Trusts § 1.852-2 Method of taxation of regulated investment companies. (a) Imposition of normal... 26 Internal Revenue 9 2014-04-01 2014-04-01 false Method of taxation of regulated investment...

26 CFR 1.852-2 - Method of taxation of regulated investment companies.

Code of Federal Regulations, 2013 CFR

2013-04-01

... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Regulated Investment Companies and Real Estate Investment Trusts § 1.852-2 Method of taxation of regulated investment companies. (a) Imposition of normal... 26 Internal Revenue 9 2013-04-01 2013-04-01 false Method of taxation of regulated investment...

Health insurance and the demand for medical care: Instrumental variable estimates using health insurer claims data.

PubMed

Dunn, Abe

2016-07-01

This paper takes a different approach to estimating demand for medical care that uses the negotiated prices between insurers and providers as an instrument. The instrument is viewed as a textbook "cost shifting" instrument that impacts plan offerings, but is unobserved by consumers. The paper finds a price elasticity of demand of around -0.20, matching the elasticity found in the RAND Health Insurance Experiment. The paper also studies within-market variation in demand for prescription drugs and other medical care services and obtains comparable price elasticity estimates. Published by Elsevier B.V.

Key Policy Makers' Awareness of Tobacco Taxation Effectiveness through a Sensitization Program.

PubMed

Heydari, Gholamreza; Ebn Ahmady, Arezoo; Lando, Harry A; Chamyani, Fahimeh; Masjedi, Mohammadreza; Shadmehr, Mohammad B; Fadaizadeh, Lida

2015-12-01

The implementation of 5 of the 6 WHO MPOWER program in Iran is satisfactory; the only notable shortcoming is the lack of tobacco taxation increases. This study was designed to increase key policy makers' awareness of tobacco taxation effectiveness through a sensitization program in Iran. This analytical and semi-experimental study in 2014 included 110 tobacco control key policy makers, who were trained and received educational materials on the importance of tobacco taxation. A valid and reliable questionnaire was completed before and three months after intervention. Data were analyzed using mean (SD), t-Test and analysis of variance. The mean (SD) scores at pre- and post-test were 2.7 ± 3 and 8.8 ± 1 out of 10, respectively. Paired t-tests demonstrated a significant difference in the pre- post-test knowledge scores. Increasing knowledge and promoting favorable attitudes of policy makers can lead to greater attention which could in turn change tobacco taxation policies.

General equilibrium incidence of energy taxation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Solow, J.L.

1984-04-01

The pervasiveness of energy in the economy and the numerous ways in which energy taxation can distort resource allocations implies the necessity of a general equilibrium approach to the question of energy tax incidence. The author presents a general equilibrium model that accounts for domestic energy production and energy imports, direct energy consumption and use of energy as an intermediate good, and production of energy intensive and nonenergy intensive goods. He examines the incidence of three broadly-based energy taxation policies: a tax on all energy consumption, a subsidy to domestic energy production, and a tariff on energy imports. The subsidy,more » although not a revenue raising measure, is included because, like the other policies, it acts to reduce energy imports. Such a measure may be of interest by reducing reliance on unstable foreign sources of supply. 12 references, 3 tables.« less

Selected Audio-Visual Materials for Consumer Education.

ERIC Educational Resources Information Center

Oppenheim, Irene

This monograph provides an annotated listing of suggested audiovisual materials which teachers should consider as they plan consumer education programs. The materials are divided into a general section on consumer education and a section on specific topics, such as credit, decision making, health, insurance, money management, and others. The…

75 FR 81544 - Request for Information Regarding Value-Based Insurance Design in Connection With Preventive Care...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-28

..., Department of Labor; Office of Consumer Information and Insurance Oversight, Department of Health and Human... group health plans and health insurance issuers can employ value-based insurance design in the coverage... Insurance Oversight, Department of Health and Human Services, Attention: HHS-OS- 2010-002, Room 445-G...

26 CFR 1.991-1 - Taxation of a domestic international sales corporation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 10 2010-04-01 2010-04-01 false Taxation of a domestic international sales corporation. 1.991-1 Section 1.991-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Domestic International Sales Corporations § 1.991-1 Taxation...

20 CFR 638.812 - State and local taxation of Job Corps deliverers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false State and local taxation of Job Corps deliverers. 638.812 Section 638.812 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF... § 638.812 State and local taxation of Job Corps deliverers. The Act provides that transactions conducted...

20 CFR 638.812 - State and local taxation of Job Corps deliverers.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false State and local taxation of Job Corps deliverers. 638.812 Section 638.812 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF... § 638.812 State and local taxation of Job Corps deliverers. The Act provides that transactions conducted...

Energy conservation, energy efficiency and energy savings regulatory hypotheses - taxation, subsidies and underlying economics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Trumpy, T.

1995-12-01

More efficient use of energy resources can be promoted by various regulatory means, i.e., taxation, subsidies, and pricing. Various incentives can be provided by income and revenue tax breaks-deductible energy audit fees, energy saving investment credits, breaks for energy saving entrepreneurs, and energy savings accounts run through utility accounts. Value added and excise taxes can also be adjusted to reward energy saving investments and energy saving entrepreneurial activity. Incentives can be provided in the form of cash refunds, including trade-in-and-scrap programs and reimbursements or subsidies on audit costs and liability insurance. Pricing incentives include lower rates for less energy use,more » prepayment of deposit related to peak load use, electronically dispatched multiple tariffs, savings credits based on prior peak use, and subsidized {open_quotes}leasing{close_quotes} of more efficient appliances and lights. Credits, with an emphasis on pooling small loans, and 5-year energy savings contracts are also discussed.« less

12 CFR Appendix A to Part 343 - Consumer Grievance Process

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Consumer Grievance Process A Appendix A to Part... POLICY CONSUMER PROTECTION IN SALES OF INSURANCE Pt. 343, App. A Appendix A to Part 343—Consumer Grievance Process Any consumer who believes that any bank or any other person selling, soliciting...

26 CFR 1.991-1 - Taxation of a domestic international sales corporation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 10 2011-04-01 2011-04-01 false Taxation of a domestic international sales corporation. 1.991-1 Section 1.991-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY...-1 Taxation of a domestic international sales corporation. (a) In general. A corporation which is a...

From Risk to Opportunity. How Insurers Can Proactively and Profitably Manage Climate Change

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mills, E.; Lecomte, E.

2006-08-15

Last year's USD 45 billion of insured losses from Hurricane Katrina was only the latest reminder of why investors and consumers are concerned about the impacts of climate change on the insurance industry. Twelve months after the devastating storm hit New Orleans, insurers and their shareholders are still feeling the ripples. Record insured losses, rating downgrades, coverage pullbacks and class-action lawsuits are just a few of the reverberations that have been felt across the industry. Meanwhile, consumers are feeling the combined sting of price shocks and reduced availability. So serious is the issue that 20 leading investors, representing over $800more » billion in assets, called on the nation's largest insurance companies to disclose their financial exposure from climate change and steps they are taking to reduce those financial impacts. But, while most of the attention is focused on the growing risks, climate change also creates vast business opportunities to be part of the solution to global warming. Just as the industry has historically asserted its leadership to minimize risks from building fires and earthquakes, insurers have a huge opportunity today to develop creative loss-prevention products and services that will reduce climate-related losses for consumers, governments and insurers, while trimming the emissions causing global warming. This report focuses on the encouraging progress made by insurers to develop these new products and services. It identifies more than 190 concrete examples available, or soon-to-be-available, from dozens of insurance providers in 16 countries. In addition to benefiting insurers' core business and investment activities, these programs afford insurers the opportunity to differentiate their products from their competitors, while also enhancing their reputation with customers who are increasingly looking for all sectors of the industry to come forward with effective responses to the threats caused by climate change. More

26 CFR 1.860C-1 - Taxation of holders of residual interests.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 9 2013-04-01 2013-04-01 false Taxation of holders of residual interests. 1.860C-1 Section 1.860C-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Real Estate Investment Trusts § 1.860C-1 Taxation...

26 CFR 1.860C-1 - Taxation of holders of residual interests.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 9 2014-04-01 2014-04-01 false Taxation of holders of residual interests. 1.860C-1 Section 1.860C-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Real Estate Investment Trusts § 1.860C-1 Taxation...

26 CFR 1.860C-1 - Taxation of holders of residual interests.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 9 2012-04-01 2012-04-01 false Taxation of holders of residual interests. 1.860C-1 Section 1.860C-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Real Estate Investment Trusts § 1.860C-1 Taxation...

26 CFR 1.860C-1 - Taxation of holders of residual interests.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Taxation of holders of residual interests. 1.860C-1 Section 1.860C-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Real Estate Investment Trusts § 1.860C-1 Taxation of holders...

26 CFR 1.860C-1 - Taxation of holders of residual interests.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 9 2011-04-01 2011-04-01 false Taxation of holders of residual interests. 1.860C-1 Section 1.860C-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Real Estate Investment Trusts § 1.860C-1 Taxation...

12 CFR Appendix A to Part 14 - Consumer Grievance Process

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Consumer Grievance Process A Appendix A to Part 14 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY CONSUMER PROTECTION IN SALES OF INSURANCE Pt. 14, App. A Appendix A to Part 14—Consumer Grievance Process Any consumer who...

12 CFR Appendix A to Part 536 - Consumer Grievance Process

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Consumer Grievance Process A Appendix A to Part 536 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY CONSUMER PROTECTION IN SALES OF INSURANCE Pt. 536, App. A Appendix A to Part 536—Consumer Grievance Process Any consumer who...

12 CFR Appendix A to Part 14 - Consumer Grievance Process

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 1 2011-01-01 2011-01-01 false Consumer Grievance Process A Appendix A to Part 14 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY CONSUMER PROTECTION IN SALES OF INSURANCE Pt. 14, App. A Appendix A to Part 14—Consumer Grievance Process Any consumer who...

Assessing early implementation of state autism insurance mandates.

PubMed

Baller, Julia Berlin; Barry, Colleen L; Shea, Kathleen; Walker, Megan M; Ouellette, Rachel; Mandell, David S

2016-10-01

In the United States, health insurance coverage for autism spectrum disorder treatments has been historically limited. In response, as of 2015, 40 states and Washington, DC, have passed state autism insurance mandates requiring many health plans in the private insurance market to cover autism diagnostic and treatment services. This study examined five states' experiences implementing autism insurance mandates. Semi-structured, key-informant interviews were conducted with 17 participants representing consumer advocacy organizations, provider organizations, and health insurance companies. Overall, participants thought that the mandates substantially affected the delivery of autism services. While access to autism treatment services has increased as a result of implementation of state mandates, states have struggled to keep up with the demand for services. Participants provided specific information about barriers and facilitators to meeting this demand. Understanding of key informants' perceptions about states' experiences implementing autism insurance mandates is useful for other states considering adopting or expanding mandates or other policies to expand access to autism treatment services. © The Author(s) 2015.

48 CFR 229.170 - Reporting of foreign taxation on U.S. assistance programs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Reporting of foreign taxation on U.S. assistance programs. 229.170 Section 229.170 Federal Acquisition Regulations System... General 229.170 Reporting of foreign taxation on U.S. assistance programs. ...

48 CFR 229.170 - Reporting of foreign taxation on U.S. assistance programs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Reporting of foreign taxation on U.S. assistance programs. 229.170 Section 229.170 Federal Acquisition Regulations System... General 229.170 Reporting of foreign taxation on U.S. assistance programs. ...

Medical Underwriting In Long-Term Care Insurance: Market Conditions Limit Options For Higher-Risk Consumers.

PubMed

Cornell, Portia Y; Grabowski, David C; Cohen, Marc; Shi, Xiaomei; Stevenson, David G

2016-08-01

A key feature of private long-term care insurance is that medical underwriters screen out would-be buyers who have health conditions that portend near-term physical or cognitive disability. We applied common underwriting criteria based on data from two long-term care insurers to a nationally representative sample of individuals in the target age range (50-71 years) for long-term care insurance. The screening criteria put upper bounds on the current proportion of Americans who could gain coverage in the individual market without changes to medical underwriting practice. Specifically, our simulations show that in the target age range, approximately 30 percent of those whose wealth meets minimum industry standards for suitability for long-term care insurance would have their application for such insurance rejected at the underwriting stage. Among the general population-without considering financial suitability-we estimated that 40 percent would have their applications rejected. The predicted rejection rates are substantially higher than the rejection rates of about 20-25 percent of applicants in the actual market. In evaluating reforms for long-term care financing and their potential to increase private insurance rates, as well as to reduce financial pressure on public safety-net programs, policy makers need to consider the role of underwriting in the market for long-term care insurance. Project HOPE—The People-to-People Health Foundation, Inc.

[Taxation of traditional rums in French overseas territories and public health: The example of Reunion Island].

PubMed

Mété, D

2017-11-01

France has a complex system for the taxation of alcoholic beverages. In the French overseas territories (FOT), the system includes little-known specificities whose purpose is to preserve the sugar-cane-rum sector, a pillar for the weak economies in these territories. Taxes are reduced for traditional rums produced and sold locally. This favors the marketing of alcoholic spirits at low prices. In metropolitan France, on the contrary, spirits are heavily taxed drinks and their share in consumption is minor. Reunion Island (RI) is a FOT confronted with significant socioeconomic precariousness and with one of the highest national morbidity and mortality rates associated with alcohol abuse. Spirits account for half of the total consumption of pure alcohol, with a strong predominance for local traditional rums. These products are preferentially consumed by vulnerable subjects, often affected by an alcohol-use disorder. This study consists of three parts. First, a comparative analysis of alcoholic beverage prices between RI and mainland France. Second, an analysis of the bibliography on the consequences of preferential consumption of spirits. Third, a literature review on the impact of taxation on alcohol-related morbidity and mortality. In France, the cheapest gram of pure alcohol is found in the FOT. The preferential consumption of spirits is associated with more frequent and more rapid complications. It is correlated with the level of alcoholic psychoses. Taxation is effective in reducing damage caused by the abuse of alcoholic beverages. The World Health Organization recommends the application of a minimum price for alcohol and tax increases. The reduced taxation of the traditional rums of the FOT does not take into account public health data. Its purpose is economic. In RI, it contributes to a high level of consumption of spirits and encourages excess mortality through alcohol abuse. It constitutes an inequality of health for these populations. Changes in this tax

75 FR 37242 - Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-28

... Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and Affordable... Labor and the Office of Consumer Information and Insurance Oversight of the U.S. Department of Health... guidance to employers, group health plans, and health insurance issuers providing group health insurance...

Consumer Protection in Managed Care: A Third-Generation Approach.

ERIC Educational Resources Information Center

Rother, John

1996-01-01

Discusses three generations of consumer protection issues related to managed care: (1) individual treatment decisions--individuals wanting treatment their plan does not cover or deems unnecessary; (2) insurance practices and risk selection--impact of health management organizations on the rest of the health insurance system; and (3) health plan…

Estimated impacts of alternative Australian alcohol taxation structures on consumption, public health and government revenues.

PubMed

Doran, Christopher M; Byrnes, Joshua M; Cobiac, Linda J; Vandenberg, Brian; Vos, Theo

2013-11-04

To examine health and economic implications of modifying taxation of alcohol in Australia. Economic and epidemiological modelling of four scenarios for changing the current taxation of alcohol products, including: replacing the wine equalisation tax (WET) with a volumetric tax; applying an equal tax rate to all beverages equivalent to a 10% increase in the current excise applicable to spirits and ready-to-drink products; applying an excise tax rate that increases exponentially by 3% for every 1% increase in alcohol content above 3.2%; and applying a two-tiered volumetric tax. We used annual sales data and taxation rates for 2010 as the base case. Alcohol consumption, taxation revenue, disability-adjusted life-years (DALYs) averted and health care costs averted. In 2010, the Australian Government collected close to $8.6 billion from alcohol taxation. All four of the proposed variations to current rates of alcohol excise were shown to save money and more effectively reduce alcohol-related harm compared with the 2010 base case. Abolishing the WET and replacing it with a volumetric tax on wine would increase taxation revenue by $1.3 billion per year, reduce alcohol consumption by 1.3%, save $820 million in health care costs and avert 59 000 DALYs. The alternative scenarios would lead to even higher taxation receipts and greater reductions in alcohol use and harm. Our research findings suggest that any of the proposed variations to current rates of alcohol excise would be a cost-effective health care intervention; they thus reinforce the evidence that taxation is a cost-effective strategy. Of all the scenarios, perhaps the most politically feasible policy option at this point in time is to abolish the WET and replace it with a volumetric tax on wine. This analysis supports the recommendation of the National Preventative Health Taskforce and the Henry Review towards taxing alcohol according to alcohol content.

Averting obesity and type 2 diabetes in India through sugar-sweetened beverage taxation: an economic-epidemiologic modeling study.

PubMed

Basu, Sanjay; Vellakkal, Sukumar; Agrawal, Sutapa; Stuckler, David; Popkin, Barry; Ebrahim, Shah

2014-01-01

Taxing sugar-sweetened beverages (SSBs) has been proposed in high-income countries to reduce obesity and type 2 diabetes. We sought to estimate the potential health effects of such a fiscal strategy in the middle-income country of India, where there is heterogeneity in SSB consumption, patterns of substitution between SSBs and other beverages after tax increases, and vast differences in chronic disease risk within the population. Using consumption and price variations data from a nationally representative survey of 100,855 Indian households, we first calculated how changes in SSB price alter per capita consumption of SSBs and substitution with other beverages. We then incorporated SSB sales trends, body mass index (BMI), and diabetes incidence data stratified by age, sex, income, and urban/rural residence into a validated microsimulation of caloric consumption, glycemic load, overweight/obesity prevalence, and type 2 diabetes incidence among Indian subpopulations facing a 20% SSB excise tax. The 20% SSB tax was anticipated to reduce overweight and obesity prevalence by 3.0% (95% CI 1.6%-5.9%) and type 2 diabetes incidence by 1.6% (95% CI 1.2%-1.9%) among various Indian subpopulations over the period 2014-2023, if SSB consumption continued to increase linearly in accordance with secular trends. However, acceleration in SSB consumption trends consistent with industry marketing models would be expected to increase the impact efficacy of taxation, averting 4.2% of prevalent overweight/obesity (95% CI 2.5-10.0%) and 2.5% (95% CI 1.0-2.8%) of incident type 2 diabetes from 2014-2023. Given current consumption and BMI distributions, our results suggest the largest relative effect would be expected among young rural men, refuting our a priori hypothesis that urban populations would be isolated beneficiaries of SSB taxation. Key limitations of this estimation approach include the assumption that consumer expenditure behavior from prior years, captured in price elasticities

Direct-to-consumer advertising: its effects on stakeholders.

PubMed

Montoya, Isaac D; Lee-Dukes, Gwen; Shah, Dhvani

2008-01-01

The escalating growth in the development of pharmaceutical drugs has caused the pharmaceutical industry to market drugs directly to consumers. Direct-to-consumer (DTC) advertising has increased immensely in the past 15 years and continues to grow each year. The advantages of DTC advertising include an increase in consumer knowledge, patient autonomy, and possibly providing physicians and pharmacists with up-to-date information about the recent trends in the marketplace. However, there is also an equally notable list of disadvantages, which include concerns about the quality of information provided, loss in physician productivity due to time spent convincing patients that what they want is not in their best interest, and increases in the reimbursement expenditure of the insurers. Because of these conflicting outcomes, the issue of DTC advertising has become controversial. This report offers an overview of DTC advertising and focuses on its effects on physicians, pharmacists, consumers, insurers, the government, and pharmaceutical manufacturers.

24 CFR 1000.242 - When does the requirement for exemption from taxation apply to affordable housing activities?

Code of Federal Regulations, 2010 CFR

2010-04-01

... exemption from taxation apply to affordable housing activities? 1000.242 Section 1000.242 Housing and Urban... ACTIVITIES Indian Housing Plan (IHP) § 1000.242 When does the requirement for exemption from taxation apply to affordable housing activities? The requirement for exemption from taxation applies only to rental...

24 CFR 1000.242 - When does the requirement for exemption from taxation apply to affordable housing activities?

Code of Federal Regulations, 2011 CFR

2011-04-01

... exemption from taxation apply to affordable housing activities? 1000.242 Section 1000.242 Housing and Urban... ACTIVITIES Indian Housing Plan (IHP) § 1000.242 When does the requirement for exemption from taxation apply to affordable housing activities? The requirement for exemption from taxation applies only to rental...

75 FR 51168 - Consumer Protections for Depository Institution Sales of Insurance

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-18

... addresses: Office of Information and Regulatory Affairs, Attention: Desk Officer for OTS, U.S. Office of..., advertising, and offers of any insurance product by a depository institution or by other persons performing...

75 FR 45204 - Consumer Protections for Depository Institution Sales of Insurance

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-02

... addresses: Office of Information and Regulatory Affairs, Attention: Desk Officer for OTS, U.S. Office of..., solicitations, advertising, and offers of any insurance product by a depository institution or by other persons...

Long-term care: long-term care insurance--2005. End of Year Issue Brief.

PubMed

Tanner, Rachel; Bercaw, Lawren

2005-12-31

As the "Baby Boom" generation approaches retirement, state and federal lawmakers are struggling to ensure that the nation's long-term care system will provide adequate services for the growing number of senior citizens. A 2003 Administration on Aging report predicted that the elderly population will double by 2030. Accordingly, policymakers must prepare for the impending squeeze on public health and Medicaid resources. Many consumers are exploring private long-term care insurance options as a means of preparing for the cost of eldercare. Yet, a lack of market uniformity has rendered the long-term care insurance industry somewhat difficult for consumers to decipher. In addition, senior care insurance is often costly, particularly for those over age 50.

Taxation of oil and gas revenues: Canada

DOE Office of Scientific and Technical Information (OSTI.GOV)

Helliwell, J.F.

1982-04-01

The policy of Canadianization must be included in any analysis of energy taxation in Canada, where energy resources are unevenly divided among the provinces. The provinces own most natural resources, but the oil and gas industry is dominated by foreign ownership and control. The Federal National Energy Program (NEP) of 1980 target of 50% Canadian ownership by 1990 conflicts with provincial practices by shifting incentives from depletion allowance to ownership grants for buy backs. The NEP compares unfavorably with US taxation, and that, combined with US deregulation, has shifted drilling activity to the US. The controversial tax elements do comparemore » with those of the United Kingdom and other North Sea producers. Although recent controversy has caused investors to defer projects, Canadian investment is competitive with most countries. 5 references, 1 table. (DCK)« less

20 CFR 209.14 - Report of separation allowances subject to tier II taxation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Report of separation allowances subject to tier II taxation. 209.14 Section 209.14 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER... separation allowances subject to tier II taxation. For any employee who is paid a separation payment, the...

20 CFR 209.14 - Report of separation allowances subject to tier II taxation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Report of separation allowances subject to tier II taxation. 209.14 Section 209.14 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER... separation allowances subject to tier II taxation. For any employee who is paid a separation payment, the...

Creating more effective health plan quality reports for consumers: lessons from a synthesis of qualitative testing.

PubMed Central

Harris-Kojetin, L D; McCormack, L A; Jaël, E F; Sangl, J A; Garfinkel, S A

2001-01-01

OBJECTIVE: Social marketing techniques such as consumer testing have only recently been applied to develop effective consumer health insurance information. This article discusses lessons learned from consumer testing to create consumer plan choice materials. DATA SOURCES/STUDY SETTING: Data were collected from 268 publicly and privately insured consumers in three studies between 1994 and 1999. STUDY DESIGN: Iterative testing and revisions were conducted to design seven booklets to help Medicaid, Medicare, and employed consumers choose a health plan. DATA COLLECTION METHODS: Standardized protocols were used in 11 focus groups and 182 interviews to examine the content, comprehension, navigation, and utility of the booklets. PRINCIPAL FINDINGS: A method is suggested to help consumers narrow their plan choices by breaking down the process into smaller decisions using a set of guided worksheets. CONCLUSION: Implementing these lessons is challenging and not often done well. This article gives examples of evidence-based approaches to address cognitive barriers that designers of consumer health insurance information can adapt to their needs. Images Figure. 3 PMID:11482584

Adverse Selection and Inertia in Health Insurance Markets: When Nudging Hurts.

PubMed

Handel, Benjamin R

2013-12-01

This paper investigates consumer inertia in health insurance markets, where adverse selection is a potential concern. We leverage a major change to insurance provision that occurred at a large firm to identify substantial inertia, and develop and estimate a choice model that also quantifies risk preferences and ex ante health risk. We use these estimates to study the impact of policies that nudge consumers toward better decisions by reducing inertia. When aggregated, these improved individual-level choices substantially exacerbate adverse selection in our setting, leading to an overall reduction in welfare that doubles the existing welfare loss from adverse selection.

Towards a stakeholders' consensus on patient payment policy: the views of health-care consumers, providers, insurers and policy makers in six Central and Eastern European countries.

PubMed

Tambor, Marzena; Pavlova, Milena; Golinowska, Stanisława; Sowada, Christoph; Groot, Wim

2015-08-01

Although patient charges for health-care services may contribute to a more sustainable health-care financing, they often raise public opposition, which impedes their introduction. Thus, a consensus among the main stakeholders on the presence and role of patient charges should be worked out to assure their successful implementation. To analyse the acceptability of formal patient charges for health-care services in a basic package among different health-care system stakeholders in six Central and Eastern European countries (Bulgaria, Hungary, Lithuania, Poland, Romania and Ukraine). Qualitative data were collected in 2009 via focus group discussions and in-depth interviews with health-care consumers, providers, policy makers and insurers. The same participants were asked to fill in a self-administrative questionnaire. Qualitative and quantitative data are analysed separately to outline similarities and differences in the opinions between the stakeholder groups and across countries. There is a rather weak consensus on patient charges in the countries. Health policy makers and insurers strongly advocate patient charges. Health-care providers overall support charges but their financial profits from the system strongly affects their approval. Consumers are against paying for services, mostly due to poor quality and access to health-care services and inability to pay. To build consensus on patient charges, the payment policy should be responsive to consumers' needs with regard to quality and equity. Transparency and accountability in the health-care system should be improved to enhance public trust and acceptance of patient payments. © 2012 John Wiley & Sons Ltd.

U.S. Taxation of Business: Relevance of the European Experience. German Studies Notes.

