Explaining High Health Care Spending in the United States: An International Comparison of Supply, Utilization, Prices, and Quality
This analysis uses data from the Organization for Economic Cooperation and Development and other sources to compare health care spending, supply, utilization, prices, and quality in 13 industrialized countries: Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. The U.S. spends far more on health care than any other country. However this high spending cannot be attributed to higher income, an older population, or greater supply or utilization of hospitals and doctors. Instead, the findings suggest the higher spending is more likely due to higher prices and perhaps more readily accessible technology and greater obesity. Health care quality in the U.S. varies and is not notably superior to the far less expensive systems in the other study countries. Of the countries studied, Japan has the lowest health spending, which it achieves primarily through aggressive price regulation.
Why is road safety in the U.S. not on par with Sweden, the U.K., and the Netherlands? Lessons to be learned
Source: University of Michigan Transportation Research Institute
This study compared road safety and related factors in the U.S. with those in Sweden, the United Kingdom, and the Netherlands, in order to identify actions most likely to produce casualty reductions in the U.S. The reviewed topics were basic country statistics, road fatalities and various fatality rates, national road-safety strategies, and selected road-safety issues. The main differences concerned structural and cultural factors (such as vehicle distance driven), and procedural factors (such as road-safety strategies and targets, alcohol-impaired driving, exceeding speed limits, and use of seat belts). The main recommendations for improving road safety in the U.S. are as follows: (1) lower states’ BAC limits to 0.5 g/l and introduce effective random breath testing, (2) reexamine the current speed-limit policies and improve speed enforcement, (3) implement primary seat-belt-wearing laws in each state that would cover both front and rear occupants, and reward vehicle manufacturers for installation of advanced seat-belt reminders, (4) reconsider road-safety target setting so that the focus is on reducing fatalities and not on reducing fatality rate per distance driven, and (5) consider new strategies to reduce vehicle distance driven.
Grandparenting and mothers’ labour force participation: A comparative analysis using the Generations and Gender Survey
It is well known that the provision of public childcare plays an important role for women labour force participation and its availability varies tremendously across countries. In many countries, informal childcare is also important and typically provided by the grandparents, but its role on mothers’ employment is not yet well understood. Understanding the relationship between labour supply decisions and grandparental childcare is complex. While the provision of grandparental childcare is clearly a function of the social and institutional context of a country, it also depends on family preferences, which are typically unobserved in surveys.OBJECTIVEWe analyze the role of informal childcare provided by grandparents on mothers’ labour force participation keeping unobserved preferences into account.METHODSBivariate probit models with instrumental variables are estimated on data from seven countries (Bulgaria, France, Georgia, Germany, Hungary, Russia and The Netherlands) drawn from the Generations and Gender Survey.RESULTSWe find that only in some countries mothers’ employment is positively and significantly associated with grandparents providing childcare. In other countries, once we control for unobserved preferences, we do not find this effect.CONCLUSIONSThe role of grandparents is an important element to reconcile work and family for women in some countries. Our results show the importance of considering family preferences and country differences when studying the relationship between grandparental childcare and mothers’ labour supply.COMMENTSOur results are consistent with previous research on this topic. However, differently from previous studies, we conduct separate analyses by country and show that the effect of grandparental childcare varies considerably. The fact that we also include in the analyses Bulgaria, Hungary, Russia and Georgia is an important novelty as there are no studies on this issue for these countries.
New 2011 Survey of Patients with Complex Care Needs in Eleven Countries Finds That Care Is Often Poorly Coordinated
An international survey of adults living with health problems and complex care needs found that patients in the United States are much more likely than those in 10 other high-income countries to forgo needed care because of costs and to struggle with medical debt. In all the countries surveyed, patients who have a medical home reported better coordination of care, fewer medical errors, and greater satisfaction with care than those without one.
- Sicker adults in the U.S. stood out for having cost and access problems. More than one of four (27%) were unable to pay or encountered serious problems paying medical bills in the past year, compared with between 1 percent and 14 percent of adults in the other countries. In the U.S., 42 percent reported not visiting a doctor, not filling a prescription, or not getting recommended care. This is twice the rate for every other country but Australia, New Zealand, and Germany.
- In the U.S., cost-related access problems and medical bill burdens were concentrated among adults under age 65. Compared with Medicare-aged adults 65 or older, adults under 65 were far more likely to go without care because of the cost or to have problems paying bills.
- Adults with complex care needs who received care from a medical home—an accessible primary care practice that knows their medical history and helps coordinate care—were less likely to report experiencing medical errors, test duplication, and other care coordination failures. They were also more likely to report having arrangements for follow-up care after a hospitalization and more likely to rate their care highly.
- Sicker adults in the U.K. and Switzerland were the most likely to have a medical home: nearly three-quarters were connected to practices that have medical home characteristics, compared with around half in most of the other countries.
