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1.
Brasília; Conselho Nacional de Saúde; 9 set. 2021. 2 p.
Não convencional em Português | CNS - Conselho Nacional de Saúde do Brasil | ID: biblio-1291289

RESUMO

Recomenda ad referendum do Pleno do Conselho Nacional de Saúde ao Exmo Sr. Presidente do Senado Federal, às lideranças partidárias do Senado Federal e aos senadores a rejeição do PL 2337, especialmente dos dispositivos cujas alterações relativas ao PIS/COFINS aumentam a carga de tributos do setor saúde, uma vez que esse PL retirou os benefícios tributários sobre medicamentos e insumos, o que ampliará os custos da cadeia produtiva desse setor e reduzirá o acesso às ações e serviços essenciais à saúde da população brasileira.


Assuntos
Humanos , Impostos/economia , Custos de Medicamentos/legislação & jurisprudência , Projeto de Lei , Acesso a Medicamentos Essenciais e Tecnologias em Saúde
2.
PLoS One ; 16(6): e0253627, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34170947

RESUMO

Two studies explored whether and how mindfulness relates with citizens' tax evasion intentions and support for progressive tax rates. Based on theoretical and empirical grounds, in Study 1 (N = 1,175) we proposed that mindfulness would be negatively related with tax evasion intentions through decreased social dominance orientation. Drawing on Duckitt's dual-process motivational model, in Study 2 (N = 722) we proposed that mindfulness would be positively related with support for progressive taxation through the mediation of lower competitive-jungle beliefs, and then lower social dominance orientation. Instead, we did not expect to find mediation of the link between mindfulness and support for progressive taxation through dangerous-world beliefs and right-wing authoritarianism. These studies inform about the motivational pathways through which mindfulness relates with tax evasion intentions and support for progressive taxation.


Assuntos
Atenção Plena , Motivação , Impostos/economia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade
3.
PLoS One ; 16(6): e0252094, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34077430

RESUMO

INTRODUCTION: Sugar-sweetened beverage (SSB) taxes have been implemented worldwide to raise revenue and reduce consumption of SSBs, which is associated with health harms. Empirical evaluations have found that these taxes are successful at reducing demand for SSBs; however, SSB taxes face opposition, in part because of claims that they will lead to substantial job losses. The purpose of this study is to examine the impact of the San Francisco SSB tax, implemented on January 1st, 2018, on employment. METHODS: Monthly employment counts were obtained from the Bureau of Labor Statistics from January 2013 (5-years pre-tax) through December 2019 (2-years post-tax) for the overall economy, private sector, supermarkets and other grocery stores, convenience stores, limited-service restaurants, and beverage manufacturing. A synthetic control analysis was conducted for each employment outcome. The synthetic controls (i.e., estimated counterfactuals) were generated from a pool of urban control counties using pre-tax labor market-related characteristics. RESULTS: The synthetic controls had similar labor market-related characteristics and employment outcomes to those in San Francisco in the pre-tax period. Up to 2 years post-tax, differences in employment between San Francisco and the synthetic controls were small and not "statistically significant" based on placebo tests for all employment outcomes. CONCLUSIONS: Up to two years post-tax, we do not find evidence that the San Francisco SSB tax negatively impacted net employment, employment in the private sector, or employment in specific SSB-related industries.


Assuntos
Comércio/economia , Emprego/estatística & dados numéricos , Bebidas Adoçadas com Açúcar/economia , Bebidas Adoçadas com Açúcar/legislação & jurisprudência , Impostos/economia , Humanos , São Francisco
5.
Urol Clin North Am ; 48(2): 269-277, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33795061

RESUMO

Although physicians enjoy extensive educational backgrounds, financial planning typically is not a significant component of the curricula they have completed. As a result, many physicians could benefit from greater financial acumen, and their preparation for retirement might be lacking in light of their relatively high-income levels. This article by a private wealth advisor with 29 years of industry experience provides physicians with the basic building blocks to understand and manage their finances. It focuses on 3 pillars of financial planning: (1) protecting themselves, their families, and their assets; (2) reducing their taxes; and (3) growing their wealth.