ERIC Educational Resources Information Center

McLure, Charles E., Jr.

American and European business taxation policies are compared in this booklet. Topics discussed in the paper include effects of the corporation income tax, integration of income taxation, and the value added tax. Two major differences between the American and European systems are noted. First, European countries derive substantial portions of…

Green commercial building insurance in Malaysia

NASA Astrophysics Data System (ADS)

Yang, Yu Xin Ou; Chew, Boon Cheong; Loo, Heoy Shin; Tan, Lay Hong

2017-03-01

Green building construction is growing tremendously globally even in Malaysia. Currently, there are approximate 636 buildings have registered and to be certified with Green Building Index. Among these buildings, 45 buildings have already fulfilled the requirements and fully certified. The other buildings still under provisional certification stage. Malaysia had adopted Green Building Index in 2009 to support a move to promote green building concept. Malaysia starts to move towards green building because Malaysian construction and building industry realizes that both energy consumed and waste produced are reduced without irreversible impacts to ecosystems. Consequently, insurance companies such as Fireman's Fund from America has started the green building insurance policies for their green building in the year of 2006, while Malaysia still remain the coverage for green buildings using conventional property insurance. There are lacks of efforts to be seen from insurance companies to propose green building insurance for these green buildings. There are a few factors which can take into consideration for insurance companies to start the very first green building insurance in Malaysia. Although there are challenges, some efficient strategies have been identified to overcome the problems. The methods used in this research topic is qualitative research. The results obtained shows that green commercial building insurance has a huge business opportunity in Malaysia because the number of green commercial buildings are increasing tremendously in Malaysia. It is a favor to implement green building insurance in Malaysia. Furthermore, insurance companies can consider to add in extra coverage in standard building policy to provide extra protection for non-certified green buildings which have the intention to rebuilt in green when damage happens. Generally, it is very important to introduce green commercial buildings insurance into Malaysia so that all of the green commercial

Preferred providers and the credible commitment problem in health insurance: first experiences with the implementation of managed competition in the Dutch health care system.

PubMed

Boonen, Lieke H H M; Schut, Frederik T

2011-04-01

We investigate the impact of the transition towards managed competition in the Dutch health care system on health insurers' contracting behaviour. Specifically, we examine whether insurers have been able to take up their role as prudent buyers of care and examine consumers' attitudes towards insurers' new role. Health insurers' contracting behaviour is investigated by an extensive analysis of available information on purchasing practices by health insurers and by interviews with directors of health care purchasing of the four major health insurers, accounting for 90% of the market. Consumer attitudes towards insurers' new role are investigated by surveys among a representative sample of enrollees over the period 2005-2009. During the first four years of the reform, health insurers were very reluctant to engage in selective contracting and preferred to use 'soft' positive incentives to encourage preferred provider choice rather than engaging in restrictive managed care activities. Consumer attitudes towards channelling vary considerably by type of provider but generally became more negative in the first two years after the reform. Insurers' reluctance to use selective contracting can be at least partly explained by the presence of a credible-commitment problem. Consumers do not trust that insurers with restrictive networks are committed to provide good quality care. The credible-commitment problem seems to be particularly relevant to the Netherlands, since Dutch enrollees are not used to restrictions on provider choice. Since consumers are quite sensitive to differences in provider quality, more reliable information about provider quality is required to reduce the credible-commitment problem.

Optimal health insurance: the case of observable, severe illness.

PubMed

Chernew, M E; Encinosa, W E; Hirth, R A

2000-09-01

We explore optimal cost-sharing provisions for insurance contracts when individuals have observable, severe diseases with a discrete number of medically appropriate treatment options. Variation in preferences for alternative treatments is unobserved by the insurer and non-contractible. Interest in such situations is increasingly common, exemplified by disease carve-out programs and shared decision-making (SDM) tools. We demonstrate that optimal insurance charges a copay to patients choosing the high-cost treatment and provides consumers of the low-cost treatment a cash payment. A simulation of the effect of such a policy, based on prostate cancer, indicates a substantial reduction in moral hazard.

12 CFR 14.60 - Qualification and licensing requirements for insurance sales personnel.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Qualification and licensing requirements for insurance sales personnel. 14.60 Section 14.60 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY CONSUMER PROTECTION IN SALES OF INSURANCE § 14.60 Qualification and licensing...

Can decision biases improve insurance outcomes? An experiment on status quo bias in health insurance choice.

PubMed

Krieger, Miriam; Felder, Stefan

2013-06-19

Rather than conforming to the assumption of perfect rationality in neoclassical economic theory, decision behavior has been shown to display a host of systematic biases. Properly understood, these patterns can be instrumentalized to improve outcomes in the public realm. We conducted a laboratory experiment to study whether decisions over health insurance policies are subject to status quo bias and, if so, whether experience mitigates this framing effect. Choices in two treatment groups with status quo defaults are compared to choices in a neutrally framed control group. A two-step design features sorting of subjects into the groups, allowing us to control for selection effects due to risk preferences. The results confirm the presence of a status quo bias in consumer choices over health insurance policies. However, this effect of the default framing does not persist as subjects repeat this decision in later periods of the experiment. Our results have implications for health care policy, for example suggesting that the use of non-binding defaults in health insurance can facilitate the spread of co-insurance policies and thereby help contain health care expenditure.

26 CFR 1.1293-1 - Current taxation of income from qualified electing funds.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 11 2010-04-01 2010-04-01 true Current taxation of income from qualified electing funds. 1.1293-1 Section 1.1293-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE... Losses § 1.1293-1 Current taxation of income from qualified electing funds. (a) In general. [Reserved] (1...

26 CFR 1.1293-1 - Current taxation of income from qualified electing funds.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 11 2011-04-01 2011-04-01 false Current taxation of income from qualified electing funds. 1.1293-1 Section 1.1293-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE... Gains and Losses § 1.1293-1 Current taxation of income from qualified electing funds. (a) In general...

Towards a coherent European approach for taxation of combustible waste.

PubMed

Dubois, Maarten

2013-08-01

Although intra-European trade of combustible waste has grown strongly in the last decade, incineration and landfill taxes remain disparate within Europe. The paper proposes a more coherent taxation approach for Europe that is based on the principle of Pigovian taxation, i.e. the internalization of environmental damage costs. The approach aims to create a level playing field between European regions while reinforcing incentives for sustainable management of combustible waste. Three important policy recommendations emerge. First, integrating waste incineration into the European Emissions Trading System for greenhouse gases (EU ETS) reduces the risk of tax competition between regions. Second, because taxation of every single air pollutant from waste incineration is cumbersome, a differentiated waste incineration tax based on NO(x) emissions can serve as a second-best instrument. Finally, in order to strengthen incentives for ash treatment, a landfill tax should apply for landfilled incineration residues. An example illustrates the coherence of the policy recommendations for incineration technologies with diverse environmental effects. Copyright © 2013 Elsevier Ltd. All rights reserved.

78 FR 71558 - Insurance Cost Information Regulation

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-29

... [Docket No. NHTSA-2013-0078] Insurance Cost Information Regulation AGENCY: National Highway Traffic Safety... method for reporting simple and understandable motor vehicle damage susceptibility information to consumers. NHTSA plans to use this information to meet a requirement by Congress that it study and report...

Alternative approaches to the taxation of heavy vehicles

DOT National Transportation Integrated Search

1998-01-01

This report contains recommendations that are applicable to federal and state governments for evaluating alternatives to the taxation of heavy vehicles. An evaluation procedure and general assessments and recommendations on future activities are pres...

Economic aspects of tobacco use and taxation policy.

PubMed Central

Godfrey, C.; Maynard, A.

1988-01-01

Tax levels have important effects on cigarette prices and tax revenues. Over 70p of every pound spent on tobacco goes to the Chancellor of the Exchequer, yielding over 5 billion pounds. But the value of tobacco tax revenues have generally fallen--by 1986 they were 10% lower than at their peak in 1965, and tobacco revenue is becoming a smaller proportion of total tax receipts. The impact of a consistent increase in tobacco taxation is important in terms of reduced consumption (and harm to health) as well as in terms of reduced employment. Revenue may, however, increase in the short term. Finally, if the findings of Townsend and Atkinson et al (see above) still apply then the distributive effects of increased taxation on the poor might be less than is sometimes feared. PMID:3416168

How much downside? Quantifying the relative harm from tobacco taxation

PubMed Central

Wilson, N; Thomson, G; Tobias, M; Blakely, T

2004-01-01

Objective: To estimate the loss of life expectancy attributable to tobacco taxation (via financial hardship and flow-on health effect) in New Zealand. Design: Data were used on the gradients in life expectancy and smoking by neighbourhood socioeconomic deprivation and survey data on tobacco expenditure. Three estimates were modelled of the percentage of the crude association of neighbourhood deprivation with life expectancy that might be mediated via financial hardship: 100%, 50%, and 25% (best estimate). From this information the impact of tobacco taxation on life expectancy was estimated. Main results: For the total population, the estimated loss of life expectancy due to tobacco tax ranged from 0.005 years to 0.027 years. For people living in the most deprived 30% of neighbourhoods, the range was 0.009 to 0.044 years (that is, 3 to 16 days of lost life expectancy). For the total population the loss of life expectancy attributable to tobacco tax ranged from 119 to 460 times less than that attributable to deprivation. The loss of life expectancy attributable to tobacco tax was 42 to 257 times less than that attributable to smoking. Conclusions: The estimated harm to life expectancy from tobacco taxation (via financial hardship) is orders of magnitude smaller than the harm from smoking. Although the analyses involve a number of simplistic assumptions, this conclusion is likely to be robust. Policy makers should be reassured that tobacco taxation is likely to be achieving far more benefit than harm in the general population and in socioeconomically deprived populations. PMID:15143110

12 CFR 741.220 - Privacy of consumer financial information.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Privacy of consumer financial information. 741.220 Section 741.220 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING... Privacy of consumer financial information. Any credit union which is insured pursuant to Title II of the...

12 CFR 741.220 - Privacy of consumer financial information.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 7 2012-01-01 2012-01-01 false Privacy of consumer financial information. 741.220 Section 741.220 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING... Privacy of consumer financial information. Any credit union which is insured pursuant to Title II of the...

12 CFR 741.220 - Privacy of consumer financial information.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 7 2014-01-01 2014-01-01 false Privacy of consumer financial information. 741.220 Section 741.220 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING... Privacy of consumer financial information. Any credit union which is insured pursuant to title II of the...

12 CFR 741.220 - Privacy of consumer financial information.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 7 2013-01-01 2013-01-01 false Privacy of consumer financial information. 741.220 Section 741.220 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING... Privacy of consumer financial information. Any credit union which is insured pursuant to Title II of the...

12 CFR 741.220 - Privacy of consumer financial information.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Privacy of consumer financial information. 741.220 Section 741.220 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING... Privacy of consumer financial information. Any credit union which is insured pursuant to Title II of the...

Common state mechanisms regulating tribal tobacco taxation and sales, the USA, 2015

PubMed Central

DeLong, Hillary; Chriqui, Jamie; Leider, Julien; Chaloupka, Frank J

2016-01-01

Background Native American tribes, as sovereign nations, are exempt from state tobacco excise taxation, and self-govern on-reservation activity in the USA. Under Federal law, state excise taxes are owed by non-members purchasing tobacco on tribal land, but states are limited in how they enforce or collect these taxes. This study highlights the various policy approaches that states have taken to regulate tobacco sales on tribal lands given jurisdictional challenges. Methods State laws (statutes, regulations and case law), Attorney General opinions, and revenue notices and rulings effective as of 1 January 2015 for all 50 states and the District of Columbia were compiled using Boolean searches in Lexis-Nexis and Westlaw. Laws were limited to those addressing taxation compacts or tobacco sales involving tribal entities. Master Settlement Agreement laws and non-codified tribal codes/compacts were excluded. Results Twenty of the 34 states with tribal lands address tribal tobacco sales. Fourteen states address intergovernmental compacts: 11 are tobacco specific, and suggest or require specific provisions. Fifteen states address tribal tax stamps: 2 explicitly prohibit stamping tribally sold products, 9 stamp all products, and 4 stamp some. Prepayment of excise tax is required in 12 states: 6 on all products, 4 on products in excess of quota, and 2 on products sold by non-tribal retailers. 6 states use quotas to limit tax-free tobacco available to tribes. Conclusions Many states with a tribal presence have no formal strategies for non-members purchasing tobacco on tribal lands. Formalising policies and harmonising tax rates may assist states in collecting tax revenue from non-tribal consumers. PMID:27354677

75 FR 34571 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-17

... Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered Health Plan... of Consumer Information and Insurance Oversight of the U.S. Department of Health and Human Services... health insurance coverage offered in connection with a group health plan under the Employee Retirement...

Finance issue brief: long-term care insurance: year end report-2003.

PubMed

Tanner, Rachel C

2003-12-31

A 1996 federal law made it more attractive for states to consider long-term care insurance, and states have responded by implementing policies to make the purchase of these long-term care coverage more affordable and consumer-friendly. At present, policymakers continue to debate the future role of private long-term care insurance in subsidizing the increasing demand for long-term care services.

26 CFR 1.852-4 - Method of taxation of shareholders of regulated investment companies.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Method of taxation of shareholders of regulated investment companies. 1.852-4 Section 1.852-4 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE... Investment Trusts § 1.852-4 Method of taxation of shareholders of regulated investment companies. (a...

26 CFR 1.852-4 - Method of taxation of shareholders of regulated investment companies.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 9 2011-04-01 2011-04-01 false Method of taxation of shareholders of regulated investment companies. 1.852-4 Section 1.852-4 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE... Real Estate Investment Trusts § 1.852-4 Method of taxation of shareholders of regulated investment...

75 FR 43109 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-23

... Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and Appeals and... the Office of Consumer Information and Insurance Oversight of the U.S. Department of Health and Human... health insurance coverage offered in connection with a group health plan under the Employee Retirement...

Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study.

PubMed

Brown, V; Moodie, M; Cobiac, L; Mantilla Herrera, A M; Carter, R

2017-05-04

Reducing automobile dependence and improving rates of active transport may reduce the impact of obesogenic environments, thereby decreasing population prevalence of obesity and other diseases where physical inactivity is a risk factor. Increasing the relative cost of driving by an increase in fuel taxation may therefore be a promising public health intervention for obesity prevention. A scoping review of the evidence for obesity or physical activity effect of changes in fuel price or taxation was undertaken. Potential health benefits of an increase in fuel excise taxation in Australia were quantified using Markov modelling to simulate obesity, injury and physical activity related health impacts of a fuel excise taxation intervention for the 2010 Australian population. Health adjusted life years (HALYs) gained and healthcare cost savings from diseases averted were estimated. Incremental cost-effectiveness ratios (ICERs) were reported and results were tested through sensitivity analysis. Limited evidence on the effect of policies such as fuel taxation on health-related behaviours currently exists. Only three studies were identified reporting associations between fuel price or taxation and obesity, whilst nine studies reported associations specifically with physical activity, walking or cycling. Estimates of the cross price elasticity of demand for public transport with respect to fuel price vary, with limited consensus within the literature on a probable range for the Australian context. Cost-effectiveness modelling of a AUD0.10 per litre increase in fuel excise taxation using a conservative estimate of cross price elasticity for public transport suggests that the intervention would be cost-effective from a limited societal perspective (237 HALYs gained, AUD2.6 M in healthcare cost savings), measured against a comparator of no additional increase in fuel excise. Under "best case" assumptions, the intervention would be more cost-effective (3181 HALYs gained, AUD34.2�

76 FR 30250 - Share Insurance and Appendix

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-25

...-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank Act) \\1\\ provides that, on a temporary... the time of failure. For example, if pursuant to an agreement between an insured credit union and its... unions would retain flexibility regarding the form of the notice. Therefore, in conjunction with...

Insurance Exchange Marketplace: Implications for Emergency Medicine Practice

PubMed Central

Rankey, David S.

2012-01-01

The Patient Protection and Affordable Care Act of 2010 requires states to establish healthcare insurance exchanges by 2014 to facilitate the purchase of qualified health plans. States are required to establish exchanges for small businesses and individuals. A federally operated exchange will be established, and states failing to participate in any other exchanges will be mandated to join the federal exchange. Policymakers and health economists believe that exchanges will improve healthcare at lower cost by promoting competition among insurers and by reducing burdensome transaction costs. Consumers will no longer be isolated from monthly insurance premium costs. Exchanges will increase the number of patients insured with more cost-conscious managed care and high-deductible plans. These insurance plan models have historically undervalued emergency medical services, while also underinsuring patients and limiting their healthcare system access to the emergency department. This paradoxically increases demand for emergency services while decreasing supply. The continual devaluation of emergency medical services by insurance payers will result in inadequate distribution of resources to emergency care, resulting in further emergency department closures, increases in emergency department crowding, and the demise of acute care services provided to families and communities. PMID:22900107

Can Decision Biases Improve Insurance Outcomes? An Experiment on Status Quo Bias in Health Insurance Choice

PubMed Central

Krieger, Miriam; Felder, Stefan

2013-01-01

Rather than conforming to the assumption of perfect rationality in neoclassical economic theory, decision behavior has been shown to display a host of systematic biases. Properly understood, these patterns can be instrumentalized to improve outcomes in the public realm. We conducted a laboratory experiment to study whether decisions over health insurance policies are subject to status quo bias and, if so, whether experience mitigates this framing effect. Choices in two treatment groups with status quo defaults are compared to choices in a neutrally framed control group. A two-step design features sorting of subjects into the groups, allowing us to control for selection effects due to risk preferences. The results confirm the presence of a status quo bias in consumer choices over health insurance policies. However, this effect of the default framing does not persist as subjects repeat this decision in later periods of the experiment. Our results have implications for health care policy, for example suggesting that the use of non-binding defaults in health insurance can facilitate the spread of co-insurance policies and thereby help contain health care expenditure. PMID:23783222

Averting Obesity and Type 2 Diabetes in India through Sugar-Sweetened Beverage Taxation: An Economic-Epidemiologic Modeling Study

PubMed Central

Basu, Sanjay; Vellakkal, Sukumar; Agrawal, Sutapa; Stuckler, David; Popkin, Barry; Ebrahim, Shah

2014-01-01

Background Taxing sugar-sweetened beverages (SSBs) has been proposed in high-income countries to reduce obesity and type 2 diabetes. We sought to estimate the potential health effects of such a fiscal strategy in the middle-income country of India, where there is heterogeneity in SSB consumption, patterns of substitution between SSBs and other beverages after tax increases, and vast differences in chronic disease risk within the population. Methods and Findings Using consumption and price variations data from a nationally representative survey of 100,855 Indian households, we first calculated how changes in SSB price alter per capita consumption of SSBs and substitution with other beverages. We then incorporated SSB sales trends, body mass index (BMI), and diabetes incidence data stratified by age, sex, income, and urban/rural residence into a validated microsimulation of caloric consumption, glycemic load, overweight/obesity prevalence, and type 2 diabetes incidence among Indian subpopulations facing a 20% SSB excise tax. The 20% SSB tax was anticipated to reduce overweight and obesity prevalence by 3.0% (95% CI 1.6%–5.9%) and type 2 diabetes incidence by 1.6% (95% CI 1.2%–1.9%) among various Indian subpopulations over the period 2014–2023, if SSB consumption continued to increase linearly in accordance with secular trends. However, acceleration in SSB consumption trends consistent with industry marketing models would be expected to increase the impact efficacy of taxation, averting 4.2% of prevalent overweight/obesity (95% CI 2.5–10.0%) and 2.5% (95% CI 1.0–2.8%) of incident type 2 diabetes from 2014–2023. Given current consumption and BMI distributions, our results suggest the largest relative effect would be expected among young rural men, refuting our a priori hypothesis that urban populations would be isolated beneficiaries of SSB taxation. Key limitations of this estimation approach include the assumption that consumer expenditure behavior from

Statewide Taxation of Nonresidential Property for Education.

ERIC Educational Resources Information Center

Ladd, Helen F.; Harris, Edward W.

1995-01-01

Assuming that New York will continue to rely heavily on the property tax to finance education, this paper summarizes the conceptual arguments for statewide taxation of business property for education. The plan would improve local decision making, but would lead to highly undesirable consequences for New York City's school children and…

Healthy food subsidies and unhealthy food taxation: A systematic review of the evidence.

PubMed

Niebylski, Mark L; Redburn, Kimbree A; Duhaney, Tara; Campbell, Norm R

2015-06-01

The Global Burden of Disease Study and related studies report unhealthy diet is the leading risk for death and disability globally. Given the evidence associating diet and non-communicable diseases (NCDs), international and national health bodies including the World Health Organization and United Nations have called for population health interventions to improve diet as a means to target NCDs. One of the proposed interventions is to ensure healthy foods/beverages are more accessible to purchasers and unhealthy ones less accessible via fiscal policy, namely taxation and subsidies. The objective of this systematic review was to evaluate the evidence base to assess the effect of healthy food/beverage subsidies and unhealthy food/beverage taxation. A comprehensive review was conducted by searching PubMed, Medline, and Google Scholar for peer-reviewed publications and seventy-eight studies were identified for inclusion in this review. This review was performed in keeping with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. Although moderate in quality, there was consistent evidence that taxation and subsidy intervention influenced dietary behaviors. The quality, level and strength of evidence along with identified gaps in research support the need for further policies and ongoing evaluation of population-wide food/beverage subsidies and taxation. To maximize success and effect, this review suggests that food taxes and subsidies should be a minimum of 10 to 15% and preferably used in tandem. Implementation of population-wide polices for taxation and subsides with ongoing evaluation of intended and unintended effects are supported by this review. Copyright © 2015 Elsevier Inc. All rights reserved.

Registered indians and tobacco taxation: a culturally-appropriate strategy?

PubMed

Wardman, A E Dennis; Khan, Nadia A

2005-01-01

Taxation of tobacco is a widely-used strategy that prompts smoking cessation among adults and reduces cigarette consumption among continuing smokers. Registered Indian tobacco use prevalence is at least double that of the rest of Canadians and is in part due to the lower cost of tobacco products purchased on reserve by Registered Indians (RIs) as they are tax exempt. Although registered Indian communities have the ability to collect tax on tobacco products and direct the use of these revenues, this strategy is rarely utilized. Tobacco taxation could have substantial health and economic benefits to RI communities, but perhaps is not culturally-appropriate. In order to better support RI communities, governments and other organizations need to examine this policy instrument in the context of RI populations.

Pedagogy of natural resource taxation in professional accounting programs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Reese, C.E.

1983-03-01

After a brief discussion of the traditional view of tax education, the author traces its explosive growth at the graduate level during the past decade. He analyzes the current status of graduate tax education, including natural resource taxation as a component of the curriculum. He recommends ways to integrate natural resource taxation topics into the curriculum of future professional tax accountants that will acknowledge the importance of natural resources to our nation's continued prosperity. An expanded private sector financial and moral support will be necessary. This could be in the form of course development grants, a faculty internship with amore » natural resource industrial firm, faculty research grants, and endowed professorships. A sample course outline appears in the the appendix.« less

26 CFR 1.61-2T - Taxation of fringe benefits-1985 through 1988 (temporary).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Taxation of fringe benefits-1985 through 1988 (temporary). 1.61-2T Section 1.61-2T Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY..., and Taxable Income § 1.61-2T Taxation of fringe benefits—1985 through 1988 (temporary). (a) Fringe...

Finance issue brief: long-term care insurance: year end report-2002.

PubMed

Tanner, Rachel

2002-12-31

A 1996 federal law made it more attractive for states to consider long-term care insurance, and states have responded by implementing policies to make the purchase of these long-term care coverage more affordable and consumer-friendly. At present, policy makers continue to debate the future role of private long-term care insurance in subsidizing the increasing demand for long-term care services.

Self-Selection, Optimal Income Taxation, and Redistribution

ERIC Educational Resources Information Center

Amegashie, J. Atsu

2009-01-01

The author makes a pedagogical contribution to optimal income taxation. Using a very simple model adapted from George A. Akerlof (1978), he demonstrates a key result in the approach to public economics and welfare economics pioneered by Nobel laureate James Mirrlees. He shows how incomplete information, in addition to the need to preserve…

Estimated Effects of Different Alcohol Taxation and Price Policies on Health Inequalities: A Mathematical Modelling Study.

PubMed

Meier, Petra S; Holmes, John; Angus, Colin; Ally, Abdallah K; Meng, Yang; Brennan, Alan

2016-02-01

While evidence that alcohol pricing policies reduce alcohol-related health harm is robust, and alcohol taxation increases are a WHO "best buy" intervention, there is a lack of research comparing the scale and distribution across society of health impacts arising from alternative tax and price policy options. The aim of this study is to test whether four common alcohol taxation and pricing strategies differ in their impact on health inequalities. An econometric epidemiological model was built with England 2014/2015 as the setting. Four pricing strategies implemented on top of the current tax were equalised to give the same 4.3% population-wide reduction in total alcohol-related mortality: current tax increase, a 13.4% all-product duty increase under the current UK system; a value-based tax, a 4.0% ad valorem tax based on product price; a strength-based tax, a volumetric tax of £0.22 per UK alcohol unit (= 8 g of ethanol); and minimum unit pricing, a minimum price threshold of £0.50 per unit, below which alcohol cannot be sold. Model inputs were calculated by combining data from representative household surveys on alcohol purchasing and consumption, administrative and healthcare data on 43 alcohol-attributable diseases, and published price elasticities and relative risk functions. Outcomes were annual per capita consumption, consumer spending, and alcohol-related deaths. Uncertainty was assessed via partial probabilistic sensitivity analysis (PSA) and scenario analysis. The pricing strategies differ as to how effects are distributed across the population, and, from a public health perspective, heavy drinkers in routine/manual occupations are a key group as they are at greatest risk of health harm from their drinking. Strength-based taxation and minimum unit pricing would have greater effects on mortality among drinkers in routine/manual occupations (particularly for heavy drinkers, where the estimated policy effects on mortality rates are as follows: current tax

26 CFR 1.857-6 - Method of taxation of shareholders of real estate investment trusts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Method of taxation of shareholders of real estate investment trusts. 1.857-6 Section 1.857-6 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT...-6 Method of taxation of shareholders of real estate investment trusts. (a) Ordinary income. Except...

