Suchergebnisse

The structure of German Official Development Assistance (ODA) is in a state of transition. Germany's growing international role, the increasing importance of climate issues as well as the refugee crisis are contributing greatly to a significant increase in German ODA, which has more than doubled since 2012 and amounted to around EUR 22 billion in 2017. The coalition agreement between the CDU/CSU and the SPD in 2018 has prioritised ODA-eligible expenditures and views development policy as a priority area. Significant changes can also be seen with regard to the scope and pattern of ODA expenditures:The budget of the Federal Ministry for Economic Cooperation and Development (BMZ) and its share of the federal budget have increased due to an upvaluation of development cooperation (DC). At the same time, the BMZ's portion in Germany's overall ODA fell from 73 per cent in 1995 to 33 per cent in 2016. Nonetheless, projections for 2017 based on the second government draft for the 2018 budget indicate a trend reversal. Projection for 2017: BMZ 37 per cent, with KfW market funds 45 per cent; Federal Foreign Office (AA) 14 per cent; Projection for 2018: BMZ 49 per cent, with KfW market funds 53 per cent; AA 13 per cent.ODA-eligible contributions of other federal ministries have increased significantly. Both the ODA-eligible portion of the EU budget and the development policy contributions of the federal states have doubled since 1995. Market funds mobilised via the KfW as well as the eligible expenditures for refugees in Germany have been particularly important at times.The following interpretations can be drawn based on those trends:Largely positive interpretation from a development policy perspective: Development cooperation has become more important in recent years and is no longer a comparatively small area of activity that relates exclusively to the BMZ. New challenges have resulted from other ministries having a much stronger interest in maintaining and using resources for development cooperation. Germany's ODA contributions have thus risen overall and the BMZ's share of the budget has increased.Largely critical interpretation from a development policy perspective: The distribution of funds among a larger number of actors is making it difficult to pursue a coherent development policy approach, and other policy areas are not primarily aimed at development policy objectives due to their tasks and interests. The current situation implies a loss of importance for the BMZ and thus the original development policy area.Due to a rise in ODA contributions and the growing importance of a wide variety of development policy actors in Germany, there is now an increased need for greater coordination. The following is therefore recommended:conduct systematic development policy reviews of all ODA projects of all ministriesmore intensively coordinate Germany's ODA con¬tributions through the BMZ in a steering groupconcentrate ODA funds more towards the BMZ, which is the specialised department in development policy.

The structure of German Official Development Assistance (ODA) is in a state of transition. Germany's growing international role, the increasing importance of climate issues as well as the refugee crisis are contributing greatly to a significant increase in German ODA, which has more than doubled since 2012 and amounted to around EUR 22 billion in 2017. The coalition agreement between the CDU/CSU and the SPD in 2018 has prioritised ODA-eligible expenditures and views development policy as a priority area. Significant changes can also be seen with regard to the scope and pattern of ODA expenditures: The budget of the Federal Ministry for Economic Cooperation and Development (BMZ) and its share of the federal budget have increased due to an upvaluation of development cooperation (DC). At the same time, the BMZ's portion in Germany's overall ODA fell from 73 per cent in 1995 to 33 per cent in 2016. Nonetheless, projections for 2017 based on the second government draft for the 2018 budget indicate a trend reversal. Projection for 2017: BMZ 37 per cent, with KfW market funds 45 per cent; Federal Foreign Office (AA) 14 per cent; Projection for 2018: BMZ 49 per cent, with KfW market funds 53 per cent; AA 13 per cent. ODA-eligible contributions of other federal ministries have increased significantly. Both the ODA-eligible portion of the EU budget and the development policy contributions of the federal states have doubled since 1995. Market funds mobilised via the KfW as well as the eligible expenditures for refugees in Germany have been particularly important at times. The following interpretations can be drawn based on those trends: Largely positive interpretation from a development policy perspective: Development cooperation has become more important in recent years and is no longer a comparatively small area of activity that relates exclusively to the BMZ. New challenges have resulted from other ministries having a much stronger interest in maintaining and using resources for development cooperation. Germany's ODA contributions have thus risen overall and the BMZ's share of the budget has increased. Largely critical interpretation from a development policy perspective: The distribution of funds among a larger number of actors is making it difficult to pursue a coherent development policy approach, and other policy areas are not primarily aimed at development policy objectives due to their tasks and interests. The current situation implies a loss of importance for the BMZ and thus the original development policy area. Due to a rise in ODA contributions and the growing importance of a wide variety of development policy actors in Germany, there is now an increased need for greater coordination. The following is therefore recommended: conduct systematic development policy reviews of all ODA projects of all ministries more intensively coordinate Germany's ODA con¬tributions through the BMZ in a steering group concentrate ODA funds more towards the BMZ, which is the specialised department in development policy.

The aim of our research was to collect comprehensive data about the public and physician awareness, acceptance and use of Personalized Medicine (PM), as well as their opinions on PM reimbursement and genetic privacy protection in the U.S. and Germany. In order to give a better overview, we compared our survey results with the results from other studies and discussed Personalized Medicine preconditions for its wide implementation into the medical standard. For the data collection, using the same methodology, we performed several surveys in Pennsylvania (U.S.) and Bavaria (Germany). Physicians were contacted via letter, while public representatives in person. Survey results, analyzed by means of descriptive and non-parametric statistic methods, have shown that awareness, acceptance, use and opinions on PM aspects in Pennsylvania and Bavaria were not significantly different. In both states there were strong concerns about genetic privacy protection and no support of one genetic database. The costs for Personalized Medicine were expected to be covered by health insurances and governmental funds. Summarizing, we came to the conclusion that for PM wide implementation there will be need to adjust the healthcare reimbursement system, as well as adopt new laws which protect against genetic misuse and simultaneously enable voluntary data provision.