Assuntos
Administração Financeira/organização & administração , Administração da Prática Médica/economia , Urologistas/economia , Financiamento Pessoal/economia , Humanos , Seguro de Vida/economia , Pensões , Aposentadoria/economia , Impostos/economia , Testamentos/economia
6.
Aust N Z J Public Health ; 45(1): 26-33, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33559964

RESUMO

OBJECTIVE: The Northern Territory (NT) Government introduced a minimum unit price (MUP) of $1.30 per standard drink (10g pure alcohol) explicitly aimed at reducing the consumption of cheap wine products from October 2018. We aimed to assess the impact of the NT MUP on estimates of beverage-specific population-adjusted alcohol consumption using wholesale alcohol supply data. METHODS: Interrupted time series analyses were conducted to examine MUP effects on trends in estimated per capita alcohol consumption (PCAC) for cask wine, total wine and total alcohol, across the NT and in the Darwin/Palmerston region. RESULTS: Significant step decreases were found for cask wine and total wine PCAC in Darwin/Palmerston and across the Northern Territory. PCAC of cask wine decreased by 50.6% in the NT, and by 48.8% in Darwin/Palmerston compared to the prior year. PCAC for other beverages (e.g. beer) were largely unaffected by MUP. Overall, PCAC across the Territory declined, but not in Darwin/Palmerston. CONCLUSION: With minimal implementation costs, the Northern Territory Government's MUP policy successfully targeted and reduced cask wine and total wine consumption. Cask wine, in particular, almost halved in Darwin/Palmerston where the impact of the MUP was able to be determined and considering other interventions. Implications for public health: Implementation of a minimum unit price for retail alcohol sales is a cost-effective way to reduce the consumption of high alcohol content and high-risk products, such as cheap cask wine.


Assuntos
Consumo de Bebidas Alcoólicas/tendências , Bebidas Alcoólicas/provisão & distribuição , Comércio/economia , Impostos/economia , Vinho/provisão & distribuição , Consumo de Bebidas Alcoólicas/economia , Bebidas Alcoólicas/economia , Comportamento do Consumidor/economia , Comportamento do Consumidor/estatística & dados numéricos , Humanos , Northern Territory , Vinho/economia
7.
Am J Public Health ; 111(4): 677-686, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33600243

RESUMO

We sought to examine the strategies promoting and countering state preemption of local sugar-sweetened beverage (SSB) taxes in the United States. Using Crosbie and Schmidt's tobacco preemption framework, we analyzed key tactics used by the SSB industry to achieve state preemption of local taxes identified in news sources, industry Web sites, government reports, and public documents.Starting in 2017, 4 states rejected and 4 passed laws preempting local SSB taxes. The beverage industry attempted to secure state preemption through front groups and trade associations, lobbying key policymakers, inserting preemptive language into other legislation, and issuing legal threats and challenges. The public health community's response is in the early stages of engaging in media advocacy, educating policymakers, mobilizing national collaboration, and expanding legal networks.State preemption of local SSB taxes is in the early stages but will likely scale up as local tax proposals increase. The public health community has a substantial role in proactively working to prevent preemption concurrent with health policy activity and using additional strategies successfully used in tobacco control to stop preemption diffusion.


Assuntos
Comércio/legislação & jurisprudência , Manobras Políticas , Formulação de Políticas , Bebidas Adoçadas com Açúcar , Impostos/economia , Humanos , Saúde Pública , Estados Unidos
8.
PLoS One ; 16(1): e0244884, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33395444