Common state mechanisms regulating tribal tobacco taxation and sales, the USA, 2015.

PubMed

DeLong, Hillary; Chriqui, Jamie; Leider, Julien; Chaloupka, Frank J

2016-10-01

Native American tribes, as sovereign nations, are exempt from state tobacco excise taxation, and self-govern on-reservation activity in the USA. Under Federal law, state excise taxes are owed by non-members purchasing tobacco on tribal land, but states are limited in how they enforce or collect these taxes. This study highlights the various policy approaches that states have taken to regulate tobacco sales on tribal lands given jurisdictional challenges. State laws (statutes, regulations and case law), Attorney General opinions, and revenue notices and rulings effective as of 1 January 2015 for all 50 states and the District of Columbia were compiled using Boolean searches in Lexis-Nexis and Westlaw. Laws were limited to those addressing taxation compacts or tobacco sales involving tribal entities. Master Settlement Agreement laws and non-codified tribal codes/compacts were excluded. Twenty of the 34 states with tribal lands address tribal tobacco sales. Fourteen states address intergovernmental compacts: 11 are tobacco specific, and suggest or require specific provisions. Fifteen states address tribal tax stamps: 2 explicitly prohibit stamping tribally sold products, 9 stamp all products, and 4 stamp some. Prepayment of excise tax is required in 12 states: 6 on all products, 4 on products in excess of quota, and 2 on products sold by non-tribal retailers. 6 states use quotas to limit tax-free tobacco available to tribes. Many states with a tribal presence have no formal strategies for non-members purchasing tobacco on tribal lands. Formalising policies and harmonising tax rates may assist states in collecting tax revenue from non-tribal consumers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Taxation and life expectancy in Western Europe.

PubMed

Bagger, P J

2004-06-01

With the exception of Denmark, life expectancy in Western Europe has shown a significant increase over the last decades. During that period of time overall taxation has increased in most of the countries, especially in Denmark. We, therefore, examined whether taxation could influence life expectancy in Western Europe. We used information on the sum of income tax and employees' social contribution in percentage of gross wage earnings from the OECD database and data on disability adjusted life expectancy at birth from the World Health Organization database. We arbitrarily only included countries with populations in excess of 4 millions and thereby excluded smaller countries where tax exemption is part of the national monetary policy. We found that disability adjusted life expectancy at birth was inversely correlated to the total tax burden in Western Europe. We speculate whether a threshold exists where high taxes exert a negative influence on life expectancy despite increased welfare spending. The study suggests that tax burden should be considered among the multiple factors influencing life expectancy.

Empirical investigation of optimal severance taxation in Alabama. Volume II

DOE Office of Scientific and Technical Information (OSTI.GOV)

Leathers, C.G.; Zumpano, L.V.

1980-10-01

The research develops a theoretical and empirical foundation for the analysis of severance taxation in Alabama. Primary emphasis was directed to delineating an optimal severance tax structure for the state of Alabama and, in the process, assess the economic and fiscal consequences of current severance tax usage. The legal and economic basis and justification for severance taxation, the amounts and distribution of severance tax revenues currently generated, the administration of the tax, and severance tax practices prevailing in other states were compared in Volume I. These data, findings, and quantitative analyses were used to ascertain the fiscal and economic effectsmore » of changes in the structure and utilization of severance taxation in Alabama. The actual and potential productivity of severance taxation in Alamama is discussed. The analysis estimates the state's severance tax revenue capacity relative to the nation and to regional neighbors. The analysis is followed by an intrastate fiscal examination of the state and local tax system. In the process, the relative revenue contribution of severance taxes to state and local revenues is quantified, as well as comparing the revenue capacity and utilization of severance taxes to other state and local levies. An examination is made of the question of who actually pays the severance taxes by an analysis of the shifting and incidence characteristics of taxes on natural resources. Serious doubt is raised that states can, under normal economic circumstances, export a large portion of the severance tax burden to out-of-state users. According to the analytical results of the study, profit margins will be affected; therefore, higher severance taxes should only be imposed after rational assessment of the consequences on business incentives and employment in the extractive inudstries, especially coal.« less

26 CFR 1.522-2 - Manner of taxation of cooperative associations subject to section 522.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 7 2011-04-01 2009-04-01 true Manner of taxation of cooperative associations subject to section 522. 1.522-2 Section 1.522-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF...-2 Manner of taxation of cooperative associations subject to section 522. (a) In general. Farmers...

Cancer insurance policies in Japan and the United States.

PubMed Central

Bennett, C L; Weinberg, P D; Lieberman, J J

1998-01-01

Cancer care in the United States often results in financial hardship for patients and their families. Standard health insurance covers most medical costs, but nonmedical costs (such as lost wages, deductibles, copayments, and travel to and from caregivers) are paid out of pocket. Over the course of treatment, these costs can become substantial. Insurance companies have addressed the burden of these out-of-pocket costs by offering supplemental cancer insurance policies that, upon diagnosis of cancer, pay cash benefits for items that usually require out-of-pocket expenditures and are distinct from reimbursements made by traditional health insurance. Limitations associated with managed care have fostered increased consumer awareness and interest in the United States for cancer insurance and its ability to defray treatment expenditures that usually require out-of-pocket payments. Marketing campaigns are becoming more aggressive, and the number of cancer insurance policies sold has been steadily rising. While cancer insurance is only recently gaining popularity in the United States, it has been a successful product in Japan for over twenty years. In Japan, approximately one-quarter of the population own cancer insurance, and ten-year retention rates are estimated at 75%. As a result, individuals are afforded good access to nonmedical cancer services. Understanding the factors that led to the success of cancer insurance in Japan may assist policymakers in evaluating cancer insurance policies as they become more prevalent in the United States. PMID:9448483

Cancer insurance policies in Japan and the United States.

PubMed

Bennett, C L; Weinberg, P D; Lieberman, J J

1998-01-01

Cancer care in the United States often results in financial hardship for patients and their families. Standard health insurance covers most medical costs, but nonmedical costs (such as lost wages, deductibles, copayments, and travel to and from caregivers) are paid out of pocket. Over the course of treatment, these costs can become substantial. Insurance companies have addressed the burden of these out-of-pocket costs by offering supplemental cancer insurance policies that, upon diagnosis of cancer, pay cash benefits for items that usually require out-of-pocket expenditures and are distinct from reimbursements made by traditional health insurance. Limitations associated with managed care have fostered increased consumer awareness and interest in the United States for cancer insurance and its ability to defray treatment expenditures that usually require out-of-pocket payments. Marketing campaigns are becoming more aggressive, and the number of cancer insurance policies sold has been steadily rising. While cancer insurance is only recently gaining popularity in the United States, it has been a successful product in Japan for over twenty years. In Japan, approximately one-quarter of the population own cancer insurance, and ten-year retention rates are estimated at 75%. As a result, individuals are afforded good access to nonmedical cancer services. Understanding the factors that led to the success of cancer insurance in Japan may assist policymakers in evaluating cancer insurance policies as they become more prevalent in the United States.

An equilibrium-conserving taxation scheme for income from capital

NASA Astrophysics Data System (ADS)

Tempere, Jacques

2018-02-01

Under conditions of market equilibrium, the distribution of capital income follows a Pareto power law, with an exponent that characterizes the given equilibrium. Here, a simple taxation scheme is proposed such that the post-tax capital income distribution remains an equilibrium distribution, albeit with a different exponent. This taxation scheme is shown to be progressive, and its parameters can be simply derived from (i) the total amount of tax that will be levied, (ii) the threshold selected above which capital income will be taxed and (iii) the total amount of capital income. The latter can be obtained either by using Piketty's estimates of the capital/labor income ratio or by fitting the initial Pareto exponent. Both ways moreover provide a check on the amount of declared income from capital.

Mobilising public opinion for the tobacco industry: the Consumer Tax Alliance and excise taxes.

PubMed

Campbell, R; Balbach, E D

2008-10-01

Tobacco industry funding was instrumental in creating and financing the Consumer Tax Alliance in 1989 as an organisation that relied upon extensive media outreach to build opposition to excise taxes as a regressive form of taxation. By obscuring its own role in this effort, the tobacco industry undermined the public's reasonable expectations for transparency in the policy-making process. To examine the formation and activities of the Consumer Tax Alliance as a "hybrid" form of interest group in order to provide tobacco control and public health advocates with a better understanding of unanticipated tobacco industry coalitions and facilitate appropriate countermeasures. Document searches through the Legacy Tobacco Documents Library and through Tobacco Documents Online and review of background literature. The Tobacco Institute actively sought liberal allies beginning in the mid-1980s in seeking to build public opposition to cigarette excise tax increases by promoting them as a regressive form of taxation. The creation of the Consumer Tax Alliance in 1989 was expressly intended to turn labour and middle-class opinion against prospective excise tax increases in federal budget deficit negotiations, without divulging the tobacco industry's role in its formation. It is important to understand the dynamic by which trusted organisations can be induced to alter their agendas in response to funding sources. Advocates need to understand this form of interest group behaviour so that they are better able to negotiate the policy arena by diagnosing and exposing this influence where it occurs and, by doing so, be better prepared to take appropriate countermeasures.

National Health Insurance and Health Education: Strategies for Change.

ERIC Educational Resources Information Center

Dwore, Richard B.

1980-01-01

The concept of National Health Insurance (NHI) as one of several strategies for resolving health problems in the U.S. is discussed. NHI goals include comprehensive health care, quality health care, efficient delivery systems, phased-in benefits, and consumer representation. (JD)

The RAND Health Insurance Experiment, Three Decades Later*

PubMed Central

Aron-Dine, Aviva; Einav, Liran; Finkelstein, Amy

2013-01-01

We re-present and re-examine the analysis from the famous RAND Health Insurance Experiment from the 1970s on the impact of consumer cost sharing in health insurance on medical spending. We begin by summarizing the experiment and its core findings in a manner that would be standard in the current age. We then examine potential threats to the validity of a causal interpretation of the experimental treatment effects stemming from different study participation and differential reporting of outcomes across treatment arms. Finally, we re-consider the famous RAND estimate that the elasticity of medical spending with respect to its out-of-pocket price is −0.2, emphasizing the challenges associated with summarizing the experimental treatment effects from non-linear health insurance contracts using a single price elasticity. PMID:24610973

Personal Income Taxation. National Education Association Search.

ERIC Educational Resources Information Center

National Education Association, Washington, DC. Research Div.

The second in a series on school finance, this report describes the principles of fair and adequate state and local income taxation. The political setting is discussed, and the nature of indiviudal income taxes is explained by examining which states tax income and what income they tax. Tables 2, 3, and 4 demonstrate the expanding school financing…

Consumer Expectations of Online Services in the Insurance Industry: An Exploratory Study of Drivers and Outcomes.

PubMed

Méndez-Aparicio, M Dolores; Izquierdo-Yusta, Alicia; Jiménez-Zarco, Ana I

2017-01-01

Today, the customer-brand relationship is fundamental to a company's bottom line, especially in the service sector and with services offered via online channels. In order to maximize its effects, organizations need (1) to know which factors influence the formation of an individual's service expectations in an online environment; and (2) to establish the influence of these expectations on customers' likelihood of recommending a service before they have even used it. In accordance with the TAM model (Davis, 1989; Davis et al., 1992), the TRA model (Fishbein and Ajzen, 1975), the extended UTAUT model (Venkatesh et al., 2012), and the approach described by Alloza (2011), this work proposes a theoretical model of the antecedents and consequences of consumer expectations of online services. In order to validate the proposed theoretical model, a sample of individual insurance company customers was analyzed. The results showed, first, the importance of customers' expectations with regard to the intention to recommend the "private area" of the company's website to other customers prior to using it themselves. They also revealed the importance to expectations of the antecedents perceived usefulness, ease of use, frequency of use, reputation, and subjective norm.

Consumer Expectations of Online Services in the Insurance Industry: An Exploratory Study of Drivers and Outcomes

PubMed Central

Méndez-Aparicio, M. Dolores; Izquierdo-Yusta, Alicia; Jiménez-Zarco, Ana I.

2017-01-01

Today, the customer-brand relationship is fundamental to a company’s bottom line, especially in the service sector and with services offered via online channels. In order to maximize its effects, organizations need (1) to know which factors influence the formation of an individual’s service expectations in an online environment; and (2) to establish the influence of these expectations on customers’ likelihood of recommending a service before they have even used it. In accordance with the TAM model (Davis, 1989; Davis et al., 1992), the TRA model (Fishbein and Ajzen, 1975), the extended UTAUT model (Venkatesh et al., 2012), and the approach described by Alloza (2011), this work proposes a theoretical model of the antecedents and consequences of consumer expectations of online services. In order to validate the proposed theoretical model, a sample of individual insurance company customers was analyzed. The results showed, first, the importance of customers’ expectations with regard to the intention to recommend the “private area” of the company’s website to other customers prior to using it themselves. They also revealed the importance to expectations of the antecedents perceived usefulness, ease of use, frequency of use, reputation, and subjective norm. PMID:28798705

26 CFR 1.881-2 - Taxation of foreign corporations not engaged in U.S. business.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Taxation of foreign corporations not engaged in U.S. business. 1.881-2 Section 1.881-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Foreign Corporations § 1.881-2 Taxation of foreign...

26 CFR 1.881-2 - Taxation of foreign corporations not engaged in U.S. business.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 9 2011-04-01 2011-04-01 false Taxation of foreign corporations not engaged in U.S. business. 1.881-2 Section 1.881-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE... Taxation of foreign corporations not engaged in U.S. business. (a) Imposition of tax. (1) This section...

26 CFR 1.857-6 - Method of taxation of shareholders of real estate investment trusts.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 9 2011-04-01 2011-04-01 false Method of taxation of shareholders of real estate investment trusts. 1.857-6 Section 1.857-6 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT... Trusts § 1.857-6 Method of taxation of shareholders of real estate investment trusts. (a) Ordinary income...

Understanding consumer preferences in the context of managed competition: evidence from a choice experiment in Colombia.

PubMed

Trujillo, Antonio J; Ruiz, Fernando; Bridges, John F P; Amaya, Jeannette L; Buttorff, Christine; Quiroga, Angélica M

2012-03-01

In many countries, health insurance coverage is the primary way for individuals to access care. Governments can support access through social insurance programmes; however, after a certain period, governments struggle to achieve universal coverage. Evidence suggests that complex individual behaviour may play a role. Using a choice experiment, this research explored consumer preferences for health insurance in Colombia. We also evaluated whether preferences differed across consumers with differing demographic and health status factors. A household field experiment was conducted in Bogotá in 2010. The sample consisted of 109 uninsured and 133 low-income insured individuals. Each individual evaluated 12 pair-wise comparisons of hypothetical health plans. We focused on six characteristics of health insurance: premium, out-of-pocket expenditure, chronic condition coverage, quality of care, family coverage and sick leave. A main effects orthogonal design was used to derive the 72 scenarios used in the choice experiment. Parameters were estimated using conditional logit models. Since price data were included, we estimated respondents' willingness to pay for characteristics. Consumers valued health benefits and family coverage more than other attributes. Additionally, differences in preferences can be exploited to increase coverage. The willingness to pay for benefits may partially cover the average cost of providing them. Policy makers might be able to encourage those insured via the subsidized system to enrol in the next level of the social health insurance scheme through expanding benefits to family members and expanding the level of chronic condition coverage.

Genetic testing when there is a mix of compulsory and voluntary health insurance.

PubMed

Hoel, Michael; Iversen, Tor

2002-03-01

When the insurer has access to information about test status, genetic insurance can handle the negative effects of genetic testing on insurance coverage and income distribution. Hence, efficient testing is promoted. When information about prevention and test status is private, two types of social inefficiencies may occur; genetic testing may not be done when it is socially efficient and genetic testing may be done although it is socially inefficient. The first type of inefficiency is shown to be likely for consumers with compulsory insurance only, while the second type of inefficiency is more likely for those who have supplemented the compulsory insurance with substantial voluntary insurance. This second type of inefficiency is more important the less effective prevention is. It is therefore a puzzle that many countries have imposed strict regulation on the genetic information insurers have access to. A reason may be that genetic insurance is not yet a political issue, and the advantage of shared genetic information is therefore not transparent.

Small employers and self-insured health benefits: too small to succeed?

PubMed

Yee, Tracy; Christianson, Jon B; Ginsburg, Paul B

2012-07-01

Over the past decade, large employers increasingly have bypassed traditional health insurance for their workers, opting instead to assume the financial risk of enrollees' medical care through self-insurance. Because self-insurance arrangements may offer advantages--such as lower costs, exemption from most state insurance regulation and greater flexibility in benefit design--they are especially attractive to large firms with enough employees to spread risk adequately to avoid the financial fallout from potentially catastrophic medical costs of some employees. Recently, with rising health care costs and changing market dynamics, more small firms--100 or fewer workers--are interested in self-insuring health benefits, according to a new qualitative study from the Center for Studying Health System Change (HSC). Self-insured firms typically use a third-party administrator (TPA) to process medical claims and provide access to provider networks. Firms also often purchase stop-loss insurance to cover medical costs exceeding a predefined amount. Increasingly competitive markets for TPA services and stop-loss insurance are making self-insurance attractive to more employers. The 2010 national health reform law imposes new requirements and taxes on health insurance that may spur more small firms to consider self-insurance. In turn, if more small firms opt to self-insure, certain health reform goals, such as strengthening consumer protections and making the small-group health insurance market more viable, may be undermined. Specifically, adverse selection--attracting sicker-than-average people--is a potential issue for the insurance exchanges created by reform.

A political history of federal mental health and addiction insurance parity.

PubMed

Barry, Colleen L; Huskamp, Haiden A; Goldman, Howard H

2010-09-01

This article chronicles the political history of efforts by the U.S. Congress to enact a law requiring "parity" for mental health and addiction benefits and medical/surgical benefits in private health insurance. The goal of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity (MHPAE) Act of 2008 is to eliminate differences in insurance coverage for behavioral health. Mental health and addiction treatment advocates have long viewed parity as a means of increasing fairness in the insurance market, whereas employers and insurers have opposed it because of concerns about its cost. The passage of this law is viewed as a legislative success by both consumer and provider advocates and the employer and insurance groups that fought against it for decades. Twenty-nine structured interviews were conducted with key informants in the federal parity debate, including members of Congress and their staff; lobbyists for consumer, provider, employer, and insurance groups; and other key contacts. Historical documentation, academic research on the effects of parity regulations, and public comment letters submitted to the U.S. Departments of Labor, Health and Human Services, and Treasury before the release of federal guidance also were examined. Three factors were instrumental to the passage of this law: the emergence of new evidence regarding the costs of parity, personal experience with mental illness and addiction, and the political strategies adopted by congressional champions in the Senate and House of Representatives. Challenges to implementing the federal parity policy warrant further consideration. This law raises new questions about the future direction of federal policymaking on behavioral health. © 2010 Milbank Memorial Fund. Published by Wiley Periodicals Inc.

A Political History of Federal Mental Health and Addiction Insurance Parity

PubMed Central

Barry, Colleen L; Huskamp, Haiden A; Goldman, Howard H

2010-01-01

Context: This article chronicles the political history of efforts by the U.S. Congress to enact a law requiring “parity” for mental health and addiction benefits and medical/surgical benefits in private health insurance. The goal of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity (MHPAE) Act of 2008 is to eliminate differences in insurance coverage for behavioral health. Mental health and addiction treatment advocates have long viewed parity as a means of increasing fairness in the insurance market, whereas employers and insurers have opposed it because of concerns about its cost. The passage of this law is viewed as a legislative success by both consumer and provider advocates and the employer and insurance groups that fought against it for decades. Methods: Twenty-nine structured interviews were conducted with key informants in the federal parity debate, including members of Congress and their staff; lobbyists for consumer, provider, employer, and insurance groups; and other key contacts. Historical documentation, academic research on the effects of parity regulations, and public comment letters submitted to the U.S. Departments of Labor, Health and Human Services, and Treasury before the release of federal guidance also were examined. Findings: Three factors were instrumental to the passage of this law: the emergence of new evidence regarding the costs of parity, personal experience with mental illness and addiction, and the political strategies adopted by congressional champions in the Senate and House of Representatives. Conclusions: Challenges to implementing the federal parity policy warrant further consideration. This law raises new questions about the future direction of federal policymaking on behavioral health. PMID:20860577

Consumer Perspectives on Information Needs for Health Plan Choice

PubMed Central

Gibbs, Deborah A.; Sangl, Judith A.; Burrus, Barri

1996-01-01

The premise that competition will improve health care assumes that consumers will choose plans that best fit their needs and resources. However, many consumers are frustrated with currently available plan comparison information. We describe results from 22 focus groups in which Medicare beneficiaries, Medicaid enrollees, and privately insured consumers assessed the usefulness of indicators based on consumer survey data and Health Employer Data Information Set (HEDIS)-type measures of quality of care. Considerable education would be required before consumers could interpret report card data to inform plan choices. Policy implications for design and provision of plan information for Medicare beneficiaries and Medicaid enrollees are discussed. PMID:10165037

Health insurance in Croatia: dynamics and politics of balancing revenues and expenditures.

PubMed

Voncina, Luka; Kehler, Jenni; Evetovits, Tamas; Bagat, Mario

2010-04-01

Since 2002, the Croatian social health insurance system has undergone substantial reforms, initiated for the most part with the aim of addressing the perpetual financial deficits of the state health insurance fund. While the reforms focussed heavily on increasing the inflow of private funds into the health care system, underlying inefficiencies contributing significantly to poor financial performance have been largely ignored. Furthermore, contrary to demographic trends and developments in social health insurance schemes in other countries, funding health care became even more dependent on its main collection mechanism-payroll tax-and consequently on the employment ratio and wage level. Little effort has been made to diversify the revenue base or to increase the efficiency of revenue collection. Like other countries, Croatia is facing difficulties in adjusting its 'Bismarck' system to its changing demographic and socioeconomic context. Instead of targetting a comprehensive effort at improving revenue collection and limitating unnecessary expenditure and system inefficiencies, simplified approaches to balance the budget have been implemented at a high price to users and with limited effect. As a result, the Croatian health insurance system now offers a lower level of financial protection, while still facing the problem of spending more than can be collected through the current mix of revenue collection mechanisms. The authors suggest that, in order to meet the sustainability requirement of the health financing system, measures affecting both revenue and expenditure should be considered and implemented. On the revenue collection side, the Croatian government must make further efforts to improve collection from the informally employed to broaden the base of contributing members; equally important is the diversification of revenue sources by increasing transfers from general taxation revenues. On the expenditure side, exploring inefficiencies of the delivery system can

75 FR 35816 - Establishment of the Consumer Operated and Oriented Plan (CO-OP) Advisory Board

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-23

... (CO-OP) Advisory Board AGENCY: Department of Health and Human Services, Office of Consumer Information & Insurance Oversight. ACTION: Federal Register Notice. Authority: The Consumer Operated and Oriented Plan (CO... (PPACA) that calls for the establishment of the Consumer Operated and Oriented Plans (CO-OP) Program...

Managing moral hazard in motor vehicle accident insurance claims.

PubMed

Ebrahim, Shanil; Busse, Jason W; Guyatt, Gordon H; Birch, Stephen

2013-05-01

Motor vehicle accident (MVA) insurance in Canada is based primarily on two different compensation systems: (i) no-fault, in which policyholders are unable to seek recovery for losses caused by other parties (unless they have specified dollar or verbal thresholds) and (ii) tort, in which policyholders may seek general damages. As insurance companies pay for MVA-related health care costs, excess use of health care services may occur as a result of consumers' (accident victims) and/or producers' (health care providers) behavior - often referred to as the moral hazard of insurance. In the United States, moral hazard is greater for low dollar threshold no-fault insurance compared with tort systems. In Canada, high dollar threshold or pure no-fault versus tort systems are associated with faster patient recovery and reduced MVA claims. These findings suggest that high threshold no-fault or pure no-fault compensation systems may be associated with improved outcomes for patients and reduced moral hazard.

ESTIMATING WELFARE IN INSURANCE MARKETS USING VARIATION IN PRICES*

PubMed Central

Einav, Liran; Finkelstein, Amy; Cullen, Mark R.

2009-01-01

We provide a graphical illustration of how standard consumer and producer theory can be used to quantify the welfare loss associated with inefficient pricing in insurance markets with selection. We then show how this welfare loss can be estimated empirically using identifying variation in the price of insurance. Such variation, together with quantity data, allows us to estimate the demand for insurance. The same variation, together with cost data, allows us to estimate how insurer’s costs vary as market participants endogenously respond to price. The slope of this estimated cost curve provides a direct test for both the existence and nature of selection, and the combination of demand and cost curves can be used to estimate welfare. We illustrate our approach by applying it to data on employer-provided health insurance from one specific company. We detect adverse selection but estimate that the quantitative welfare implications associated with inefficient pricing in our particular application are small, in both absolute and relative terms. PMID:21218182

An Initial Design of ISO 19152:2012 LADM Based Valuation and Taxation Data Model

NASA Astrophysics Data System (ADS)

Çağdaş, V.; Kara, A.; van Oosterom, P.; Lemmen, C.; Işıkdağ, Ü.; Kathmann, R.; Stubkjær, E.

2016-10-01

A fiscal registry or database is supposed to record geometric, legal, physical, economic, and environmental characteristics in relation to property units, which are subject to immovable property valuation and taxation. Apart from procedural standards, there is no internationally accepted data standard that defines the semantics of fiscal databases. The ISO 19152:2012 Land Administration Domain Model (LADM), as an international land administration standard focuses on legal requirements, but considers out of scope specifications of external information systems including valuation and taxation databases. However, it provides a formalism which allows for an extension that responds to the fiscal requirements. This paper introduces an initial version of a LADM - Fiscal Extension Module for the specification of databases used in immovable property valuation and taxation. The extension module is designed to facilitate all stages of immovable property taxation, namely the identification of properties and taxpayers, assessment of properties through single or mass appraisal procedures, automatic generation of sales statistics, and the management of tax collection, dealing with arrears and appeals. It is expected that the initial version will be refined through further activities held by a possible joint working group under FIG Commission 7 (Cadastre and Land Management) and FIG Commission 9 (Valuation and the Management of Real Estate) in collaboration with other relevant international bodies.

