Evaluates changes in the welfare system in Sweden, the UK and the USA over a decade, basing arguments on the divergence of economic globalization and domestic forces. Presents brief economic snapshots of each country, stating quite categorically that the welfare state is an impediment to capitalist profit‐making, hence all three nations have retrenched welfare systems in the hope of remaining globally economically competitive. Lays the responsibility for retrenchment firmly at the door of conservative political parties. Takes into account public opinion, national institutional structures, multiculturalism and class issues. Explores domestic structures of accumulation (DSA) and refers to changes in the international economy, particularly the Bretton Woods system (Pax Americana), and notes how the economic health of nations mirrors that of the US. Investigates the roles of multinationals and direct foreign investment in the global economy, returning to how economic policy affects the welfare state. Points out the changes made to the welfare state through privatization, decentralization and modification of public sector financing. Concludes that the main result has been an increase in earnings inequality and poverty.
At the heart of any credit financing system lies the ability of both lenders and borrowers to assess credit risk. Municipal credit markets have been slow to develop in emerging countries because the risks of municipal lending have been difficult to identify, and even more difficult to limit in reliable fashion except through central-government guarantees. Municipal borrowing in recent years has grown rapidly and is likely to accelerate in view of the immense investment backlogs that local governments face and the continuing decentralization of service responsibilities. Some developing countries have been able to involve the private sector in direct municipal lending. This paper contains the following chapters: introduction, credit risk and creditworthiness, assessing and improving sectoral credit risk, municipal debt burden and debt structure, and pledged security.
This dissertation examines why and how jurisdictions choose to finance their roads. The systematic causes of revenue choice are explored qualitatively by examining the history of turnpikes. The question is approached analytically by employing game theory to model revenue choice on a long road. The road is covered by a series of jurisdictions seeking to maximize local welfare. Jurisdictions are responsible for building and maintaining the local network. Complexity arises because local network users may not be local residents, and local residents may use non-local networks. Key factors posited to explain the choice of revenue mechanism include the length of trips using the road, the size of the governing jurisdiction, the degree of excludability, and the transaction costs of toll collection. These factors dictate the size and scope of the free rider problem. It is hypothesized that smaller jurisdictions and lower collection costs favor tolling policies over taxes.The analytical model is operationalized by assuming jurisdictions have two decisions: the strategic decision to tax or toll, and the tactical decision of setting the rate of tax or toll. Models of user demand as a function of trip distance and monetary cost and of network costs as a function of traffic flow and the number of toll collections are specified. The values of the constants and coefficients of the model are developed from recent cost literature and the estimation of a model of collection costs from California Toll Bridge data.The model is applied to evaluate the dissertation's hypotheses. The application evaluates the welfare implications of a jurisdiction and its neighbors imposing general tax, cordon toll, odometer tax, or perfect toll policies. Sensitivity tests of the model under alternative behavioral assumptions, and with varying model coefficients are conducted. Finally, policy implications from the analysis are drawn. The general trends which bode well for road pricing (electronic toll collection (ETC), decentralization, advanced infrastructure, privatization, and federal rules) are established. Possible scenarios for three cases are presented: deploying ETC and building new toll roads, and converting free roads.
Through analyzing the softness and hardness of budgeting constraints in research and development (R&D) investment under different institutions, we develop a theory of optimal R&D financing. Our theory not only provides a clear comparison of investment efficiency between centralized economies and market economies but also extends the analysis of soft budget constraints to firms in market economy. Based on this theory, we characterize optimal choices of R&D project financing in centralized and decentralized economies. Our results explain why some projects are financed internally by a large firm but others are cofinanced externally by several firms. We also explain what makes a centralized economy inefficient in R&D.
