In Crypto '93, S. Brands presented a very eecient oo-line electronic cash scheme based on the representation problem in groups of prime order. In Crypto '95 a very eecient oo-line divisible e-cash scheme based on factoring Williams integers was presented by T. Okamoto. We demonstrate one eecient attack on Okamoto's scheme and two on Brands' scheme which allow users to misrepresent their identit...

Electronic cash (E-cash) is the digital counterpart of cash payment. They allow users to spend anonymously unless they “double spend” their electronic coins. However, it is not possible to prevent users from misbehaving under some other subjective definitions of misbehavior, such as money laundering. One solution is to incorporate a trusted third party (TTP), which, upon complaint, uses its pow...

Aging and declining health are intrinsically related and are resulting in increasing healthcare spending in many countries. Control of healthcare spending and patient usage behavior are linked. This study examines the healthcare usage behavior of chronically ill elderly patients in Taiwan following an increase in co-payments. The differences in usage behavior are interpreted by comparing the fr...

To contain escalating healthcare spending has become a great challenge for many countries around the world. Among all factors influencing medical costs, extensive studies have shown that adoption of healthy lifestyles such as not smoking, moderate drinking, eating healthy food, and exercising regularly can contribute to good health and lower the odds of having diseases that result in higher med...

We describe research on the impact of health insurance on healthcare spending (“moral hazard”), and use this context to illustrate the value of and important complementarities between different empirical approaches. One common approach is to emphasize a credible research design; we review results from two randomized experiments, as well as some quasi-experimental studies. This work has produced...

BACKGROUND  Despite the growing chronic disease burden in low- and middle-income countries, there are significant gaps in our understanding of the financial impact of these illnesses on households. As countries make progress towards universal health coverage, specific information is needed about how chronic disease care drives health expenditure over time, and how this spending differs from spe...

BACKGROUND Periods of financial crisis are associated with higher psychological stress among the population and greater use of mental health services. The objective is to analyse contextual factors associated with mental health among the Spanish population during the recession. METHODOLOGY Cross-sectional, descriptive study of two periods: before the recession (2006) and after therecession (2...

In this article, we illustrate the relevance of queuing theory principles to the healthcare sector through a case study of a day surgery unit in a hospital in Melbourne, Australia. The hospital has an acknowledged problem: patients are spending longer-than-anticipated periods of time in the day surgery unit, and they are facing excessive waiting times at all stages of their healthcare delivery ...

Healthcare is burdensome to many nations. Safety and Sustainability are key issues. Medical practice has much to learn from aviation in terms of safety. Some 40 years after aviation became safe, medicine was deemed unsafe as reported by the Institute of Medicine in 1999. Some countries spend up to 16% of their GDP on healthcare. Some companies spend up to 30 cents in every dollar of costs on em...

Tough economic times stir up anxiety over the affordability of public services—especially healthcare. As governments struggle to balance budgets, and healthcare spending continues to grow faster than the economy, conditions are ripe for old—and often discredited—policy ideas to make a comeback. User fees are no exception. At first blush, user fees appear to be an obvious solution. After all, an...