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Sensitivity of musculoskeletal models to variation in muscle architecture parameters
- Patricia Ann Kramer, Elen M. Feuerriegel, Steven G. Lautzenheiser, Adam D. Sylvester
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- Journal:
- Evolutionary Human Sciences / Volume 4 / 2022
- Published online by Cambridge University Press:
- 15 February 2022, e6
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Musculoskeletal models, like all theoretical models of physical processes, depend on the assumptions needed to construct the model. For musculoskeletal models, these assumptions include, among other things, the kinematic data, the kinetic data and the muscle parameters. The former (dynamic) data can be acquired relatively easily from living subjects, but the latter are usually based on limited information, frequently determined from cadaver studies performed on elderly individuals. Previously, we determined the sensitivity of forces to dynamic differences among 10 humans walking on a straight path. Here, we assess the sensitivity of the muscle and joint reaction forces developed in human walking to variable muscle parameters obtained from 10 living adults, whose data were recently reported, and compared the results with the values from a standard model that depends on cadaveric data. We found that, while the force patterns across the stance cycle were similar among muscle parameter models, differences of as much as 15% in the force magnitude were produced. Whether or not the variation between the standard model and other muscle parameters is important depends on why the forces are required.
Just say no? Public attitudes about supportive and punitive policies to combat the opioid epidemic
- Steven M. Sylvester, Simon F. Haeder, Timothy Callaghan
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- Journal:
- Journal of Public Policy / Volume 42 / Issue 2 / June 2022
- Published online by Cambridge University Press:
- 09 February 2022, pp. 270-297
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Using an original demographically representative survey, we estimate the determinants of public support for a set of supportive and punitive policies to combat the opioid epidemic among a sample of 2,131 Americans. Our findings indicate that individuals who attribute blame for the epidemic to the personal choices of individuals, conservatives and those high in racial resentment are consistently more likely to support punitive policies to combat the opioid epidemic and less likely to favour policies to support individuals with substance use disorders. Individuals who have a personal connection to someone struggling with opioid use disorder favour policies to support such individuals but have nuanced attitudes towards punitive policies. Importantly, we find overwhelming support for all supportive policies except supervised injection sites, while roughly 50% of our sample supported the set of punitive policy choices. Our research represents a significant step forward toward understanding public opinion about the opioid epidemic and policies to combat it.
Past experiences with surprise medical bills drive issue knowledge, concern and attitudes toward federal policy intervention
- Timothy Callaghan, Simon F. Haeder, Steven Sylvester
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- Journal:
- Health Economics, Policy and Law / Volume 17 / Issue 3 / July 2022
- Published online by Cambridge University Press:
- 21 October 2021, pp. 298-331
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Scholars and journalists have devoted considerable attention to understanding the circumstances in which Americans receive surprise medical bills. Previous research on this issue has focused on the scope of the problem, including the conditions that are most likely to lead to surprise bills. However, the existing literature has almost exclusively relied on claims data, limiting our understanding of consumer experiences and attitudes toward policy changes to address surprise billing. Using a survey administered to a nationally representative sample of 4998 Americans, we analyze consumer experiences with surprise billing, knowledge of the issue, how concerned Americans are about receiving surprise bills and how past experiences influence policy preferences toward federal action on surprise billing. Our analysis demonstrates that knowledge and concern about surprise billing are the highest among the educated and those who have previously received a surprise bill. These factors also predict support for federal policy action, with high levels of support for federal policy action across the population, including among both liberals and conservatives. However, more detailed federal policy proposals receive significantly less support among Americans, suggesting that stand-alone policy action may not be viable. Our results show bipartisan support among American consumers for federal action on surprise billing in the abstract but no consistent views on specific policy proposals.