Thesis (Ph. D.)--University of Wisconsin--Madison, 1953. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves [144]-149).

This thesis focuses on the comparison between immigrants and non-immigrants with respect to various health-related behaviours perspective/viewpoints. Specifically, this thesis comprises three essays. First, I investigate any differences in the factors for utilizing general practitioners (GP) and specialists (SP) between immigrants and non-immigrants in Canada. Second, I examine the causal effects of language proficiency on the health and health behaviours of immigrants to Canada. Finally, I investigate whether there are any differences in the claiming patterns of the Medical Expense Tax Credit (METC) and/or Medical Expense Supplement (MES) for immigrants compared to non-immigrants in Canada. Chapter 1 investigates any differences in healthcare utilization patterns between immigrants and non-immigrants. We implement a two-part model, where the first part applies logistic regressions to assess factors associated with visiting a physician, and the second applies zero-truncated negative binomial regression models to capture the frequency of using healthcare services, conditional on having at least one visit. Our results show that the patterns of healthcare utilization are different for immigrants compared to non-immigrants; differences are also observed by gender and age. More specifically, prescription drug insurance coverage and chronic conditions play opposing roles for male and female immigrants compared to their non-immigrants counterparts. Moreover, the number of years since migration is an important factor in increasing the probability of any general practitioner (GP) and specialist (SP) visit for all immigrants. Chapter 2 is to my knowledge, the first research on the causal effects of language proficiency on health outcomes and healthcare utilization of immigrants in Canada. My finding contradicts the idea that immigrants with poor language facilities are less likely to have a regular doctor. I find that good self-reported health is positively associated with language proficiency. However, I find no statistically significant causal effect of language proficiency on reporting ‘good mental health’. In addition, I find strong evidence that the utilization of hospital and mental health care services are positively associated with being English-language proficient even after controlling for many possible sets of factors. Chapter 3 contributes by supporting existing literature, but with a completely different dimension: the medical tax perspective. I am unaware of any previous research that directly compares the claim patterns of the Medical Expense Tax Credit (METC) and/or refundable Medical Expense Supplement (MES) for immigrants with those of non-immigrants in Canada. My results show that there are differences in the proportions of tax filers who claimed the METC and/or MES, and the amounts of a claim for the METC and/or MES for immigrants compared to non-immigrants; differences are also observed by age, years since migration (YSM), province and immigration categories. In both couples and single families, a lower proportion of immigrant tax filers claimed gross immediate family medical expenses (GME), potential METC claims, and METC refunds compared to non-immigrants. In the case of single families, a higher proportion of non-immigrant tax filers claimed MES compared to their immigrant counterparts. / Thesis / Doctor of Philosophy (PhD) / This thesis focuses on the comparison between immigrants and non-immigrants with respect to various health-related behaviours perspective/viewpoints. Specifically, this thesis comprises three essays. First, I investigate any differences in the factors for utilizing general practitioners (GP) and specialists (SP) between immigrants and non-immigrants in Canada. Second, I examine the causal effects of language proficiency on the health and health behaviours of immigrants to Canada. Finally, I investigate whether there are any differences in the claiming patterns of the Medical Expense Tax Credit (METC) and/or Medical Expense Supplement (MES) for immigrants compared to non-immigrants in Canada.