Towards a coherent European approach for taxation of combustible waste

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dubois, Maarten, E-mail: maarten.dubois@kuleuven.be

2013-08-15

Highlights: • Current European waste taxes do not constitute a level playing field. • Integrating waste incineration in EU ETS avoids regional tax competition. • A differentiated incineration tax is a second-best instrument for NO{sub x} emissions. • A tax on landfilled incineration residues stimulates ash treatment. - Abstract: Although intra-European trade of combustible waste has grown strongly in the last decade, incineration and landfill taxes remain disparate within Europe. The paper proposes a more coherent taxation approach for Europe that is based on the principle of Pigovian taxation, i.e. the internalization of environmental damage costs. The approach aims tomore » create a level playing field between European regions while reinforcing incentives for sustainable management of combustible waste. Three important policy recommendations emerge. First, integrating waste incineration into the European Emissions Trading System for greenhouse gases (EU ETS) reduces the risk of tax competition between regions. Second, because taxation of every single air pollutant from waste incineration is cumbersome, a differentiated waste incineration tax based on NO{sub x} emissions can serve as a second-best instrument. Finally, in order to strengthen incentives for ash treatment, a landfill tax should apply for landfilled incineration residues. An example illustrates the coherence of the policy recommendations for incineration technologies with diverse environmental effects.« less

12 CFR Appendix A to Subpart H of... - Consumer Grievance Process

Code of Federal Regulations, 2010 CFR

2010-01-01

... Subpart H of Part 208 Banks and Banking FEDERAL RESERVE SYSTEM BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM MEMBERSHIP OF STATE BANKING INSTITUTIONS IN THE FEDERAL RESERVE SYSTEM (REGULATION H) Consumer Protection in Sales of Insurance Pt. 208, Subpt. H, App. A Appendix A to Subpart H of Part 208—Consumer...

Insurance against climate change and flood risk: Insurability and decision processes of insurers

NASA Astrophysics Data System (ADS)

Hung, Hung-Chih; Hung, Jia-Yi

2016-04-01

1. Background Major portions of the Asia-Pacific region is facing escalating exposure and vulnerability to climate change and flood-related extremes. This highlights an arduous challenge for public agencies to improve existing risk management strategies. Conventionally, governmental funding was majorly responsible and accountable for disaster loss compensation in the developing countries in Asia, such as Taiwan. This is often criticized as an ineffective and inefficient measure of dealing with flood risk. Flood insurance is one option within the toolkit of risk-sharing arrangement and adaptation strategy to flood risk. However, there are numerous potential barriers for insurance companies to cover flood damage, which would cause the flood risk is regarded as uninsurable. This study thus aims to examine attitudes within the insurers about the viability of flood insurance, the decision-making processes of pricing flood insurance and their determinants, as well as to examine potential solutions to encourage flood insurance. 2. Methods and data Using expected-utility theory, an insurance agent-based decision-making model was developed to examine the insurers' attitudes towards the insurability of flood risk, and to scrutinize the factors that influence their decisions on flood insurance premium-setting. This model particularly focuses on how insurers price insurance when they face either uncertainty or ambiguity about the probability and loss of a particular flood event occurring. This study considers the factors that are expected to affect insures' decisions on underwriting and pricing insurance are their risk perception, attitudes towards flood insurance, governmental measures (e.g., land-use planning, building codes, risk communication), expected probabilities and losses of devastating flooding events, as well as insurance companies' attributes. To elicit insurers' utilities about premium-setting for insurance coverage, the 'certainty equivalent,' 'probability

[ROM and the position of the health insurance companies].

PubMed

Laane, R; Luijk, R

2012-01-01

Up till 2008 the Dutch mental health services came under the Dutch General Law on Special Medical Costs (AWBZ). Health insurers regarded the mental health services as 'black box'. In 2008 the mental health services were transferred to the basic health insurance system and the health insurers became responsible for the healthcare purchasing services. In the same year the mental health services began to use ROM to measure the effects of treatment and thereby improve the quality of treatment. To clarify the use that the insurers make of ROM. The developments in this field are described. The feedback supplied by ROM enables therapists to improve treatment. An additional benefit is that the mental health services are then in a position to improve quality at aggregate level and compare their own results with those of others. Nationally, ROM can provide health insurers with information about treatment quality in combination with the Consumer Quality Index (CQI), and national 'benchmarks' can be implemented. To facilitate the interpretation of these rom data the health insurers set up the independent foundation, Stichting Benchmark GGZ (mental health care), in which GGZ Nederland has participated since 2010. ROM provides therapists with a means for improving treatment and provides insurers with a means by which they can express their views about the quality of the mental health services at aggregate level.

Harnessing Private-Sector Innovation to Improve Health Insurance Exchanges.

PubMed

Gresenz, Carole Roan; Hoch, Emily; Eibner, Christine; Rudin, Robert S; Mattke, Soeren

2016-05-09

Overhauling the individual health insurance market-including through the creation of health insurance exchanges-was a key component of the Patient Protection and Affordable Care Act's multidimensional approach to addressing the long-standing problem of the uninsured in the United States. Despite succeeding in enrolling millions of Americans, the exchanges still face several challenges, including poor consumer experience, high operational and development costs, and incomplete market penetration. In light of these challenges, analysts considered a different model for the exchanges-privately facilitated exchanges-which could address these challenges and deepen the Affordable Care Act's impact. In this model, the government retains control over sovereign exchange functions but allows the private sector to assume responsibility for more-peripheral exchange functions, such as developing and sustaining exchange websites. Although private-sector entities have already undertaken exchange-related functions on a limited basis, privately facilitated exchanges could conceivably relieve the government of its responsibility for front-end website operations and consumer decision-support functions entirely. A shift to privately facilitated exchanges could improve the consumer experience, increase enrollment, and lower costs for state and federal governments. A move to such a model requires, nonetheless, managing its risks, such as reduced consumer protection, increased consumer confusion, and the possible lack of a viable revenue base for privately facilitated exchanges, especially in less populous states. On net, the benefits are large enough and the risks sufficiently manageable to seriously consider such a shift. This paper provides background information and more detail on the analysts' assessment.

Harnessing Private-Sector Innovation to Improve Health Insurance Exchanges

PubMed Central

Gresenz, Carole Roan; Hoch, Emily; Eibner, Christine; Rudin, Robert S.; Mattke, Soeren

2016-01-01

Abstract Overhauling the individual health insurance market—including through the creation of health insurance exchanges—was a key component of the Patient Protection and Affordable Care Act's multidimensional approach to addressing the long-standing problem of the uninsured in the United States. Despite succeeding in enrolling millions of Americans, the exchanges still face several challenges, including poor consumer experience, high operational and development costs, and incomplete market penetration. In light of these challenges, analysts considered a different model for the exchanges—privately facilitated exchanges—which could address these challenges and deepen the Affordable Care Act's impact. In this model, the government retains control over sovereign exchange functions but allows the private sector to assume responsibility for more-peripheral exchange functions, such as developing and sustaining exchange websites. Although private-sector entities have already undertaken exchange-related functions on a limited basis, privately facilitated exchanges could conceivably relieve the government of its responsibility for front-end website operations and consumer decision-support functions entirely. A shift to privately facilitated exchanges could improve the consumer experience, increase enrollment, and lower costs for state and federal governments. A move to such a model requires, nonetheless, managing its risks, such as reduced consumer protection, increased consumer confusion, and the possible lack of a viable revenue base for privately facilitated exchanges, especially in less populous states. On net, the benefits are large enough and the risks sufficiently manageable to seriously consider such a shift. This paper provides background information and more detail on the analysts' assessment. PMID:28083414

Consumer-oriented health care reform strategies: a review of the evidence on managed competition and consumer-directed health insurance.

PubMed

Buchmueller, Thomas C

2009-12-01

For many years, leading health care reform proposals have been based on market-oriented strategies. In the 1990s, a number of reform proposals were built around the concept of "managed competition," but more recently, "consumer-directed health care" models have received attention. Although price-conscious consumer demand plays a critical role in both the managed competition and consumer-directed health care models, the two strategies are based on different visions of the health care marketplace and the best way to use market forces to achieve greater systemwide efficiencies. This article reviews the research literature that tests the main hypotheses concerning the two policy strategies. Numerous studies provide consistent evidence that consumers' health plan choices are sensitive to out-of-pocket premiums. The elasticity of demand appears to vary with consumers' health risk, with younger, healthier individuals being more price sensitive. This heterogeneity increases the potential for adverse selection. Biased risk selection also is a concern when the menu of health plan options includes consumer-directed health plans. Several studies confirm that such plans tend to attract healthier enrollees. A smaller number of studies test the main hypothesis regarding consumer-directed health plans, which is that they result in lower medical spending than do more generous plans. These studies find little support for this claim. The experiences of employers that have adopted key elements of managed competition are generally consistent with the key hypotheses underlying that strategy. Research in this area, however, has focused on only a narrow range of questions. Because consumer-directed health care is such a recent phenomenon, research on this strategy is even more limited. Additional studies on both topics would be valuable.

26 CFR 1.871-7 - Taxation of nonresident alien individuals not engaged in U.S. business.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Taxation of nonresident alien individuals not engaged in U.S. business. 1.871-7 Section 1.871-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF... Corporations § 1.871-7 Taxation of nonresident alien individuals not engaged in U.S. business. (a) Imposition...

26 CFR 1.871-7 - Taxation of nonresident alien individuals not engaged in U.S. business.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 9 2011-04-01 2011-04-01 false Taxation of nonresident alien individuals not engaged in U.S. business. 1.871-7 Section 1.871-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF... Foreign Corporations § 1.871-7 Taxation of nonresident alien individuals not engaged in U.S. business. (a...

Insurer Market Power Lowers Prices In Numerous Concentrated Provider Markets.

PubMed

Scheffler, Richard M; Arnold, Daniel R

2017-09-01

Using prices of hospital admissions and visits to five types of physicians, we analyzed how provider and insurer market concentration-as measured by the Herfindahl-Hirschman Index (HHI)-interact and are correlated with prices. We found evidence that in the range of the Department of Justice's and Federal Trade Commission's definition of a moderately concentrated market (HHI of 1,500-2,500), insurers have the bargaining power to reduce provider prices in highly concentrated provider markets. In particular, hospital admission prices were 5 percent lower and cardiologist, radiologist, and hematologist/oncologist visit prices were 4 percent, 7 percent, and 19 percent lower, respectively, in markets with high provider concentration and insurer HHI above 2,000, compared to such markets with insurer HHI below 2,000. We did not find evidence that high insurer concentration reduced visit prices for primary care physicians or orthopedists, however. The policy dilemma that arises from our findings is that there are no insurer market mechanisms that will pass a portion of these price reductions on to consumers in the form of lower premiums. Large purchasers of health insurance such as state and federal governments, as well as the use of regulatory approaches, could provide a solution. Project HOPE—The People-to-People Health Foundation, Inc.

Estimated Effects of Different Alcohol Taxation and Price Policies on Health Inequalities: A Mathematical Modelling Study

PubMed Central

Meier, Petra S.; Holmes, John; Angus, Colin; Ally, Abdallah K.; Meng, Yang; Brennan, Alan

2016-01-01

Introduction While evidence that alcohol pricing policies reduce alcohol-related health harm is robust, and alcohol taxation increases are a WHO “best buy” intervention, there is a lack of research comparing the scale and distribution across society of health impacts arising from alternative tax and price policy options. The aim of this study is to test whether four common alcohol taxation and pricing strategies differ in their impact on health inequalities. Methods and Findings An econometric epidemiological model was built with England 2014/2015 as the setting. Four pricing strategies implemented on top of the current tax were equalised to give the same 4.3% population-wide reduction in total alcohol-related mortality: current tax increase, a 13.4% all-product duty increase under the current UK system; a value-based tax, a 4.0% ad valorem tax based on product price; a strength-based tax, a volumetric tax of £0.22 per UK alcohol unit (= 8 g of ethanol); and minimum unit pricing, a minimum price threshold of £0.50 per unit, below which alcohol cannot be sold. Model inputs were calculated by combining data from representative household surveys on alcohol purchasing and consumption, administrative and healthcare data on 43 alcohol-attributable diseases, and published price elasticities and relative risk functions. Outcomes were annual per capita consumption, consumer spending, and alcohol-related deaths. Uncertainty was assessed via partial probabilistic sensitivity analysis (PSA) and scenario analysis. The pricing strategies differ as to how effects are distributed across the population, and, from a public health perspective, heavy drinkers in routine/manual occupations are a key group as they are at greatest risk of health harm from their drinking. Strength-based taxation and minimum unit pricing would have greater effects on mortality among drinkers in routine/manual occupations (particularly for heavy drinkers, where the estimated policy effects on

Disease management programs in Germany's statutory health insurance system.

PubMed

Busse, Reinhard

2004-01-01

The introduction in 1996 of free choice among sickness funds in Germany was accompanied by a "risk structure compensation" (RSC) mechanism based on average spending by age and sex. Because chronically ill people were not adequately taken into account, competition for newly insured consumers concentrated on the healthy. The introduction in 2002 of disease management programs addresses this problem: Insured people in such programs are treated as a separate RSC category, making them a more "attractive" group that no longer generates a deficit. The degree of sickness fund activities and the fierce dispute with physicians are valid indicators that the incentives work.

Public Preferences for the Use of Taxation and Labelling Policy Measures to Combat Obesity in Young Children in Australia

PubMed Central

Comans, Tracy; Moretto, Nicole; Byrnes, Joshua

2017-01-01

Objective: Childhood obesity is a serious concern for developed and developing countries. This study aimed to assess the level of support in Australia for regulation and to assess whether systematic differences occur between individuals who support increased regulation and individuals who oppose it. Methods: An online survey (n = 563) was used to assess parental/caregiver preferences for taxation policy options and nutrition labelling designed to address the incidence of childhood obesity. Participants were parents or caregivers of young children (3 to 7 years) who were actively enrolled in an existing birth cohort study in South-East Queensland, Australia. Results: The majority of the parents (over 80%) strongly agreed or agreed with labelling food and drink with traffic light or teaspoon labelling. Support for taxation was more variable with around one third strongly supporting and a further 40% of participants equivocal about using taxation; however, a quarter strongly rejected this policy. Cluster analysis did not detect any socio-demographic differences between those who strongly supported taxation and those who did not. Conclusions: Better food labelling would be welcomed by parents to enhance food choices for their children. Taxation for health reasons would not be opposed by most parents. Implications for Public Health: Governments should consider taxation of unhealthy drinks and improved labelling to encourage healthy food purchasing. PMID:28335575

Public Preferences for the Use of Taxation and Labelling Policy Measures to Combat Obesity in Young Children in Australia.

PubMed

Comans, Tracy; Moretto, Nicole; Byrnes, Joshua

2017-03-21

Objective : Childhood obesity is a serious concern for developed and developing countries. This study aimed to assess the level of support in Australia for regulation and to assess whether systematic differences occur between individuals who support increased regulation and individuals who oppose it. Methods : An online survey ( n = 563) was used to assess parental/caregiver preferences for taxation policy options and nutrition labelling designed to address the incidence of childhood obesity. Participants were parents or caregivers of young children (3 to 7 years) who were actively enrolled in an existing birth cohort study in South-East Queensland, Australia. Results : The majority of the parents (over 80%) strongly agreed or agreed with labelling food and drink with traffic light or teaspoon labelling. Support for taxation was more variable with around one third strongly supporting and a further 40% of participants equivocal about using taxation; however, a quarter strongly rejected this policy. Cluster analysis did not detect any socio-demographic differences between those who strongly supported taxation and those who did not. Conclusions : Better food labelling would be welcomed by parents to enhance food choices for their children. Taxation for health reasons would not be opposed by most parents. Implications for Public Health: Governments should consider taxation of unhealthy drinks and improved labelling to encourage healthy food purchasing.

76 FR 77392 - Patient Protection and Affordable Care Act; Establishment of Consumer Operated and Oriented Plan...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-13

... to protect CO-OP members against insurance industry involvement and interference. To ensure consumer... Protection and Affordable Care Act; Establishment of Consumer Operated and Oriented Plan (CO-OP) Program... the Consumer Operated and Oriented Plan (CO-OP) program, which provides loans to foster the creation...

A race against time: can CO-OPs and provider start-ups survive in the health insurance marketplaces?

PubMed

Eggbeer, Bill

2015-12-01

> The Affordable Care Act's state and federal health insurance marketplaces, designed to provide affordable insurance coverage to individuals and small groups, are proving hostile territory to new market entrants. Efforts to inject competition into the marketplaces are being challenged by the wide-scale withdrawal o consumer-operated and oriented plans (CO-OPs). Meanwhile, premiums appear likely to increase for consumers as plans seek to balance medical losses. Flaws in the "Three R's" (reinsurance, risk corridors, and risk-adjustment) program are viewed as a threat to the survival of CO-OPs and start-ups.

First Nations Communities and Tobacco Taxation: A Commentary

ERIC Educational Resources Information Center

Samji, Hasina; Wardman, Dennis

2009-01-01

Taxation of tobacco is a widely used strategy that promotes smoking cessation among adults and reduces cigarette consumption among continuing smokers. First Nations (FN) populations' tobacco use is estimated to be 2-3 times that of other Canadians and, in part, a reflection that tobacco products purchased on reserve by FN people are tax exempt.…

Knowledge as a Predictor of Insurance Coverage Under the Affordable Care Act.

PubMed

Hoerl, Maximiliane; Wuppermann, Amelie; Barcellos, Silvia H; Bauhoff, Sebastian; Winter, Joachim K; Carman, Katherine G

2017-04-01

The Affordable Care Act established policy mechanisms to increase health insurance coverage in the United States. While insurance coverage has increased, 10%-15% of the US population remains uninsured. To assess whether health insurance literacy and financial literacy predict being uninsured, covered by Medicaid, or covered by Marketplace insurance, holding demographic characteristics, attitudes toward risk, and political affiliation constant. Analysis of longitudinal data from fall 2013 and spring 2015 including financial and health insurance literacy and key covariates collected in 2013. A total of 2742 US residents ages 18-64, 525 uninsured in fall 2013, participating in the RAND American Life Panel, a nationally representative internet panel. Self-reported health insurance status and type as of spring 2015. Among the uninsured in 2013, higher financial and health insurance literacy were associated with greater probability of being insured in 2015. For a typical uninsured individual in 2013, the probability of being insured in 2015 was 8.3 percentage points higher with high compared with low financial literacy, and 9.2 percentage points higher with high compared with low health insurance literacy. For the general population, those with high financial and health insurance literacy were more likely to obtain insurance through Medicaid or the Marketplaces compared with being uninsured. The magnitude of coefficients for these predictors was similar to that of commonly used demographic covariates. A lack of understanding about health insurance concepts and financial illiteracy predict who remains uninsured. Outreach and consumer-education programs should consider these characteristics.

Nudging Leads Consumers In Colorado To Shop But Not Switch ACA Marketplace Plans.

PubMed

Marzilli Ericson, Keith M; Kingsdale, Jon; Layton, Tim; Sacarny, Adam

2017-02-01

The Affordable Care Act (ACA) dramatically expanded the use of regulated marketplaces in health insurance, but consumers often fail to shop for plans during open enrollment periods. Typically these consumers are automatically reenrolled in their old plans, which potentially exposes them to unexpected increases in their insurance premiums and cost sharing. We conducted a randomized intervention to encourage enrollees in an ACA Marketplace to shop for plans. We tested the effect of letters and e-mails with personalized information about the savings on insurance premiums that they could realize from switching plans and the effect of generic communications that simply emphasized the possibility of saving. The personalized and generic messages both increased shopping on the Marketplace's website by 23 percent, but neither type of message had a significant effect on plan switching. These findings show that simple "nudges" with even generic information can promote shopping in health insurance marketplaces, but whether they can lead to switching remains an open question. Project HOPE—The People-to-People Health Foundation, Inc.

"We Need a Woman, We Need a Black Woman": Gender, Race, and Identity Taxation in the Academy

ERIC Educational Resources Information Center

Hirshfield, Laura E.; Joseph, Tiffany D.

2012-01-01

In 1994, Amado Padilla used the phrase "cultural taxation" to describe the extra burden of service responsibilities placed upon minority faculty members because of their racial or ethnic background. In this paper, we expand upon Padilla's work and introduce the concept of "identity taxation" to encompass how other marginalised social identities…

Health insurance exchanges bring potential opportunities.

PubMed

Jacobs, M Orry; Eggbeer, Bill

2012-11-01

The introduction of the state health insurance exchanges, as provided for in the Affordable Care Act, has many strategic implications for healthcare providers: Unprecedented transparency; The "Walmart Effect", with patients playing a greater role as healthcare consumers; A rise in narrow networks spurred by low prices and narrow geographies; The potential end of the cross subsidy of Medicare and Medicaid by commercial plans; The possible end of not-for-profit status for hospitals

Guaranteed renewability and the problem of risk variation in individual health insurance markets.

PubMed

Patel, Vip; Pauly, Mark V

2002-01-01

Consumers should be protected against fluctuations in premiums for private individual health insurance associated with the onset of high-cost chronic conditions. The most commonly discussed way to do so is through community rating, which provides protection but can require a heavy regulatory burden and can create incentives for adverse selection and cream skimming. This paper describes an alternative method of providing the same type of protection: insurance contract provisions that guarantee renewability for the next coverage period at class-average rates. Drawing on recent work in insurance theory, the paper shows that such protection is feasible in competitive insurance markets. Guaranteed renewability, which is required of all individual health insurance by the Health Insurance Portability and Accountability Act (HIPAA) of 1996, is incomplete because the law fails to require that premiums be the same for all insured persons in a rating class. However, the paper reports the results of a recent survey of state insurance regulation, which indicates that all but three state insurance departments report having such a requirement. The paper concludes with a discussion of possible threats to the protection guaranteed renewability provides against risk segmentation.

Consumer Competency Means High School Diploma in Omaha School

ERIC Educational Resources Information Center

Carlock, LaNeta L.

1977-01-01

Westside High School in Omaha, Nebraska, developed a series of minimum competencies in seven areas as standards for their graduates. One of the seven areas, consumerism, covers money management, credit, insurance, taxes, buying decisions, and consumer protection. (BM)

Poor Consumer Comprehension and Plan Selection Inconsistencies Under the 2016 HealthCare.gov Choice Architecture.

PubMed

Wang, Annabel Z; Scherr, Karen A; Wong, Charlene A; Ubel, Peter A

2017-01-01

Many health policy experts have endorsed insurance competition as a way to reduce the cost and improve the quality of medical care. In line with this approach, health insurance exchanges, such as HealthCare.gov, allow consumers to compare insurance plans online. Since the 2013 rollout of HealthCare.gov, administrators have added features intended to help consumers better understand and compare insurance plans. Although well-intentioned, changes to exchange websites affect the context in which consumers view plans, or choice architecture, which may impede their ability to choose plans that best fit their needs at the lowest cost. By simulating the 2016 HealthCare.gov enrollment experience in an online sample of 374 American adults, we examined comprehension and choice of HealthCare.gov plans under its choice architecture. We found room for improvement in plan comprehension, with higher rates of misunderstanding among participants with poor math skills (P < 0.05). We observed substantial variations in plan choice when identical plan sets were displayed in different orders (P < 0.001). However, regardless of order in which they viewed the plans, participants cited the same factors as most important to their choices (P > 0.9). Participants were drawn from a general population sample. The study does not assess for all possible plan choice influencers, such as provider networks, brand recognition, or help from others. Our findings suggest two areas of improvement for exchanges: first, the remaining gap in consumer plan comprehension and second, the apparent influence of sorting order - and likely other choice architecture elements - on plan choice. Our findings inform strategies for exchange administrators to help consumers better understand and select plans that better fit their needs.

Taxator-tk: precise taxonomic assignment of metagenomes by fast approximation of evolutionary neighborhoods

PubMed Central

Dröge, J.; Gregor, I.; McHardy, A. C.

2015-01-01

Motivation: Metagenomics characterizes microbial communities by random shotgun sequencing of DNA isolated directly from an environment of interest. An essential step in computational metagenome analysis is taxonomic sequence assignment, which allows identifying the sequenced community members and reconstructing taxonomic bins with sequence data for the individual taxa. For the massive datasets generated by next-generation sequencing technologies, this cannot be performed with de-novo phylogenetic inference methods. We describe an algorithm and the accompanying software, taxator-tk, which performs taxonomic sequence assignment by fast approximate determination of evolutionary neighbors from sequence similarities. Results: Taxator-tk was precise in its taxonomic assignment across all ranks and taxa for a range of evolutionary distances and for short as well as for long sequences. In addition to the taxonomic binning of metagenomes, it is well suited for profiling microbial communities from metagenome samples because it identifies bacterial, archaeal and eukaryotic community members without being affected by varying primer binding strengths, as in marker gene amplification, or copy number variations of marker genes across different taxa. Taxator-tk has an efficient, parallelized implementation that allows the assignment of 6 Gb of sequence data per day on a standard multiprocessor system with 10 CPU cores and microbial RefSeq as the genomic reference data. Availability and implementation: Taxator-tk source and binary program files are publicly available at http://algbio.cs.uni-duesseldorf.de/software/. Contact: Alice.McHardy@uni-duesseldorf.de Supplementary information: Supplementary data are available at Bioinformatics online. PMID:25388150

Knowledge as a predictor of insurance coverage under the Affordable Care Act

PubMed Central

Hoerl, Maximiliane; Wuppermann, Amelie; Barcellos, Silvia H.; Bauhoff, Sebastian; Winter, Joachim K.

2016-01-01

Background The Affordable Care Act established policy mechanisms to increase health insurance coverage in the United States. While insurance coverage has increased, 10 to 15% of the U.S. population remains uninsured. Objectives To assess whether health insurance literacy and financial literacy predict being uninsured, covered by Medicaid, or covered by Marketplace insurance, holding demographic characteristics, attitudes toward risk, and political affiliation constant. Research Design Analysis of longitudinal data from fall 2013 and spring 2015 including financial and health insurance literacy and key covariates collected in 2013. Subjects 2,742 U.S. residents ages 18-64, 525 uninsured in fall 2013, participating in the RAND American Life Panel, a nationally representative internet panel. Measures Self-reported health insurance status and type as of spring 2015. Results Among the uninsured in 2013, higher financial and health insurance literacy were associated with greater probability of being insured in 2015. For a typical uninsured individual in 2013, the probability of being insured in 2015 was 8.3 percentage points higher with high compared to low financial literacy, and 9.2 percentage points higher with high compared to low health insurance literacy. For the general population, those with high financial and health insurance literacy were more likely to obtain insurance via Medicaid or the Marketplaces compared to being uninsured. The magnitude of coefficients for these predictors was similar to that of commonly used demographic covariates. Conclusions A lack of understanding about health insurance concepts and financial illiteracy predict who remains uninsured. Outreach and consumer-education programs should consider these characteristics. PMID:27820594

Pharmaceutical promotion, advertising, and consumers.