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. Douglas Meeks, Monica Jyotsna Melanchthon, Ilie Melniciuc-Puica, Everett Mendoza, Raymond A. Mentzer, William W. Menzies, Ina Merdjanova, Franziska Metzger, Constant J. Mews, Marvin Meyer, Carol Meyers, Vasile Mihoc, Gunner Bjerg Mikkelsen, Maria Inêz de Castro Millen, Clyde Lee Miller, Bonnie J. Miller-McLemore, Alexander Mirkovic, Paul Misner, Nozomu Miyahira, R. W. L. Moberly, Gerald Moede, Aloo Osotsi Mojola, Sunanda Mongia, Rebeca Montemayor, James Moore, Roger E. Moore, Craig E. Morrison O.Carm, Jeffry H. Morrison, Keith Morrison, Wilson J. Moses, Tefetso Henry Mothibe, Mokgethi Motlhabi, Fulata Moyo, Henry Mugabe, Jesse Ndwiga Kanyua Mugambi, Peggy Mulambya-Kabonde, Robert Bruce Mullin, Pamela Mullins Reaves, Saskia Murk Jansen, Heleen L. Murre-Van den Berg, Augustine Musopole, Isaac M. T. Mwase, Philomena Mwaura, Cecilia Nahnfeldt, Anne Nasimiyu Wasike, Carmiña Navia Velasco, Thulani Ndlazi, Alexander Negrov, James B. Nelson, David G. Newcombe, Carol Newsom, Helen J. Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. Stewart, Cynthia Stokes Brown, Ken Stone, Anne Stott, Elizabeth Stuart, Monya Stubbs, Marjorie Hewitt Suchocki, David Kwang-sun Suh, Scott W. Sunquist, Keith Suter, Douglas Sweeney, Charles H. Talbert, Shawqi N. Talia, Elsa Tamez, Joseph B. Tamney, Jonathan Y. Tan, Yak-Hwee Tan, Kathryn Tanner, Feiya Tao, Elizabeth S. Tapia, Aquiline Tarimo, Claire Taylor, Mark Lewis Taylor, Bishop Abba Samuel Wolde Tekestebirhan, Eugene TeSelle, M. Thomas Thangaraj, David R. Thomas, Andrew Thornley, Scott Thumma, Marcelo Timotheo da Costa, George E. “Tink” Tinker, Ola Tjørhom, Karen Jo Torjesen, Iain R. Torrance, Fernando Torres-Londoño, Archbishop Demetrios [Trakatellis], Marit Trelstad, Christine Trevett, Phyllis Trible, Johannes Tromp, Paul Turner, Robert G. Tuttle, Archbishop Desmond Tutu, Peter Tyler, Anders Tyrberg, Justin Ukpong, Javier Ulloa, Camillus Umoh, Kristi Upson-Saia, Martina Urban, Monica Uribe, Elochukwu Eugene Uzukwu, Richard Vaggione, Gabriel Vahanian, Paul Valliere, T. J. Van Bavel, Steven Vanderputten, Peter Van der Veer, Huub Van de Sandt, Louis Van Tongeren, Luke A. Veronis, Noel Villalba, Ramón Vinke, Tim Vivian, David Voas, Elena Volkova, Katharina von Kellenbach, Elina Vuola, Timothy Wadkins, Elaine M. Wainwright, Randi Jones Walker, Dewey D. Wallace, Jerry Walls, Michael J. Walsh, Philip Walters, Janet Walton, Jonathan L. Walton, Wang Xiaochao, Patricia A. Ward, David Harrington Watt, Herold D. Weiss, Laurence L. Welborn, Sharon D. Welch, Timothy Wengert, Traci C. West, Merold Westphal, David Wetherell, Barbara Wheeler, Carolinne White, Jean-Paul Wiest, Frans Wijsen, Terry L. Wilder, Felix Wilfred, Rebecca Wilkin, Daniel H. Williams, D. Newell Williams, Michael A. Williams, Vincent L. Wimbush, Gabriele Winkler, Anders Winroth, Lauri Emílio Wirth, James A. Wiseman, Ebba Witt-Brattström, Teofil Wojciechowski, John Wolffe, Kenman L. Wong, Wong Wai Ching, Linda Woodhead, Wendy M. Wright, Rose Wu, Keith E. Yandell, Gale A. Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- The Cambridge Dictionary of Christianity
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- 05 August 2012
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- 20 September 2010, pp xi-xliv
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Acknowledgments
- Steven A. Nyce, Watson Wyatt Worldwide, Washington DC, Sylvester J. Schieber, Watson Wyatt Worldwide, Washington DC
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- The Economic Implications of Aging Societies
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Frontmatter
- Steven A. Nyce, Watson Wyatt Worldwide, Washington DC, Sylvester J. Schieber, Watson Wyatt Worldwide, Washington DC
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- The Economic Implications of Aging Societies
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3 - Pension Options, Motivations and Choices
- Steven A. Nyce, Watson Wyatt Worldwide, Washington DC, Sylvester J. Schieber, Watson Wyatt Worldwide, Washington DC
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Summary
In many regards, the aging of societies is overwhelmingly good news. Most people welcome the improvements in life expectancy realized in recent decades, especially because they are largely due to the elimination of diseases like smallpox and control of those like polio and malaria. For centuries, human beings have struggled to eliminate and control diseases and conditions that led to early death. The accelerated advances in hygiene and health sciences during the twentieth century and their effects on our lives are beyond the stretch of the wildest imagination of our forebears at the beginning of the last millennium, or even the last century. More recent progress in combating heart disease, cancer, and chronic conditions is both extending life and improving its quality. The advances leading to longer life spans in wealthy nations have generally spread to less wealthy societies, improving life for those citizens as well.