Home care is the fastest growing sector of medicine today. It has increased at approximately 20% per year since 1989, and this double-digit growth is expected to continue into the future. In 1990, The Prospective Payment Assessment Commission (DHHS) reported that Medicare expenditures for home healthcare services were $3.5 billion. This increased nearly fivefold, to $16.9 billion, in 1996, and it is expected to have reached $19 billion in 1997.1 Estimates by the Congressional Budget Office estimate the spending for home health services will exceed $30 billion by 2002.2 In 1996, 10% of the Medicare population received in-home services for a total of 280 million visits to 3.8 million beneficiaries.1 Most of the patients (75%) who receive in-home services are 65 years of age or older, with an average age of 70 years, and according to the 1992 National Home and Hospice Care Survey conducted by the National Center for Health Statistics, for every resident in a nursing facility, there are three to four patients of equal debility residing in the community with the assistance of family, friends, and the intermittent services of home healthcare agencies. The comparison between the institutionalized and home-bound populations and the most frail patients in ambulatory practice is especially instructive in exposing the level of involvement of the medical community. The discrepancies between the different settings are striking. In the care of chronically ill patients, it is usually the physician who recommends the frequency of visits for follow-up and monitoring. These are the patients in the office in “fair to poor” health who see their physicians an average of 11 times a year3; in the nursing home, these patient are seen a minimum of 6 times a year, and often 12 or more. The homebound patient is often among the highest users of acute medical services, at great risk for complications, and among the most ethically challenging. Their care demands the highest degree of coordination with other health care providers as well as counseling of family members. Yet in 1994, when 3.1 million Medicare beneficiaries were provided with home care services, only 1.5 million home visits were made by physicians. On average, homebound patients get one visit every 2 years, even though 90% of primary care physicians who answered recent surveys agreed that house calls are important in their management.4 The reason cited most commonly for the low numbers of home visits has been the poor payment for these services. A 1990 AMA telephone survey of a nationally representative sample of 1161 family physicians and internists found that 88% felt that reimbursement was inadequate for physician services in the home.4 The Physician Payment Review Commission stated in their 1994 report to Congress: “First, the homebound represent perhaps one of the most vulnerable Medicare populations. Declines in primary care services to this population might, therefore, merit more attention than would changes in services to other Medicare beneficiaries. Second, home visit services take a considerable amount of physician time but are relatively poorly paid… Advisors to the Commission have suggested that the combination of time and low hourly remuneration along with financial pressures on providers' practices might make home visits a service that is curtailed by providers.” The Office of Inspector General, in their June 1995 report, The Physician's Role in Home Health Care found: “Fourteen percent of physicians report making home visits; most of them say these visits are infrequent and only when absolutely necessary. They add that since Medicare pays so little for a home visit, it is not affordable for them to see patients in their homes.”6 Then there is the lack of medical education. In the past 30 years, medical schools and residency training programs have provided few, if any, home care training experiences. As a result, the majority of physicians in practice today are unaware of the opportunities and “best practice” models for caring for patients in the home. See also p 174 But the times they are a'changin'. Through the persistent efforts of a small committed group, led by the American Academy of Home Care Physicians, the Health Care Financing Administration agreed to reassess the value of physician involvement in the home care arena.7 As of January 1998, Medicare has made extensive revisions to the rules for home visits. These modification are likely to stimulate a profound reconfiguration of the delivery of health care to the chronically ill in this country. The current procedural terminology codes for house calls have been expanded to more closely reflect those used in ambulatory care, and there has been a significantly improved reimbursement structure that makes house calls a financially viable alternative setting for medical practice. Most importantly, the upper level codes allow for the comprehensive assessment of complex patients in the home for both new and established patients. It is now feasible to provide an appropriate level of service for the more seriously ill patients who wish to eschew the hospital and are often too frail to travel to the office. It is also more practicable for acute care services to be brought to the home, avoiding the emergency department and the inevitable hospital admission. It is now conceivable that a growing number of physicians, as recently demonstrated in Chicago and Detroit, will embrace the home as their principle setting for providing care. The second major change is the expansion of nurse practitioner and physician assistant services into the home, without on-site supervision by the physician, and at 85% of the reimbursement.7 This change will allow physicians and mid-level practitioners to work in partnership in the management of the chronically ill, sharing the monitoring visits and using the physician more effectively in unsettled or more complex situations. Nurse practitioners and physician assistants have proven themselves highly capable in the management of frail patients in the institutional setting through such programs as EverCare and Elder Health as well as through the personal experiences of many physicians in a variety of settings. Similarly, this extension of the partnership into home care should lead to a successful augmentation of the array of services provided by larger group practices. In this issue of JAGS, Dr. Fried describes the population of patients most likely to benefit from physician home visits and an academic ambulatory care practice that demonstrates many of the principles needed to incorporate a house call program.8 The patients are typical