Cost shifting

Rizzo, J.D. Vogelsang, G.B. Krumm, S. Frink, B. Mock, V. Bass, E.B. Outpatient-based bone mamrw transplantation for hematologic malignancies Cost savings or cost shifting J. Clin. Oncol. 1999, 17 (9), 2811 2818. 

Although use of nonprescription medications can be viewed as a reduction in the cost of prescription medications, cost shifting to out of pocket expense greatly affects patients on fixed incomes. Many... 

In France, despite co-payment for drugs, prescription drugs are virtually free for the 80% of the population who enjoyed supplemental insurance in 1990. The supplemental private companies or co-operatives reimburse most or all of the co-payments. The recent law on universal health insurance coverage will extend this supplemental insurance to 100% of the population [5], Such exemptions, and reinsurance options for the population, offset the effect of co-payment in reducing the use of drugs that are not needed, or too expensive. Of OECD countries only Austria, Germany, Japan, Spain and Switzerland have officially excluded such a cost shifting by reinsurance in second-tier payment systems (Table 1). 

Butler, Richard J., David L. Drtrbitt, and Nurhan M. Helvacian. 1996. Increasing Claims for Soft Tissue Injuries in Workers Compensation Cost Shifting and Moral Hazard. Journal of Risk and Uncertainty 13(1) 73-87. 

Butler, Richard J., Robert P. Hartwig, and Harold H. Gardner. 1997. HMOs, Moral Hazard and Cost Shifting in Workers Compensation. Journal of... 

One can easily see that global minimum of stack cost shifts from 52.62 per kW at an annual production rate of 1000 stacks to 15.86 per kW at a production of 500,000 stacks per year. Surprisingly, the simple model predicts minimum stack cost at much higher platinum loading than the one used in the DoE studies 2012 and 2013 (Table 14.3). 

Butler, R.J., Durbin, D.L., and Helvacian, N.M. 1996. Increasing claims for soft tissne injuries in workers compensation Cost shifting and moral hazard. Journal of Risk and Uncertainty, 13, 73-87. 

Low pressure methanol carbonylation transformed the market because of lower cost raw materials, gender, lower cost operating conditions, and higher yields. Reaction temperatures are 150—200°C and the reaction is conducted at 3.3—6.6 MPa (33—65 atm). The chief efficiency loss is conversion of carbon monoxide to CO2 and H2 through a water-gas shift as shown. 

Although the rapid cost increases and shortages of petroleum-based feedstocks forecast a decade ago have yet to materialize, shift to natural gas or coal may become necessary in the new century. Under such conditions, it is possible that acrylate manufacture via acetylene, as described above, could again become attractive. It appears that condensation of formaldehyde with acetic acid might be preferred. A coal gasification complex readily provides all of the necessary intermediates for manufacture of acrylates (92). 

In the late 1980s attempts were made in California to shift fuel use to methanol in order to capture the air quaHty benefits of the reduced photochemical reactivity of the emissions from methanol-fueled vehicles. Proposed legislation would mandate that some fraction of the sales of each vehicle manufacturer be capable of using methanol, and that fuel suppHers ensure that methanol was used in these vehicles. The legislation became a study of the California Advisory Board on Air QuaHty and Fuels. The report of the study recommended a broader approach to fuel quaHty and fuel choice that would define environmental objectives and allow the marketplace to determine which vehicle and fuel technologies were adequate to meet environmental objectives at lowest cost and maximum value to consumers. The report directed the California ARB to develop a regulatory approach that would preserve environmental objectives by using emissions standards that reflected the best potential of the cleanest fuels. 

Some processes use only one reactor (57) or a combination of liquid- and vapor-phase reactors (58). The goal of these schemes is to reduce energy consumption and capital cost. Hydrogenation normally is carried out at 2—3 MPa (20—30 atm). Temperature is maintained at 300—350°C to meet a typical specification of less than 500 ppm benzene in the product at higher temperatures, thermodynamic equiUbrium shifts to favor benzene and the benzene specification is impossible to attain. Also, at higher temperatures, isomerization of cyclohexane to methylcyclopentane occurs typically there is a 200 ppm specification limit on methylcyclopentane content. 

Use of a low temperature shift converter in a PSA hydrogen plant is not needed it does, however, reduce the feed and fuel requirements for the same amount of hydrogen production. For large plants, the inclusion of a low temperature shift converter should be considered, as it increases the thermal efficiency by approximately 1% and reduces the unit cost of hydrogen production by approximately 0.70/1000 (20/1000 ft ) (140,141). 

By 1980, research and development shifted from relatively inexpensive surfactants such as petroleum sulfonates to more cosdy but more effective surfactants tailored to reservoir and cmde oil properties. Critical surfactant issues are performance in saline injection waters, adsorption on reservoir rock, partitioning into reservoir cmde oil, chemical stabiUty in the reservoir, interactions with the mobiUty control polymer, and production problems caused by resultant emulsions. Reservoir heterogeneity can also greatly reduce process effectiveness. The decline in oil prices in the early 1980s halted much of the work because of the relatively high cost of micellar processes. 

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