Optimal Disability Insurance with Informal Child Care

Abstract The possibility of engaging in household child care may exacerbate the incentives of parents and grandparents to falsely claim disability benefits as households also get to save on formal child care costs. This paper considers a multi-generational family model with persistence in privately observed shocks and presents an efficient implementation case for subsidizing formal child care costs of the disabled. An implementation of the optimal scheme that consists of capped formal day care subsidies, non-linear income taxation and asset-testing is proposed. Simulations based on a parametrization that targets key features of the US labor and child care markets suggest that day care subsidies may lead to sizeable cost savings.

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Efficient Child Care Subsidies

The American Economic Review ◽

10.1257/aer.20170581 ◽

2020 ◽

Vol 110 (1) ◽

pp. 162-199 ◽

Cited By ~ 3

Author(s):

Christine Ho ◽

Nicola Pavoni

Keyword(s):

Child Care ◽

Low Income ◽

The United States ◽

Tax Rates ◽

Child Care Subsidies ◽

Optimal Program ◽

The Us ◽

Marginal Tax Rates ◽

Welfare Problem ◽

Care Costs

We study the design of child care subsidies in an optimal welfare problem with heterogeneous private market productivities. The optimal subsidy schedule is qualitatively similar to the existing US scheme. Efficiency mandates a subsidy on formal child care costs, with higher subsidies paid to lower income earners and a kink as a function of child care expenditure. Marginal labor income tax rates are set lower than the labor wedges, with the potential to generate negative marginal tax rates. We calibrate our simple model to features of the US labor market and focus on single mothers with children aged below 6. The optimal program provides stronger participation but milder intensive margin incentives for low-income earners with subsidy rates starting very high and decreasing with income more steeply than those in the United States. (JEL D82, H21, H24, J13, J16, J32)

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Health Care Costs and Savings Associated with Increased Dairy Consumption among Adults in the United States

Nutrients ◽

10.3390/nu12010233 ◽

2020 ◽

Vol 12 (1) ◽

pp. 233 ◽

Cited By ~ 2

Author(s):

Carolyn G. Scrafford ◽

Xiaoyu Bi ◽

Jasjit K. Multani ◽

Mary M. Murphy ◽

Jordana K. Schmier ◽

...

Keyword(s):

United States ◽

Type 2 Diabetes ◽

Health Care ◽

Health Care Costs ◽

Annual Cost ◽

Cost Savings ◽

Dairy Consumption ◽

The Us ◽

Care Costs

Background: The purpose of this study is to estimate the impact on health care costs if United States (US) adults increased their dairy consumption to meet Dietary Guidelines for Americans (DGA) recommendations. Methods: Risk estimates from recent meta-analyses quantifying the association between dairy consumption and health outcomes were combined with the increase in dairy consumption under two scenarios where population mean dairy intakes from the 2015–2016 What We Eat in America were increased to meet the DGA recommendations: (1) according to proportions by type as specified in US Department of Agriculture Food Intake Patterns and (2) assuming the consumption of a single dairy type. The resulting change in risk was combined with published data on annual health care costs to estimate impact on costs. Health care costs were adjusted to account for potential double counting due to overlapping comorbidities of the health outcomes included. Results: Total dairy consumption among adults in the US was 1.49 cup-equivalents per day (c-eq/day), requiring an increase of 1.51 c-eq/day to meet the DGA recommendation. Annual cost savings of $12.5 billion (B) (range of $2.0B to $25.6B) were estimated based on total dairy consumption resulting from a reduction in stroke, hypertension, type 2 diabetes, and colorectal cancer and an increased risk of Parkinson’s disease and prostate cancer. Similar annual cost savings were estimated for an increase in low-fat dairy consumption ($14.1B; range of $0.8B to $27.9B). Among dairy sub-types, an increase of approximately 0.5 c-eq/day of yogurt consumption alone to help meet the DGA recommendations resulted in the highest annual cost savings of $32.5B (range of $16.5B to $52.8B), mostly driven by a reduction in type 2 diabetes. Conclusions: Adoption of a dietary pattern with increased dairy consumption among adults in the US to meet DGA recommendations has the potential to provide billions of dollars in savings.