of the frail and highly impaired older patients followed by home care agencies; 30 to 40% were actively receiving care at the time of the survey. The range of illnesses is also typical of that seen in the clinic and is managed in much the same way, except that the patients were in a setting more conducive to their needs. Many were quite adamant in their refusal to allow hospitalization and obviously tested the acute care capabilities of the practice, which proved very adept at responding to their needs despite the limited resources. One of the three geriatricians took primary responsibilities for the house call program along with the nurse practitioner, who handled the bulk of the visits and telephone calls. They defined a reasonable catchment area to decrease travel time and time away from the practice, and they made both regularly scheduled visits for those patients unable to come to the practice and acute care visits during the day as time permitted. Office procedures established the house call practice as a separate, but highly integrated, part of the overall service. The limitations were driven predominantly by the lack of reimbursement for the nurse practitioner visits and the constraints of an academic affiliation. Nevertheless, the care was clearly highly valued by both the patients and the staff. Much can also be learned from the recognized weaknesses of this program. The network of home care providers and the integration of services across disciplines were not as developed as in other models. Often a home care agency will assign nurses to a larger house call practice and encourage regularly scheduled meetings to facilitate care coordination. Social workers, therapists, and nutritionists from the agency may also participate. The benefits to the agency in improved communication, efficiency in completion of the documentation and orders, and the increase in referrals more than offsets the costs of the personnel. Similar benefits can entice participation by a local pharmacy that delivers medications to the home, a durable medical equipment vendor, and an infusion company. The mutual interests and ability to complement each other's services promote a strong sense of teamsmanship and can result in a more profitable business. A second area that was not fully developed in the program described was the use of newly available, highly portable diagnostic instruments and therapeutic technologies. Advances in miniaturization and automation give the physician on-site access to a wide range of equipment for analyzing blood and urine samples, simple radiography, oximetry, and electrocardiography. Digital processing allows for easy transmission of the results and telecommunication with consultants. Other specialized adjunctive services, which may be available in larger metropolitan areas, include ultrasonography, echocardiography, and Doppler studies. Therapeutic modalities include infusion devices for enteral and parenteral therapies, oxygen delivery devices and ventilators, peritoneal and hemodialysis devices, and specialty support surfaces for wound management. In a well organized program, virtually any service available in a hospital room can be provided in a patient's home. With the changes in Medicare policies and regulations, the opportunities in home care are enormous and the future bright for both the healthcare industry and academia. Visionary leaders in healthcare organizations and physicians' groups recognize that the overwhelming majority of chronically ill patients can be successfully cared for in the home, and nearly everyone would choose care at home to admission to a nursing home. Several studies both here and abroad show that a well organized program of home-centered care for frail older people and vulnerable younger patients can be the most cost-effective, efficient, and most preferred healthcare alternative.9, 10 In addition, the Hartford Foundation has supported a select group of medical schools in the development of home care curricula to educate physicians in training. For those physicians already in practice, the American Academy of Home Care Physicians is providing ongoing education in the administrative and clinical aspects of home care. Many challenges still lay ahead. A decentralized system of health care is highly dependent on information management technologies that are not yet fully standardized or implemented. Increasing numbers of widely disbursed patients will require us to investigate alternative methods of healthcare delivery using less expensive personnel with more focused skills and the training and management strategies to supervise their care.11 However, only with the continuing support of federal, state, and private insurance will the knowledge gained from these experiences lead to the development of a comprehensive spectrum of services in a seamless system of care.
Intergovernmental fiscal relations play a fundamental role in the economic and social development of Vietnam. As in all unitary forms of government, the central government sets national policies and assists with the financing of the activities of subnational administrative units, as well as undertaking certain expenditure responsibilities directly. On the other hand, decentralization facilitates implementation of policies that reflect the preferences of inhabitants of subnational administrative units. An important objective, therefore, is to design a system that reconciles the sometimes conflicting objectives of centralization and decentralization. This report is intended to assist the government of Vietnam in designing its system of intergovernmental fiscal relations (IFR).The next section describes the political system within which intergovernmental fiscal relations are imbedded. The third section provides an overview of intergovernmental fiscal relations in Vietnam. Section IV describes the assignment of expenditure responsibilities among levels of government, Section V discusses fiscal management and budgeting, and Section VI describes and appraises the revenue side of intergovernmental fiscal relations. These sections contain descriptions of current practice, a brief statement of criteria against which they are to be appraised, an appraisal of current practice, and recommendations for improvements. Section VII describes how the present system of subventions could be replaced by an improved system of intergovernmental transfers. This discussion focuses primarily on relations between the central government and the provinces; relations between provinces and districts and between districts and communes are generally quite similar.Working Paper Number 98-02.