RESUMO

INTRODUCTION: Taxes on sugar-sweetened beverages (SSBs) have gained support as a policy response to adverse health effects associated with SSB consumption. On July 1, 2017, Oakland, California, implemented a one-cent/ounce tax on SSBs with ≥25 calories/12 fluid ounces. This study estimated the long-term impact of the tax on taxed and untaxed beverage prices. METHODS: Data on 5,830 taxed and 5,146 untaxed beverage prices were obtained from 99 stores in Oakland and 111 stores in Sacramento (comparison site), California, in late May-June 2017 and June 2019. Linear regression difference-in-differences models were computed with store and product fixed effects, with robust standard errors clustered on store, weighted based on volume sold by beverage sweetener status, type, and size. RESULTS: Taxed beverage prices increased by 0.73 cents/ounce (95% CI = 0.47,1.00) on average in supermarkets and grocery stores in Oakland relative to Sacramento and 0.74 cents/ounce (95% CI = 0.39,1.09) in pharmacies, but did not change in convenience stores (-0.09 cents/ounce, 95% CI = -0.56,0.39). Untaxed beverage prices overall increased by 0.40 cents/ounce (95% CI = 0.05,0.75) in pharmacies but did not change in other store types. Prices of taxed individual-size soda specifically increased in all store types, by 0.91-2.39 cents/ounce (p<0.05), as did prices of untaxed individual-size soda in convenience stores (0.79 cents/ounce, 95% CI = 0.01,1.56) and pharmacies (1.66 cents/ounce, 95% CI = 0.09,3.23). CONCLUSIONS: Two years following SSB tax implementation, there was partial tax pass-through with differences by store type and by beverage type and size within store type.


Assuntos
Bebidas Adoçadas com Açúcar/economia , Impostos/economia , Impostos/tendências , Bebidas/economia , California , Bebidas Gaseificadas/economia , Comércio/métodos , Comércio/tendências , Alimentos/economia , Humanos , Políticas , Bebidas Adoçadas com Açúcar/efeitos adversos , Bebidas Adoçadas com Açúcar/estatística & dados numéricos , Impostos/estatística & dados numéricos
9.
Nicotine Tob Res ; 23(4): 716-723, 2021 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-32936883

RESUMO

INTRODUCTION: Assessing long-term smoking cessation after tobacco price increases is more valuable than short-term cessation as smokers often relapse after temporary cessation. We investigated whether tobacco price increases were associated with long-term smoking cessation and whether the association differed according to demographic, socioeconomic, and behavioral factors, using a national longitudinal survey of middle-aged individual-level data from 10 waves, every November from 2005 to 2014. METHODS: Temporary and long-term at least 1 year (1y+) or 2 years (2y+) quitters were defined by smoking in any one wave and quitting in the subsequent two or three waves in a discrete-time design. November 2006 (after July 11% increase) and November 2010 (after October 37% increase) were used as proxy variables for price increases. Generalized estimating equation models adjusted for demographic, socioeconomic, and behavioral covariates, and analyses stratified by these covariates were performed to estimate the association between price increases and smoking cessation. RESULTS: Of 43 630 smokers aged 50-65, 7.7%, 5.6%, and 5.2% of smokers quit temporarily, for at least 1 year and at least 2 years, respectively. 2y+ quitters significantly increased in November 2005-November 2008 (adjusted odds ratio = 1.23, 95% confidence interval: 1.06-1.43) and November 2009-November 2012 (adjusted odds ratio = 1.85, 95% confidence interval = 1.57-2.16). In stratified analyses, higher prices were associated with 2y+ quitters in all subgroups with some exceptions, including participants who smoked 21-30 cigarettes per day and those aged 60-65. CONCLUSIONS: Increasing tobacco prices may be effective in promoting long-term smoking cessation in various subgroups among middle-aged Japanese adults. IMPLICATIONS: Few longitudinal studies have examined the effect of a tobacco price increase on long-term smoking cessation. In a national longitudinal survey of middle-aged Japanese from 10 waves, the 37% tobacco price increase was found to be a trigger for successful smoking cessation for two or more years. Price increases were significantly associated with 2y+ smoking cessation in most demographic, behavioral, and socioeconomic subgroups. Results indicate that higher tobacco prices may be effective for long-term smoking cessation in almost all subgroups. Raising tobacco taxes and prices may be one of the most effective strategies for promoting long-term smoking cessation.