Another phenomenon, largely of twentieth century origins, that accompanied the aging of our societies was the evolution of organized retirement programs. Today, the prevalence and structure of these retirement programs, in conjunction with the aging of national populations, are raising concerns about the cost burdens ahead. Analysts believe the combination of an aging society and the promise of retirement benefits may cause economic difficulties in many countries.
Like improvements in health and longevity, the evolution of retirement programs is very good news in most regards.
8 - Too Many Wants or Too Few Workers?
- Steven A. Nyce, Watson Wyatt Worldwide, Washington DC, Sylvester J. Schieber, Watson Wyatt Worldwide, Washington DC
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Summary
We began the discussion in Chapter 7 with a simple model of an economy depicted in Figure 7-1. The model showed that the level of labor demand in an economy is ultimately determined by two factors: the efficiency with which workers are employed in producing output, and the level of output that employers produce. The amount of output produced by employers is driven by the level of demand for goods and services. Of course, government programs affect aggregate demand, and imports to and exports from other countries are also important. In estimating the amount of labor the OECD economies might need to meet future demand, we can simplify the macroeconomic discussion by focusing on the inputs used in producing GDP. Keeping Figure 7-1 in mind will help in understanding how the analysis unfolds.
In this chapter, we evaluate the probability of the developed economies not having enough workers to satisfy consumer demand for goods and services over the next couple of decades. There are two ways around the projected labor shortfalls. One is to boost productivity high enough to make up for labor shortages. Achieving such high rates of productivity improvement poses its own set of challenges to employers, which we will explore in Chapter 10. The other is to boost workforce participation, either by attracting more workers into the workforce, convincing existing workers to work more hours or delay retirement, or some combination of the two.
4 - Pension Structures and the Implications of Aging
- Steven A. Nyce, Watson Wyatt Worldwide, Washington DC, Sylvester J. Schieber, Watson Wyatt Worldwide, Washington DC
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- The Economic Implications of Aging Societies
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Summary
In much of the discussion about aging populations to date, the problem has been framed as being about retirement systems and the relative merits of one type of retirement system or the other. Policy analysts have focused mostly on whether our retirement systems should be funded or financed on a pay-go basis, or whether they should be run through the central government or “privatized” to some extent. Deciding whether a retirement system should be operated on a funded or pay-go basis depends on a variety of economic and demographic factors as we explored in Chapter 3.
In comparing the retirement systems from around the world today, especially the developed countries, it becomes very clear that although there are many similarities among systems, there are remarkable variations in how different countries provide income security for the elderly. It is important to understand these similarities and differences in order to appreciate why some countries seem to be better positioned to deal with their aging populations than others.
Contemporary Approaches to Providing Income Security for the Elderly
To some extent, the plans established in the early days of the social insurance movement in the late eighteenth and early nineteenth century are still operating today. But dynamic political and social environments have led to many changes in their structures. Around the world today, the government pillar tends to be made up of one or two tiers.
1 - Introduction
- Steven A. Nyce, Watson Wyatt Worldwide, Washington DC, Sylvester J. Schieber, Watson Wyatt Worldwide, Washington DC
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Summary
All the world's a stage, and all the men and women merely players; they have their exits and their entrances, and one man in his time plays many parts, his acts being seven ages.
William Shakespeare From “As You Like It”Shakespeare's seven ages of life begin with youth and progress through old age, which he describes as a period of second childhood when we live in oblivion, our senses largely gone. In Shakespeare's day in the late sixteenth and early seventeenth centuries, few people survived to an age we would today consider the seventh stage of life, as life expectancy at birth would have been between 25 and 30 years. Of those who made it to old age, many had to continue working until shortly before their death in order to meet their basic needs. Today, life expectancy is three times that of Shakespeare's era in the developed world and is nearing that in many of the developing countries. And when most people reach the final stage of their lifetimes today, what we now call retirement, their senses are still vitally intact and their lives are not all that different than those they lived before crossing into old age. But as our life expectancies have lengthened, our societies have grown older. As we look to the future, we expect them to grow older still.
