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Steffie Woolhandler – One of the best experts on this subject based on the ideXlab platform.

  • health care Administrative Costs in the united states and canada 2017
    Annals of Internal Medicine, 2020
    Co-Authors: David U. Himmelstein, Terry Campbell, Steffie Woolhandler
    Abstract:

    Before Canada implemented a single-payer health system, its health Costs and the number of health Administrative personnel per capita were similar to those of the United States. By 1999, administra…

  • A comparison of hospital Administrative Costs In eight nations: US Costs exceed all others by far
    Health affairs (Project Hope), 2014
    Co-Authors: David U. Himmelstein, Miraya Jun, Reinhard Busse, Karine Chevreul, Alexander Geissler, Patrick P.t. Jeurissen, Sarah Thomson, Marie-amelie Vinet, Steffie Woolhandler
    Abstract:

    A few studies have noted the outsize Administrative Costs of US hospitals, but no research has compared these Costs across multiple nations with various types of health care systems. We assembled a team of international health policy experts to conduct just such a challenging analysis of hospital Administrative Costs across eight nations: Canada, England, Scotland, Wales, France, Germany, the Netherlands, and the United States. We found that Administrative Costs accounted for 25.3 percent of total US hospital expenditures—a percentage that is increasing. Next highest were the Netherlands (19.8 percent) and England (15.5 percent), both of which are transitioning to market-oriented payment systems. Scotland and Canada, whose single-payer systems pay hospitals global operating budgets, with separate grants for capital, had the lowest Administrative Costs. Costs were intermediate in France and Germany (which bill per patient but pay separately for capital projects) and in Wales. Reducing US per capita spendin…

  • Costs of health care administration in the united states and canada
    The New England Journal of Medicine, 2003
    Co-Authors: Steffie Woolhandler, Terry Campbell, David U. Himmelstein
    Abstract:

    background A decade ago, the Administrative Costs of health care in the United States greatly exceeded those in Canada. We investigated whether the ascendancy of computerization, managed care, and the adoption of more businesslike approaches to health care have decreased Administrative Costs. methods For the United States and Canada, we calculated the Administrative Costs of health insurers, employers’ health benefit programs, hospitals, practitioners’ offices, nursing homes, and home care agencies in 1999. We analyzed published data, surveys of physicians, employment data, and detailed cost reports filed by hospitals, nursing homes, and home care agencies. In calculating the Administrative share of health care spending, we excluded retail pharmacy sales and a few other categories for which data on Administrative Costs were unavailable. We used census surveys to explore trends over time in Administrative employment in health care settings. Costs are reported in U.S. dollars. results In 1999, health administration Costs totaled at least $294.3 billion in the United States, or $1,059 per capita, as compared with $307 per capita in Canada. After exclusions, administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada. Canada’s national health insurance program had overhead of 1.3 percent; the overhead among Canada’s private insurers was higher than that in the United States (13.2 percent vs. 11.7 percent). Providers’ Administrative Costs were far lower in Canada. Between 1969 and 1999, the share of the U.S. health care labor force accounted for by Administrative workers grew from 18.2 percent to 27.3 percent. In Canada, it grew from 16.0 percent in 1971 to 19.1 percent in 1996. (Both nations’ figures exclude insurance-industry personnel.) conclusions The gap between U.S. and Canadian spending on health care administration has grown to $752 per capita. A large sum might be saved in the United States if Administrative Costs could be trimmed by implementing a Canadian-style health care system.

David U. Himmelstein – One of the best experts on this subject based on the ideXlab platform.

  • health care Administrative Costs in the united states and canada 2017
    Annals of Internal Medicine, 2020
    Co-Authors: David U. Himmelstein, Terry Campbell, Steffie Woolhandler
    Abstract:

    Before Canada implemented a single-payer health system, its health Costs and the number of health Administrative personnel per capita were similar to those of the United States. By 1999, administra…

  • A comparison of hospital Administrative Costs In eight nations: US Costs exceed all others by far
    Health affairs (Project Hope), 2014
    Co-Authors: David U. Himmelstein, Miraya Jun, Reinhard Busse, Karine Chevreul, Alexander Geissler, Patrick P.t. Jeurissen, Sarah Thomson, Marie-amelie Vinet, Steffie Woolhandler
    Abstract:

