Peter Oppenheimer

Cost comparison of different methods of screening for cystic fibrosis

Objective To compare the costs of several proposed methods of screening for cystic fibrosis. Setting England and Wales. Methods The costs of screening carried out at hospital antenatal clinics, general practitioner (GP) antenatal consultations, GP surgeries, and at work were estimated using data from demonstration projects. Couple screening, stepwise screening, and screening of individuals were considered. Results Couple screening at antenatal hospital clinics was the least expensive per carrier couple detected, amounting to £35 700 (£142 900 for each potential cystic fibrosis fetus detected). The costs of the reagents (£25 per test) accounted for over 60% of this total. Conclusions Antenatal screening, in addition to being the most cost effective method of screening, is also medically the screening method of choice as it provides information at the latest time when effective preventive action can be taken and at a time when all people to be screened are likely to be accessible. If the costs of the reagents could be reduced to £5 (still higher than the costs of most diagnostic reagents) the cost for each pregnant carrier couple offered screening would be reduced by 50% to about £18 000, and the cost of offering screening to 684 000 pregnant couples in England and Wales would be about 91/2 instead of £19m.

The Future of International Commercial Banking

International commercial banking is a subset of commercial banking transactions or activities that involve some cross-border element. Three different types of activities can be distinguished. One type of activity involves a loan from a bank in one country to a borrower in some other country; or individuals residing in one country may acquire deposits from a bank in some other country. Within the last decade banks have become important intermediaries in international capital flows; and their loans have increased rapidly relative to direct portfolio flows. The second type of activity occurs when banks with their headquarters in one country sell deposits and buy loans through a branch or subsidiary located in some other country with the transactions denominated in the currency of the country in which these banks are based. The third type of activity occurs when the foreign branches or subsidiaries of banks based in particular countries sell deposits or buy loans denominated in the currencies of the countries in which they are located in competition with host country banks.

The new Europe and the Middle East : scenarios for energy planning

Abstract This article outlines key building blocks for (mainly upstream) energy scenarios over the next decade, focusing on world economic growth, energy intensity, inter-fuel competition and the implications for Arabian Gulf countries. Attention is given to possible impacts of Perestroika in the Eastern Bloc, of environmental concerns and of the 1990 Gulf Crisis. Despite increased dominance of the Gulf in the ownership of oil reserves its share of world energy production will not necessarily rise in the next few decades, thanks to greater emphasis on natural gas and intensified exploration efforts in other geographical areas (including the Soviet Union).

Monetary union: A survey of the main issues

SummaryExchange-rate union in the EEC would involve member countries surrendering a key instrument of economic policy. This is unlikely to find acceptance in the foreseeable future, because of the inadequacy on the one hand of substitute instruments (control of wages and prices; mobility of factors of production; regional policy) and on the other hand of compensating benefits (elimination of intra-European exchange risk and currency speculation; reduced costs of money-changing; greater immunity to US monetary conditions). The world currency situation points the way to a looser form of monetary association, a European currency bloc not committed to exchange-rate unification internally.

Support for Individual Investment Projects Versus Overall Improvement of the Investment Climate in Russia

There has recently been a resurgence of calls for the Russian authorities to develop and implement an active industrial policy, identifying sectors and individual companies as priority targets for government support. However, in our view, the fundamental question still facing the Russian economy is not whether to support individual industries, let alone individual enterprises and projects, but how to attract private investment and improve the overall business climate.

Comment on Savona, Maccario, and Oldani's “On Monetary Analysis of Derivatives”

Commentators and discussants tend either to focus on disagreements with principal authors or else to pursue their own unrelated thoughts. So let me stress at the outset that I strongly endorse the authors’ central conclusion concerning tension between the findings of microeconomic research on derivatives and their possible macroeconomic impact. Microeconomic research, as reported by Paolo Savona, Aurelio Maccario, and Chiara Oldani (henceforth SMO), appears to show that derivatives reduce volatility and enhance efficiency of financial markets, but macroeconomically derivatives create a potential for more severe financial-market disruption. I return to this contrast in my concluding paragraphs.

Strategic Issues for the Oil Majors — 1992

Strategic issues facing oil majors in the 1990s are very diffuse — in contrast with both the 1970s (when strategy meant the response to high oil prices) and the 1980s (when it meant anticipating and exploiting a drop in prices). Mainly upstream issues include the future of price management by OPEC or a successor, the speed of development of new markets for natural gas in power generation and the role of Russia in world energy markets. Other issues include the impact of environmental regulations and taxes on the product mix and on marketing. Human-resource management will continue to face the task of reconciling career opportunities with static or declining manpower requirements; and corporate cash mountains may periodically recur.