PubMed

Batchlor, Elaine; Laouri, Marianne

2003-01-01

Proponents of drug promotion and advertising claim that it is informative and educational; opponents are concerned that the information conveyed encourages inappropriate and unnecessary use. Health Affairs papers by Joel Weissman and colleagues and by Robert Dubois provide some validation for the views of both sides of this debate but do not allow us to draw definitive conclusions about key issues involving inappropriate use of expensive medications and their substitution for cheaper medications that are just as effective. The extent to which consumers have been protected from the rising cost of pharmaceuticals further muddles the picture. However, new insurance benefit designs that threaten to shift more costs to consumers may fuel demand for more comprehensive and balanced information.

Health insurance theory: the case of the missing welfare gain.

PubMed

Nyman, John A

2008-11-01

An important source of value is missing from the conventional welfare analysis of moral hazard, namely, the effect of income transfers (from those who purchase insurance and remain healthy to those who become ill) on purchases of medical care. Income transfers are contained within the price reduction that is associated with standard health insurance. However, in contrast to the income effects contained within an exogenous price decrease, these income transfers act to shift out the demand for medical care. As a result, the consumer's willingness to pay for medical care increases and the resulting additional consumption is welfare increasing.

Medicare Part D: Are Insurers Gaming the Low Income Subsidy Design?

PubMed

Decarolis, Francesco

2015-04-01

This paper shows how in Medicare Part D insurers' gaming of the subsidy paid to low-income enrollees distorts premiums and raises the program cost. Using plan-level data from the first five years of the program, I find multiple instances of pricing strategy distortions for the largest insurers. Instrumental variable estimates indicate that the changes in a concentration index measuring the manipulability of the subsidy can explain a large share of the premium growth observed between 2006 and 2011. Removing this distortion could reduce the cost of the program without worsening consumer welfare.

7 CFR 457.121 - Arizona-California citrus crop insurance provisions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Provisions with (1) controlling (2), etc. 1. Definitions Carton. The standard container for marketing the fresh packed citrus fruit crop as shown below. In the absence of marketing records on a carton basis... the tree before cutting. Direct marketing. Sale of the insured crop directly to consumers without the...

Taxation and Revenues for Education. Education Partners Working Papers.

ERIC Educational Resources Information Center

Crampton, Faith; Whitney, Terry

Funding education with property taxes has always been controversial. This paper examines taxation and the sources of revenue for education. The historical context in which tax and revenue sources have supported education in the United States is described. Also discussed are state tax-policy goals and education funding, and the embattled role of…

Taxation and Skills. OECD Tax Policy Studies. No. 24

ERIC Educational Resources Information Center

OECD Publishing, 2017

2017-01-01

This Tax Policy Study on Taxation and Skills examines how tax policy can encourage skills development in OECD countries. This study also assesses the returns to tertiary and adult education and examines how these returns are shared between governments and students. The study builds indicators that examine incentives for individuals and governments…

Voluntary health insurance in the European Union: a critical assessment.

PubMed

Mossialos, Elias; Thomson, Sarah M S

2002-01-01

The authors examine the role and nature of the market for voluntary health insurance in the European Union and review the impact of public policy, at both the national and E.U. levels, on the development of this market in recent years. The conceptual framework, based on a model of industrial analysis, allows a wide range of policy questions regarding market structure, conduct, and performance. By analyzing these three aspects of the market for voluntary health insurance, the authors are also able to raise questions about the equity and efficiency of voluntary health insurance as a means of funding health care in the European Union. The analysis suggests that the market for voluntary health insurance in the European Union suffers from significant information failures that seriously limit its potential for competition or efficiency and also reduce equity. Substantial deregulation of the E.U. market for voluntary health insurance has stripped regulatory bodies of their power to protect consumers and poses interesting challenges for national regulators, particularly if the market is to expand in the future. In a deregulated environment, it is questionable whether this method of funding health care will encourage a more efficient and equitable allocation of resources.

[Insurance system. Prevention from viewpoint of the insurer].

PubMed

Brechtbühl, P

1978-12-01

The purpose of an insurance must not be restricted to the payment of claims to those insured persons who suffered a loss, for loss prevention is much preferable to claim settlement. A whole range of different institutions and measures has been established by the Swiss insurers, in which many insurance branches participate. The loss preventing activities can be listed as follows:--Activities of the fire insurers to prevent and fight fires. This is the prevailing duty of the Consulting Agency for Fire Prevention (BfB) as well as the Fire Prevention Service for Industry and Trade (BVD).--Activities of the accident insurers to prevent accidents. The fight against accidents, mostly traffic accidents, in sports and at home is the foremost task of the Swiss Council for the Prevention of Accidents (BfU), an institution created by the Conference of Accident Insurance Managers (UDK) and the Swiss National Accident Insurance Fund (SUVA).--The Health Service in life insurance, after all the periodical medical examinations and consultations granted by many insurers to their insured persons, as well as the pamphlets aiming at health education published by several Companies and finally institutions and measures to promote fitness, e.g. VITA-Parcours.

The health benefits of selective taxation as an economic instrument in relation to IHD and nutrition-related cancers.

PubMed

Holm, Astrid L; Laursen, Mai-Britt; Koch, Maria; Jensen, Jørgen D; Diderichsen, Finn

2013-12-01

The present study aimed to estimate the health benefits of selective taxation of healthy and unhealthy food commodities in relation to CVD and nutrition-related cancers. The potential health effects of a selective taxation scenario were estimated as changes in the burden of disease, measured by disability-adjusted life years, from health outcomes affected by the changes in food intake. The change in burden of a disease was calculated as the change in incidence of the disease due to a modified exposure level, using the potential impact fraction. Estimates of relative risk for the associations between various foods and relevant diseases were found through a literature search and used in the calculation of potential impact fractions. The study was based in Denmark, estimating the health effects of a Danish selective taxation scenario. The potential health effects of selective taxation were modelled for the adult Danish population. Halving the rate of value-added tax on fruit and vegetables and increasing the tax on fats would result in moderate reductions in the burden of disease from IHD, ischaemic stroke, and colorectal, lung and breast cancer (0·4–2·4 % change). The largest effect could be obtained through increased intake of fruit and vegetables (0·9–2·4 %). Applying selective taxation to healthy and unhealthy foods can moderately reduce the burden of disease in the Danish population.

24 CFR 266.602 - Mortgage insurance premium: Insured advances.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Mortgage insurance premium: Insured... Contract Rights and Obligations Mortgage Insurance Premiums § 266.602 Mortgage insurance premium: Insured.... On each anniversary of the initial closing, the HFA shall pay an interim mortgage insurance premium...

24 CFR 266.602 - Mortgage insurance premium: Insured advances.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Mortgage insurance premium: Insured... Contract Rights and Obligations Mortgage Insurance Premiums § 266.602 Mortgage insurance premium: Insured.... On each anniversary of the initial closing, the HFA shall pay an interim mortgage insurance premium...

26 CFR 1.338-4 - Aggregate deemed sale price; various aspects of taxation of the deemed asset sale.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 4 2010-04-01 2010-04-01 false Aggregate deemed sale price; various aspects of taxation of the deemed asset sale. 1.338-4 Section 1.338-4 Internal Revenue INTERNAL REVENUE SERVICE... Aggregate deemed sale price; various aspects of taxation of the deemed asset sale. (a) Scope. This section...

Taxation: Myths and Realities. A Courses by Newspaper Reader.

ERIC Educational Resources Information Center

Break, George F., Ed.; Wallin, Bruce, Ed.

This reader is one of two supplementary materials for a newspaper course about taxation and tax reform. Five units contain 75 primary-source readings about topics such as tax loopholes, social security financing, income tax reform, the impact of taxes on the economy, and alternatives to the property tax. Sources include government publications,…

Health Benefits for Vocational Rehabilitation Consumers: Comparison of Access Rates with Workers in the General Population

ERIC Educational Resources Information Center

Lustig, Daniel C.; Strauser, David R.

2010-01-01

Access to health insurance is one of the critical aspects of securing employment for people with disabilities. This study investigated whether vocational rehabilitation consumers secured employment with an employer who offered health insurance at similar rates to workers in the general population. In general, the results show that vocational…

45 CFR 155.215 - Standards applicable to Navigators and Non-Navigator Assistance Personnel carrying out consumer...

Code of Federal Regulations, 2014 CFR

2014-10-01

... consumer who receives application assistance from the Navigator: (A) Any lines of insurance business, not... application assistance from the entity or individual: (A) Any lines of insurance business, not covered by the...; (iv) Obtain continuing education and be certified and/or recertified on at least an annual basis; and...

45 CFR 155.215 - Standards applicable to Navigators and Non-Navigator Assistance Personnel carrying out consumer...

Code of Federal Regulations, 2013 CFR

2013-10-01

... consumer who receives application assistance from the Navigator: (A) Any lines of insurance business, not... application assistance from the entity or individual: (A) Any lines of insurance business, not covered by the...; (iv) Obtain continuing education and be certified and/or recertified on at least an annual basis; and...

Development of soil taxation and soil classification as furthered by the Austrian Soil Science Society

NASA Astrophysics Data System (ADS)

Baumgarten, Andreas

2013-04-01

Soil taxation and soil classification are important drivers of soil science in Austria. However, the tasks are quite different: whereas soil taxation aims at the evaluation of the productivity potential of the soil, soil classification focusses on the natural development and - especially nowadays - on functionality of the soil. Since the foundation of the Austrian Soil Science Society (ASSS), representatives both directions of the description of the soil have been involved in the common actions of the society. In the first years it was a main target to improve and standardize field descriptions of the soil. Although both systems differ in the general layout, the experts should comply with identical approaches. According to this work, a lot of effort has been put into the standardization of the soil classification system, thus ensuring a common basis. The development, state of the art and further development of both classification and taxation systems initiated and carried out by the ASSS will be shown.

Inequity in Health Care Financing in Iran: Progressive or Regressive Mechanism?

PubMed

Rad, Enayatollah Homaie; Khodaparast, Marzie

2016-06-01

Having progressive health finance mechanism is very important to decrease inequity in health systems. Revenue collection is one of the aspects of health care financing. In this study, taxation system and health insurance contribution of Iranians were assessed. Data of 2012 household expenditures survey were used in this study, and payments of the families for health insurances and tax payments were extracted from the study. Kakwani index was calculated for assessing the progressivity of these payments. At the end, a model was designed to find the effective factors. We found that taxation mechanism was progressive, but insurance contribution mechanism was very regressive. The portion of people living in urban regions was higher in the payments of insurance and tax. Less educated families had lower contribution in health insurance and families with more aging persons paid more for health insurance. Policy makers must pay more attention to the health insurance contribution and change the laws in favour of the poor.

Inequity in Health Care Financing in Iran: Progressive or Regressive Mechanism?

PubMed Central

Rad, Enayatollah Homaie; Khodaparast, Marzie

2016-01-01

Objective: Having progressive health finance mechanism is very important to decrease inequity in health systems. Revenue collection is one of the aspects of health care financing. In this study, taxation system and health insurance contribution of Iranians were assessed. Materials and Methods: Data of 2012 household expenditures survey were used in this study, and payments of the families for health insurances and tax payments were extracted from the study. Kakwani index was calculated for assessing the progressivity of these payments. At the end, a model was designed to find the effective factors. Results: We found that taxation mechanism was progressive, but insurance contribution mechanism was very regressive. The portion of people living in urban regions was higher in the payments of insurance and tax. Less educated families had lower contribution in health insurance and families with more aging persons paid more for health insurance. Conclusion: Policy makers must pay more attention to the health insurance contribution and change the laws in favour of the poor. PMID:27551174

Economic approaches to nonrenewable resource taxation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brewer, K.J.; Hamilton, S.E.; Westin, R.A.

1996-12-31

The purpose of this Article is to provide the reader with a survey of the current status of natural resource economics insofar as it related to tax policy. The topic is limited to oil, gas and minerals. The Article begins with a review of the kinds of oil and gas exploitation contracts that arose in the U.S. in a free-wheeling industry, the primary feature of which is that private owners of the oil and gas interests are able to enforce the property interests created by those contracts. The subject is important because (1) those contracts spread into the mining (andmore » to a lesser extent the timber) industry, and (2) the contracts are closely analogous to later tax systems in which the state owns the resources. There is a tendency among thinkers in the area to overlook these market-based arrangements and to imagine that they are logically separate from tax systems. They are not separate. Moreover, by understanding the private forms, one is well-armed to evaluate the taxation of natural resources and to detect the limits, especially the inflexibility, of government-designed systems. One can then ask questions about the wisdom of any particular country`s choices in the field of natural resource taxation. The Article then moves to the economist`s stand on the subject, as expressed in the prevailing literature. Finally, the Article closes with some policy considerations with respect to structuring tax systems in which the state is the proprietor of the resources.« less

Mobilizing Public Opinion for the Tobacco Industry: The Consumer Tax Alliance and Excise Taxes

PubMed Central

Campbell, Richard; Balbach, Edith D.

2009-01-01

Background Tobacco industry funding was instrumental in creating and financing the Consumer Tax Alliance in 1989 as an ostensibly organization that relied upon extensive media outreach to build opposition to excise taxes as a regressive form of taxation. By obscuring its own role in this effort, the tobacco industry undermined the public’s reasonable expectations for transparency in the policy making process. Aim To examine the formation and activities of the Consumer Tax Alliance as a “hybrid” form of interest group in order to provide tobacco control and public health advocates with a better understanding of unanticipated tobacco industry coalitions and facilitate appropriate counter measures. Methods Document searches through the Legacy Tobacco Documents Library and through Tobacco Documents Online and review of background literature. Results The Tobacco Institute actively sought liberal allies beginning in the mid-1980s in seeking to build public opposition to cigarette excise tax increases by promoting them as a regressive form of taxation. The creation of the Consumer Tax Alliance in 1989 was expressly intended to turn labor and middle class opinion against prospective excise tax increases in federal budget deficit negotiations, without divulging the tobacco industry’s role in its formation. Conclusion It is important to understand the dynamic by which trusted organizations can be induced to alter their agendas in response to funding sources. Advocates need to understand this form of interest group behavior so that they are better able to negotiate the policy arena by diagnosing and exposing this influence where it occurs and, by doing so, be better prepared to take appropriate counter measures. What this paper adds The tobacco industry’s political strategies for utilizing third party efforts to contest cigarette excise tax increases have not been extensively studied. While there has been some attention to industry sponsorship of third parties, the

5 CFR 870.502 - Basic insurance: Waiver/cancellation of insurance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... insurance: Waiver/cancellation of insurance. (a) An insured individual may cancel his/her Basic insurance at... cancel the insurance. (b) An individual who cancels his/her Basic insurance automatically cancels all...

Consumer-Oriented Health Care Reform Strategies: A Review of the Evidence on Managed Competition and Consumer-Directed Health Insurance

PubMed Central

Buchmueller, Thomas C

2009-01-01

Context: For many years, leading health care reform proposals have been based on market-oriented strategies. In the 1990s, a number of reform proposals were built around the concept of “managed competition,” but more recently, “consumer-directed health care” models have received attention. Although price-conscious consumer demand plays a critical role in both the managed competition and consumer-directed health care models, the two strategies are based on different visions of the health care marketplace and the best way to use market forces to achieve greater systemwide efficiencies. Methods: This article reviews the research literature that tests the main hypotheses concerning the two policy strategies. Findings: Numerous studies provide consistent evidence that consumers’ health plan choices are sensitive to out-of-pocket premiums. The elasticity of demand appears to vary with consumers’ health risk, with younger, healthier individuals being more price sensitive. This heterogeneity increases the potential for adverse selection. Biased risk selection also is a concern when the menu of health plan options includes consumer-directed health plans. Several studies confirm that such plans tend to attract healthier enrollees. A smaller number of studies test the main hypothesis regarding consumer-directed health plans, which is that they result in lower medical spending than do more generous plans. These studies find little support for this claim. Conclusions: The experiences of employers that have adopted key elements of managed competition are generally consistent with the key hypotheses underlying that strategy. Research in this area, however, has focused on only a narrow range of questions. Because consumer-directed health care is such a recent phenomenon, research on this strategy is even more limited. Additional studies on both topics would be valuable. PMID:20021587

Energy use and taxation policy in the New Zealand car fleet

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1984-02-01

The report describes the composition of the New Zealand car fleet and the relationship between design factors, fleet composition, vehicle useage and fuel consumption. The indirect energy content of the vehicle and roadway are discussed. Existing and potential Government policy instruments for promoting fuel economy in the car fleet are discussed and evaluated. The report conclusions favor flat rate sales tax on vehicles regardless of engine size together with an appropriate level of petrol tax in preference to taxation that varies with vehicle size or engine capacity. A review of hire purchase regulations is proposed. Prior to publication of thismore » report the Industries Development Commission Plan for the motor vehicle industry was released which proposes changes to the tariff, taxation and credit purchase regime applying to motor vehicles. These changes are summarized.« less

Variables associated with seeking information from doctors and the internet after exposure to direct-to-consumer advertisements for prescription medications.

PubMed

Fogel, Joshua; Teichman, Chaim

2014-01-01

This study examines variables associated with seeking information from doctors, the Internet, and a combination of both doctors and Internet after exposure to direct-to-consumer advertisements. Data were analyzed from 462 college students. Younger age, women, and health insurance were associated with greater odds for doctor; women, subjective norms, intentions, and greater time since seen doctor were associated with greater odds for Internet; and African American, Hispanic, subjective norms, intentions, and health insurance were associated with greater odds for both doctor and Internet. Marketers of direct-to-consumer advertisements can use these findings for tailoring and targeting direct-to-consumer advertisements.

Should Australia Ban the Use of Genetic Test Results in Life Insurance?

PubMed

Tiller, Jane; Otlowski, Margaret; Lacaze, Paul

2017-01-01

Under current Australian regulation, life insurance companies can require applicants to disclose all genetic test results, including results from research or direct-to-consumer tests. Life insurers can then use this genetic information in underwriting and policy decisions for mutually rated products, including life, permanent disability, and total income protection insurance. Over the past decade, many countries have implemented moratoria or legislative bans on the use of genetic information by life insurers. The Australian government, by contrast, has not reviewed regulation since 2005 when it failed to ensure implementation of recommendations made by the Australian Law Reform Commission. In that time, the Australian life insurance industry has been left to self-regulate its use of genetic information. As a result, insurance fears in Australia now are leading to deterred uptake of genetic testing by at-risk individuals and deterred participation in medical research, both of which have been documented. As the potential for genomic medicine grows, public trust and engagement are critical for successful implementation. Concerns around life insurance may become a barrier to the development of genomic health care, research, and public health initiatives in Australia, and the issue should be publicly addressed. We argue a moratorium on the use of genetic information by life insurers should be enacted while appropriate longer term policy is determined and implemented.

Taxation and the Preservation of Tribal Political and Geographical Autonomy.

ERIC Educational Resources Information Center

Clow, Richmond L.

1991-01-01

Examines the complexities of the taxation issue in Indian affairs, both for American Indian reservations and adjacent local governments. Demonstrates the role of statutes and case law in the recurring struggle to balance tribal immunities guaranteed by the federal government with the expectations of non-Indian taxpayers. (SV)

Verification of consumers' experiences and perceptions of genetic discrimination and its impact on utilization of genetic testing.

PubMed

Barlow-Stewart, Kristine; Taylor, Sandra D; Treloar, Susan A; Stranger, Mark; Otlowski, Margaret

2009-03-01

To undertake a systematic process of verification of consumer accounts of alleged genetic discrimination. Verification of incidents reported in life insurance and other contexts that met the criteria of genetic discrimination, and the impact of fear of such treatment, was determined, with consent, through interview, document analysis and where appropriate, direct contact with the third party involved. The process comprised obtaining evidence that the alleged incident was accurately reported and determining whether the decision or action seemed to be justifiable and/or ethical. Reported incidents of genetic discrimination were verified in life insurance access, underwriting and coercion (9), applications for worker's compensation (1) and early release from prison (1) and in two cases of fear of discrimination impacting on access to genetic testing. Relevant conditions were inherited cancer susceptibility (8), Huntington disease (3), hereditary hemochromatosis (1), and polycystic kidney disease (1). In two cases, the reversal of an adverse underwriting decision to standard rate after intervention with insurers by genetics health professionals was verified. The mismatch between consumer and third party accounts in three life insurance incidents involved miscommunication or lack of information provision by financial advisers. These first cases of verified genetic discrimination make it essential for policies and guidelines to be developed and implemented to ensure appropriate use of genetic test results in insurance underwriting, to promote education and training in the financial industry, and to provide support for consumers and health professionals undertaking challenges of adverse decisions.

26 CFR 1.871-8 - Taxation of nonresident alien individuals engaged in U.S. business or treated as having...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Taxation of nonresident alien individuals engaged in U.S. business or treated as having effectively connected income. 1.871-8 Section 1.871-8...) INCOME TAXES Nonresident Aliens and Foreign Corporations § 1.871-8 Taxation of nonresident alien...

26 CFR 1.871-8 - Taxation of nonresident alien individuals engaged in U.S. business or treated as having...

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 9 2011-04-01 2011-04-01 false Taxation of nonresident alien individuals engaged in U.S. business or treated as having effectively connected income. 1.871-8 Section 1.871-8...) INCOME TAXES (CONTINUED) Nonresident Aliens and Foreign Corporations § 1.871-8 Taxation of nonresident...

Financial coping strategies of mental health consumers: managing social benefits.

PubMed

Caplan, Mary Ager

2014-05-01

Mental health consumers depend on social benefits in the forms of supplemental security income and social security disability insurance for their livelihood. Although these programs pay meager benefits, little research has been undertaken into how this population makes ends meet. Using a qualitative approach, this study asks what are the financial coping strategies of mental health consumers? Seven approaches were identified: subsidies, cost-effective shopping, budgeting, prioritizing, technology, debt management, and saving money. Results illustrate the resourcefulness of mental health consumers in managing meager social benefits and highlight the need to strengthen community mental health efforts with financial capabilities education.

Meteorological and hydrological extremes derived from taxation records: case study for south-western Moravia (Czech Republic)

NASA Astrophysics Data System (ADS)

Chromá, Kateřina; Brázdil, Rudolf; Valášek, Hubert; Zahradníček, Pavel

2013-04-01

Meteorological and hydrological extremes (MHEs) cause great material damage or even loss of human lives in the present time, similarly as it was in the past. In the Czech Lands (recently the Czech Republic), systematic meteorological and hydrological observations started generally in the latter half of the 19th century. Therefore, in order to create long-term series of such extremes, it is necessary to search for other sources of information. Different types of documentary evidence are used in historical climatology and hydrology to find such information. Some of them are related to records connected with taxation system. The taxation system in Moravia allowed farmers to request tax relief if their crops have been damaged by MHEs. The corresponding documents contain information about the type of extreme event and the date of its occurrence; often also impacts on crops or land may be derived. The nature of events leading to damage include particularly hailstorms, torrential rain, flash floods, floods (in regions along larger rivers), less frequently windstorms, late frosts and in some cases also information about droughts or extreme snow depths. However, the results obtained are influenced by uncertainties related to taxation records - their temporal and spatial incompleteness, limitation of the MHEs occurrence in the period of main agricultural work (May-August) and the purpose for which they were originally collected (primarily tax alleviation, i.e. information about MHEs was of secondary importance). All these aspects related to the study of MHEs from taxation records are demonstrated for five estates (Bítov, Budkov, Jemnice with Staré Hobzí, Nové Syrovice and Uherčice) in the south-western part of Moravia for the 18th-19th centuries. The analysis shows importance of taxation records for the study of past MHEs as well as great potential for their use.

Petroleum taxation: a comparison between Russia and Kazakhstan

NASA Astrophysics Data System (ADS)

Tsibulnikova, M. R.; Salata, D. V.; Drebot, V. V.; Vorozheykina, E. A.

2016-09-01

The paper compares mineral resource recovery taxes for oil to be paid in Kazakhstan and the RF. It provides a case study on an average Kazakh oil and gas company and presents tax calculations as an example. To compare the taxation systems in Kazakhstan and the RF, the situation is modelled as if the field was located in the RF and the relevant calculations are carried out in compliance with national laws and regulations.

26 CFR 1.871-13 - Taxation of individuals for taxable year of change of U.S. citizenship or residence.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Taxation of individuals for taxable year of change of U.S. citizenship or residence. 1.871-13 Section 1.871-13 Internal Revenue INTERNAL REVENUE... Foreign Corporations § 1.871-13 Taxation of individuals for taxable year of change of U.S. citizenship or...

26 CFR 1.871-13 - Taxation of individuals for taxable year of change of U.S. citizenship or residence.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 9 2011-04-01 2011-04-01 false Taxation of individuals for taxable year of change of U.S. citizenship or residence. 1.871-13 Section 1.871-13 Internal Revenue INTERNAL REVENUE...) Nonresident Aliens and Foreign Corporations § 1.871-13 Taxation of individuals for taxable year of change of U...