If self-sustaining local credit markets are to emerge, a re-thinking of policy and institutions will have to take place. This report takes stock of international experience to shed light on a single question: How can efficient local credit markets be built? Some of the lessons from past experience are negative. Attempts to design municipal development funds in particular often have been marred by perverse incentives, some of which recur so frequently that merely avoiding these errors in the future should substantially improve chances for constructing market-oriented local credit systems. The establishment of successful credit markets will be a joint enterprise. It will engage national government planners working on financial sector reform and fiscal decentralization. It will require the commitment of private sector bankers and other private financial institutions that supply credit. In decentralized government systems, states and cities as well will have a crucial role to play in shaping the credit systems that will finance part of their finance investment budgets. Finally international organizations will have to exert leadership in designing local credit mechanisms that can evolve into self-sustaining private credit markets as well as meet the agencies' short-run project implementation goals. the report looks at local borrowing and local credit markets, and showcases the models of Colombia and the Czech Republic as examples of the transition to a competitive credit market.
<p>This paper presents the first efficient statistical zero-knowledge protocols to prove statements such as:<br />A committed number is a pseudo-prime.<br />A committed (or revealed) number is the product of two safe primes, i.e., primes p and q such that (p - 1)=2 and (q - 1)=2 are primes as well.<br />A given value is of large order modulo a composite number that consists of two safe prime factors.</p><p>So far, no methods other than inefficient circuit-based proofs are known for proving such properties. Proving the second property is for instance necessary in many recent cryptographic schemes that rely on both the hardness of computing discrete logarithms and of difficulty computing roots modulo a composite.<br />The main building blocks of our protocols are statistical zero-knowledge proofs that are of independent interest. Mainly, we show how to prove the correct computation of a modular addition, a modular multiplication, or a modular exponentiation, where all values including the modulus are committed but not<br />publicly known. Apart from the validity of the computation, no other information about the modulus (e.g., a generator which order equals the modulus) or any other operand is given. Our technique can be generalized to prove in zeroknowledge<br />that any multivariate polynomial equation modulo a certain modulus is satisfied, where only commitments to the variables of the polynomial and a commitment to the modulus must be known. This improves previous results,<br />where the modulus is publicly known.<br />We show how a prover can use these building blocks to convince a verifier that a committed number is prime. This finally leads to efficient protocols for proving that a committed (or revealed) number is the product of two safe primes. As a consequence, it can be shown that a given value is of large order modulo a<br />given number that is a product of two safe primes.</p><p> </p><p>Keywords. RSA-based protocols, zero-knowledge proofs of knowledge, primality tests.</p>
With the increasing interest in the potential use of blockchain
systems for virtual assets, there is a need for these assets to have
mobility across blockchain systems. An interoperability architecture
for blockchain systems is needed in order to permit the secure flow of
virtual assets between blockchain systems, satisfying the properties
of transfer atomicity, consistency and durability. The architecture
must recognize that there are different blockchain systems, and that
the interior constructs in these blockchains maybe incompatible with
one another. Gateway nodes perform the transfer of virtual assets
between blockchain systems while masking the complexity of the
interior constructs of the blockchain that they represent.
While industrialists are discovering the hidden costs of minimal compliance with environmental regulation, environmentalists assert that EPA regulations contain too many loopholes. Since government regulation pleases neither environmentalists nor the regulated industries, we have to think in new directions. Can financing alternative technology be superior to monitoring pollution? Can local communities play a role in creating cohesion out of decentralization? What are the best new strategies both on the level of local communities and alternative technologies?