Assuntos
Comércio/economia , Fumantes/psicologia , Abandono do Hábito de Fumar/economia , Fumar/economia , Adulto , Idoso , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Japão/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fumar/epidemiologia , Fumar/psicologia , Abandono do Hábito de Fumar/psicologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Impostos/economia , Produtos do Tabaco/economia
10.
Nicotine Tob Res ; 23(1): 40-47, 2021 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-32697827

RESUMO

INTRODUCTION: Tobacco product prices and consumers' income are the two major economic determinants of tobacco demand. The affordability of tobacco products is dependent on the price of tobacco products relative to consumer income. Increase in tobacco tax is expected to lead to higher price, lower affordability, and reduced consumption. Price elasticity and affordability elasticity are used in analyzing the effect of tobacco tax increases on tobacco consumption and public health. The availability of both parameters raises the question of which one to apply in policy discussions. AIMS AND METHODS: Using global data on cigarette consumption, price, income, and tobacco control measures for 169 countries over 2007-2016, this study estimated the price elasticity and affordability elasticity of cigarette consumption by country income classification using country-specific fixed effects model for panel data. RESULTS: The estimates show that the restriction of equal strength of the effects of price and income changes on tobacco consumption maintained in affordability elasticity estimation is valid for low- and middle-income countries, while it is rejected for high-income countries. CONCLUSIONS: Affordability elasticity may prove to be a useful parameter to explain and predict the sensitivity of consumers to tobacco tax and price policy changes under conditions of robust economic growth, which are more likely to be observed in countries with initial low- or middle-income setting. It can provide a reasonable benchmark for tobacco tax and price increase necessary to effectively reduce affordability and consumption of tobacco, which can form a basis for building systematic tax and price increases into the tobacco tax policy mechanism. IMPLICATIONS: Price elasticity measures the sensitivity of consumers to changes in real prices, holding real income constant. Affordability elasticity measures the sensitivity of consumers to price changes adjusted for inflation and income changes. Existing scientific literature on tobacco demand abounds in both price and affordability elasticity estimates, without providing a clear explanation of the theoretical and policy implications of using one parameter over the other. By estimating and comparing price and affordability elasticities for high-income and low-and-middle-income countries separately, this article offers a guide to the practitioners in tobacco taxation for evaluating the effectiveness of tax-induced price increases on tobacco consumption.


Assuntos
Comércio/economia , Custos e Análise de Custo , Renda , Impostos/economia , Produtos do Tabaco/economia , Uso de Tabaco/economia , Uso de Tabaco/epidemiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Pública , Uso de Tabaco/psicologia , Estados Unidos/epidemiologia , Adulto Jovem
11.
Am Surg ; 87(1): 92-96, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32812778

RESUMO

BACKGROUND: The incidence of alcoholic liver disease (ALD) has increased, causing it to become a primary indication for liver transplantation in the United States. We hypothesized an association between alcohol taxation and prevalence of ALD. METHODS: We conducted a retrospective study of united network for organ sharing (UNOS) waitlist additions for liver transplantation between January 2007 and December 2016. We also analyzed the average excise tax (2007-2016) for beer, wine, and spirits in listing states of liver transplant waitlist additions (LTWA). RESULTS: There were 104 805 adult UNOS LTWA with assigned diagnoses, an annual increase from 22% to 28%. There were 24 316 LTWA with ALD diagnosis. The mean value for beer tax was significantly lower for ALD patients than for non-ALD patients across all age groups (P < .001). The analysis demonstrated significantly more ALD in waitlisted patients 35-54 years of age (30%), compared with 18-34 years (10%) and ≥55 years (20%), P < .001. The data confirmed significantly more ALD Medicaid patients in the 35-54 year age group (28%) compared with other age groups, P < .001. DISCUSSION: Our research demonstrated an association between lower beer tax and higher ALD prevalence across all age groups. We found a larger percentage of middle-aged (35-54 years) Medicaid patients listed with ALD. These findings raise the need for further investigation of a potential public health concern for an association between ALD and beer tax, especially for middle-aged patients of lower socioeconomic status.