Consumers' Perspectives on National Health Insurance in South Africa: Using a Mobile Health Approach

PubMed Central

Stuttaford, Maria C

2014-01-01

Background Building an equitable health system is a cornerstone of the World Health Organization (WHO) health system building block framework. Public participation in any such reform process facilitates successful implementation. South Africa has embarked on a major reform in health policy that aims at redressing inequity and enabling all citizens to have equal access to efficient and quality health services. Objective This research is based on a survey using Mxit as a mobile phone–based social media network. It was intended to encourage comments on the proposed National Health Insurance (NHI) and to raise awareness among South Africans about their rights to free and quality health care. Methods Data were gathered by means of a public e-consultation, and following a qualitative approach, were then examined and grouped in a theme analysis. The WHO building blocks were used as the conceptual framework in analysis and discussion of the identified themes. Results Major themes are the improvement of service delivery and patient-centered health care, enhanced accessibility of health care providers, and better health service surveillance. Furthermore, health care users demand stronger outcome-based rather than rule-based indicators of the health system’s governance. Intersectoral solidarity and collaboration between private and public health care providers are suggested. Respondents also propose a code of ethical values for health care professionals to address corruption in the health care system. It is noteworthy that measures for dealing with corruption or implementing ethical values are neither described in the WHO building blocks nor in the NHI. Conclusions The policy makers of the new health system for South Africa should address the lack of trust in the health care system that this study has exposed. Furthermore, the study reveals discrepancies between the everyday lived reality of public health care consumers and the intended health policy reform. PMID:25351980

Insuring against health shocks: Health insurance and household choices.

PubMed

Liu, Kai

2016-03-01

This paper provides empirical evidence on the role of public health insurance in mitigating adverse outcomes associated with health shocks. Exploiting the rollout of a universal health insurance program in rural China, I find that total household income and consumption are fully insured against health shocks even without access to health insurance. Household labor supply is an important insurance mechanism against health shocks. Access to health insurance helps households to maintain investment in children's human capital during negative health shocks, which suggests that one benefit of health insurance could arise from reducing the use of costly smoothing mechanisms. Copyright © 2016 Elsevier B.V. All rights reserved.

Heal the damage: prescription drug consumer advertisements and relative choices.

PubMed

Gilhooley, Margaret

2005-01-01

The process of choosing and prescribing prescription drugs is complex. While the choice about which drug to prescribe is made by the physician, the physician may be influenced by patient demand, which, in turn, may be influenced by consumer advertisements. As a result, consumer advertisements for prescription drugs need to provide information that gives consumers an understanding, not only of drug risks and efficacy but also of the notable limits on benefits claimed. This Article examines the drug-specific focus of consumer advertising for prescription drugs from two perspectives: the need to prevent confusion that could affect medical decisions about alternative treatments and the need to prevent misimpressions about the value of a drug that can create consumer demand on physicians and insurers for more expensive drugs than needed.

Strategic Messaging to Promote Taxation of Sugar-Sweetened Beverages: Lessons From Recent Political Campaigns

PubMed Central

Jou, Judy; Niederdeppe, Jeff; Barry, Colleen L.; Gollust, Sarah E.

2014-01-01

Objectives. This study explored the use of strategic messaging by proponents of sugar-sweetened beverage (SSB) taxation to influence public opinion and shape the policy process, emphasizing the experiences in El Monte and Richmond, California, with SSB tax proposals in 2012. Methods. We conducted 18 semistructured interviews with key stakeholders about the use and perceived effectiveness of messages supporting and opposing SSB taxation, knowledge sharing among advocates, message dissemination, and lessons learned from their messaging experiences. Results. The protax messages most frequently mentioned by respondents were reinvesting tax revenue into health-related programs and linking SSB consumption to health outcomes such as obesity and diabetes. The most frequently mentioned antitax messages addressed negative economic effects on businesses and government restriction of personal choice. Factors contributing to perceived messaging success included clearly defining “sugar-sweetened beverage” and earmarking funds for obesity prevention, incorporating cultural sensitivity into messaging, and providing education about the health effects of SSB consumption. Conclusions. Sugar-sweetened beverage taxation has faced significant challenges in gaining political and public support. Future campaigns can benefit from insights gained through the experiences of stakeholders involved in previous policy debates. PMID:24625177

Strategic messaging to promote taxation of sugar-sweetened beverages: lessons from recent political campaigns.

PubMed

Jou, Judy; Niederdeppe, Jeff; Barry, Colleen L; Gollust, Sarah E

2014-05-01

This study explored the use of strategic messaging by proponents of sugar-sweetened beverage (SSB) taxation to influence public opinion and shape the policy process, emphasizing the experiences in El Monte and Richmond, California, with SSB tax proposals in 2012. We conducted 18 semistructured interviews with key stakeholders about the use and perceived effectiveness of messages supporting and opposing SSB taxation, knowledge sharing among advocates, message dissemination, and lessons learned from their messaging experiences. The protax messages most frequently mentioned by respondents were reinvesting tax revenue into health-related programs and linking SSB consumption to health outcomes such as obesity and diabetes. The most frequently mentioned antitax messages addressed negative economic effects on businesses and government restriction of personal choice. Factors contributing to perceived messaging success included clearly defining "sugar-sweetened beverage" and earmarking funds for obesity prevention, incorporating cultural sensitivity into messaging, and providing education about the health effects of SSB consumption. Sugar-sweetened beverage taxation has faced significant challenges in gaining political and public support. Future campaigns can benefit from insights gained through the experiences of stakeholders involved in previous policy debates.

The debate over weight- versus price-based taxation of snuff in the United States' state legislatures.

PubMed

Timberlake, David S; Sami, Mojgan; Patel, Sonam; Thiagarajan, Shamili; Badiyan, Ramin; Willard, Shay

2014-08-01

Discount snuff, known for its cheap price, high nicotine content, and popularity among youth, has increased substantially in market share in the United States. As a likely result, the leading manufacturer of premium snuff has supported legislation changing the basis for taxing snuff from price to weight. To determine which public health issues arose in legislative debates, we transcribed 17 of 52 bills from US state legislatures and coded for arguments broadly categorized into public health, fair taxation, tax revenue, tax efficiency, and anti-competitiveness. State legislators expressed frustration that equitable taxation, revenue generation, and prevention of youth tobacco use were frequently conflated in the debates. Public health advocates expressed concerns over youths' incentives to purchase low-weight snuff, but seldom discussed youths' growing preference for discount snuff. The evolving market of moist snuff is a critical consideration for US state legislators as well as policy makers from other countries who may evaluate taxation methods for alternate tobacco products.

Determinants of Coverage Decisions in Health Insurance Marketplaces: Consumers' Decision-Making Abilities and the Amount of Information in Their Choice Environment

PubMed Central

Barnes, Andrew J; Hanoch, Yaniv; Rice, Thomas

2015-01-01

Objective To investigate the determinants and quality of coverage decisions among uninsured choosing plans in a hypothetical health insurance marketplace. Study Setting Two samples of uninsured individuals: one from an Internet-based sample comprised largely of young, healthy, tech-savvy individuals (n = 276), and the other from low-income, rural Virginians (n = 161). Study Design We assessed whether health insurance comprehension, numeracy, choice consistency, and the number of plan choices were associated with participants' ability to choose a cost-minimizing plan, given their expected health care needs (defined as choosing a plan costing no more than $500 in excess of the total estimated annual costs of the cheapest plan available). Data Collection Primary data were collected using an online questionnaire. Principal Findings Uninsured who were more numerate showed higher health insurance comprehension; those with more health insurance comprehension made choices of health insurance plans more consistent with their stated preferences; and those who made choices more concordant with their stated preferences were less likely to choose a plan that cost more than $500 in excess of the cheapest plan available. Conclusions Increasing health insurance comprehension and designing exchanges to facilitate plan comparison will be critical to ensuring the success of health insurance marketplaces. PMID:24779769

The dominant firm in health insurance.

PubMed

Goldberg, L G; Greenberg, W

1985-01-01

Blue Cross, the largest insurer of hospital costs in most parts of the U.S., has a varying market share by area. This paper examines the factors affecting the market share of Blue Cross by state. The regression analysis finds that the Blue Cross discount has an important impact upon market structure and that certain regulatory factors have had an impact while others, such as the premium tax, have not. Hypotheses related to the effects of consumer demand and the structure of the industry on Blue Cross market share are also tested and largely rejected.

Acceptability of, and willingness to pay for, community health insurance in rural India.

PubMed

Jain, Ankit; Swetha, Selva; Johar, Zeena; Raghavan, Ramesh

2014-09-01

To understand the acceptability of, and willingness to pay for, community health insurance coverage among residents of rural India. We conducted a mixed methods study of 33 respondents located in 8 villages in southern India. Interview domains focused on health-seeking behaviors of the family for primary healthcare, household expenditures on primary healthcare, interest in pre-paid health insurance, and willingness to pay for such a product. Most respondents reported that they would seek care only when symptoms were manifest; only 6 respondents recognized the importance of preventative services. None reported impoverishment due to health expenditures. Few viewed health insurance as necessary either because they did not wish to be early adopters, because they had alternate sources of financial support, or because of concerns with the design of insurance coverage or the provider. Those who were interested reported being willing to pay Rs. 1500 ($27) as the modal annual insurance premium. Penetration of community health insurance programs in rural India will require education of the consumer base, careful attention to premium rate setting, and deeper understanding of social networks that may act as financial substitutes for health insurance. Copyright © 2013 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

"The lobbying strategy is to keep excise as low as possible" - tobacco industry excise taxation policy in Ukraine

PubMed Central

2010-01-01

Background Tobacco taxes are one of the most effective ways to reduce tobacco use. Transnational tobacco companies (TTCs) claim they wish to develop and secure excise systems that benefit both governments and the profitability of the companies themselves. The objective of the paper is to use the case of Ukraine, with its inconsistent history of excise tax changes in 1992-2008, to explore tobacco industry taxation strategies and tactics, and their implications for governmental revenues. Methods Details of tobacco industry policy on tobacco taxation in Ukraine were obtained by searching tobacco industry internal documents and various published reports. Results Even before entering the market in Ukraine, TTCs had made efforts to change the excise system in the country. In 1993-1994, TTCs lobbied the Ukrainian Government, and succeeded in achieving a lowering in tobacco tax. This, however, did not produce revenue increase they promised the Government. In 1996-1998, Ukrainian authorities increased excise several times, ignoring the wishes of TTCs, caused significant growth in revenue. Due to TTCs lobbying activities in 1999-2007 the tax increases were very moderate and it resulted in increased tobacco consumption in Ukraine. In 2008, despite the TTCs position, excise rates were increased twice and it was very beneficial for revenues. Conclusions The Framework Convention on Tobacco Control includes provisions both on tobacco taxation policy and on protection of public health policy from vested interests of tobacco industry. This paper provides arguments why tobacco taxation policy should also be protected from vested interests of tobacco industry. TTCs taxation strategy appears to be consistent: keep excise as low as possible. Apparent conflicts between TTCs concerning tax structures often hide their real aim to change tax structures for competing interests without increasing total tax incidence. Governments, that aim to reduce levels of tobacco use, should not allow

How the Affordable Care Act Has Helped Women Gain Insurance and Improved Their Ability to Get Health Care: Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2016.

PubMed

Gunja, Munira Z; Collins, Sara R; Doty, Michelle M; Beautel, Sophie

2017-08-01

ISSUE: Prior to the Affordable Care Act (ACA), one-third of women who tried to buy a health plan on their own were either turned down, charged a higher premium because of their health, or had specific health problems excluded from their plans. Beginning in 2010, ACA consumer protections, particularly coverage for preventive care screenings with no cost-sharing and a ban on plan benefit limits, improved the quality of health insurance for women. In 2014, the law’s major insurance reforms helped millions of women who did not have employer insurance to gain coverage through the ACA’s marketplaces or through Medicaid. GOALS: To examine the effects of ACA health reforms on women’s coverage and access to care. METHOD: Analysis of the Commonwealth Fund Biennial Health Insurance Surveys, 2001–2016. FINDINGS AND CONCLUSIONS: Women ages 19 to 64 who shopped for new coverage on their own found it significantly easier to find affordable plans in 2016 compared to 2010. The percentage of women who reported delaying or skipping needed care because of costs fell to an all-time low. Insured women were more likely than uninsured women to receive preventive screenings, including Pap tests and mammograms.

Analysis of consumer information brochures on osteoporosis prevention and treatment.

PubMed

Meyer, Gabriele; Steckelberg, Anke; Mühlhauser, Ingrid

2007-01-11

Evidence-based consumer information is a prerequisite for informed decision making. So far, there are no reports on the quality of consumer information brochures on osteoporosis. In the present study we analysed brochures on osteoporosis available in Germany. All printed brochures from patient and consumer advocacy groups, physician and governmental organisations, health insurances, and pharmaceutical companies were initially collected in 2001, and updated in December 2004. Brochures were analysed by two independent researchers using 37 internationally proposed criteria addressing evidence-based content, risk communication, transparency of the development process, and layout and design. A total of 165 brochures were identified; 59 were included as they specifically targeted osteoporosis prevention and treatment. Most brochures were provided by pharmaceutical companies (n=25), followed by health insurances (n=11) and patient and consumer advocacy groups (n=11). Quality of brochures did not differ between providers. Only 1 brochure presented lifetime risk estimate; 4 mentioned natural course of osteoporosis. A balanced report on benefit versus lack of benefit was presented in 2 brochures and on benefit versus adverse effects in 8 brochures. Four brochures mentioned relative risk reduction, 1 reported absolute risk reduction through hormone replacement therapy (HRT). Out of 28 brochures accessed in 2004 10 still recommended HRT without discussing adverse effects. Transparency of the development process was limited: 25 brochures reported publication date, 26 cited author and only 1 references. In contrast, readability and design was generally good. The quality of consumer brochures on osteoporosis in Germany is utterly inadequate. They fail to give evidence-based data on diagnosis and treatment options. Therefore, the material is not useful to enhance informed consumer choice.

Analysis of consumer information brochures on osteoporosis prevention and treatment

PubMed Central

Meyer, Gabriele; Steckelberg, Anke; Mühlhauser, Ingrid

2007-01-01

Purpose: Evidence-based consumer information is a prerequisite for informed decision making. So far, there are no reports on the quality of consumer information brochures on osteoporosis. In the present study we analysed brochures on osteoporosis available in Germany. Method: All printed brochures from patient and consumer advocacy groups, physician and governmental organisations, health insurances, and pharmaceutical companies were initially collected in 2001, and updated in December 2004. Brochures were analysed by two independent researchers using 37 internationally proposed criteria addressing evidence-based content, risk communication, transparency of the development process, and layout and design. Results: A total of 165 brochures were identified; 59 were included as they specifically targeted osteoporosis prevention and treatment. Most brochures were provided by pharmaceutical companies (n=25), followed by health insurances (n=11) and patient and consumer advocacy groups (n=11). Quality of brochures did not differ between providers. Only 1 brochure presented lifetime risk estimate; 4 mentioned natural course of osteoporosis. A balanced report on benefit versus lack of benefit was presented in 2 brochures and on benefit versus adverse effects in 8 brochures. Four brochures mentioned relative risk reduction, 1 reported absolute risk reduction through hormone replacement therapy (HRT). Out of 28 brochures accessed in 2004 10 still recommended HRT without discussing adverse effects. Transparency of the development process was limited: 25 brochures reported publication date, 26 cited author and only 1 references. In contrast, readability and design was generally good. Conclusion: The quality of consumer brochures on osteoporosis in Germany is utterly inadequate. They fail to give evidence-based data on diagnosis and treatment options. Therefore, the material is not useful to enhance informed consumer choice. PMID:19675709

24 CFR 266.600 - Mortgage insurance premium: Insurance upon completion.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Mortgage insurance premium... MULTIFAMILY PROJECT LOANS Contract Rights and Obligations Mortgage Insurance Premiums § 266.600 Mortgage insurance premium: Insurance upon completion. (a) Initial premium. For projects insured upon completion, on...

24 CFR 266.600 - Mortgage insurance premium: Insurance upon completion.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Mortgage insurance premium... MULTIFAMILY PROJECT LOANS Contract Rights and Obligations Mortgage Insurance Premiums § 266.600 Mortgage insurance premium: Insurance upon completion. (a) Initial premium. For projects insured upon completion, on...

Taxation, smuggling and demand for cigarettes in Canada: evidence from time-series data.

PubMed

Galbraith, J W; Kaiserman, M

1997-06-01

This study analyzes Canadian cigarette consumption and taxation between 1980 and 1994, a period in which there have been large price rises and declines, and a dramatic increase in the consumption of contraband tobacco products. We examine elasticities of legal cigarette sales and total sales (including contraband) with respect to the price of legal cigarettes and various other factors. The growth of the contraband market since 1987 appears to have created two classes of cigarette--taxed and untaxed--with responses to changes in the legal price that are respectively higher, and lower, than was previously the case. The sensitivity of total cigarette sales to the taxation instrument is much lower than it would appear from sales of taxed cigarettes alone.

The impact of health insurance reform on insurance instability.

PubMed

Freund, Karen M; Isabelle, Alexis P; Hanchate, Amresh D; Kalish, Richard L; Kapoor, Alok; Bak, Sharon; Mishuris, Rebecca G; Shroff, Swati M; Battaglia, Tracy A

2014-02-01

We investigated the impact of the 2006 Massachusetts health care reform on insurance coverage and stability among minority and underserved women. We examined 36 months of insurance claims among 1,946 women who had abnormal cancer screening at six community health centers pre-(2004-2005) and post-(2007-2008) insurance reform. We examined frequency of switches in insurance coverage as measures of longitudinal insurance instability. On the date of their abnormal cancer screening test, 36% of subjects were publicly insured and 31% were uninsured. Post-reform, the percent ever uninsured declined from 39% to 29% (p .001) and those consistently uninsured declined from 23% to 16%. To assess if insurance instability changed between the pre- and post-reform periods, we conducted Poisson regression models, adjusted for patient demographics and length of time in care. These revealed no significant differences from the pre- to post-reform period in annual rates of insurance switches, incident rate ratio 0.98 (95%- CI 0.88-1.09). Our analysis is limited by changes in the populations in the pre- and post-reform period and inability to capture care outside of the health system network. Insurance reform increased stability as measured by decreasing uninsured rates without increasing insurance switches.

Income, insurance, and technology: why does health spending outpace economic growth?

PubMed

Smith, Sheila; Newhouse, Joseph P; Freeland, Mark S

2009-01-01

A broad consensus holds that increased medical capability-technology-is the primary driver of health spending growth. However, technology does not expand independently of historical context; it is fueled by rising incomes and more generous insurance coverage. We estimate that medical technology explains 27-48 percent of health spending growth since 1960-a smaller percentage than earlier estimates. Income (gross domestic product, or GDP) growth plays a critical role, primarily through the actions of governments and employers on behalf of pools of consumers. The contribution of insurance is likely to differ, with less of a push from increasing generosity of coverage and more of a push from changes in provider payment.

Exploring health insurance services in Sudan from the perspectives of insurers

PubMed Central

Salim, Anas Mustafa Ahmed; Hamed, Fatima Hashim Mahmoud

2018-01-01

Background: It has been 20 years since the introduction of health insurance in Sudan. This study was the first one that explored health insurance services in Sudan from the perspectives of the insurers. Methods: This was a qualitative, exploratory, interview study. The sampling frame was the list of Social Health Insurance and Private Health Insurance institutions in Sudan. Participants were selected from the four Social Health Insurance institutions and from five Private Health Insurance companies. The study was conducted in January and February 2017. In-depth individual interviews were conducted with a convenient sample of key executives from the different health insurers. Ideas and themes were identified and analysed using thematic analysis. Results: The result showed that universal coverage was not achieved despite long time presence of Social Health Insurance and Private Health Insurance in Sudan. All participants described their services as comprehensive. All participants have good perception of the quality of the services they provide, although none of them investigated customer satisfaction. The main challenges facing Social Health Insurance are achieving universal coverage, ensuring sustainability and recruitment of the informal sector and self-employed population. Consumers’ affordability of the premiums is the main obstacle for Private Health Insurance, while rising healthcare cost due to economic inflation is a challenge facing both Social Health Insurance and Private Health Insurance. Conclusion: In spite of the presence of Social Health Insurance and Private Health Insurance in Sudan, the country is still far from achieving universal coverage. Moreover, the sustainability of health insurance is questionable. The main reasons include low governmental financial resources and lack of affordability by beneficiaries especially for Private Health Insurance. This necessitates finding solutions to improve them or trying other types of health insurance

Food taxation and pricing strategies to "thin out" the obesity epidemic.

PubMed

Kim, Daniel; Kawachi, Ichiro

2006-05-01

This article highlights characteristics of two related yet distinct economic approaches to addressing the current obesity epidemic in the United States: the general taxation of soft drinks, snack foods, and/or fast foods, and the application of pricing incentives/disincentives on foods sold in schools and worksites. The article specifically focuses on the: (1) rationale for, (2) potential barriers and limitations to, and (3) possible unintended consequences of implementing these policy interventions at the state level. Novel empirical evidence showing strong positive associations between the presence of state-level taxation on soft drinks or snack foods between 1991 and 1998 and relative changes in obesity prevalence over the same time period is further presented. The article concludes by summarizing the similarities and dissimilarities of the two approaches, and by emphasizing some of the gaps and priorities regarding these strategies that should be addressed in future research and policies to best effect obesity prevention.

Individual Decision Making in the Non-Purchase of Long-Term Care Insurance

ERIC Educational Resources Information Center

Curry, Leslie A.; Robison, Julie; Shugrue, Noreen; Keenan, Patricia; Kapp, Marshall B.

2009-01-01

Purpose: Although prior research suggests that economic, behavioral, and psychosocial factors influence decisions not to purchase long-term care insurance, few studies have examined the interplay among these factors in depth and from the consumer's point of view. This study was intended to further illuminate these considerations, generate…

Medical care use and selection in a social health insurance with an equalization fund: evidence from Colombia.

PubMed

Trujillo, Antonio J

2003-03-01

This paper studies the relationship between health status and insurance participation, and between insurance status and medical use in the context of a social health insurance with an equalization fund (SHIEF). Under this system, revenues from a mandatory payroll tax are collected into a single pool (equalization fund) that reimburses for-profit insurance companies according to a capitated formula. Although competition should induce insurers to control costs without reducing the quality of service necessary to attract consumers, limitations in the capitation formula might induce insurers to select against bad risks, and limitations in the contribution system might induce more healthy individuals to evade enrollment. A three-equation model having social health insurance, private health insurance, and using medical services is estimated using a 1997 Colombian household survey. Consistent with similar studies, participation in SHIEF increases medical care use. On the other hand, the evidence on selection is somewhat mixed: individuals who report good health status are more likely to participate in SHIEF, while those without a chronic condition are less likely to participate in SHIEF. Copyright 2002 John Wiley & Sons, Ltd.

42 CFR 411.39 - Automobile and liability insurance (including self-insurance), no-fault insurance, and workers...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Automobile and liability insurance (including self-insurance), no-fault insurance, and workers' compensation: Final conditional payment amounts via Web portal... Coverage That Limits Medicare Payment: General Provisions § 411.39 Automobile and liability insurance...

42 CFR 411.39 - Automobile and liability insurance (including self-insurance), no-fault insurance, and workers...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Automobile and liability insurance (including self-insurance), no-fault insurance, and workers' compensation: Final conditional payment amounts via Web portal... Coverage That Limits Medicare Payment: General Provisions § 411.39 Automobile and liability insurance...

Willingness to pay for voluntary community-based health insurance: findings from an exploratory study in the state of Penang, Malaysia.

PubMed

Shafie, A A; Hassali, M A

2013-11-01

Health care in Malaysia is funded primarily through taxation and is no longer sustainable. One funding option is voluntary community-based health insurance (VCHI), which provides insurance coverage for those who are unable to benefit immediately from either a social or private health insurance plan. This study is performed to assess the willingness of Malaysians to participate in a VCHI plan. A cross-sectional study was performed in the state of Penang between August and mid-September 2009 with 472 randomly selected respondents. The respondents were first asked to select their preferred health financing plan from three plans (out-of-pocket payment, compulsory social health insurance and VCHI). The extent of the household's willingness to pay for the described VCHI plan was later assessed using the contingent valuation method in an ex-ante bidding game approach until the maximum amount they would be willing to pay to obtain such a service was agreed upon. Fifty-four per cent of the participants were female, with a mean age of 34 years (SD = 11.9), the majority of whom had a monthly income of Int$1157-2312. The results indicated that more than 63.1% of the respondents were willing to join and contribute an average of Int$114.38 per month per household towards VCHI. This amount was influenced by ethnicity, educational level, household monthly income, the presence of chronic disease and the presence of private insurance coverage (p < 0.05). In conclusion, our study findings suggest that most Malaysians are willing to join the proposed VCHI and to pay an average of Int$114.38 per month per household for the plan. Copyright © 2013 Elsevier Ltd. All rights reserved.

Billions of Dollars are Involved in Taxation of the Life Insurance Industry -- Some Corrections in the Law are Needed.

DTIC Science & Technology

1981-09-17

leading life companies, 1979 69 i A A TABLES 16 A comparative example of the reserve test Calculation 76 17 Comparative income tax burden of life...pp. 159-61. 2/J. David Cummins, An Econometric Model of the Life Insurance Sector of the U.S. Economy (Lexington, Mass.: Lexington Books, 1975), p. 57...3/Cummins, Econometric Model, p. 44. 4/Fact Book 1979, p. 32. 23 decades earlier. 1/ This decline has been attributed to two sources. First, as

Tobacco taxation: the importance of earmarking the revenue to health care and tobacco control.

PubMed

Vardavas, Constantine I; Filippidis, Filippos T; Agaku, Israel; Mytaras, Vasileios; Bertic, Monique; Connolly, Gregory N; Tountas, Yannis; Behrakis, Panagiotis

2012-01-01

Increases in tobacco taxation are acknowledged to be one of the most effective tobacco control interventions. This study aimed at determining the mediating role of socioeconomical status (SES) and the earmarking of revenue to healthcare and tobacco control, in influencing population support for the adoption of a 2 Euro tobacco tax increase in Greece, amid the challenging economic environment and current austerity measures. Data was collected from two national household surveys, the "Hellas Health III" survey, conducted in October 2010 and the "Hellas Tobacco survey" conducted in September 2012. Data was analyzed from 694 and 1066 respondents aged 18 years or more, respectively. Logistic regression models were fitted to measure the adjusted relationship between socio-economic factors for the former, and support for increased taxation on tobacco products for the latter. In 2012 amidst the Greek financial crisis, population support for a flat two euro tax increase reached 72.1%, if earmarked for health care and tobacco control, a percentage high both among non-smokers (76%) and smokers (64%) alike. On the contrary, when not earmarked, only 43.6% of the population was in support of the equivalent increase. Women were more likely to change their mind and support a flat two-euro increase if the revenue was earmarked for health care and tobacco control (aOR = 1.70; 95% C.I: 1.22-2.38, p = 0.002). Furthermore, support for an increase in tobacco taxation was not associated with SES and income. Despite dire austerity measures in Greece, support for an increase in tobacco taxation was high among both smokers and non-smokers, however, only when specifically earmarked towards health care and tobacco control. This should be taken into account not only in Greece, but within all countries facing social and economic reform.