Reconstructing Africa's war damaged economies is an urgent task. This is especially so in a group of countries - Angola, Eritrea, Ethiopia, Guinea-Bissau, and Mozambique - which must also complete their economic and political transition from state socialism. Somalia, which shares their common history, must eventually be rebuilt. All of these countries must address their deep problems of underdevelopment and poverty. The challenges are therefore three-fold: to overcome underdevelopment, to make the transition from state socialism, and to reconstruct economies and societies. Socialism was influential across post-independence Africa. But UTR countries drew more explicitly on Marxism-Leninism and the Soviet development model. With the aim of accelerating growth, enterprises and property were nationalized and controls were established. But the result was a fatal over-centralization of political and economic power, and a slide into conflict exacerbated and fuelled by the politics of the cold war. Somalia collapsed into a turmoil from which it is yet to recover. Mozambique has made the most progress and, until their border war this year, Eritrea and Ethiopia were both moving forward. Angola faces urgent reconstruction problems but progress had been slow, and a return to outright war cannot be ruled out. Guinea-Bissau was knocked off course by a military revolt in 1998. Progress has therefore been tentative in the UTR group, and their future prospects depend on them finding political settlements that can secure their prospects for economic development. War, and the uncertainty associated with it, distorts economies; investments with long- term returns, mainly in production activities such as agriculture and manufacturing, are cut back, and the economy becomes dominated by activities with short-term returns, such as commerce in cities and safe areas. Natural resource sectors may continue to operate, however, when protected by their location (for example offshore oil and gas) and when combatants seek to preserve them as the 'prize' for capturing the state. Past failure to achieve broad-based growth contributed to conflict. This implies that reconstruction cannot simply entail the recreation of the pre-conflict economy. Policies, public expenditures, and institutions must be changed, often fundamentally. For this reason the agendas of reconstruction and economic reform (transition) cross over. Well- designed reforms can contribute to reconstruction and vice versa. But too often there is a mismatch between the reform and reconstruction programmes, and the ground for broad-based development is not secured. Aid is important, but success ultimately depends on the actions of three national actors: communities, entrepreneurs, and states. However, communities are impoverished, private sectors are underdeveloped, and state capacities are weak. For communities, the main challenges are to deal with the immediate post-war humanitarian and security problems and, equally important, accelerate programmes for longer-term poverty reduction. Regarding the first of these, the tasks are to resettle displaced populations, disarm and demobilize ex-combatants and assist their reintegration, reduce the level of violence (by filling the security gap and decommissioning weapons), remove land mines which disrupt community livelihoods, and protect food security while phasing out food aid and increasing targeted support. Regarding longer-term poverty reduction, the future pattern of growth is determined by (i) the distribution of human and social capital, access and control over natural capital (including land tenure) and access to physical infrastructure (ii) the policy framework which determines the returns to household investments and (iii) the quality of institutions, including the legal framework. State socialism and conflict altered every aspect of the pattern of growth, and transition and reconstruction alters it again. Focusing public policy more effectively on poverty reduction, in particular on core services of most benefit to the poor, is therefore an urgent task. To support this, the relationship between donors and governments should be changed in order to focus more on monitoring social outputs and less on unworkable policy conditionalities (and to direct aid to governments committed to poverty reduction). More investment in collecting social data is needed to understand the impact of reconstruction and transition on communities. Turning to the second key actor, entrepreneurs, we can see that a new private sector is being created in UTR countries following decontrol and privatization. Overcoming investor uncertainty is a key task; this can persist and limit investment despite a fall in actual country risks. Angola and Mozambique are so far the largest recipients of foreign investment in UTR countries. But the impact of Mozambique's large investment programme is virtually unknown, while foreign investment in Angola is confined to the oil sector, which has few links to the rest of the economy. Privatization is proceeding at different speeds across UTR countries. Privatization in the financial sector is especially important; reconstruction requires a financial sector capable of mobilizing and intermediating savings into private investment. Recapitalizing the banking sector is expensive, and requires private capital, which implies privatization. Political influence can create unsound banks and better financial regulation is needed. But the phenomenon of 'straddling', in which political leaders invest in commercial enterprises, endangers the independence of financial regulation, and can distort the privatization process. Privatization in the agricultural sector has seen the non- transparent privatizations of state farms and the denial of community rights and some inconsistencies between privatization and agricultural policy reform. Encouraging more private investment in agricultural marketing is especially important for food security and rural poverty reduction. The third national actor is the state. A developmental state must be constructed. This is a set of democratically accountable institutions capable of effective policy design and implementation. If this is successful, the new state will look very different to the old state, but it is unlikely to be 'minimal'. The onus is therefore on democratic governments to prove that they provide value for money to communities and entrepreneurs. The new state agenda will remain a wish list unless it is properly financed, which it is not at present. Reconstruction expenditures are high, revenues are low (war reduced tax bases) and distorted (over dependence on trade taxes). Countries are severely indebted; almost all Africa's conflict/post-conflict countries are classified as 'Heavily Indebted Poor Countries' (HIPCs). The fiscal peace dividend is small (at least in the early years) and the high level of insecurity in Africa keeps military budgets high. Budgetary institutions are weak at mobilizing revenues and allocating them to priorities, and non-transparency and the improper use of public funds must be reduced. As a result of these problems, and the sheer scale of reconstruction expenditures, fiscal deficits before grants are very high. Nobody seriously questions the principle of fiscal prudence but the IMF's fiscal policy conditionality may be over-restrictive; certainly many other donor agencies believe that this is the case. This leaves many investments with high social returns on the shelf, implying slower growth and poverty reduction. A much longer time frame is therefore necessary to evaluate fiscal policy in an economy under reconstruction. The IMF's caution in part arises from the observation that real aid flows are in decline, and it therefore advises governments to move to a fiscal position in which any downturn in aid will not affect their recurrent, as opposed to their capital, spending. However, it is still possible for aid flows to individual countries to maintain their present levels or rise, and this is in fact the way the donor community is moving in seeking to redirect aid to countries committed to broad-based development. The IMF's fiscal policy conditionality, when it is over-restrictive, works against the new aid paradigm. Moreover, over-tight fiscal policy can lead to the use of distorting taxes that undermine reconstruction, it can work against improvements in budgeting, and it may be incompatible with democratization. The paper only touches on some of the major challenges facing the UTR group of countries. Decentralizing political and economic power, minimizing macro-economic shocks, and preventing conflict through broad-based development are all crucial. This requires hard choices over resource allocations and public policy. But these choices are a great deal easier to make than those involved in ending a conflict and initiating reconstruction. Ex ante action - good economic policy - is always better and cheaper than ex post crisis management.