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Child Care and Child Health: Use of Population Surveys

PEDIATRICS ◽

10.1542/peds.94.6.1096 ◽

1994 ◽

Vol 94 (6) ◽

pp. 1096-1098

Author(s):

Virginia S. Cain

Keyword(s):

Child Care ◽

Labor Force ◽

Day Care ◽

Population Based ◽

Sample Survey ◽

Day Care Centers ◽

Social Trends ◽

The Us ◽

Age Range ◽

Women's Labor Force Participation

While the health of children in the US has been a long-standing issue, concern has heightened as children are increasingly found in some type of child-care arrangement. Trends in a number of social forces in the US have resulted in more children spending greater amounts of time in the care of someone other than their parents. As children move out of the home into group-care settings such as day-care centers on preschools, they are in contact with many more children and the possibility of exposure to a variety of infectious diseases. Several studies have examined childhood disease within the context of center-based care.1-3 However, most preschool children are not in center-based care.4 A more general study of the health of children in child care requires an approach that provides data on children in a variety of child-care arrangements and covers a broader age range than that found in most day-care centers. This paper argues that the population-based sample-survey approach to the study of the health of children in child care provides the necessary breadth. However, there is a clear need for improving measurement of critical variables. SOCIAL TRENDS While researchers increasingly have become concerned with the child-care arrangements of children of nonemployed women, it is the revolution in women's labor-force participation that has driven the increase in use of child care in the last two decades. Among children under 6 years of age, the percentage with mothers in the labor force has increased from 29% in 1970 to 53% in 1990.5,6

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GSS 2011 Linked with TIFF: Exploring the Cost of Child Care in Canada and the Use of the Child Care Tax Benefit

Canadian Journal of Family and Youth / Le Journal Canadien de Famille et de la Jeunesse ◽

10.29173/cjfy29492 ◽

2019 ◽

Vol 12 (1) ◽

pp. 81-103

Author(s):

Leanne Findlay ◽

Dafna Kohen

Keyword(s):

Child Care ◽

General Social Survey ◽

Cost Of Care ◽

Indigenous Identity ◽

Social Survey ◽

The Cost ◽

Care Costs ◽

Compare And Contrast ◽

Employment Characteristics ◽

Different Sources

Affordability of child care is fundamental to parents’, in particular, women’s decision to work. However, information on the cost of care in Canada is limited. The purpose of the current study was to examine the feasibility of using linked survey and administrative data to compare and contrast parent-reported child care costs based on two different sources of data. The linked file brings together data from the 2011 General Social Survey (GSS) and the annual tax files (TIFF) for the corresponding year (2010). Descriptive analyses were conducted to examine the socio-demographic and employment characteristics of respondents who reported using child care, and child care costs were compared. In 2011, parents who reported currently paying for child care (GSS) spent almost $6700 per year ($7,500 for children age 5 and under). According to the tax files, individuals claimed just over $3900 per year ($4,700). Approximately one in four individuals who reported child care costs on the GSS did not report any amount on their tax file; about four in ten who claimed child care on the tax file did not report any cost on the survey. Multivariate analyses suggested that individuals with a lower education, lower income, with Indigenous identity, and who were self-employed were less likely to make a tax claim despite reporting child care expenses on the GSS. Further examination of child care costs by province and by type of care are necessary, as is research to determine the most accurate way to measure and report child care costs.