    A few studies have noted the outsize Administrative Costs of US hospitals, but no research has compared these Costs across multiple nations with various types of health care systems. We assembled a team of international health policy experts to conduct just such a challenging analysis of hospital Administrative Costs across eight nations: Canada, England, Scotland, Wales, France, Germany, the Netherlands, and the United States. We found that Administrative Costs accounted for 25.3 percent of total US hospital expenditures—a percentage that is increasing. Next highest were the Netherlands (19.8 percent) and England (15.5 percent), both of which are transitioning to market-oriented payment systems. Scotland and Canada, whose single-payer systems pay hospitals global operating budgets, with separate grants for capital, had the lowest Administrative Costs. Costs were intermediate in France and Germany (which bill per patient but pay separately for capital projects) and in Wales. Reducing US per capita spendin…

  • Costs of health care administration in the united states and canada
    The New England Journal of Medicine, 2003
    Co-Authors: Steffie Woolhandler, Terry Campbell, David U. Himmelstein
    Abstract:

    background A decade ago, the Administrative Costs of health care in the United States greatly exceeded those in Canada. We investigated whether the ascendancy of computerization, managed care, and the adoption of more businesslike approaches to health care have decreased Administrative Costs. methods For the United States and Canada, we calculated the Administrative Costs of health insurers, employers’ health benefit programs, hospitals, practitioners’ offices, nursing homes, and home care agencies in 1999. We analyzed published data, surveys of physicians, employment data, and detailed cost reports filed by hospitals, nursing homes, and home care agencies. In calculating the Administrative share of health care spending, we excluded retail pharmacy sales and a few other categories for which data on Administrative Costs were unavailable. We used census surveys to explore trends over time in Administrative employment in health care settings. Costs are reported in U.S. dollars. results In 1999, health administration Costs totaled at least $294.3 billion in the United States, or $1,059 per capita, as compared with $307 per capita in Canada. After exclusions, administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada. Canada’s national health insurance program had overhead of 1.3 percent; the overhead among Canada’s private insurers was higher than that in the United States (13.2 percent vs. 11.7 percent). Providers’ Administrative Costs were far lower in Canada. Between 1969 and 1999, the share of the U.S. health care labor force accounted for by Administrative workers grew from 18.2 percent to 27.3 percent. In Canada, it grew from 16.0 percent in 1971 to 19.1 percent in 1996. (Both nations’ figures exclude insurance-industry personnel.) conclusions The gap between U.S. and Canadian spending on health care administration has grown to $752 per capita. A large sum might be saved in the United States if Administrative Costs could be trimmed by implementing a Canadian-style health care system.

John Douglas Wilson – One of the best experts on this subject based on the ideXlab platform.

  • Tax policy and the missing middle: Optimal tax remittance with firm-level Administrative Costs
    Journal of Public Economics, 2010
    Co-Authors: Dhammika Dharmapala, Joel Slemrod, John Douglas Wilson
    Abstract:

    Abstract We analyze the optimal taxation of firms when the government faces fixed (per-firm) Administrative Costs of tax collection. The tax instruments at the government’s disposal are a fixed (per-firm) fee and a linear tax on output. If all firms in an industry are taxed, we show that it is optimal to impose a positive fee to internalize Administrative Costs. The output taxes satisfy the inverse elasticity rule for taxed industries, but industries with sufficiently high Administrative Costs should be exempted from taxation. We also investigate the case where firms with outputs below a cutoff level can be exempted from taxation. It may be optimal to set the cutoff high enough to exempt a sizable number of firms, even though some firms reduce their outputs to the cutoff level, creating a “missing middle”: small and large firms – but not those of intermediate size – exist. Thus, this common phenomenon in developing countries may result from optimal policies. The paper also presents a modified inverse-elasticity rule when output cutoffs are used, and it extends the analysis to include optimal nonlinear taxes on output.

