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DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 Joiners, leavers, stayers and abstainers: Private health insurance choices in Australia Stephanie A Knox1, Elizabeth Savage1 Denzil G Fiebig1,2, Vineta Salale1,2, 1 Centre for Health Economics Research and Evaluation The University of Technology, Sydney 2 School of Economics The University of New South Wales Abstract The percentage of Australians taking up Private Health Insurance (PHI) was in decline following the introduction of Medicare in 1984 (PHIAC). To arrest this decline the Australian Government introduced a suite of policies, between 1997 and 2000, to create incentives for Australians to purchase private health insurance. These policies include an increased Medicare levy for those without PHI on high incomes, introduced in 1997, a 30% rebate for private hospital cover (introduced 1998), and the Lifetime Health Cover (LHC) policy where PHI premiums are set at age of entry, increasing for each year older than 30 years (introduced 2000). In 2004 the longitudinal study on Household Income and Labour Dynamics in Australia (HILDA), included a series of questions on private health insurance and hospital use. We used the HILDA data to investigate the demographic, health and income factors related to the PHI decisions, especially around the introduction of the Lifetime Health Cover policy. Specifically we investigate who was most influenced to purchase PHI (specifically hospital cover) in 2000 as a response to the Lifetime Health Cover policy deadline. Are those who have joined PHI since the introduction of LHC different from those who joined prior to LHC? What are the characteristics of those who have dropped PHI since the introduction of LHC? We model the PHI outcomes allowing for heterogeneity of choice and correlation across alternatives. After controlling for other factors, we find that LHC prompted moderately well-off working age adults (30-49 yrs) to purchase before the 2000 deadline. Young singles or couples with no children, and the overseas born were more likely to purchase since 2000, while the relatively less well-off continue to drop PHI in spite of current policy incentives. 1. Introduction The universal Australian public health care system, Medicare, was introduced in 1984. Subsequently the private health insurance coverage of the population fell steadily, reaching its lowest level of just over thirty percent in 1998. Governments of both political persuasions at the Commonwealth level, argued that if the decline of private health insurance was to continue it would place unaccepTable pressure on public hospitals in the future. Therefore over the last decade the Commonwealth introduced a suite of policies to create incentives for Australians to purchase private 1 DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 health insurance with the aim of promoting choice and relieving pressure on the public hospital system. In 1997, the government introduced a private insurance tax rebate for low income singles and families and a tax surcharge (one percent of taxable income) for those on high incomes. The tax surcharge could be avoided by purchasing private health insurance. In 1999, the income-tested rebate for low earners was replaced with a constant thirty percent premium rebate, available to all regardless of income. In 2000, the Lifetime Health Cover policy (LHC) reform introduced an age gradient into the premium schedule. After July 15, 2000, all new private insurance enrollees aged over 30 pay a premium loading in future period of two percent for each year of age over 30 at entry. The loading is capped at 70 percent. Irrespective of age, people already insured prior to the deadline who maintain their private insurance coverage are exempt from the loading. The 2000 reform was accompanied by extensive publicly- funded advertising under the theme "Run for Cover". As a result of these insurance incentives, private insurance coverage in Australia increased from 30.1 percent in 1998 to 43 percent in 2000, a jump of nearly 50 percent, most of which occurred just prior to July 2000. There was also a change in the mix of the insured population with large fall in the percentage aged over 65. Three policies remained relevant in 2000: 1) the increased Medicare levy for 'high income' earners who did not purchase private hospital cover; 2) the 30% rebate for the purchase of hospital cover; and 3) The Lifetime Health Cover policy. Previous Australian research on private health insurance falls into three categories: analysis of insurance demand prior to the reforms of the last decade; analyses of the PHI incentives overall; and analyses of the incentives that focuses on heterogeneity across individuals or families. The factors influencing the demand for private insurance coverage prior to LHC have been examined using the ABS National Health Surveys (NHS). Using the NHS surveys undertaken between 1983 and 1995, Schofield et al (1997) examine PHI the changing composition of PHI coverage of the population. They identify a decline among middle income families compared with both upper and lower income groups and a smaller decline among families headed by a person over 55 years old than younger families. They also find that rising premiums had the greatest impact on low income families. Using the 1989 and 1995 NHS data respectively, Savage and Wright (2003) and Barrett and Conlon (2003) found a strong association between demand for insurance and income. Savage and Wright also examined the association between utilisation and insurance for private hospital length of stay. They found that insurance could more than double the average length of private hospital stay. The introduction of the insurance incentives generated considerable research. Butler (2002) analyses the "carrots and sticks" financial incentives for PHI and finds that the membership uptake that occurred was largely attribuTable to LHC, a policy that had virtually no cost to government. He also examines the changing age composition of the insured pool after September 2000, and observes that the increasing average age of