The use of taxation records in assessing historical floods in South Moravia, Czech Republic

NASA Astrophysics Data System (ADS)

Brázdil, R.; Chromá, K.; Řezníčková, L.; Valášek, H.; Dolák, L.; Stachoň, Z.; Soukalová, E.; Dobrovolný, P.

2014-10-01

Since the second half of the 17th century, tax relief has been available to farmers and landowners to offset flood damage to property (buildings) and land (fields, meadows, pastures, gardens) in South Moravia, Czech Republic. Historically, the written applications for this were supported by a relatively efficient bureaucratic process that left a clear data trail of documentation, preserved at several levels: in the communities affected, in regional offices, and in the Moravian Land Office, all of which are to be found in estate and family collections in the Moravian Land Archives in the city of Brno, the provincial capital. As well as detailed information about damage done and administrative responses to it, data are often preserved as to the flood event itself, the time of its occurrence and its impacts, sometimes together with causes and stages. The final flood database based on taxation records is used here to describe the temporal and spatial density of both flood events and the records themselves. The information derived is used to help create long-term flood chronologies for the rivers Dyje, Jihlava, Svratka and Morava, combining floods interpreted from taxation records with other documentary data and floods derived from later systematic hydrological measurements (water levels, discharges). Common periods of higher flood frequency appear largely in the periods 1821-1850 and 1921-1950, although this shifts to several other decades for individual rivers. A number of uncertainties are inseparable from flood data taxation records: their spatial and temporal incompleteness; the inevitable limitation to larger-scale damage and restriction to the summer half-year; and the different characters of rivers, including land-use changes and channel modifications. Taxation data have considerable potential for extending our knowledge of past floods for the rest of the Czech Republic, not to mention other European countries in which records have survived.

Tobacco taxation: the importance of earmarking the revenue to health care and tobacco control

PubMed Central

2012-01-01

Background Increases in tobacco taxation are acknowledged to be one of the most effective tobacco control interventions. This study aimed at determining the mediating role of socioeconomical status (SES) and the earmarking of revenue to healthcare and tobacco control, in influencing population support for the adoption of a 2 Euro tobacco tax increase in Greece, amid the challenging economic environment and current austerity measures. Methods Data was collected from two national household surveys, the “Hellas Health III” survey, conducted in October 2010 and the "Hellas Tobacco survey” conducted in September 2012. Data was analyzed from 694 and 1066 respondents aged 18 years or more, respectively. Logistic regression models were fitted to measure the adjusted relationship between socio-economic factors for the former, and support for increased taxation on tobacco products for the latter. Results In 2012 amidst the Greek financial crisis, population support for a flat two euro tax increase reached 72.1%, if earmarked for health care and tobacco control, a percentage high both among non-smokers (76%) and smokers (64%) alike. On the contrary, when not earmarked, only 43.6% of the population was in support of the equivalent increase. Women were more likely to change their mind and support a flat two-euro increase if the revenue was earmarked for health care and tobacco control (aOR = 1.70; 95% C.I: 1.22-2.38, p = 0.002). Furthermore, support for an increase in tobacco taxation was not associated with SES and income. Conclusion Despite dire austerity measures in Greece, support for an increase in tobacco taxation was high among both smokers and non-smokers, however, only when specifically earmarked towards health care and tobacco control. This should be taken into account not only in Greece, but within all countries facing social and economic reform. PMID:23270412

26 CFR 1.882-1 - Taxation of foreign corporations engaged in U.S. business or of foreign corporations treated as...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Taxation of foreign corporations engaged in U.S. business or of foreign corporations treated as having effectively connected income. 1.882-1 Section 1.882-1...) INCOME TAXES Foreign Corporations § 1.882-1 Taxation of foreign corporations engaged in U.S. business or...

26 CFR 1.882-1 - Taxation of foreign corporations engaged in U.S. business or of foreign corporations treated as...

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 9 2011-04-01 2011-04-01 false Taxation of foreign corporations engaged in U.S. business or of foreign corporations treated as having effectively connected income. 1.882-1 Section 1.882-1...) INCOME TAXES (CONTINUED) Foreign Corporations § 1.882-1 Taxation of foreign corporations engaged in U.S...

Consumer cost sharing and use of biopharmaceuticals for rheumatoid arthritis.

PubMed

Robinson, James C

2013-06-01

To evaluate the effect of consumer cost sharing on use of physician-administered and patient self-administered specialty drugs for rheumatoid arthritis. Multivariate statistical analysis of probability and use of physician-administered specialty drugs, patient self-injected specialty drugs, non-biologic disease-modifying anti-rheumatic drugs, and symptom relief drugs. Analyses were conducted for patients enrolling in preferred provider organization (PPO) plans and health maintenance organization (HMO) plans with different cost-sharing requirements, adjusted for patient demographics, health status, and geographical location. Professional, facility, and pharmaceutical claims for beneficiaries of CalPERS, the public employee insurance purchasing alliance in California, for 2008-2009. Consumer cost-sharing requirements were obtained for each type of drug and service for each type of insurance plan. PPO insurance enrollees face substantially higher cost sharing for physician-administered specialty drugs, compared with HMO enrollees in CalPERS. PPO patients with rheumatoid arthritis are only half as likely as HMO enrollees to choose a physician-administered specialty drug (4.2% vs 9.3%) (P ≤.05), and use 25% less of the drugs if they use any ($10,356 vs $13,678) (P ≤.05). They are 30% more likely to use a self-administered specialty drug than are HMO enrollees (29.3% vs 22.1%) (P ≤.05), and use 35% more of the drugs if any ($16,015 vs $12,378) (P ≤.05). Consumer cost sharing reduces the use of physician-administered specialty drugs for rheumatoid arthritis. The higher use of patient self-administered specialty drugs suggests that the disincentives for use of physician-administered drugs were offset by an increased incentive to use self-administered drugs.

26 CFR 1.1291-1 - Taxation of U.S. persons that are shareholders of PFICs that are not pedigreed QEFs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 11 2010-04-01 2010-04-01 true Taxation of U.S. persons that are shareholders of PFICs that are not pedigreed QEFs. 1.1291-1 Section 1.1291-1 Internal Revenue INTERNAL REVENUE... Determining Capital Gains and Losses § 1.1291-1 Taxation of U.S. persons that are shareholders of PFICs that...

26 CFR 1.1291-1 - Taxation of U.S. persons that are shareholders of PFICs that are not pedigreed QEFs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 11 2011-04-01 2011-04-01 false Taxation of U.S. persons that are shareholders of PFICs that are not pedigreed QEFs. 1.1291-1 Section 1.1291-1 Internal Revenue INTERNAL REVENUE... Rules for Determining Capital Gains and Losses § 1.1291-1 Taxation of U.S. persons that are shareholders...

Insurance premiums and insurance coverage of near-poor children.

PubMed

Hadley, Jack; Reschovsky, James D; Cunningham, Peter; Kenney, Genevieve; Dubay, Lisa

States increasingly are using premiums for near-poor children in their public insurance programs (Medicaid/SCHIP) to limit private insurance crowd-out and constrain program costs. Using national data from four rounds of the Community Tracking Study Household Surveys spanning the seven years from 1996 to 2003, this study estimates a multinomial logistic regression model examining how public and private insurance premiums affect insurance coverage outcomes (Medicaid/SCHIP coverage, private coverage, and no coverage). Higher public premiums are significantly associated with a lower probability of public coverage and higher probabilities of private coverage and uninsurance; higher private premiums are significantly related to a lower probability of private coverage and higher probabilities of public coverage and uninsurance. The results imply that uninsurance rates will rise if both public and private premiums increase, and suggest that states that impose or increase public insurance premiums for near-poor children will succeed in discouraging crowd-out of private insurance, but at the expense of higher rates of uninsurance. Sustained increases in private insurance premiums will continue to create enrollment pressures on state insurance programs for children.

Impact of sugars and sugar taxation on body weight control: A comprehensive literature review.

PubMed

Bes-Rastrollo, Maira; Sayon-Orea, Carmen; Ruiz-Canela, Miguel; Martinez-Gonzalez, Miguel A

2016-07-01

To conduct a comprehensive literature review in the field of added-sugar consumption on weight gain including the effect of fructose-containing caloric sweeteners and sugar taxation. A search of three databases was conducted in the time period from the inception of the databases to August 2015. Sensitive search strategies were used in order to retrieve systematic reviews (SR) of fructose, sucrose, or sugar-sweetened beverages (SSBs) on weight gain and metabolic adverse effects, conducted on humans and written in English, Spanish, or French. In addition, a review about SSB taxation and weight outcomes was conducted. The search yielded 24 SRs about SSBs and obesity, 23 SRs on fructose or SSBs and metabolic adverse effects, and 24 studies about SSB taxation and weight control. The majority of SRs, especially the most recent ones, with the highest quality and without any disclosed conflict of interest, suggested that the consumption of SSBs is a risk factor for obesity. The effect of fructose-containing caloric sweeteners, on weight gain is mediated by overconsumption of beverages with these sweeteners, leading to an extra provision of energy intake. The tax tool alone on added sugars appears insufficient to curb the obesity epidemic, but it needs to be included in a multicomponent structural strategy. © 2016 The Obesity Society.

From managed care to consumer health insurance: the fall and rise of Aetna.

PubMed

Robinson, James C

2004-01-01

This paper documents Aetna's fall as the nation's largest managed care plan and its subsequent reemergence as a smaller but more profitable multiproduct insurer. The paper emphasizes the transformation in corporate goals, product design, organizational structure, information technology, product mix, premiums, cash flow, net income, and share prices. Disciplined underwriting and pricing have restored the firm to profitability and set the foundation for new growth. The implications for the health care system as a whole are less unambiguously positive.

Insuring the unknown.

PubMed

Parsons, C

2015-12-01

Uncertainty is the central element in insurance. This article examines how insurers evaluate and price risks that can present very high levels of uncertainty, and which many underwriters regard as especially hazardous in insurance terms. These are the risks associated with new medical devices, new pharmaceutical products and others substances for human consumption, such as food additives. Insurance is likely to be needed for these products both during their research and development phases, including insurance for clinical trials, and also once the device, drug or other substance gains approval and is in regular use.The article examines the types of insurance that are available to cover these risks, the organizations that provide insurance and how the insurance is organised. It discusses the basic principles that insurers use to price insurance before considering the difficulties presented by novel and complex risks generally. The article concludes with a description of the techniques that insurers employ to analyse and price the particular risks that are our subject and a discussion of how underwriters seek to overcome the special problems associated with them. © The Author(s) 2015.

Report on the Audit of DoD Immunity From State Taxation

DTIC Science & Technology

1991-02-15

This is our final report on the audit of DOD Immunity from State Taxation for your information and use. We made the audit from July to September 1990...The objective of the audit was to determine whether DoD was unnecessarily paying state sales taxes. We also determined if sales taxes were being

Healthcare plans and consumer perceptions of healthcare institutions.

PubMed

Arboleda-Arango, Ana M

2015-01-01

This study evaluates the effect of healthcare insurance plans on consumer perception of trust in a healthcare institution, and the mediating effect of trust on consumer loyalty towards an institution. The study was conducted at a healthcare institution in Colombia where a total of 841 patients responded to a questionnaire. A structural equation model shows that individuals who have a pre-paid healthcare plan have a stronger evaluation of trust compared to those who hold a regulated healthcare plan (i.e., subsidized and contributory plans). In turn, trust positively predicts consumers' loyalty towards an institution. The relationship between the patients' healthcare plans and their degree of loyalty towards healthcare institutions is completely mediated by their perception of trust towards the institution. A greater perception of trust is explained by having a medical plan that provides consumers with more flexibility, allowing them to select their health provider at a premium price. Although health institutions do not control healthcare regimes, these affect consumers' trust in their service. Institutions cannot modify characteristics of the regime, but they can promote a trustworthy environment to strengthen consumers' loyalty to the institution.

Demand for private health insurance: how important is the quality gap?

PubMed

Costa, Joan; García, Jaume

2003-07-01

Perceived quality of private and public health care, income and insurance premium are among the determinants of demand for private health insurance (PHI). In the context of a model in which individuals are expected utility maximizers, the non purchasing choice can result in consuming either public health care or private health care with full cost paid out-of-pocket. This paper empirically analyses the effect of the determinants of the demand for PHI on the probability of purchasing PHI by estimating a pseudo-structural model to deal with missing data and endogeneity issues. Our findings support the hypothesis that the demand for PHI is indeed driven by the quality gap between private and public health care. As expected, PHI is a normal good and a rise in the insurance premium reduces the probability of purchasing PHI albeit displaying price elasticities smaller than one in absolute value for different groups of individuals. Copyright 2002 John Wiley & Sons, Ltd.

5 CFR 870.505 - Optional insurance: Waiver/cancellation of insurance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... § 870.505 Optional insurance: Waiver/cancellation of insurance. (a) An insured individual may cancel...: an individual who has assigned his/her insurance under subpart I of this part cannot cancel Option A... is cancelled because there are no eligible family members, the effective date is retroactive to the...

Uniformity of Taxation and Illinois School Funding: A State Constitutional Perspective

ERIC Educational Resources Information Center

Reynolds, Laurie

2008-01-01

The Illinois Supreme Court has permitted the General Assembly to create a system of public school funding that is widely disparate and disadvantageous to students in school districts with low-property wealth. In this Article, I argue that the court has not adequately considered the nexus between the Uniformity of Taxation provision and the…

'Genetics is not the issue': insurers on genetics and life insurance.

PubMed

Van Hoyweghen, Ine; Horstman, Klasien; Schepers, Rita

2005-04-01

This article offers an analysis of the way private insurers deal with the issue of genetics and insurance. Drawing on specific written insurance sources, a reconstruction is made of internal debates on genetics and insurance within the private insurance world in Europe and the United States. The article starts by analyzing the way insurers initially framed the issue of genetics. It proceeds by showing how ideas with respect to this issue developed beyond public policy debates in the nineties. Although not a strictly linear development, a trend towards a change in perspective can be demonstrated: at the beginning most insurance companies took another stance than they do nowadays. The article concludes by questioning the effect of these changes within the insurance world for the definition of the problem with respect to genetics and insurance. Does taking into account the public concerns around genetics also include taking genetics as a public problem?

Exploration risks and mineral taxation: how fiscal regimes affect exploration incentives

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stauffer, T.R.; Gault, J.C.

1985-01-01

This paper investigates the effects of taxation on exploration risk and establishes certain criteria for an optimal tax on mineral resources, such as oil and gas, where exploration risk (i.e., geological risk) is a key decision variable. The optimization is considered in the context of government ownership of the resource rights, but with an eye to the after-tax incentives perceived by private-sector explorationists. Any government that relies on the private sector for discovery and development must recognize those effects. Taxation affects not only the expected returns from mineral exploration ventures but also the riskiness of such ventures. The potential formore » misdesign is great. The authors show, however, that it is possible, in realistic cases, simultaneously to increase government revenues, improve the explorationist's return, and reduce exploration risk. The opportunity for such improvements arises because most common mineral tax schemes skew the tax burdens across fields of different sizes or qualities. A key consideration in optimizing a tax regime is designing the tax to assign the appropriate burdens to different classes of discoveries. 7 tables.« less

Why not private health insurance? 1. Insurance made easy

PubMed Central

Deber, R; Gildiner, A; Baranek, P

1999-01-01

How realistic are proposals to expand the financing of Canadian health care through private insurance, either in a parallel stream or an expanded supplementary tier? Any successful business requires that revenues exceed expenditures. Under a voluntary health insurance plan those at highest risk would be the most likely to seek coverage; insurers working within a competitive market would have to limit their financial risk through such mechanisms as "risk selection" to avoid clients likely to incur high costs and/or imposing caps on the costs covered. It is unlikely that parallel private plans will have a market if a comprehensive public insurance system continues to exist and function well. Although supplementary plans are more congruous with insurance principles, they would raise costs for purchasers and would probably not provide full open-ended coverage to all potential clients. Insurance principles suggest that voluntary insurance plans that shift costs to the private sector would damage the publicly funded system and would be unable to cover costs for all services required. PMID:10497613

Private expenditure and the role of private health insurance in Greece: status quo and future trends.

PubMed

Siskou, Olga; Kaitelidou, Daphne; Economou, Charalampos; Kostagiolas, Peter; Liaropoulos, Lycourgos

2009-10-01

The health care system in Greece is financed in almost equal proportions by public and private sources. Private expenditure, consists mostly of out-of-pocket and under-the-table payments. Such payments strongly suggest dissatisfaction with the public system, due to under financing during the last 25 years. This gap has been filled rapidly by the private sector. From this point of view, one might suggest that the flourishing development of private provision may lead in turn to a corresponding growth in private health insurance (PHI). This paper aims to examine the role of PHI in Greece, to identify the factors influencing its development, and to make some suggestions about future policies and trends. In the decade of 1985-1995 PHI show increasing activity, reflecting the intention of some citizens to seek health insurance solutions in the form of supplementary cover in order to ensure faster access, better quality of services, and increased consumer choice. The benefits include programs covering hospital expenses, cash benefits, outpatient care expenses, disability income insurance, as well as limited managed care programs. However, despite recent interest, PHI coverage remains low in Greece compared to other EU countries. Economic, social and cultural factors such as low average household income, high unemployment, obligatory and full coverage by social insurance, lead to reluctance to pay for second-tier insurance. Instead, there is a preference to pay a doctor or hospital directly even in the form of under-the-table payments (which are remarkably high in Greece), when the need arises. There are also factors endogenous to the PHI industry, related to market policies, low organisational capacity, cream skimming, and the absence of insurance products meeting consumer requirements, which explain the relatively low state of development of PHI in Greece.

Cigarette taxation in China: lessons from international experiences

PubMed Central

Hu, T.

1997-01-01

This paper draws upon the experiences of foreign countries in implementing tobacco taxation to provide lessons the Chinese government can use when considering the feasibility of raising additional taxes on cigarettes. Based on current international data and Chinese published data, this paper concludes that there is still leeway to raise existing taxes. The Chinese government should consider conducting some pilot experiments in tobacco tax increases, with some of the new revenues allocated for tobacco control programmes as well as for financing healthcare services among the poor. 


 PMID:9291224

Health Insurance Basics

MedlinePlus

... Staying Safe Videos for Educators Search English Español Health Insurance Basics KidsHealth / For Teens / Health Insurance Basics What's ... thought advanced calculus was confusing. What Exactly Is Health Insurance? Health insurance is a plan that people buy ...

Minimum pricing of alcohol versus volumetric taxation: which policy will reduce heavy consumption without adversely affecting light and moderate consumers?

PubMed

Sharma, Anurag; Vandenberg, Brian; Hollingsworth, Bruce

2014-01-01

We estimate the effect on light, moderate and heavy consumers of alcohol from implementing a minimum unit price for alcohol (MUP) compared with a uniform volumetric tax. We analyse scanner data from a panel survey of demographically representative households (n = 885) collected over a one-year period (24 Jan 2010-22 Jan 2011) in the state of Victoria, Australia, which includes detailed records of each household's off-trade alcohol purchasing. The heaviest consumers (3% of the sample) currently purchase 20% of the total litres of alcohol (LALs), are more likely to purchase cask wine and full strength beer, and pay significantly less on average per standard drink compared to the lightest consumers (A$1.31 [95% CI 1.20-1.41] compared to $2.21 [95% CI 2.10-2.31]). Applying a MUP of A$1 per standard drink has a greater effect on reducing the mean annual volume of alcohol purchased by the heaviest consumers of wine (15.78 LALs [95% CI 14.86-16.69]) and beer (1.85 LALs [95% CI 1.64-2.05]) compared to a uniform volumetric tax (9.56 LALs [95% CI 9.10-10.01] and 0.49 LALs [95% CI 0.46-0.41], respectively). A MUP results in smaller increases in the annual cost for the heaviest consumers of wine ($393.60 [95% CI 374.19-413.00]) and beer ($108.26 [95% CI 94.76-121.75]), compared to a uniform volumetric tax ($552.46 [95% CI 530.55-574.36] and $163.92 [95% CI 152.79-175.03], respectively). Both a MUP and uniform volumetric tax have little effect on changing the annual cost of wine and beer for light and moderate consumers, and likewise little effect upon their purchasing. While both a MUP and a uniform volumetric tax have potential to reduce heavy consumption of wine and beer without adversely affecting light and moderate consumers, a MUP offers the potential to achieve greater reductions in heavy consumption at a lower overall annual cost to consumers.

Relieving Consumer Overindebtedness in South Africa: Policy Reviews and Recommendations

ERIC Educational Resources Information Center

Ssebagala, Ralph Abbey

2017-01-01

A large fraction of South African consumers are highly leveraged, inadequately insured, and/or own little to no assets of value, which increases their exposure not only to idiosyncratic risk but also to severe indebtedness and/or default. This scenario can present negative ramifications that lead well beyond the confines of individual households.…

How Will the Affordable Care Act's Cost-Sharing Reductions Affect Consumers' Out-of-Pocket Costs in 2016?

PubMed

Collins, Sara R; Gunja, Munira; Beutel, Sophie

2016-03-01

Health insurers selling plans in the Affordable Care Act's market­places are required to reduce cost-sharing in silver plans for low- and moderate-income people earning between 100 percent and 250 percent of the federal pov­erty level. In 2016, as many as 7 million Americans may have plans with these cost-sharing reductions. In the largest markets in the 38 states using the federal website for marketplace enrollment, the cost-sharing reductions substantially lower projected out-of-pocket costs for people who qualify for them. However, the degree to which consumers' out-of-pocket spending will fall varies by plan and how much health care they use. This is because insurers use deductibles, out-of-pocket limits, and copayments in different combinations to lower cost-sharing for eligible enrollees. In 2017, marketplace insurers will have the option of offering standard plans, which may help simplify consumers' choices and lead to more equal cost-sharing.

Insurance Accounts: The Cultural Logics of Health Care Financing.

PubMed

Mulligan, Jessica

2016-03-01

The financial exuberance that eventually culminated in the recent world economic crisis also ushered in dramatic shifts in how health care is financed, administered, and imagined. Drawing on research conducted in the mid-2000s at a health insurance company in Puerto Rico, this article shows how health care has been financialized in many ways that include: (1) privatizing public services; (2) engineering new insurance products like high deductible plans and health savings accounts; (3) applying financial techniques to premium payments to yield maximum profitability; (4) a managerial focus on shareholder value; and (5) prioritizing mergers and financial speculation. The article argues that financial techniques obfuscate how much health care costs, foster widespread gaming of reimbursement systems that drives up prices, and "unpool" risk by devolving financial and moral responsibility for health care onto individual consumers. © 2015 by the American Anthropological Association.

The Effect of Income Taxation on Labor Supply in the United States.

ERIC Educational Resources Information Center

Triest, Robert K.

1990-01-01

A study used an econometric model to examine the effect of income taxation on labor supply of married women and men. Male labor supply was found to be relatively invariant to income. Impact on married women depended upon the method used to estimate the labor supply function. (SK)

Paying for Equity: The Role of Taxation in Driving Canada's Educational Success

ERIC Educational Resources Information Center

Freiler, Christa

2011-01-01

Using research conducted by the federal government's own finance department, social policy groups released the report, "Paying for Canada: Perspectives on Public Finance and National Programs." It showed that deliberate government policy to reduce taxation levels for some of the most economically advantaged groups in Canada had resulted…

Healthcare financing reform in Latvia: switching from social health insurance to NHS and back?

PubMed

Mitenbergs, Uldis; Brigis, Girts; Quentin, Wilm

2014-11-01

In the 1990s, Latvia aimed at introducing Social Health Insurance (SHI) but later changed to a National Health Service (NHS) type system. The NHS is financed from general taxation, provides coverage to the entire population, and pays for a basic service package purchased from independent public and private providers. In November 2013, the Cabinet of Ministers passed a draft Healthcare Financing Law, aiming at increasing public expenditures on health by introducing Compulsory Health Insurance (CHI) and linking entitlement to health services to the payment of income tax. Opponents of the reform argue that linking entitlement to health services to the payment of income tax does not have the potential to increase public expenditures on health but that it can contribute to compromising universal coverage and access to health services of certain population groups. In view of strong opposition, it is unlikely that the law will be adopted before parliamentary elections in October 2014. Nevertheless, the discussion around the law is interesting because of three main reasons: (1) it can illustrate why the concept of SHI remains attractive - not only for Latvia but also for other countries, (2) it shows that a change from NHS to SHI does not imply major institutional reforms, and (3) it demonstrates the potential problems of introducing SHI, i.e. of linking entitlement to health services to the payment of contributions. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Why don't people buy long-term-care insurance?

PubMed

Cramer, Anne Theisen; Jensen, Gail A

2006-07-01

The objective of this article was to assess the determinants of an individual's decision to purchase long-term-care (LTC) insurance. This article focuses on the decision to purchase a new policy as opposed to renewing an existing policy. This study gave special consideration to the role of policy price, the savings associated with buying a policy now as opposed to later, the purchaser's education, and the purchaser's income. Using data from the 2002 Health and Retirement Survey, we estimated logistic regressions to model consumer decisions to purchase LTC insurance. We explored several alternative measures of the price of a policy. Price was a significant determinant in decisions to purchase coverage. The demand for coverage, however, was price inelastic, with elasticities ranging from -0.23 to -0.87, depending on the specification of the model. The education level and income of the purchaser were also important. This analysis provides the first estimates of price elasticity of demand for LTC insurance. The finding that demand is very price inelastic suggests that state initiatives that effectively subsidize premiums as a way of stimulating purchases are likely to meet with very limited success in the present environment.

Life insurance and genetic test results: a mutation carrier's fight to achieve full cover.