This paper is one of eight case studies in the health sector conducted under the project "Population and Urbanization: Managing the Urbanization Process Under the decentralized Governance Framework" jointly undertaken by the Philippine Institute for Development Studies, National Economic and Development Authority and Development Academy of the Philippines. This paper is a case study on Cotabato City recommended by NEDA-Region XII as a model city for health. The city has come up with the Special Project on Health and Sanitation that won a silver Award in the 1997 Health and Management Information System Contest.
Decentralization of welfare policy for the elderly in recent Japan made local municipalities have responsibility to provide services. This means, however, the varieties in the quantity and the quality of services between municipalities. It is difficult to obtain the land for institutions especially in urban municipalities because of the high price of land. Therefore, the shortage of provision is serious problem in urban administration. Furthermore, the demand for services can not be satisfied in own municipality and affects neighborhood municipalities.From these problems, the present paper aims to clarify how the institutional care services were provided and the needs for services were satisfied in and out of one municipality. Nagoya City, the study area, is one of the major metropolitan city in Japan, with over two million population and it is divided into 16 wards. The object of this study is nursing home for the elderly, which is the most major service in institutional care in Japan.The results of the study can be summarized as follows:1) The locations of nursing homes are remarkable in peripheral than central wards of the city relatively. The capacity of beds by wards is not proportional to the population 65 and above.2) Each nursing homes bases on a variety of types of the organizations; public, welfare facilities, hospital, religious group, private person and so on. Since 1994, the outer organization of the administration, which had financed half by the administration, had built many homes remarkably. Consequently, the location of homes proceeded also in the central wards, where there were no homes so far. This means that unless positive policy for the provision of homes by the administration is adopted it is not easy to increase homes in urban region, where the availability of land is low.3) Regarding use of nursing homes, many of migrations to enter homes leave for own or neighbor wards. There are more immigrations from other wards where the degree of congestion of homes (the number of beds per 100 people aged 65 years and over) is relatively loose.4) Correlation coefficient between the provision of nursing homes (the number of persons entered in homes) and the demand (the number of entered and waiting lists) was not significantly different from zero at the 0.05 level. Therefore, the level of territorial justice on nursing homes in Nagoya City is not high.5) As a result of the principal component analysis on the migrations to enter homes in Nagoya City, six components (cumulative percentage of the total variance; 73.3%) were extracted. By the interpretation of the components, major patterns of immigrants were to“northeast wards”, “southwest wards”and“eastern wards”.6) Although immigrations to other municipalities leave for the whole of Aichi Prefecture, municipalities in western region of the prefecture had accepted many people from Nagoya City. Immigrations to the municipalities in the next region, policy for provision of services for the elderly, of Nagoya City is surpassing from the peripheral ward which locates on a line from the central of Nagoya City toward to a municipality of destination.7) Although by municipalities in the prefecture the degree of congestion of homes doesn't have relations with the number of persons from Nagoya City, by the policy district it was obviously proportional to ones. Consequently, most of eleven cities with populated above 100 thousand people had so congested that immigrations from Nagoya City were not so many, except for Toyohashi and Toyokawa where the degree of congestion of homes were loose.8) Finally, horizontal intergovernmental relations between Nagoya City and its next municipalities were evaluated through the comparison the number of immigrations from Nagoya City and each of their own demand for homes.