those insured suggests the possible reappearance of an adverse selection dynamic. He argues that the 'trick' delivered by LHC may not be maintained in the longer term. 2 DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 Walker et al (2005) present an historical analysis of the impacts of the different PHI incentives in terms of the proportion of Australians having hospital insurance cover by age, gender and socioeconomic status. They find that the increased cover was due mainly to the richest 20% of the population. Among the poorest 40% the impact was minimal. Dawkins et al (2004) find strong evidence that households most affected by the PHI policy changes were those with high socio-economic standing and high income and little evidence that the policies alleviated the burden of public hospitals. Vaithianathan (2004) argues that the subsidy to health insurance should have been an effective means to increase PHI coverage, but was ineffective because community rating was ineffective. Despite community rating rules which prohibit age adjusted premiums, Household Expenditure Survey data indicates finds that young adults pay considerably less for their insurance than older adults. She concludes that insurers circumvented community rating through plan design, screening older consumers into more expensive plans. She also finds that the penalty of 2 per cent per year for delaying insurance, introduced as part of the lifetime cover plan, is too low to be effective. Doiron et al (forthcoming) investigate the relationship between ex ante risk and private health insurance using the NHS 2001 and find a strong positive association between self-assessed health and private health cover and identify the factors responsible for favourable selection. They find that those persons who engage in risk- taking behaviours are simultaneously less likely to be in good health and less likely to buy insurance. Palangkaraya and Yong (2005) attempts to isolate the effects of the different insurance incentives using 1995 and 2001 NHS data. Focusing on single individuals their counterfactual analysis indicates that LHC caused between 42% and 75% of the overall increase in PHI membership. Ellis and Savage (2005) develop and use NHS2001 data to estimate a model of individual decisions to enroll in private health insurance order to understand the effects of the PHI reforms on the age and income distribution of those with private cover over time. They conclude that the major impacts of the three reforms can be understood as a broad-based "Run for Cover", a response to a deadline and an advertising blitz, rather than a pure price response. They also find that LHC would have had a larger impact on coverage for families without the 30% premium subsidy. Lu and Savage (2006) use the 2001 NHS to examine the impact of increased private insurance coverage on use of both public and private hospital systems focusing on how behaviour varies with insurance duration. They find that those who enrolled in response to the incentives behave more like the uninsured than the long-term insured. While the insurance incentives substantially increased the proportion of the population with supplementary private insurance, the impact on the use of the public system by new entrants appears to be quite modest. They conclude that using financial PHI incentives is not a cost-effective way of reducing pressure on public hospital systems. Feibig et al 2007 analyse private health insurance behaviours among respondents to the 2001 NHS to identify insurance 'types' according to stated reasons for buying health insurance. They find considerable evidence of unexplained heterogeneity 3 DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 among the privately insured population and that insurance type is significantly associated with hospital utilisation, particularly the probability of being admitted as a public or private patient. The government's insurance incentives were more attractive to particular types of the insured population and this limits their effectiveness in reducing pressure on the public hospital system. In this paper we use the HILDA data to further explore heterogeneity of private health insurance choices. We investigate demographic, family, health and income factors related to respondent's private health insurance decisions in the light of recent policy changes. We focus on whether these policy changes attracted a different demographic to purchase private health insurance than previously. We are also interested in describing those who have dropped private health insurance since the introduction of LHC. Since the policies only apply to the purchase of hospital cover, we have excluded ancillary cover only from our definition of private health insurance. We identify six distinct groups: those who purchased private hospital cover before LHC; those who reported they took up private hospital cover in 2000 in response to LHC; those who took up private hospital cover after the insurance incentives; those who dropped private hospital cover after 2000; those who had dropped private hospital cover prior to 2000 and remained uninsured; those who had never purchased private hospital cover. We model the insurance decisions using a multinomial probit model which allows for heterogeneity of choice and correlation across alternatives. We use our preferred model to simulate predicted probabilities for each alternative outcome. To illustrate our results we constructed a series of hypothetical index individuals for each outcome alternative of interest, setting the levels of the explanatory variables to give a high simulated probability of choice for that alternative. We then use the index individual as a base to examine the effect of a change in the level of each explanatory variable on the probability of choice for the alternative of interest, keeping all other variables at the level of the index individual. The results focus on the three groups whose decisions would be affected by Lifetime Health Cover: those who joined PHI because of the lifetime Health cover deadline, those who joined after the deadline and those who dropped hospital cover since the introduction of the policy. 