Assuntos
Bebidas Alcoólicas/economia , Hepatopatias Alcoólicas/epidemiologia , Transplante de Fígado/estatística & dados numéricos , Impostos/economia , Adulto , Feminino , Humanos , Hepatopatias Alcoólicas/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Impostos/legislação & jurisprudência , Estados Unidos , Listas de Espera , Adulto Jovem
12.
Drug Alcohol Depend ; 219: 108415, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33307302

RESUMO

BACKGROUND: Many countries have implemented alcohol excise taxes. However, measures of excise taxes as a percentage of alcohol prices have not been systematically studied. METHODS: Data on the retail prices of alcoholic beverages sold in stores and excise taxes in 26 countries during 2003-2018 was from the Economist Intelligence Unit price city data and the Organization for Economic Co-operation and Development (OECD) tax database. The percentages of excise taxes in off-premise retail prices were derived as the ratio of taxes to prices at different price levels. Changes of excise taxes over time were assessed using negative binominal regressions. RESULTS: The percentage of excise taxes in average off-premise alcohol prices was from 5 % in Luxembourg to 59 % in Iceland for beer, and from 0 % in France to 26 % in Iceland for wine. Excise taxes accounted for 5% of discount liquor prices in Czech Republic to 41 % in Sweden for Cognac, for 19 % in the United States (US) to 67 % in Sweden for Gin, for 13 % in the US to 63 % in Australia for Scotch Whisky six years old, and for 6 % in Iceland to 76 % in Sweden for Liqueur Cointreau. There were no significant changes in the percentage of excise taxes in alcohol prices over time in most countries except for Nordic countries. While wine had the lowest excise taxes, liquors had the highest tax burden. CONCLUSION: Tax burden on alcoholic beverages is low in OECD countries, indicating ample room for increasing alcohol excise taxes, particularly for beer and wine in those countries.


Assuntos
Bebidas Alcoólicas/economia , Impostos/economia , Bebidas Alcoólicas/estatística & dados numéricos , Cerveja/economia , Cerveja/estatística & dados numéricos , Comércio/economia , Humanos , Marketing , Organização para a Cooperação e Desenvolvimento Econômico , Estados Unidos , Vinho/economia , Vinho/estatística & dados numéricos
13.
Global Health ; 16(1): 116, 2020 12 10.
Artigo em Inglês | MEDLINE | ID: mdl-33302993

RESUMO

BACKGROUND: In 2016, the South African government became the first in the African region to announce the introduction of an SSB tax based on sugar content as a public health measure to reduce obesity. This tax was introduced against the backdrop of South Africa having a large sugar production and SSB manufacturing industry, as well as very high unemployment rates. The introduction of fiscal measures, such as a SSB tax, has been met with well-coordinated and funded opposition in other countries. METHODS: The aim of this study is to describe and analyse the arguments and strategies utilised by industry during policymaking processes to oppose regulatory actions in LMIC. This study analyses arguments and strategies used by the beverage and related industries during the public consultation phase of the process to adopt the South African SSB tax. RESULTS: Industry opposition to the SSB tax was comprehensive and employed several tactics. First, industry underscored its economic importance and the potential job losses and other economic harms that may arise from the tax. This argument was well-received by policymakers, and similar to industry tactics employed in other middle income countries like Mexico. Second, industry discussed self-regulation and voluntary measures as a form of policy substitution, which mirrors industry responses in the US, the Caribbean and Latin America. Third, industry misused or disputed evidence to undermine the perceived efficacy of the tax. Finally, considerations for small business and their ability to compete with multi-national corporations were a unique feature of industry response. CONCLUSIONS: Industry opposition followed both general trends, and also introduced nuanced and context-specific arguments. The industry response experienced in South Africa can be instructive for other countries contemplating the introduction of similar measures.