Leibniz-Informationszentrum Wirtschaft, Hans Dieter
Nepal is one of the poorest countries in the world, with 70% of its population below the poverty line. Subsidized national poverty lending programs have failed to attain viability, mobilize savings and reach the poor in significant numbers. Informal institutions such as the ubiquitous dhikuti were ignored. During the 90s the government has created a new policy environment focusing on decentralization, poverty alleviation, economic and financial liberalization, and a differentiated legal framework for microfinance institutions (MFIs). This has paved the way for innovations such as the establishment of Grameen replicators as banks; the upgrading of dhikuti activities to savings and finance companies with doorstep services; and the transformation of the small farmer credit operations of the Agricultural Development Bank into profitable local MFIs cooperatively owned by their members. In the framework of a wider UNDP-supported program of the Asian and Pacific Development Centre in Kuala Lumpur on Microfinance for the Poor in Asia-Pacific, six MFIs were selected from Nepal and analyzed in terms of outreach to the poor, resource mobilization, viability and sustainability: two Grameen Bank replicators - one a bank and one an NGO; two NGOs sponsored under the government's Rural Self-Reliance Fund; and two cooperatives. The outreach of the NGOs was found to be insignificant while the outreach of the Grameen Bikas Bank at the regional level and of the cooperatives at the local level was sizeable. The cooperatives performed well in terms of portfolio efficiency and were found to be financially viable; the NGOs did reasonably well; while the Grameen Bikas Bank, substituting donor funds for internal resources, was lowest (though improving) in operational and financial self-sufficiency - despite a 100% on-time repayment rate. On the whole all MFIs appeared rather hesitant to utilize their newly won freedom to vigorously expand their market, mobilize internal resources, and differentiate their products and interest rates.
We propose a new ecient protocol, which allows a pair of potentially mistrusting parties to exchange digital signatures over the Internet in a fair way, such that after the protocol is running, either each party obtains the other's signature, or neither of them does. The pro- tocol relies on an o-line Trusted Third Party (TTP), which does not take part in the exchange unless any of the parties behaves improperly or other faults occur. Eciency of the protocol is achieved by using a cryptographic primitive, called conrmable signatures (or designated con- rmer signatures in its original proposal (9)). We recommend using a new ecient conrmable signature scheme in the proposed fair exchange pro- tocol. This scheme combines the family of discrete logarithm (DL) based signature algorithms and a zero-knowledge (ZK) proof on the equality of two DLs. The protocol has a practical level of performance: only a moderate number of communication rounds and ordinary signatures are required. The security of the protocol can be established from that of the underlying signature algorithms and that of the ZK proof used.
We investigate the computational complexity of the isomorphism problem for read-once branching programs (1-BPI): upon input of two \nread-once branching programs B \n0 \nand B \n1 \n, decide whether there exists \na permutation of the variables of B \n1 \nsuch that it becomes equivalent \nto B \n0. \nOur main result is that 1-BPI cannot be NP-hard unless the polynomial hierarchy collapses. The result is extended to the isomorphism \nproblem for arithmetic circuits over large enough fields. \nWe use the known arithmetization of read-once branching programs and arithmetic circuits into multivariate polynomials over the \nrationals. Hence, another way of stating our result is: the isomorphism problem for multivariate polynomials over large enough fields \nis not NP-hard unless the polynomial hierarchy collapses. \nWe derive this result by providing a two-round interactive proof \nfor the nonisomorphism problem for multivariate polynomials. The \nprotocol is based on the Schwartz-Zippel theorem for probabilistically \nchecking polynomial identities. \nFinally, we show that there is a perfect zero-knowledge interactive \nproof for the isomorphism problem for multivariate polynomials. \n
espanolLa evolucion de la prestacion sanitaria media parece moverse a impulsos de dos grandes factores: los tecnologicos, en gran medida exogenos a las autoridades sanitarias, y los politicos, o endogenos en respuesta a las expectativas y preferencias sociales sobre las posibilidades de la medicina en las sociedades occidentales. Como resultado, las capacidades de tratamiento sanitario se expanden, de la mano de la presion ciudadana, en sociedades cada vez mas medicalizadas y en las que la industria sanitaria tiene un gran peso mediatico. En Espana, el incremento de la prestacion sanitaria media registrada en los ultimos anos aparece como coetanea a la descentralizacion sanitaria. Asi, existe diversidad no solo en razon del contenido de algunas prestaciones sanitarias, sino tambien de su utilizacion por parte de la poblacion. Nos interrogaremos en este trabajo acerca de la influencia de la descentralizacion sanitaria como inductor del crecimiento del gasto sanitario. A dicho fenomeno se asociaran aspectos relativos aprocesos de financiera, o de emulacion de politicas con falta de corresponsabilizacion en