2. Data The Household Income and Labour Dynamics of Australia (HILDA) study is a longitudinal population survey which commenced in 2001. HILDA is a random sample of Australian households. In the baseline 2001 survey all members of 7,682 selected households were enumerated and members aged 15 years and over were interviewed. Respondents have been followed across time and interviews are conducted every 12 months. New household members are included in subsequent interview waves, while ever they share a household with a baseline respondent. The survey covers questions on income, expenditures, education, occupation and other roles, demographics, health, family formation, risk behaviours, attitudes and life events. The HILDA sample and method have been described in detail elsewhere (http://melbourneinstitute.com/hilda/). 4 DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 In WAVE4 of HILDA conducted in 2004 respondents were asked a series of questions on private health insurance and hospital usage. Did respondent currently have private health insurance? If yes, did it include hospital cover? When did he/she join? And if he/she joined in 2000 was that as a response to the LHC policy? If the respondent was not currently insured, had he/she ever had hospital cover in the past, and if so how long ago did he/she drop hospital cover? From these questions we created six groups based on the respondent's most recent decision in relation to the purchase of private hospital cover insurance. 1. Joined Prior: those who purchased private hospital cover before Lifetime Health Cover. 2. Joined because of Lifetime Health Cover(LHC): those who stated they took up private hospital cover in 2000 because of LHC. 3. Joined after: those who took up private hospital cover after 2000. 4. Left after: those who dropped private hospital cover after 2000. 5. Left prior: those who had dropped private hospital cover before 2000, including those who still held extras cover. 6. Never: those who had never purchased private hospital cover, including those who had only ever held extras cover. Since the questions on private health insurance cover were only asked in Wave4 of HILDA we adopted a retrospective cohort approach to model the factors related to private health insurance decisions. The outcome was most recent decision in relation to the purchase of private hospital cover insurance in Wave4 of HILDA. The explanatory variables were responses recorded in Wave1 of HILDA. We chose Wave1 as the baseline because that was the closest time period to the 2000 policy changes and therefore was the best available measure of the respondent's status at the time of the policy changes. In addition differences between Waves 1 and 2 in income, financial assets and health were used to measure the effect of prospective changes after 2001 on more recent decisions to purchase or drop private hospital cover after the introduction of LHC. Explanatory variables fall into five categories: 1. Demographic variables included age, sex, region of residence, education, occupation, country of birth and languages spoken other than English. Family formation variables included couple status, the number of respondent's resident children < 25 years and the age of the youngest resident child. 2. Health variables included long-term illness or disability, the Short Form Health Survey (SF-36) items and scales, alcohol consumption, smoking status and exercise. 3. Financial variables included individual, partner's and household wages, benefits and financial assets. Attitudes to financial risk and self-assessed prosperity were also included. 4. Retrospective life events in the 12 months prior to 2001 included self-report of financial improvement or worsening, losing a job, being promoted, changing jobs, retiring, marriage, separation, reconciliation, becoming pregnant, a new baby, injury or illness for self or family. 5 DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 5. Prospective changes in the 12 months from 2001 to 2002 included personal and household income and financial assets, changes in disability/illness and SF-36 self-assessed health. In the analysis we used the balanced panel of respondents aged 18 years and over who had complete data for the relevant variables in Wave1 to Wave4. There were 13,191 respondents 18 years and over in Wave1 of HILDA. The balanced panel aged 18 years and over from Waves 1 to 4 comprised 9,377 respondents, 98% of whom answered the self-completion questionnaire in Wave1. Eight respondents did not answer the questions on private health insurance in Wave4. This gave a final sample of 9,196. Half of the sample (49.6%) held private hospital insurance in 2004. A further 336 (3.6%) held ancilliary cover only. A quarter of respondents (25.7%) had never held any private hospital cover. The private health insurance choice (hospital cover only) categories used in the analysis are shown in Table 1. TABLE 1 NEAR HERE The majority of respondents who had dropped private hospital cover by 2004 had done so 8 or more years ago (1779 of 2281). Of those who had dropped private hospital cover after 2000, half (219 of 424) had done so less than 2 years ago. A summary of the characteristics of the total sample and each choice category is shown in Table 2. TABLE 2 NEAR HERE Respondents with private hospital cover in 2004 were more likely in 2001 to have tertiary qualifications, to be living in a major city, to be a non-smoker and have higher average wages than those without insurance. A greater proportion of those who took up hospital cover in response to LHC policy were couples with children, compared to the other groups. Those who joined private hospital cover after 2000 had a marked increase in household wages from 2001 to 2002. In contrast those who dropped private hospital cover after 2000 had a marked decrease in household wages from 2001 to 2002. 