Assuntos
Política Nutricional , Saúde Pública , Bebidas Adoçadas com Açúcar , Bebidas/economia , Açúcares da Dieta/economia , Indústria Alimentícia , Humanos , Formulação de Políticas , África do Sul , Impostos/economia
14.
JAMA Netw Open ; 3(12): e2031083, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33369659

RESUMO

Importance: Health taxes are policy tools used to reduce harmful consumption of products and raise tax revenue, and they may also be associated with signaling (ie, informational and educational) factors that enhance their impact. Objectives: To examine changes in prices and volume sold of sweetened beverages following the implementation and repeal of the Cook County, Illinois, Sweetened Beverage Tax (SBT) compared with the comparison site of St Louis County and city, Missouri, which did not impose a tax. Design, Setting, and Participants: This study used interrupted time series analyses to assess changes in price and volume sold of taxed (based on beverage type and sweetener status) and untaxed beverages in Cook County compared with St Louis following the implementation of the SBT on August 2, 2017, and its repeal effective December 1, 2017. Statistical analysis was performed from January to June 2020. Exposures: Implementation and repeal of the Cook County SBT. Main Outcomes and Measures: Changes in taxed and untaxed beverage prices and volume sold. Nielsen food store scanner data were obtained for weekly volume and dollar amount sold of nonalcoholic beverage universal product codes (UPCs) for each site in supermarkets and mass merchandise, grocery, drug, convenience, and dollar stores. Results: The analytic samples included 16 510 UPCs for volume and 2141 UPCs (balanced sample) for prices for 122 pretax weeks, 16 tax weeks, and 35 postrepeal weeks. Compared with St Louis, posttax implementation in Cook County resulted in a level increase in taxed beverage prices of 1.13 cents per fluid ounce (95% CI, 1.01 to 1.25 cents per fluid ounce), representing a slight overshifting, followed by a posttax repeal level decrease of -1.19 cents per fluid ounce (95% CI, -1.33 to -1.04 cents per fluid ounce), with no resulting change pretax to posttax repeal. Volume sold of taxed beverages in Cook County compared with St Louis exhibited a posttax implementation level decrease of 25.7% (ß = -0.297; 95% CI, -0.415 to -0.179) and a posttax repeal level increase of 30.5% (ß = 0.266, 95% CI, 0.124 to 0.408), with no net change in volume sold from pretax to 8 months after repeal. Conclusions and Relevance: This study using interrupted time series analysis found no net change in volume sold of taxed beverages following the implementation and repeal of the Cook County SBT, suggesting the tax had no signaling association. Repeals of such taxes may fully reverse their associations with reduced demand and harms associated with sweetened beverage intake.


Assuntos
Comércio/estatística & dados numéricos , Comportamento do Consumidor/economia , Bebidas Adoçadas com Açúcar/economia , Impostos/economia , Implementação de Plano de Saúde , Humanos , Illinois , Análise de Séries Temporais Interrompida
15.
Nature ; 588(7836): 48-56, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33177707

RESUMO

The threat of criminal activity in the fisheries sector has concerned the international community for a number of years. In more recent times, the presence of organized crime in fisheries has come to the fore. In 2008, the United Nations General Assembly asked all states to contribute to increasing our understanding the connection between illegal fishing and transnational organized crime at sea. Policy-makers, researchers and members of civil society are increasing their knowledge of the dynamics and destructiveness of the blue shadow economy and the role of organized crime within this economy. Anecdotal, scientific and example-based evidence of the various manifestations of organized crime in fisheries, its widespread adverse impacts on economies, societies and the environment globally and its potential security consequences is now publicly available. Here we present the current state of knowledge on organized crime in the fisheries sector. We show how the many facets of organized crime in this sector, including fraud, drug trafficking and forced labour, hinder progress towards the development of a sustainable ocean economy. With reference to worldwide promising practices, we highlight practical opportunities for action to address the problem. We emphasize the need for a shared understanding of the challenge and for the implementation of intelligence-led, skills-based cooperative law enforcement action at a global level and a community-based approach for targeting organized crime in the supply chain of organized criminal networks at a local level, facilitated by legislative frameworks and increased transparency.