  • Tax Policy and the Missing Middle: Optimal Tax Remittance with Firm-Level Administrative Costs
    SSRN Electronic Journal, 2008
    Co-Authors: Dhammika Dharmapala, Joel Slemrod, John Douglas Wilson
    Abstract:

    We analyze the optimal taxation of firms when the government faces fixed (per-firm) Administrative Costs of tax collection. The tax instruments at the government’s disposal are a fixed (per-firm) fee and a linear tax on output. If all firms in an industry are taxed, we show that it is optimal to impose a positive fee; this represents a Pigouvian tax that internalizes Administrative Costs. We derive an inverse elasticity rule that determines the optimal output tax for taxed industries; however, it is optimal to exempt industries with sufficiently high Administrative Costs. We also investigate the case where firms with outputs below a cutoff level can be exempted from taxation. We show that it may be optimal to set the cutoff high enough to exempt a sizable number of firms, even though this causes some firms to reduce their outputs to the cutoff level. This production distortion creates a missing middle, in which small and large firms – but not those of intermediate size – exist. The missing-middle phenomenon is common in developing countries; we demonstrate that it may result from optimal policies. The paper also presents a modified inverse-elasticity rule when output cutoffs are used, and it extends the analysis to include optimal nonlinear taxes on output.

Olivia S. Mitchell – One of the best experts on this subject based on the ideXlab platform.

  • Administrative Costs in Public and Private Retirement Systems
    , 1998
    Co-Authors: Olivia S. Mitchell
    Abstract:

    This paper collects and analyzes available information on Administrative Costs associated with public and private retirement systems. We explore expenses of the US social security system and compare these with data from national systems in other countries. We find that administration Costs of publicly-run social security systems vary a great deal across countries and institutional settings. A key factor influencing public old-age program Costs is the system’s scale: plans with more assets and more participants are less expensive. We also investigate expenses reported by US pension plans and mutual funds, programs seen by many as alternative mechanisms for managing retirement saving. Based on an analysis of Costs associated with retirement savings plans managed by financial institutions, we conclude that privately managed old-age retirement programs would be somewhat more costly to operate than current publicly-managed programs, depending on the program’s specific design. Nevertheless these Costs would be accompanied by new services for participants. (This abstract was borrowed from another version of this item.)

  • Administrative Costs in Public and Private Retirement Systems
    National Bureau of Economic Research, 1996
    Co-Authors: Olivia S. Mitchell
    Abstract:

    This paper collects and analyzes available information on Administrative Costs associated with public and private retirement systems. We explore expenses of the US social security system and compare these with data from national systems in other countries. We find that administration Costs of publicly-run social security systems vary a great deal across countries and institutional settings. A key factor influencing public old-age program Costs is the system’s scale: plans with more assets and more participants are less expensive. We also investigate expenses reported by US pension plans and mutual funds, programs seen by many as alternative mechanisms for managing retirement saving. Based on an analysis of Costs associated with retirement savings plans managed by financial institutions, we conclude that privately managed old-age retirement programs would be somewhat more costly to operate than current publicly-managed programs, depending on the program’s specific design. Nevertheless these Costs would be accompanied by new services for participants.

Břetislav Andrlík – One of the best experts on this subject based on the ideXlab platform.

  • Corporation Income Tax and Administrative Costs of the Public Sector
    Acta Universitatis Agriculturae et Silviculturae Mendelianae Brunensis, 2015
    Co-Authors: Břetislav Andrlík
    Abstract:

    This contribution examines the issues of measurement of corporate income tax effectiveness in the circumstances of the Czech Republic, referred to as the tax on income of legal persons. The tax on income of legal persons represents a significant part of the public budget revenue, with the volume of collection of CZK 128,002 million in 2012. The theoretical basis for this contribution is the principle of tax system effectiveness, which is one of the principles characterizing a good tax system and is related to Costs inherent in a tax system. The contribution defines two existing types of Costs expended on the collection of taxes, i. e. Administrative Costs (direct or indirect) and in theory describes excessive tax burden. In this contribution we shall focus on the measurement of direct Administrative Costs. The measurement of effectiveness of corporation income tax is performed with the use of the full-time equivalent (FTE) method, which is based on the classification of revenue authorities’ staff according to their jobs and on the determination of conversion coefficients in order to identify Costs related to the collection of a particular tax.A separate part of the article deals with measurement of Administrative Costs performed by the Organisation for Economic Co-operation and Development on the timeline ranging from year 2009 to 2011. The author of this article performed his own measurements concerning the direct Administrative Costs related to the collection of tax on income of legal persons in the Czech Republic. Results achieved in the respective monitored years are lower by the average (in the Czech Republic 2 percentage) of ca 1.66 percentage points in relation to the average value of direct Administrative Costs of the Czech tax system.