The Economic Implications of Aging Societies
- The Costs of Living Happily Ever After
- Steven A. Nyce, Sylvester J. Schieber
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- 09 August 2009
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- 17 January 2005
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The world is getting older and no one knows exactly what life will be like in tomorrow's older societies. But we do know that age dependency ratios - the ratio of retirees to workers - will be much higher than we see today. The implications of this trend are plain. The combined effects of fewer workers, more retirees and longer retirement periods threaten not only the sustainability of pension systems but also the broader economic prospects of many developed countries. This book describes trends in birth rates, longevity and labor force participation and productivity, the cross-border flow of capital, the globalization of labor markets, the financial viability of social insurance programs, and the ways economic output is shared between working-age and retiree populations. Our most effective solution will likely be a multifaceted one: more workers, longer careers, higher productivity, and more global exchange and cooperation.
Contents
- Steven A. Nyce, Watson Wyatt Worldwide, Washington DC, Sylvester J. Schieber, Watson Wyatt Worldwide, Washington DC
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- The Economic Implications of Aging Societies
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11 - Funding Pensions and Securing Retiree Claims
- Steven A. Nyce, Watson Wyatt Worldwide, Washington DC, Sylvester J. Schieber, Watson Wyatt Worldwide, Washington DC
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- The Economic Implications of Aging Societies
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Summary
Chapters 4 and 5 explored the relative operations of funded versus pay-go retirement programs under a range of alternative demographic and economic scenarios. The economic and demographic conditions leading up to the 1960s and 1970s allowed public policymakers to rationalize the operation of national retirement systems on a pay-go basis. By the early 1990s, however, financial market operations and changing demographic outlooks significantly altered the terrain of pension financing. In its 1994 study that set off much of the world discussion about pensions, the World Bank advocated basing national retirement structures on three “pillars” of income security. The first pillar should be a pay-go, publicly managed defined benefit system. The second pillar should be a funded defined contribution system, in which the assets are privately managed. The third pillar should be private savings. By the end of the 1990s, the model envisaged by the World Bank was up and running in several countries.
Case Studies of Nations Shifting to Funded Pensions
The approach that probably has received the most attention and has been emulated most widely is that of Chile. Chile's May 1981 reform of its pay-go retirement plans was truly radical. The Chileans basically transformed their system into private individual retirement accounts, which are mandatory, fully funded, fully vested, and portable. Workers must contribute 10 percent of earnings to their retirement accounts.
9 - Alternatives to Finding More Workers
- Steven A. Nyce, Watson Wyatt Worldwide, Washington DC, Sylvester J. Schieber, Watson Wyatt Worldwide, Washington DC
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- The Economic Implications of Aging Societies
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- 09 August 2009
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Summary
Enticing more people into the workforce could help alleviate the burdens of population aging throughout the world's developed economies, but it may not be enough to keep pace with the growing demand for goods and services. Once again referring back to the model of economic operations that we laid out in Figure 7-1, if labor growth rates remain too low to meet rising levels of consumer demand, the other variable that has possibilities is productivity.
Our analysis of the OECD and EC projections suggest that, in many developed nations, the higher labor force participation rates that would be required to meet consumer demand for goods and services are probably not attainable. So, in addition to realizing all the gains they can in labor force participation rates, policymakers and capital owners will need to set their sights on enhancing productivity as well. We explore two options here. One is simply providing workers with more physical capital. The other is figuring out how to get more output from existing workers through productivity-enhancing human resource policies and processes.
Capital Deepening as a Possible Alternative to Additional Labor Supply
One way to enhance labor productivity is through increased capital investment. To some degree, capital complements the existing pool of workers by making them more efficient. On the flip side, since additional capital enables workers to produce more output, capital can also be seen as replacing labor.
7 - Labor Supply and Living Standards
- Steven A. Nyce, Watson Wyatt Worldwide, Washington DC, Sylvester J. Schieber, Watson Wyatt Worldwide, Washington DC
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- The Economic Implications of Aging Societies
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- 09 August 2009
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- 17 January 2005, pp 154-192
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Summary
Much of the discussion in the last two chapters has focused on the prospect of aging populations in the world's developed economies claiming a disproportionate share of economic output and potentially slowing economic expansion. In this chapter, we begin to explore these prospects more directly.
A fundamental dynamic in every economy is the interplay between consumer demand for goods and services and society's ability to meet that demand. From the earliest systematic study of economic behavior, economists have sought to explain the production of output in terms of its inputs. While there is no universal agreement on the mathematical formulation of the model, it is well understood that the basic building blocks of economic prosperity are determined by the number of workers and the efficiency with which output is produced.
Although economists often employ complex terminology in their descriptions, at a fundamental level, economies operate in a very simple fashion, as shown in Figured 7-1. The rate at which an economy's output – what economists call gross domestic product (GDP) – grows essentially equals the sum of labor force growth plus worker productivity growth. Labor productivity is simply how much a worker can produce in a period of time – typically economists consider hourly output as the best measure.