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Treatment of venous leg ulcers using bilayered living cellular construct

Journal of Comparative Effectiveness Research ◽

10.2217/cer-2020-0076 ◽

2020 ◽

Vol 9 (13) ◽

pp. 907-918

Author(s):

Aseel Bin Sawad ◽

Fatema Turkistani

Keyword(s):

Healthcare System ◽

Cost Savings ◽

Standard Of Care ◽

Healthcare Resource Utilization ◽

Psychological Status ◽

Leg Ulcers ◽

Venous Leg Ulcers ◽

Time Period ◽

The Us ◽

Economic Analyses

Background: Venous leg ulcers (VLUs) present a significant economic burden on the US healthcare system and payers (US$14.9 billion). Aim: To evaluate the quality of life (QoL) of patients with VLUs; to analyze the limitations of standard of care (SOC) for VLUs; and to explain how using bilayered living cellular construct (BLCC) with SOC for treatment of VLUs can help heal more VLUs faster (than using SOC alone) as well as help improve QoL and help reduce the burden on the US healthcare system and payers. Materials & methods: This is a review study. The search was conducted in February 2020 by way of electronic databases to find relevant articles that provided information related to QoL of patients with VLUs, limitations of SOC for VLUs and economic analyses of using BLCC for treatment of VLUs. Results: VLUs impact patients’ physical, functional and psychological status and reduce QoL. A total 75% of VLU patients who used SOC alone failed to achieve healing in a timely fashion, which led to increased healthcare costs and healthcare resource utilization. Although the upfront cost is high, the greater effectiveness of BLCC offsets the added cost of the product during the time period of the studies. Therefore, BLCC helps to improve the QoL of VLU patients. As an example, for every 100 VLU patients in a healthcare plan, the use of BLCC can create cost savings of US$1,349,829.51. Conclusion: Payers’ coverage of BLCC results in reduction of the overall medical cost for treating VLU patients.

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Dose-optimisation intervention produces cost savings in the US

PharmacoEconomics & Outcomes News ◽

10.1007/bf03279109 ◽

2002 ◽

Vol 364 (1) ◽

pp. 5-5

Keyword(s):

Cost Savings ◽

The Us ◽

Dose Optimisation

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Performance of national COVID-19 ‘symptom checkers’: a comparative case simulation study

BMJ Health & Care Informatics ◽

10.1136/bmjhci-2020-100187 ◽

2021 ◽

Vol 28 (1) ◽

pp. e100187

Author(s):

Fatma Mansab ◽

Sohail Bhatti ◽

Daniel Goyal

Keyword(s):

Medical Care ◽

Simulation Study ◽

Bacterial Pneumonia ◽

Assessment Tools ◽

Basic Tenet ◽

The Us ◽

The Usa ◽

Case Simulation ◽

Pandemic Response ◽

Key Features

ObjectivesIdentifying those individuals requiring medical care is a basic tenet of the pandemic response. Here, we examine the COVID-19 community triage pathways employed by four nations, specifically comparing the safety and efficacy of national online ‘symptom checkers’ used within the triage pathway.MethodsA simulation study was conducted on current, nationwide, patient-led symptom checkers from four countries (Singapore, Japan, USA and UK). 52 cases were simulated to approximate typical COVID-19 presentations (mild, moderate, severe and critical) and COVID-19 mimickers (eg, sepsis and bacterial pneumonia). The same simulations were applied to each of the four country’s symptom checkers, and the recommendations to refer on for medical care or to stay home were recorded and compared.ResultsThe symptom checkers from Singapore and Japan advised onward healthcare contact for the majority of simulations (88% and 77%, respectively). The USA and UK symptom checkers triaged 38% and 44% of cases to healthcare contact, respectively. Both the US and UK symptom checkers consistently failed to identify severe COVID-19, bacterial pneumonia and sepsis, triaging such cases to stay home.ConclusionOur results suggest that whilst ‘symptom checkers’ may be of use to the healthcare COVID-19 response, there is the potential for such patient-led assessment tools to worsen outcomes by delaying appropriate clinical assessment. The key features of the well-performing symptom checkers are discussed.

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