  • Administrative Costs of property tax in the Czech Republic
    Acta Universitatis Agriculturae et Silviculturae Mendelianae Brunensis, 2014
    Co-Authors: Břetislav Andrlík
    Abstract:

    The paper deals with the efficiency of property taxes in the tax system of the Czech Republic, focusing on the Administrative Costs of taxation on the timeline 2005 to 2008. It contains a theoretical definition of tax efficiency, and describes the types of Costs connected with taxes. From this perspective it focuses on quantifying the direct Administrative Costs of inheritance tax, gift tax, property transfer tax and property tax. Direct measurement of Administrative Costs is done by using the method called WTE staff which classifies employees of regional financial institutions in separate groups and assigns each group a specific number of employees for each reference property taxes using the conversion factors. Then it defines the total expenditure of regional financial institutions using the coefficients for a particular monitored tax and it provides Administrative Costs as a percentage of property tax receipts. Finally, the results of measurements indicating the proposed amendment are discussed.

  • Administrative Costs of property tax in the czech republic
    Acta Universitatis Agriculturae et Silviculturae Mendelianae Brunensis, 2010
    Co-Authors: Břetislav Andrlík
    Abstract:

    Přispěvek se zabýva problematikou efektivnosti daňoveho systemu a vymezenim tři zakladnich složek způsobujicich neefektivnost daňoveho systemu, a to přime administrativni naklady, nepřime administrativni naklady a nadměrne daňove břemeno. Vymezuje zakladni charakteristicke rysy vsech uvedených složek nakladů daňoveho systemu a podrobněji se věnuje přimým administrativnim nakladům. U nepřimých administrativnich nakladů oznacovaných take jako vyvolane naklady se uvaději výsledky jejich měřeni provedene výzkumnými studiemi jak v zahranici, tak v podminkach Ceske republiky.Vlastni měřeni autora je provedeno u přimých administrativnich nakladů, a to pro daň dědickou, daň darovaci, daň z převodu nemovitosti a daň z nemovitosti v Ceske republice. Použitou metodou stanoveni přimých administrativnich nakladů uvedených majetkových dani je metoda tzv. přepocteneho pracovnika, ktera je podrobně definovana v textu. Výsledky dosažene v jednotlivých sledovaných letech jsou u uvedených majetkových dani alarmujici. Z vypoctených hodnot jednoznacně vyplýva, že naklady veřejneho sektoru na spravu sledovaných majetkových dani jsou bezpochyby vysoke a vlastni efekt ukladani daně je pro veřejný sektor ztratový. Hodnoty administrativnich nakladů zejmena u daně dědicke a daně darovaci přesahuji hranici 100 % a jejich výběr je pro uzemni financni organy z tohoto pohledu ztratový. V navaznosti na dosažene výsledky je vice než žadouci uvažovat o změně. Je možne identifikovat dva zakladni směry vývoje, ktere povedou ke zlepseni. Prvni možnosti je u daně dědicke a daně darovaci odstranit rozsahla osvobozeni, ktera jsou i v podminkach clenských zemi Evropske unie zcela unikatni, a tim zvýsit inkaso předmětných dani. Druhou možnosti je zruseni těchto dani jako soucasti daňoveho systemu Ceske republiky a vyslyset tak volani zejmena pravicových politických stran, ktere o jejich zruseni již dlouhodobě usiluji (konkretni připad poslaneckeho navrhu je uveden i v tomto přispěvku). U ostatnich sledovaných majetkových dani jsou sice dosažene výsledky o poznani lepsi, přesto i výběr těchto dani je velice nakladný vzhledem k výzkumu provedenemu Ministerstvem financi Ceske republiky v roce 2004, kde byla stanovena průměrna výse přimých administrativnich nakladů v Ceske republice na 2 %.Budoucnost a dalsi směřovani v oblasti majetkových dani v Ceske republice zavisi zejmena na vůli jednotlivých politických stran, ktere by se otazkou nakladnosti výběru majetkových dani měly rozhodně zabývat.