Labor force and productivity growth are based on three basic inputs into the production of goods and services: human capital, physical capital, and innovation.
6 - Beyond Pensions to Health Care Considerations
- Steven A. Nyce, Watson Wyatt Worldwide, Washington DC, Sylvester J. Schieber, Watson Wyatt Worldwide, Washington DC
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- The Economic Implications of Aging Societies
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- 09 August 2009
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- 17 January 2005, pp 129-153
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Summary
The discussion about aging populations and pension costs is partly about how societies share the output of their economies between the working and retiree populations. We will explore this in greater depth in coming chapters. The consumption of health care goods and services, however, is unique in virtually all developed societies and so should be considered on its own for a variety of reasons. Health care is largely financed through separate insurance mechanisms than are used to finance health care consumption. In most countries, these insurance mechanisms are predominantly publicly financed and administered, and generally cover both the elderly and the non-elderly populations. The notable exception is the United States, where health insurance is largely privately financed for the non-poor, working-age people and their dependents, and is financed on a mixed public-private basis for the elderly population.
In the context of the current discussion, health care includes the goods and services delivered by health practitioners as acute care or long-term care. Acute care includes ambulatory care delivered by health providers outside of hospitals, care provided to patients who are hospitalized, pharmaceuticals, and so forth. Beyond acute care, long-term care is either institutional care or home services provided to the disabled and others unable to care for themselves. The intersection of aging populations and existing health financing arrangements will create financing challenges for all developed countries in the coming decades for a couple reasons.
Index
- Steven A. Nyce, Watson Wyatt Worldwide, Washington DC, Sylvester J. Schieber, Watson Wyatt Worldwide, Washington DC
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- The Economic Implications of Aging Societies
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- 09 August 2009
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- 17 January 2005, pp 373-396
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5 - Retirement Systems and the Economic Costs of Aging
- Steven A. Nyce, Watson Wyatt Worldwide, Washington DC, Sylvester J. Schieber, Watson Wyatt Worldwide, Washington DC
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- The Economic Implications of Aging Societies
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- 09 August 2009
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- 17 January 2005, pp 107-128
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The discussion thus far has suggested that the way pension systems are structured might affect the costs associated with aged dependency. Lawrence Thompson of the Urban Institute cautions that analyses of this sort can often be misleading. He suggests that pensions are financed by a combination of contributions from labor income and returns on capital. He says that if a “lower charge to labor is offset by a higher charge to capital income, the total cost to the economy is the same even though it may be distributed differently.”
Thompson argues that the economic cost or burden of supporting a retired population is simply the total consumption of retirees divided by the total production in an economy. He expresses this relation as the product of three ratios. The first ratio is simply the consumption rate for all consumers in the economy relative to total output – i.e., the share of total output consumed rather than saved. The second ratio is the percentage of the total population that is retired. The third is the consumption rate of the elderly compared to people generally. The mathematical derivation of the retiree burden rate as equivalent to the consumption rate of the retiree population relative to total output is shown in Figure 5-1.
The economic burden that retiree populations impose on their national economies is driven by the variables in these ratios.
List of Figures and Tables
- Steven A. Nyce, Watson Wyatt Worldwide, Washington DC, Sylvester J. Schieber, Watson Wyatt Worldwide, Washington DC
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- The Economic Implications of Aging Societies
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- 17 January 2005, pp xi-xx
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13 - Risks Associated with Alternative Public Policies
- Steven A. Nyce, Watson Wyatt Worldwide, Washington DC, Sylvester J. Schieber, Watson Wyatt Worldwide, Washington DC
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- The Economic Implications of Aging Societies
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- 17 January 2005, pp 313-348
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Summary
The industrialized nations face considerable economic challenges in the years ahead. In a macroeconomic context, they must try to keep standards of living on an upward trajectory and to allocate these improvements equitably across their populations. In earlier chapters, we noted that retirement systems are fundamental to this allocation process, serving to transfer economic resources from workers to retirees. In the future, pension and health care programs will become the crucial linkage between the macroeconomic prosperity of aging societies and the relative welfare of all segments within them.
The European Commission (EC), the OECD, the World Bank, and various other entities have projected much higher costs for the pension systems in nearly all developed nations under their current policies. The evidence so far indicates that most of these countries have yet to take measures to reduce costs in ways that do not jeopardize income adequacy for retirees of the future.
The EC has identified a number of objectives that encompass three main economic goals: income adequacy for dependent populations; financial sustainability, not only of pension systems but of the entities that support them; and modernization of pension systems. Countries with high debt ratios need to adopt measures for budgetary consolidation. Enacting policies that promote longer working careers and higher workforce activity rates are an important strategy in making pensions sustainable.