el gasto por parte de sus gestores. La tesis que deseamos mantener es que la devolucion de responsabilidades fiscales a las comunidades autonomas puede ser un buen antidoto para el control del gasto sanitario y, en particular, de los diferenciales de utilizacion. Con el nuevo sistema de financiacion autonomica, la integracion de la financiacion sanitaria en la general permite introducir los mecanismos necesarios para el autocontrol del gasto que aseguren una efectiva sostenibilidad de la financiacion de la sanidad publica en el proximo futuro. EnglishTechnological and social factors are beyond the increasing share of health expenditure on GDP. This implies that a mix of exogenous and endogenous factors influence health care delivery. Professional aims and social expectations on the production possibility frontier of health, on cure and care treatments, make for a rather difficult control of public health expenditure in OECD countries if reforms are not undertaken in the near future. In Spain, the rise in public health expenditure seems to go hand by hand, with an important decentralization power of health care delivery to Regional Authorities. Whether this is just a coetaneous or a relevant explanatory factor is examined in this paper.The lack of accountability and some fiscal ilusion aspects may undoubtedly influence, overall, public expenditure. But the absence of a rational distribution formula of regional health expenditure at he national level is an important factor too. The argument of the paper focusses on the need of devolution of full responsabilities on health expenditure to the Spanish Autonomous Communities. A fiscal room process is proposed as a result of some technical adjustments on a capitative finance basis. Cross-boundary flows of patients, age structure of the population, teaching and research externalities
We show simple constant-round interactive proof systems for problems capturing the approximability, to within a factor of n , of optimization problems in integer lattices, specifically, the closest vector problem (CVP) and the shortest vector problem (SVP). These interactive proofs are for the coNP direction; that is, we give an interactive protocol showing that a vector is far from the lattice (for CVP) and an interactive protocol showing that the shortest-lattice-vector is long (for SVP). Furthermore, these interactive proof systems are honest-verifier perfect zero-knowledge. We conclude that approximating CVP (resp., SVP) within a factor of n is in N P ∩co A M . Thus, it seems unlikely that approximating these problems to within a n factor is NP-hard. Previously, for the CVP (resp., SVP) problem, Lagarias et al. (1990, Combinatorica 10 , 333–348), Håstad (1988, Combinatorica 8 , 75–81), and Banaszczyk (1993, Math. Annal. 296 , 625–635) showed that the gap problem corresponding to approximating CVP (resp., SVP) within n is in N P ∩co N P . On the other hand, Arora et al. (1997, J. Comput. System Sci. 54 , 317–331) showed that the gap problem corresponding to approximating CVP within 2 log 0.999 n is quasi-NP-hard.
Map of Former Soviet Union List of Plates Acknowledgements Introduction Note on Transliteration PART I: THE CHANGES From 1900 to the 1970: Tsarist and Post-Revolutionary Education 1970s and Early 1980s: Portrait of the Soviet School before Perestroika: Some Personal Impressions of the 1970s and 1980s the 1984 School Reform and the Beginning of Change Reactions of the Establishment Movements for Change From Innovation to Independence The Alternative School, Upbringing and Social Services in a New Era Russian Schools after Gorbachev: Decentralization and Regionalization PART II: THE PROBLEMS Financing of Schools and Material Resources Health and Social Problems National Problems of Education Epilogue Chronology Appendixes References Bibliography Index
Karen Hardee, Kokila Agarwal, Nancy Luke, Ellen Wilson · 7 authors
This report presents case studies of reproductive health (RH) and family planning programs and policies in Bangladesh India Nepal Ghana Jordan Senegal Jamaica and Peru. Data were obtained from in-depth interviews among 20-44 individuals in each country who were key representatives of population and RH government ministries parliaments academia nongovernmental organizations womens groups donor agencies and health care staff. Findings focus on the following topics: RH context; the policy process; participation support and opposition; policy implementation; financial resources; and general implementation. Progress is gauged based on improving knowledge of stakeholders; planning for integrated and decentralized services; developing human resources; improving quality of care; addressing legal social and regulatory issues; clarifying donors role; and maintaining long-term aims. All countries made considerable though limited progress according to the mandates of the 1994 Cairo Plan of Action. Population size ranges from 2.6 million in Jamaica to nearly 1 billion in India. The countries vary in level of urbanization literacy fertility contraceptive prevalence infant mortality maternal mortality and prenatal care and delivery. Although the social cultural and economic contexts vary all countries have a subordinate role for women. All countries struggled with setting priorities financing and implementation. Bangladesh made the greatest progress. Jordan still emphasizes mostly family planning. India Nepal Jordan Senegal and Peru will need donor funding to advance a broad constellation of services.