Assuntos
Crime/economia , Política Ambiental/economia , Política Ambiental/legislação & jurisprudência , Pesqueiros/economia , Oceanos e Mares , Desenvolvimento Sustentável/economia , Desenvolvimento Sustentável/legislação & jurisprudência , Animais , Tráfico de Drogas/economia , Fraude/economia , Tráfico de Pessoas/economia , Humanos , Internacionalidade , Impostos/economia
16.
J Leg Med ; 40(2): 135-170, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33137277

RESUMO

The federal Medicaid statute provides states an incentive to tax hospitals (even otherwise tax-exempt ones) as a means of raising revenue and then leverage federal matching funds by returning at least some of the tax back to the hospitals in the form of Medicaid supplemental payments. The potential for supplemental payments is attractive to hospitals, especially those struggling to recoup the costs of treating Medicaid and uninsured patients, and has resulted in political support from hospitals for states to create hospital "taxes" in name only-hospitals and states both end up with more money than they did when they started because of the federal match. When state officials begin to perceive, however, that nonprofit hospitals may be serving private rather than public interests, they are able to use these hospital taxes as a way to incrementally chip away at the historic governmental support provided through tax exemption by redirecting the revenue raised from the hospital tax to general fund purposes rather than Medicaid supplemental payments. This article looks at how states have been using hospital taxes and supplemental payments to balance state budgets and whether this practice is consistent with the Medicaid program objectives that make the taxes politically feasible.


Assuntos
Orçamentos , Financiamento Governamental/economia , Hospitais Privados/economia , Hospitais Públicos/economia , Medicaid/economia , Governo Estadual , Impostos/economia , Connecticut , Financiamento Governamental/legislação & jurisprudência , História do Século XX , Hospitais Privados/legislação & jurisprudência , Hospitais Públicos/legislação & jurisprudência , Medicaid/história , Medicaid/legislação & jurisprudência , Determinantes Sociais da Saúde , Impostos/legislação & jurisprudência , Estados Unidos
18.
Saudi Med J ; 41(10): 1121-1129, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33026054

RESUMO

OBJECTIVES: The current research aims to study the impact of raising tobacco tax and implementation of plain packaging on male smokers' quitting intentions in Saudi Arabia. METHODS: The study adopts a quantitative approach where close-ended questionnaires are distributed among 1,015 male participants from different regions of Riyadh city, Saudi Arabia. Bivariate analysis and logistic regression analysis are conducted using SPSS software to analyze the collected primary data. RESULTS: The study found a significant association of taxation and plain packaging on the quitting intentions of smokers. On taxation, while a considerable number of participants (46.5%) stated that they would not quit smoking if the cigarette prices increased, participants who were planning to give up smoking said it would strengthen their intention (p less than 0.001). In addition, logistic regression was performed to identify the independent predictors of quitting intention. Participants who did not want to apply the concept of plain packaging to Saudi Arabia were more likely to have quitting intention (odds ratio: 2.30 [1.61-3.28]) in comparison to those who wanted to apply the concept. CONCLUSION: Although the current price of cigarette packs reported to be very high by the participants, imposing a new higher tax may motivate smokers who had plans to quit in the near future. Plain packaging seems to be an effective new strategy in addition to tobacco taxation in Saudi Arabia, yet, more time and further research are required to assess the effectiveness of the strategy.


Assuntos
Atitude Frente a Saúde , Intenção , Embalagem de Produtos , Abandono do Hábito de Fumar/psicologia , Prevenção do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/métodos , Impostos , Produtos do Tabaco/economia , Fumar Tabaco/economia , Fumar Tabaco/psicologia , Uso de Tabaco/economia , Uso de Tabaco/prevenção & controle , Adulto , Estudos Transversais , Humanos , Masculino , Arábia Saudita , Inquéritos e Questionários , Impostos/economia , Impostos/estatística & dados numéricos
19.
Nutrients ; 12(11)2020 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-33121147