PubMed

Keogh, Louise A; Otlowski, Margaret F A

2013-09-02

Currently, there is debate about life insurance companies' use of genetic information for assessing applicants. In his early 20s, James (pseudonym) was denied full life insurance cover because he revealed that he had discussed genetic testing with a genetic counsellor. He was later tested and found to carry a mutation in the MSH6 gene; after disclosing this, he was denied cover for cancer by two other life insurance companies. Unsatisfied with the insurance companies' risk assessments, and based on his understanding that regular colonoscopy significantly reduced his risk of cancer, James made a complaint to the Australian Human Rights Commission. After informing the third insurance company that he had done so, he was offered full coverage, which suggests that the company did not have actuarial data to justify its decision. This case provides evidence of the high level of initiative and proactivity required for a consumer to achieve a fair result. Few Australians would be in a position to pursue the level of research and advocacy undertaken by James (a professional with scientific training). We call on a collaborative approach between industry, government and researchers to address the issues that James's case raises about genetic testing and life insurance.

Factors influencing consumer satisfaction with health care.

PubMed

Deshpande, Satish P; Deshpande, Samir S

2014-01-01

The purpose of this study was to examine factors that impact consumer satisfaction with health care. This is a secondary analysis of the Center for Studying Health System Change's 2010 Health Tracking Household Survey. Regression analysis was used to examine the impact of treatment issues, financial issues, family-related issues, sources of health care information, location, and demographics-related factors on satisfaction with health care. The study involved 12280 subjects, 56% of whom were very satisfied with their health care, whereas 66% were very satisfied with their primary care physician. Fourteen percent of the subjects had no health insurance; 34% of the subjects got their health care information from the Web. Satisfaction with primary care physician, general health status, promptness of visit to doctor, insurance type, medical cost per family, annual income, persons in family, health care information from friends, and age significantly impacted satisfaction with health care. The regression models accounted for 23% of the variance in health care satisfaction. Satisfaction with primary care physicians, health insurance, and general health status are the 3 most significant indicators of an individual's satisfaction with health care.

Regulating a health insurance exchange: implications for individuals with mental illness.

PubMed

McGuire, Thomas G; Sinaiko, Anna D

2010-11-01

Under the newly enacted health reform law, millions of lower- and middle-income Americans will purchase individual or family health insurance through state-based markets for private health insurance called insurance "exchanges," which consolidate and regulate the market for individual and small-group health insurance. The authors consider options for structuring choice and pricing of health insurance in an exchange from the perspective of efficiently and fairly serving persons with mental illness. Exchanges are intended to foster choice and competition. However, certain features-open enrollment, individual choice, and imperfect risk adjusters-create incentives for "adverse selection," especially in providing coverage for persons with mental illness, who have higher overall health care costs. The authors review the experience of persons with mental illness in insurance markets similar to the exchanges, such as the Massachusetts Connector and the Federal Employees Health Benefit Program, and note that competition among health plans for enrollees who are "good risks" can undermine coverage and efficiency. They review the possible approaches for contending with selection-related incentives, such as carving out all or part of mental health benefits, providing reinsurance for some mental health care costs, or their preferred option, running the exchange in the same way that an employer runs its employee benefits and addressing selection and cost control issues by choice of contractor. The authors also consider approaches an exchange could use to promote effective consumer choice, such as passive and active roles for the exchange authority. Regulation will be necessary to establish a foundation for success of the exchanges.

Disability Insurance and the Dynamics of the Incentive Insurance Trade-Off.

PubMed

Low, Hamish; Pistaferri, Luigi

2018-10-01

We provide a life-cycle framework for comparing insurance and disincentive effects of disability benefits. The risks that individuals face and the parameters of the Disability Insurance (DI ) program are estimated from consumption, health, disability insurance, and wage data. We characterize the effects of disability insurance and study how policy reforms impact behavior and welfare. DI features high rejection rates of disabled applicants and some acceptance of healthy applicants. Despite worse incentives, welfare increases as programs become less strict or generosity increases. Disability insurance interacts with welfare programs: making unconditional means-tested programs more generous improves disability insurance targeting and increases welfare.

Minimum Pricing of Alcohol versus Volumetric Taxation: Which Policy Will Reduce Heavy Consumption without Adversely Affecting Light and Moderate Consumers?

PubMed Central

Sharma, Anurag; Vandenberg, Brian; Hollingsworth, Bruce

2014-01-01

Background We estimate the effect on light, moderate and heavy consumers of alcohol from implementing a minimum unit price for alcohol (MUP) compared with a uniform volumetric tax. Methods We analyse scanner data from a panel survey of demographically representative households (n = 885) collected over a one-year period (24 Jan 2010–22 Jan 2011) in the state of Victoria, Australia, which includes detailed records of each household's off-trade alcohol purchasing. Findings The heaviest consumers (3% of the sample) currently purchase 20% of the total litres of alcohol (LALs), are more likely to purchase cask wine and full strength beer, and pay significantly less on average per standard drink compared to the lightest consumers (A$1.31 [95% CI 1.20–1.41] compared to $2.21 [95% CI 2.10–2.31]). Applying a MUP of A$1 per standard drink has a greater effect on reducing the mean annual volume of alcohol purchased by the heaviest consumers of wine (15.78 LALs [95% CI 14.86–16.69]) and beer (1.85 LALs [95% CI 1.64–2.05]) compared to a uniform volumetric tax (9.56 LALs [95% CI 9.10–10.01] and 0.49 LALs [95% CI 0.46–0.41], respectively). A MUP results in smaller increases in the annual cost for the heaviest consumers of wine ($393.60 [95% CI 374.19–413.00]) and beer ($108.26 [95% CI 94.76–121.75]), compared to a uniform volumetric tax ($552.46 [95% CI 530.55–574.36] and $163.92 [95% CI 152.79–175.03], respectively). Both a MUP and uniform volumetric tax have little effect on changing the annual cost of wine and beer for light and moderate consumers, and likewise little effect upon their purchasing. Conclusions While both a MUP and a uniform volumetric tax have potential to reduce heavy consumption of wine and beer without adversely affecting light and moderate consumers, a MUP offers the potential to achieve greater reductions in heavy consumption at a lower overall annual cost to consumers. PMID:24465368

Quality and consumer decision making in the market for health insurance and health care services.

PubMed

Kolstad, Jonathan T; Chernew, Michael E

2009-02-01

This article reviews the literature relating quality to consumer choice of health plan or health care provider. Evidence suggests that consumers tend to choose better performing health plans and providers and are responsive to initiatives that provide quality information. The response to quality and quality information differs significantly among consumers and across population subgroups. As such the effect of quality information on choice is apparent in only a relatively small, though perhaps consequential, number of consumers. Despite the wealth of findings on the topic to date, the authors suggest directions for future work, including better assessment of the dynamic issues related to information release, as well as a better understanding of how the response to information varies across different groups of patients.

Alternative liability insurance: a physician-owned captive insurance company.

PubMed

Lee, G F

1991-06-01

The physician-owned captive insurance company is a lesser known but dynamic alternative to commercial insurance. The Physicians Reimbursement Fund, Ltd., was founded in 1975 in response to the malpractice crisis of that year. The company insures about 100 physicians in high-risk specialties. Approximately one half are obstetrician-gynecologists. Innovative management has enabled this company to operate successfully at a fraction of the premium charged by typical insurance companies. Fourteen years of experience have demonstrated the ability of this company to successfully serve the needs of the community.

Health care consumer reports: an evaluation of employer perspectives.

PubMed

Longo, Daniel R

2004-01-01

The proliferation of health care consumer reports (also known as "consumer guides," "report cards," and "performance reports") designed to assist consumers in making more informed health care decisions makes it vital to understand the perspective of employers who provide the vast majority of health insurance to the working population regarding the use of these reports. There is little empirical evidence on how consumer reports are used by employers to make health care purchasing decisions. This study fills that gap by surveying 154 businesses in Boone County, Missouri, regarding their evaluation of a consumer guide. The majority of employers surveyed indicate that the report will not have a direct effect on their health care purchasing decisions. However, they indicate that the reports are "positive and worthwhile" and their responses reflect a favorable view of the health care organization that developed and disseminated the report. Additionally, findings indicate that employers generally prefer consumer reports as a means to compare local health care institutions, rather than reviewing national averages to locate the same information. Report developers should take precautions to determine the intent of such reports, as they may not achieve the objective of changing employers' health care purchasing behavior.

Marketing long-term care insurance. Public education ads to the proper target must precede sales efforts.

PubMed

Benet, S B; Bloom, P N

1998-01-01

The ingredients for a financial calamity affecting both government and individual citizens and their families are in place. Federal legislators have made little progress in addressing the health care needs of an aging America, and the proposals that have been advanced offer little or nothing in the way of better help with long-term care. One potential scenario is that middle-income retirees placed in long-term care will exhaust their finances and then turn to Medicaid, creating an enormous expense for the government. Long-term care insurance could alleviate the situation, but current practices by the insurance industry in marketing products to the elderly complicate the sale of such insurance. Consumers approaching retirement age are receptive to this type of product, but first they must be made aware of the merits of long-term care insurance and the paucity of alternatives. Only then can marketers promote specific products successfully.

Public health care and private insurance demand: the waiting time as a link.

PubMed

Jofre-Bonet, M

2000-01-01

This paper analyzes the effect of waiting times in the Spanish public health system on the demand for private health insurance. Expected utility maximization determines whether or not individuals buy a private health insurance. The decision depends not only on consumer's covariates such as income, socio-demographic characteristics and health status, but also on the quality of the treatment by the public provider. We interpret waiting time as a qualitative attribute of the health care provision. The empirical analysis uses the Spanish Health Survey of 1993. We cope with the absence of income data by using the Spanish Family Budget Survey of 1990-91 as a complementary data set, following the Arellano-Meghir method [4]. Results indicate that a reduction in the waiting time lowers the probability of buying private health insurance. This suggests the existence of a crowd-out in the health care provision market.

[Insurance medical consultation in private health insurance - which insurance medical questions are put to the medical consultant?].

PubMed

Hakimi, R; Herre, K; Seyffer, R

2015-03-01

This study deals with the task areas of the medical consultant in private health insurance. Although insurance medical consultation for the insurance business originated in the 19th century, the tasks and competencies of the medical consultants are still mostly unknown. This study is a complete inventory count of all insurance medical consultation requests for the year 2013. All of the 5493 insurance medical consultation requests have been evaluated. Most of the consultation requests concern the medical necessity for medical drugs, followed by the medical consultation of alternative medicine and the classification of cure and rehabilitation measures of hospital medical treatments. The need for insurance medical consultation on lifestyle drugs, cosmetic operations and artificial insemination has increased significantly in the past 10 years. Since 2009, moreover, the need for medical consultation on the subject of "Ruhensleistungen" with regard to non-payers and "Notlagentarif" has strongly increased.

Consumer subjectivity and U.S. health care reform.

PubMed

West, Emily

2014-01-01

Health care consumerism is an important frame in U.S. health care policy, especially in recent media and policy discourse about federal health care reform. This article reports on qualitative fieldwork with health care users to find out how people interpret and make sense of the identity of "health care consumer." It proposes that while the term consumer is normally understood as a descriptive label for users who purchase health care and insurance services, it should actually be understood as a metaphor, carrying with it a host of associations that shape U.S. health care policy debates in particular ways. Based on interviews with 36 people, patient was the dominant term people used to describe themselves, but consumer was the second most popular. Informants interpreted the health care consumer as being informed, proactive, and having choices, but there were also "semiotic traps," or difficult-to-resolve tensions for this identity. The discourse of consumerism functions in part as code for individual responsibility, and therefore as a classed moral discourse, with implications for U.S. health care policy.

Consumer-driven health care: answer to global competition or threat to social justice?

PubMed

Owen, Carol L

2009-10-01

Health planning in the United States is rapidly approaching a fork in the policy road, with one direction leading the nation toward a universal plan with strong government involvement and the other direction strengthening existing market-based reforms and preserving a commercial health insurance industry. "Consumer-driven health care," a slogan that captures a range of market-based approaches to preserving patient choice and increasing cost savings, is most commonly implemented in the form of individual health savings accounts. These accounts are offered to employees as a means of increasing the cost sharing ofpersonal health care expenses. The author provides an overview of health insurance history and discusses some implications of abandoning earlier practices of risk pooling health care expenses across a wider community. Access and affordability issues connected with the adoption of a consumer-driven health care system in the United States are addressed. Parallels are drawn between the expansion of community-based insurance in the United States following World War II and social work's historic commitment to social justice and economic inclusion. Suggestions are made for social workers'involvement in health policy discourse and activism during this critical time ofnational reflection on universal versus market-based reforms for the U.S. health care system.

What could family income be if health insurance were more affordable?

PubMed

Young, Richard A; Devoe, Jennifer E

2012-10-01

Adjusted for inflation, household income has been relatively flat since the mid-1990s, but the inflation rate of employer-sponsored health insurance has been greater than both household income growth and general inflation for 50 years. We estimated the effect on average family income if health insurance inflation matched the general inflation rate since 1996, and those savings were given to employees as income. We used data from the Medical Expenditure Panel Survey, the Milliman Medical Index, and other federal sources to model the relationship between private health insurance costs and household income over the last 15 years. If the cost of family health care costs had kept pace with the Consumer Price Index (CPI) rate since 1996, the average family income could have been $8,410 higher in 2010 ($68,805 versus $60,395), 13.9% more than actual earnings. If health care costs had not exceeded the CPI rate since 1996 and if all the excess costs were converted into employee wages, median family income could be substantially higher today.

An Application Domain Extension to CityGML for immovable property taxation: A Turkish case study

NASA Astrophysics Data System (ADS)

Çağdaş, Volkan

2013-04-01

It is generally acknowledged that immovable property taxes are one of the main revenue sources for local government. The literature emphasizes that the administration of property taxes needs well-developed inventories or registers that provide complete and accurate records of the taxed properties and their legal-economic attributes. This requirement is generally fulfilled by Spatial Data Infrastructures (SDIs) in which the coordinate exchange and sharing of geo-spatial data is provided by separate registers/information systems such as: cadastral systems, building and address registers. Recently, the Open Geospatial Consortium presented a core component of a 3D SDI in the form of an international domain standard for representing, storing and exchanging 3D city models. The CityGML allows the semantic and 3D geometrical representation of physical objects but does not deal with the legal and administrative aspects of the city objects which are required for the process of property taxation. This paper outlines the development of an Application Domain Extension (ADE) for the immovable property taxation domain that expands the CityGML data model with the legal and administrative concepts defined in Turkish Law. The study shows that this ADE could be a 3D national data model for municipal information systems and facilitate a more efficient taxation process, as well as providing data for urban planning, facility management and other municipal services.

The effect of taxation and regulation on cigarette smoking: Fresh evidence from Turkey.

PubMed

Cetin, Tamer

2017-12-01

Enacting Law No 5247 in May 2008, Turkey has initiated crucial anti-tobacco policies in the last decade. This paper aims to reveal on the effect of anti-tobacco policies such as excise taxes and regulations on cigarette smoking. To this aim, I empirically investigate the long-term dynamics of demand for cigarettes in Turkey through the OLS estimation strategy under various scenarios and models. Using monthly and quarterly data that cover the pre- and post- anti-smoking policy periods, I estimate demand elasticities and compare the pre- and post- taxation and regulation terms. The results presented in the paper confirm that taxation and regulation have affected the long-term dynamics of demand for cigarettes. The price and income elasticities of demand for cigarettes are significantly higher than the previous literature on Turkey. Demand elasticities have increased on average in the anti-tobacco policies period. Copyright © 2017 Elsevier B.V. All rights reserved.

76 FR 4201 - Common Crop Insurance Regulations, Macadamia Nut Crop Insurance Provisions; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-25

... Insurance Regulations, Macadamia Nut Crop Insurance Provisions; Correction AGENCY: Federal Crop Insurance... pertinent, related to the insurance of macadamia nuts. DATES: Effective Date: January 25, 2011. FOR FURTHER... Nut Crop Insurance Provisions to specify the correct crop year to which it was applicable. It was...

Sugar-Sweetened Beverage, Obesity, and Type 2 Diabetes in Children and Adolescents: Policies, Taxation, and Programs.

PubMed

Yoshida, Yilin; Simoes, Eduardo J

2018-04-18

Obesity has grown at an alarming rate in children and adolescents. Concurrently, consumption on sugar-sweetened beverages (SSBs) also rose significantly. This review provides an overview of obesity and type 2 diabetes mellitus (T2DM) related to SSBs and current policies restricting SSBs in schools, school-based interventions, and taxation on reducing SSB intake and obesity. We also discuss challenges of and future steps for these initiatives. Clinical and epidemiological studies suggest a strong association between SSB intake and obesity and T2DM. School food policies have been initiated at federal, state, and local levels. School-based interventions have shown positive effects on SSB intake and obesity reduction. Taxation on SSBs is promising in combating obesity and in generating revenue. Challenges towards compliance and implementation of the policies and programs exist. The relationship between SSB and obesity and T2DM is a complex problem which requires comprehensive solutions. Continued efforts in restricting SSBs in schools are needed. Intervention programs should be tailored to age, gender, language, and culture and involve participation from families and local communities. Taxation can reduce SSB consumption by direct economic incentive, earmarking revenues to support healthy foods, and sending negative message. However, a higher tax rate may be necessary to have a measurable effect on weight.

The Historical Development of the Content of High School-Level Consumer Education: An Examination of Selected Texts, 1938-1978.

ERIC Educational Resources Information Center

Herrmann, Robert O.

A study examined historical changes in the content of consumer education and factors associated with these changes. Analysis was based on key writings on consumer education and an examination of fifteen high school texts published between 1938 and 1978. Only a few topics--budgeting, savings and investment, life insurance, and housing--received…

Consumer Cost-Sharing in Marketplace vs. Employer Health Insurance Plans, 2015.

PubMed

Gabel, Jon; Whitmore, Heidi; Green, Matthew; Stromberg, Sam; Oran, Rebecca

2015-12-01

Using data from 49 states and Washington, D.C., we analyzed changes in cost-sharing under health plans offered to individuals and families through state and federal exchanges from 2014 to 2015. We examined eight vehicles for cost-sharing, including deductibles, copayments, coinsurance, and out-of-pocket limits, and compared findings with cost-sharing under employer-based insurance. We found cost-sharing under marketplace plans remained essentially unchanged from 2014 to 2015. Stable premiums during that period do not reflect greater costs borne by enrollees. Further, 56 percent of enrollees in marketplace plans attained cost-sharing reductions in 2015. However, for people without cost-sharing reductions, average copayments, deductibles, and out-of-pocket limits under catastrophic, bronze, and silver plans are considerably higher than under employer-based plans on average, while cost-sharing under gold plans is similar employer-based plans on average. Marketplace plans are far more likely than employer-based plans to require enrollees to meet deductibles before they receive coverage for prescription drugs.

41 CFR 60-741.25 - Health insurance, life insurance and other benefit plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life insurance and other benefit plans. 60-741.25 Section 60-741.25 Public Contracts and Property Management... Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service...

High deductible health plans: does cost sharing stimulate increased consumer sophistication?

PubMed

Gupta, Neal; Polsky, Daniel

2015-06-01

To determine whether increased cost sharing in health insurance plans induces higher levels of consumer sophistication in a non-elderly population. This analysis is based on the collection of survey and demographic data collected from enrollees in the RAND health insurance experiment (HIE). During the RAND HIE, enrollees were randomly assigned to different levels of cost sharing (0, 25, 50 and 95%). The study population compromises about 2000 people enrolled in the RAND HIE, between the years 1974 and 1982. Effects on health-care decision making were measured using the results of a standardized questionnaire, administered at the beginning and end of the experiment. Points of enquiry included whether or not enrollees' (i) recognized the need for second opinions (ii) questioned the effectiveness of certain therapies and (iii) researched the background/skill of their medical providers. Consumer sophistication was also measured for regular health-care consumers, as indicated by the presence of a chronic disease. We found no statically significant changes (P < 0.05) in the health-care decision-making strategies between individuals randomized to high cost sharing plans and low cost sharing plans. Furthermore, we did not find a stronger effect for patients with a chronic disease. The evidence from the RAND HIE does not support the hypothesis that a higher level of cost sharing incentivizes the development of consumer sophistication. As a result, cost sharing alone will not promote individuals to become more selective in their health-care decision-making. © 2012 Blackwell Publishing Ltd.

China's Insurance Regulatory Reform, Corporate Governance Behavior and Insurers' Governance Effectiveness.

PubMed

Li, Huicong; Zhang, Hongliang; Tsai, Sang-Bing; Qiu, Aichao

2017-10-17

External regulation is an important mechanism to improve corporate behavior in emerging markets. China's insurance governance regulation, which began to supervise and guide insurance corporate governance behavior in 2006, has experienced a complex process of reform. This study tested our hypotheses with a sample of 85 firms during 2010-2011, which was obtained by providing a questionnaire to all of China's shareholding insurance companies. The empirical study results generally show that China's insurance governance effectiveness has significantly improved through strict regulation. Insurance corporate governance can improve business acumen and risk-control ability, but no significant evidence was found to prove its influence on profitability, as a result of focusing less attention on governance than on management. State ownership is associated with higher corporate governance effectiveness than non-state ownership. Listed companies tend to outperform non-listed firms, and life insurance corporate governance is more effective than that of property insurers. This study not only contributes to the comprehensive understanding of corporate governance effectiveness but also to the literature by highlighting the effect of corporate governance regulation in China's insurance industry and other emerging economies of the financial sector.

Individual decision making in the non-purchase of long-term care insurance.

PubMed

Curry, Leslie A; Robison, Julie; Shugrue, Noreen; Keenan, Patricia; Kapp, Marshall B

2009-08-01

Although prior research suggests that economic, behavioral, and psychosocial factors influence decisions not to purchase long-term care insurance, few studies have examined the interplay among these factors in depth and from the consumer's point of view. This study was intended to further illuminate these considerations, generate hypotheses about non-purchasing decisions, and inform the design of policies that are responsive to concerns and preferences of potential purchasers. Qualitative study using 32 in-depth interviews and 6 focus groups, following a grounded theory approach. Five themes characterize decisions not to purchase long-term care insurance: (a) the determination that a policy is "too costly" reflects highly individualized and complex trade-offs not solely economic in nature, (b) non-purchasers are skeptical about the viability and integrity of private insurance companies and seek an unbiased source of information, (c) family dynamics play an important role in insurance decisions, (d) contemplating personal risk for long-term care triggers psychological responses that have implications for decision making, and (e) non-purchasers feel inadequately informed and overwhelmed by the process of deciding whether to purchase long-term care insurance. States are seeking to offset escalating Medicaid long-term care expenditures through a variety of policy mechanisms, including stimulating individual purchase of long-term care insurance. Findings suggest that economic incentives such as lowering premiums will be necessary but not sufficient to attract appropriate candidates. Attention to behavioral and psychosocial factors is essential to designing incentives that are responsive to concerns and preferences of potential purchasers.

International application of sugar-sweetened beverage (SSB) taxation in obesity reduction: factors that may influence policy effectiveness in country-specific contexts.

PubMed

Jou, Judy; Techakehakij, Win

2012-09-01

Sugar-sweetened beverage (SSB) taxation is becoming of increasing interest as a policy aimed at addressing the rising prevalence of obesity in many countries. Preliminary evidence indicates its potential to not only reduce obesity prevalence, but also generate public revenue. However, differences in country-specific contexts create uncertainties in its possible outcomes. This paper urges careful consideration of country-specific characteristics by suggesting three points in particular that may influence the effectiveness of a volume-based soft drink excise tax: population obesity prevalence, soft drink consumption levels, and existing baseline tax rates. Data from 19 countries are compared with regard to each point. The authors suggest that SSB or soft drink taxation policy may be more effective in reducing obesity prevalence where existing obesity prevalence and soft drink consumption levels are high. Conversely, in countries where the baseline tax rate is already considered high, SSB taxation may not have a noticeable impact on consumption patterns or obesity prevalence, and may incur negative feedback from the beverage industry or the general public. Thorough evaluation of these points is recommended prior to adopting SSB or soft drink taxation as an obesity reduction measure in any given country. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Reference Pricing Changes The 'Choice Architecture' Of Health Care For Consumers.

PubMed

Robinson, James C; Brown, Timothy T; Whaley, Christopher

2017-03-01

Reference pricing in health insurance creates incentives for patients to select for nonemergency services providers that charge relatively low prices and still offer high quality of care. It changes the "choice architecture" by offering standard coverage if the patient chooses cost-effective providers but requires considerable consumer cost sharing if more expensive alternatives are selected. The short-term impact of reference pricing has been to shift patient volumes from hospital-based to freestanding surgical, diagnostic, imaging, and laboratory facilities. This article summarizes reference pricing's impacts to date on patient choice, provider prices, surgical complications, and employer spending and estimates its potential impacts if expanded to more services and a broader population. Reference pricing induces consumers to select lower-price alternatives for all of the forms of care studied, leading to significant reductions in prices paid and spending incurred by insurers and employers. The impact on consumer cost sharing is mixed, with some studies finding higher copayments and some lower. We conclude with a discussion of the incentives created for providers to redesign their clinical processes and for efficient providers to expand into price-sensitive markets. Over time, reference pricing may increase pressures for price competition and lead to further cost-reducing innovations in health care products and processes. Project HOPE—The People-to-People Health Foundation, Inc.

Self-insured health plans

PubMed Central

McDonnell, Patricia; Guttenberg, Abbie; Greenberg, Leonard; Arnett, Ross H.

1986-01-01

Nationwide, 8 percent of all employment-related health plans were self-insured in 1984, which translates into more than 175,000 self-insured plans according to our latest study of independent health plans. The propensity of an organization to self-insure differs primarily by its size, with large establishments more likely to self-insure. In the overwhelming majority of cases, the self-insured benefit was hospital and/or medical. Among employers who self-insure, 23 percent self-administer, and the remaining 77 percent hire a commercial insurance company, Blue Cross/Blue Shield plan, or an independent third-party administrator to administer the health plan. PMID:10312008

Dental insurance: will it help or hinder adoption of caries management practices?

PubMed

Anderson, Maxwell H

2007-05-01

Whether public or private dental insurance will provide benefits for caries management practices is a business decision. The foundation for this decision is multifactorial and continually changing as the values of the purchasers and health care consumers evolve. Understanding the dynamics involved in allocating finite health care resources will help those who advocate for caries management inform decision makers about the potential benefits of these strategies.

78 FR 56583 - Deposit Insurance Regulations; Definition of Insured Deposit

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-13