全民健康保險自1995年在台灣實施以來，從設立之初面臨整合困境，到近年來因應健保財務的收支平衡及社會保險財政收入公平性規劃，而於2013年通過了改良版二代健保規劃(補充保費)，此意謂著台灣健保也面臨了一般社會保險財務沉重負擔的必然困境，同時也讓主管的衛生機關對於醫療給付的支出更限縮、管制更加嚴格。 注重醫療服務品質、衡平健保財務規劃及醫事服務機構的合理費用支付等三者平衡皆是健康保險制度能夠長久維持的重大元素。然而在總額支付制度之嚴格管制財務規劃下，雖然在名義上，健保局將醫療費用審查委託總額受託團體辦理，但受託單位角色上仍扮演行政協助角色，但健保局仍負責所有審查人員聘任、解僱、及最後審查裁量決定權，最後由健保局執行之行政程序將醫療費用支付給予醫事服務機構。 在當前醫療服務費用審查制度下，招致眾多醫療機構及醫事人員批評審查不公、惡意核刪(viciousness payment subtraction)、欠缺公民參與之黑箱審查等聲浪。細究此指摘聲浪並非空穴來風，實務上仍不免有許多謬誤醫療費用核刪、不確定法律概念(indefinite law concept)及侵犯醫事服務機構及相關醫事人員之財產權、工作權及醫療專業自主權之疑慮。 本文嘗試探討醫療費用審查之法律關係及支付制度角色，並解析目前眾多謬誤醫療費用核刪的法律明確性(principle of clarity and definiteness of law)違反、欠缺法源依據及判斷餘地瑕疵(discretion flaws)。並提出審查機制調整建議，建議將醫療費用審查制度交由公正第三人團體獨立化、專業化、減少爭議審議案件發生及爭審會行政負擔、促進公正審查(impartial review)、公開透明及避免醫療品質快速崩壞。

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This study presents an overview of the medical expenditure allowed to taxpayers in the South African Income Tax Act, 58 of 1962 (hereafter the “Income Tax Act”). The study traces the changes made to the allowed expenditure over time. Changes made to the Income Tax Act, illustrating the effect of qualifying medical expenses on the income of persons with disabilities in terms of the Income Tax Act, are described. Certain provisions of the Income Tax Act, as well as other legislation dealing with persons with disabilities, were analysed. Furthermore, the research shows the effect of moderate to severe limitations on a person’s ability to claim qualifying medical expenses. In particular, the change over from the medical tax deduction system (section 18 of the Income Tax Act) to the medical tax rebate system (sections 6A and 6B of the Income Tax Act) to redress the inequality between high income and low income earners, was analysed. Case studies were used to illustrate that the medical tax deduction system (section 18 of the Income Tax Act) favoured high income earners over low income earners. Finally, the change over from the medical tax deductions (section 18 of the Income Tax Act) system to the current system of medical tax rebates (sections 6A and 6B of the Income Tax Act) was analysed. Except for a very small group of taxpayers, the medical tax rebate system (sections 6A and 6B of the Income Tax Act) was found to be financially more favourable to all taxpayers. / Taxation / M. Compt. (Taxation)

Medical expenses refer to all medical and related expenditure reasonably incurred in respect of bodily injuries sustained. This then constitutes the primary loss in incidences of bodily injuries. However, it is accepted that bodily injuries infringe in the main the non-patrimonial aspects of the individual’s bodily integrity which is a personality right. Notwithstanding this trite provision of our law, the dissertation contends that medical expenses as a head of damages is inherently patrimonial. In essence, the true nature of medical expenses as a loss that ultimately affects both the patrimonial and non-patrimonial interests of the individual, is considered. Furthermore, the dissertation analyses the assessment and quantification mechanisms in our law, and makes a comparative study with the corresponding positions in England and Australia. The intended outcome of this dissertation is to provide clear guidelines for the award of damages, particularly where future loss is involved. / Private Law / LLM

Medical expenses refer to all medical and related expenditure reasonably incurred in respect of bodily injuries sustained. This then constitutes the primary loss in incidences of bodily injuries. However, it is accepted that bodily injuries infringe in the main the non-patrimonial aspects of the individual’s bodily integrity which is a personality right. Notwithstanding this trite provision of our law, the dissertation contends that medical expenses as a head of damages is inherently patrimonial. In essence, the true nature of medical expenses as a loss that ultimately affects both the patrimonial and non-patrimonial interests of the individual, is considered. Furthermore, the dissertation analyses the assessment and quantification mechanisms in our law, and makes a comparative study with the corresponding positions in England and Australia. The intended outcome of this dissertation is to provide clear guidelines for the award of damages, particularly where future loss is involved. / Private Law / LLM