Partner country selection is one of the key elements of development policy. It lies at the centre of the development policy decision-making of donor countries and institutions, and plays a significant role in shaping the patterns of official development assistance (ODA) allocation. The existing literature on ODA allocation has either a focus on how it should be (normatively) organised, on which determinants are (ex post) responsible for aid flows by using regression analysis looking for causal relationships, or stands somewhere between them. We argue that there is a gap in the literature in terms of analysing whether the actual flows of ODA reflect donors' stated intentions in partner country selection. It is the aim of this paper to analyse the partner country selection approaches of selected members of the Development Assistance Committee (DAC) of the Organisation for Economic Co-operation and Development (OECD) during the last years, their principles in development policy-making and how their approach is reflected in the formulae applied. The European Union, France, Germany, Japan, the Netherlands, Sweden, the United Kingdom and the United States, which roughly share 70 per cent of the total ODA flows by all DAC donors, were chosen as case studies. In a descriptive analysis, we consider how aid allocation is organised by each donor, focusing on primary institutions/agencies, decision-making processes, and the principles/basic formulae applied in selecting partner countries. A map of the donors in terms of their intentions and allocation/actual flows is drawn. While principles are considered to shape intentions, interests and other confounding factors affect actual flows. In addition, the donors are compared by looking at three aspects of their approaches: firstly, whether donors are strategically-motivated (that is, whether they have security concerns, foreign policy and economic interests as the main motivation in their partner country selection) or follow development-oriented approaches (focusing on recipient-needs); secondly, whether they follow an explicitly stated agenda; and, thirdly, whether intentions are consistent with the actual ODA flows. Looking at these aspects, we suggest that 1) not every donor follows a clear approach in partner country selection; 2) actual ODA flows do not always reflect the stated intentions; and 3) most of the time, donors follow a mixture of development-oriented and strategic approaches.

Partner country selection is one of the key elements of development policy. It lies at the centre of the development policy decision-making of donor countries and institutions, and plays a significant role in shaping the patterns of official development assistance (ODA) allocation. The existing literature on ODA allocation has either a focus on how it should be (normatively) organised, on which determinants are (ex post) responsible for aid flows by using regression analysis looking for causal relationships, or stands somewhere between them. We argue that there is a gap in the literature in terms of analysing whether the actual flows of ODA reflect donors' stated intentions in partner country selection. It is the aim of this paper to analyse the partner country selection approaches of selected members of the Development Assistance Committee (DAC) of the Organisation for Economic Co-operation and Development (OECD) during the last years, their principles in development policy-making and how their approach is reflected in the formulae applied. The European Union, France, Germany, Japan, the Netherlands, Sweden, the United Kingdom and the United States, which roughly share 70 per cent of the total ODA flows by all DAC donors, were chosen as case studies. In a descriptive analysis, we consider how aid allocation is organised by each donor, focusing on primary institutions/agencies, decision-making processes, and the principles/basic formulae applied in selecting partner countries. A map of the donors in terms of their intentions and allocation/actual flows is drawn. While principles are considered to shape intentions, interests and other confounding factors affect actual flows. In addition, the donors are compared by looking at three aspects of their approaches: firstly, whether donors are strategically-motivated (that is, whether they have security concerns, foreign policy and economic interests as the main motivation in their partner country selection) or follow development-oriented approaches (focusing on recipient-needs); secondly, whether they follow an explicitly stated agenda; and, thirdly, whether intentions are consistent with the actual ODA flows. Looking at these aspects, we suggest that 1) not every donor follows a clear approach in partner country selection; 2) actual ODA flows do not always reflect the stated intentions; and 3) most of the time, donors follow a mixture of development-oriented and strategic approaches.

Objectives: The study objective was to identify the size of different hospital financing sources for different hospital services and their impact on the uninsured. Methods: A panel dataset of 84 public general hospitals (2005–2008) with cross-section data on hospital activity and hospital revenue was created and used to calculate unit costs of different hospital services by applying multiple regression models. The resulting risk of catastrophic health expenditure (CHE) was estimated based on official income statistics. Results: Average user fees (UF) for outpatient visits and inpatient bed days were US$4.13 and US$20.27, while actual full costs (AFC) were US$8.41 and US$36.66, respectively. These unit costs were 2.5 times higher in hospitals at the central versus the provincial level. UF for surgical inpatient bed days were 3.6 times that of non-surgical treatments (US$47.50 vs. 12.87) and AFC 5.0 times (US$101.72 vs. 20.08). UF accounted for 44.6%-77.9% of the AFC, the rest (22.1%-55.4%) was provided by direct government support (DGS). One surgical inpatient treatment at either central or provincial hospital level and one non-surgical inpatient treatment at central hospital level, immediately pushed uninsured near-poor households at risk of CHE. Conclusions: Around 45% of hospital AFC was paid by DGS, the larger rest by UF. UF have become a great financial burden on the uninsured near-poor households, who have to pay for these out-of-pocket and therefore may not utilize even necessary services. If the rate of DGS were reduced, this would have the effect of increasing UF, but the savings to Government could be spent on subsidizing insurance to ensure that a larger part of the population can cover UF through insurance, especially the near-poor households.