The impact of the Balanced Budget Act of 1997 on Medicare in the USA: the fallout continues

2002 ◽  
Vol 15 (6) ◽  
pp. 249-254 ◽  
Author(s):  
Patrick A. Rivers ◽  
Kai‐Li Tsai
Author(s):  
Luc Godbout

The burden of Quebec's debt has changed significantly since 1960. While the province incurred very little debt in the years before the Quiet Revolution, its borrowing increased steadily from 1961 until the mid-1990s. By the time the trend was reversed, the Quebec government had recorded a deficit for 40 consecutive years. Having achieved one of the heaviest debt burdens, measured as a share of gross domestic product, among the Canadian provinces, and having seen two rapid downgrades of its credit rating by Moody's in the mid-1990s, fearing a further downgrade the Quebec government took steps to clean up its public finances. After outlining the evolution of Quebec's debt since the early 1960s, this article briefly describes two statutes enacted by the government to provide greater transparency with respect to the province's finances, enabling better management of its budget and debt. These statutes are the Balanced Budget Act, passed in 1996, and the Act To Reduce the Debt and Establish the Generations Fund, passed in 2006. The article discusses the impact of the Great Recession on the province's budgetary balance and indebtedness, and shows how Quebec's financial situation has changed in terms of its fiscal balance, debt, debt interest, and credit rating. It is now possible to affirm that the two statutes adopted by the government have clearly helped to improve Quebec's fiscal position.


2001 ◽  
Vol 19 (3) ◽  
pp. 58-69 ◽  
Author(s):  
Karen B. Enchelmayer ◽  
Eileen F. Hamby ◽  
Charol Martindale

Author(s):  
Helena Temkin-Greener ◽  
Mark R. Meiners ◽  
Leonard Gruenberg

This paper investigates the impact of the Medicare principal inpatient diagnostic cost group (PIP-DCG) payment model on the Program of All-Inclusive Care for the Elderly (PACE). Currently, more than 6,000 Medicare beneficiaries who are nursing home certifiable receive care from PACE, a program poised for expansion under the Balanced Budget Act of 1997. Overall, our analysis suggests that the application of the PIP-DCG model to the PACE program would reduce Medicare payments to PACE, on average, by 38%. The PIP-DCG payment model bases its risk adjustment on inpatient diagnoses and does not capture adequately the risk of caring for a population with functional impairments.


Author(s):  
Oscar Gutiérrez-Bolívar ◽  
Oscar Gutiérrez-Bolívar ◽  
Pedro Fernández Carrasco ◽  
Pedro Fernández Carrasco

The opening of relationships between United States and Cuba could be a drive for a huge increase in the affluence of tourism to Cuba and especially to the coast areas. Cuba has been for many years an important tourist destination for people from many countries, but almost forbidden for US citizens. The proximity of the USA, its amount of population as well as their great acquisition power will increase in a very substantial way the demand for accommodation and other uses in the proximity of the coasts. There will be a need to implement a package of measures that reduce the impact of such sudden increase in the coastal line. On the other hand that augment in tourism could be an opportunity to improve the standard of life of Cubans. The consideration of different possibilities of such development, the analysis of the damages that each one could cause as well as the measures that could avoid, ameliorate or compensate such effects are the goals that are going to be presented in this paper.


1987 ◽  
Vol 19 (3-4) ◽  
pp. 633-643
Author(s):  
William F. Garber

The history of human society is replete with examples of advances in technology overrunning the ability of societal organizations to efficiently handle the resulting massive societal dislocations. The social impacts of the “Industrial Revolution of the 18th and 19th Centuries” illustrate how profound such effects can be. The automation-computer-robotics revolution now underway also has the potential for serious societal changes. In this regard public works activities are subject to increasing amounts of automation with impacts upon current and net total employment and training needs. To evaluate the present status of automation in the USA, questionnaires were sent to public works authorities in 110 cities or agencies. The current degree of automation, the impact upon employment and the skills now needed by public works employers were queried. It was found that in most cases automation was just starting; but that as complete automation as was possible was inevitable given the increasing complexity of the tasks, the demands of the public and the long term prospects for public works funding. In many cases the candidates now in the work force were not properly trained for automation needs. Retraining and changes in the educational system appeared necessary if the employees now needed were to be continuously available. Public works management as well as several labor organizations appeared to be aware of this need and were organizing to handle the training problem and the changes in employment qualifications now necessary. It appeared to be a consensus that the larger societal effects of automation should be handled by society as a whole.


2021 ◽  
Vol 11 (3) ◽  
pp. 132
Author(s):  
Anna McNamara

The impact of Covid-19 placed Higher Education leadership in a state of crisis management, where decision making had to be swift and impactful. This research draws on ethea of mindfulness, actor training techniques, referencing high-reliability organisations (HRO). Interviews conducted by the author with three leaders of actor training conservatoires in Higher Education institutions in Australia, the UK and the USA reflect on crisis management actions taken in response to the impact of Covid-19 on their sector, from which high-frequency words are identified and grouped thematically. Reflecting on these high-frequency words and the thematic grouping, a model of mindful leadership is proposed as a positive tool that may enable those in leadership to recognise and respond efficiently to wider structural frailties within Higher Education, with reference to the capacity of leaders to operate with increased mindfulness, enabling a more resilient organisation that unlocks the locus of control.


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