RESUMO

BACKGROUND: Thailand has implemented a sugar-sweetened beverage (SSB) excise tax since September 2017, but questions remain about changes in individual-level SSB consumption after tax implementation. This study aimed to analyze the change in taxed and non-taxed SSB consumption in the Thai population. METHOD: This cohort study was carried out in 2018 and 2019. A total of 5594 persons who participated in both years were included in the analysis. Descriptive and t-test analyses were carried out in order to identify the significance of the difference between taxed and non-taxed SSB consumption in 2018 and 2019. RESULTS: A lower mean ratio of average taxed SSBs consumed to average non-taxed SSBs consumed was found to be statistically significant (p = 0.001). That is, the decline in taxed SSB consumption is significantly greater than that of the non-taxed consumption. The greater reduction in taxed SSB consumption than the non-taxed SSB consumption was found to be significant among males, older persons, the lower-income population, and the unemployed. CONCLUSIONS: Overall, the current SSB tax has the capacity to successfully discourage consumption of SSBs with high sugar level. The decline in SSB consumption is, however, not found across all socioeconomic groups. Thresholds for SSB-tiered tax structure may have to be reviewed.


Assuntos
Comportamento do Consumidor/economia , Bebidas Adoçadas com Açúcar/economia , Impostos/economia , Adolescente , Adulto , Idoso , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores Socioeconômicos , Tailândia , Adulto Jovem
20.
Lancet Glob Health ; 8(10): e1282-e1294, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32971051

RESUMO

BACKGROUND: Worldwide, smoking tobacco causes 7 million deaths annually, and this toll is expected to increase, especially in low-income and middle-income countries. In Latin America, smoking is a leading risk factor for death and disability, contributes to poverty, and imposes an economic burden on health systems. Despite being one of the most effective measures to reduce smoking, tobacco taxation is underused and cigarettes are more affordable in Latin America than in other regions. Our aim was to estimate the tobacco-attributable burden on mortality, disease incidence, quality of life lost, and medical costs in 12 Latin American countries, and the expected health and economic effects of increasing tobacco taxes. METHODS: In this modelling study, we developed a Markov probabilistic microsimulation economic model of the natural history, medical costs, and quality-of-life losses associated with the most common tobacco-related diseases in 12 countries in Latin America. Data inputs were obtained through a literature review, vital statistics, and hospital databases from each country: Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, Honduras, Mexico, Paraguay, Peru, and Uruguay. The main outcomes of the model are life-years, quality-adjusted life-years, disease events, hospitalisations, disease incidence, disease cost, and healthy years of life lost. We estimated direct medical costs for each tobacco-related disease included in the model using a common costing methodology for each country. The disease burden was estimated as the difference in disease events, deaths, and associated costs between the results predicted by the model for current smoking prevalence and a hypothetical cohort of people in each country who had never smoked. The model estimates the health and financial effects of a price increase of cigarettes through taxes, in terms of disease and health-care costs averted, and increased tax revenues. FINDINGS: In the 12 Latin American countries analysed, we estimated that smoking is responsible for approximately 345 000 (12%) of the total 2 860 921 adult deaths, 2·21 million disease events, 8·77 million healthy years of life lost, and $26·9 billion in direct medical costs annually. Health-care costs attributable to smoking were estimated to represent 6·9% of the health budgets of these countries, equivalent to 0·6% of their gross domestic product. Tax revenues from cigarette sales cover 36·0% of the estimated health expenditures caused by smoking. We estimated that a 50% increase in cigarette price through taxation would avert more than 300 000 deaths, 1·3 million disease events, gain 9 million healthy life-years, and save $26·7 billion in health-care costs in the next 10 years, with a total economic benefit of $43·7 billion. INTERPRETATION: Smoking represents a substantial health and economic burden in these 12 countries of Latin America. Tobacco tax increases could successfully avert deaths and disability, reduce health-care spending, and increase tax revenues, resulting in large net economic benefits. FUNDING: International Development Research Centre (IDRC), Canada.


Assuntos
Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde/estatística & dados numéricos , Fumar/economia , Fumar/epidemiologia , Impostos/economia , Produtos do Tabaco/economia , Humanos , América Latina/epidemiologia , Cadeias de Markov , Modelos Econômicos , Impostos/estatística & dados numéricos , Produtos do Tabaco/estatística & dados numéricos
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