Importance of E-services for Cultural Tourism (PDF)
Source: Research Papers in Economics
Despite a busy lifestyle – or perhaps as a result of a stressful lifestyle – more people than ever before make leisure trips, sometimes for a long time but in many cases just for short periods. Modern telecommunication technology brings attractive tourist destinations directly into the living rooms of potential travellers, also destinations that would otherwise have been difficult to find, such as certain cultural heritage objects. In this contribution, we will address the relevance of e-services in urban cultural tourism. Its aim is to map out the relative drivers of cultural visitors to cities with a particular view on the importance of modern e-services in the tourist sector. We focus on three case-study cities: Amsterdam, Leipzig and Genoa. We use discrete choice models and factor analysis to analyse the preferences of tourists for cultural heritage and e-services. Interestingly, in all three cities, the most important group of tourists, the cultural heritage enthusiasts, are often international tourists. This stresses the importance of multilingual e-services in order to maximise their impact on cultural heritage visitors and the tourism sector in general. In addition, it is also important to note that certain e-services become more important for tourists from further away, such as online booking systems.
Country Specific Information: The Netherlands
Source: U.S. Department of State
June 17, 2011
COUNTRY DESCRIPTION: The Netherlands is a highly developed, stable democracy. Tourist facilities are available throughout the country. Read the Department of State’sBackground Notes on The Netherlands for additional information.
Background And Selected Issues Related To The U.S. International Tax System And Systems That Exempt Foreign Business Income
Background And Selected Issues Related To The U.S. International Tax System And Systems That Exempt Foreign Business Income (PDF)
Source: Joint Committee on Taxation, United States Congress
The House Ways and Means Committee has scheduled a public hearing for May 24, 2011 on the rules in certain foreign jurisdictions for taxing foreign income. This document, prepared by the staff of the Joint Committee on Taxation, describes the U.S. international tax rules applicable to foreign income of resident taxpayers, provides a general overview of a territorial system of taxation, including a brief discussion of basic design considerations, and summarizes the rules of nine selected countries for the taxation of foreign income.
Poverty in households with children is rising in nearly all OECD countries. Governments should ensure that family support policies protect the most vulnerable, according to the OECD’s first-ever report on family well-being.
Doing Better for Families says that families with children are more likely to be poor today than in previous decades, when the poorest in society were more likely to be pensioners.
The share of children living in poor households has risen in many countries over the past decade, to reach 12.7% across the OECD. One in five children in Israel, Mexico, Turkey, the United States and Poland live in poverty. (The OECD defines poor as someone living in a household with less than half the median income, adjusted for family size).
+ Chapter 1. Families are changing (PDF)
Individual country reports also freely available. Full report available for purchase.
Kingdom of the Netherlands-Netherlands: Detailed Assessment Report on Anti-Money Laundering and Combating the Financing of Terrorism
Kingdom of the Netherlands-Netherlands: Detailed Assessment Report on Anti-Money Laundering and Combating the Financing of Terrorism (PDF)
Source: International Monetary Fund
Indicators suggest that the Netherlands is susceptible to money laundering (ML) owing to, among other things, the relative size of its financial sector, its openness to trade, and the amount of criminal proceeds. The 16th economy in the world by nominal GDP, it ranks 7th in terms of the systemic importance of its financial sector. It has an excellent communications network, convenient transportation infrastructure, and Rotterdam is one of the world’s busiest ports. Estimates indicate that substantial proceeds of crime are generated in the country, mostly stemming from fraud (including tax fraud) and illicit narcotics. Presently, the proceeds of domestic crime are estimated at approximately $14 billion, or 1.8 percent of the GDP. In addition, work done by academics suggests a significant amount of criminal proceeds originating from foreign countries flows into the Netherlands for laundering.
The report reviews and discusses information systems reporting on the quality or performance of providers of healthcare (‘quality information systems’) in seven countries: Denmark, England, Germany, Italy, the Netherlands, Sweden and the United States. Data collection involves a review of the published and grey literature and is complemented by information provided by key informants in the selected countries using a detailed questionnaire. Quality information systems typically address a number of audiences, including patients (or respectively the general public before receiving services and becoming patients), commissioners, purchasers and regulators. We observe that as the policy context for quality reporting in countries varies, so also does the nature and scope of quality information systems within and between countries. Systems often pursue multiple aims and objectives, which typically are (a) to support patient choice (b) to influence provider behaviour to enhance the quality of care (c) to strengthen transparency of the provider-commissioner relationship and the healthcare system as a whole and (d) to hold healthcare providers and commissioners to account for the quality of care they provide and the purchasing decisions they make. We emphasise that the main users of information systems are the providers themselves as the publication of information provides an incentive for improving the quality of care. Finally, based on the evidence reviewed, we identify a number of considerations for the design of successful quality information systems, such as the clear definition of objectives, ensuring users’ accessibility and stakeholder involvement, as well as the need to provide valid, reliable and consistent data.
Understanding the religious behaviour of Muslims in the Netherlands and the UK (PDF)
Source: Research Papers in Economics (RePEc)
The position of Muslims in Western societies is the subject of intense study and debate. However, remarkably little attention has been paid to the practice of European Muslims and how Muslim religiosity relates to conventional measures of social and economic integration. In this paper we draw on theories of secularization, assimilation, revitalization and integration to explore the correlates of attendance at religious meetings for Muslims of different backgrounds in the Netherlands and the UK. We conclude that patterns of religiosity and secularisation cannot be generalised across national contexts.