3. Modelling strategy In order to examine the explanatory variables on PHI choice, assume that each individual has an unobserved utility associated with each of six discrete outcomes. Individuals then choose the alternative with the highest utility. With a linear random utility model this implies: (1) U ij = xi′β j + ε ij ; j = 1,..,6 where x represents the vector of control variables. Under the assumption that the disturbances are distributed as iid type I extreme value, this random utility framework motivates the use of the multinomial logit model. Initially STATA was used to fit a multinomial logit model with the six PHI categories as the outcome. 6 DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 all explanatory variables were fitted in the full model in groups of related variables, specifically demographics, relationship and family formation, education and occupation, health, wages, benefits and financial assets, health risk and financial risk, retrospective self-reported life changes, prospective changes in income and financial assets. The number of variables in the model from each group of explanatory variables was reduced using backward elimination from the full model. The objective was to retain in the model those variables from each group with the greatest explanatory power, without omitting any important variables from the model. Each group of explanatory variables was reduced in the presence of all other variables, starting with the least significant variable in the group. A variable was kept or dropped based on the likelihood ratio test (alpha = .05) and the next least significant variable was tested and so on. After all variables had been tested, the next family was then reduced the same way. Age, sex, health and income are all known important explanatory variables for health insurance behaviour. Therefore appropriate measure(s) of each of these characteristics were kept in the model regardless of their significance in the sample. The final model was tested for adequacy against the full model using the likelihood ratio test. To ensure that no important explanatory variables had been omitted from the model, the coefficients in the final model were compared with the full model for any substantial changes in size The final model was tested for the assumption of independence of irrelevant alternatives, using formal tests and by running a series of binary logit models of each alternative outcome against the reference outcome "never had private health insurance" to check any changes in the coefficients. The variables retained in the final model were age, sex, partner status, number of children, age of youngest child, occupation, education, language, country of birth, region of residence, self-assessed health, disability or long-term illness, weekly exercise, self-reported prosperity and attitude to financial risk, recently fired, recent illness or disability in the family, recent worsening of financial situation, recently married, individual wages, benefits and financial assets, partner's wages and financial assets, total household wages, prospective changes in household wages, benefits and financial assets. Variables in the final model were inspected for functional form. Lowess curves were used to assess whether continuous variables were linear on the logit of each outcome category. Age was non-linear for the alternatives "joined because of lifetime health cover" and "joined after lifetime health cover". Age was therefore entered as spline variables with break-points at age 31, 46 and 66 to capture the age-related effects of the LHC policy. Increasing positive financial assets and increasing negative financial assets predicted a greater probability of having private health insurance relative to no financial assets. Therefore to capture this non-linear relationship, financial assets was fitted as two ordinal variables, positive financial assets with 6 ordinal categories ($0 to $9999, $10,000 to $19,999,…..,$40,000 to $49,999, over $50,000) and negative financial assets with 2 ordinal categories (< -$10,000, $0-$9999). Smoking status that was missing for Wave1 was imputed from later waves of the panel where possible. Complete observations were included in the multivariable analysis. There 510 observations with missing data that were omitted from the model 7 DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 (5.5% of the balanced panel). The number of complete cases in the final multinomial logit model was 8,686. The final multinomial logit model failed the test for independence of irrelevant alternatives (IIA) (Small-Hsiao test, p<.001). Furthermore, there were some changes in the size of some coefficients in the binary logit models, Therefore we investigated models that relaxed the IIA assumption using the "mdc" procedure in SAS (REF). We specified a number of different models including mixed logit with random intercepts to model heterogeneity of choice and multinomial probit that allowed heteroskedacity and correlation between error terms. The multinomial probit model assumes the error term ε ij for each alternative is normally distributed but error terms can be heteroskedastic and correlated across alternatives. Two multinomial probit models were fitted and compared: 1. An approximation to multinomial logit with restrictions on the error terms to be homoskedastic and uncorrelated across alternatives. 2. The unrestricted multinomial probit model that allowed the error terms to be heteroskedastic and freely correlated across alternatives. The fit of the unrestricted model was compared to the fit of the model with homoskedastic variance and uncorrelated error terms, using the likelihood ratio test. The final model was used to simulate predicted probabilities for each alternative for each respondent. A dataset was created with hypothetical observations to observe the effect of changing levels of each explanatory variable on the estimated probability of the alternative outcomes. The effects of age were estimated holding all other explanatory variables at the level of the sample mean. A series of index individuals were created, one for each outcome alternative, as a base to examine the effects of each explanatory variable on the probability of that particular outcome. The model coefficients were used to select levels of the explanatory to create an individual with a high probability for a particular outcome. The explanatory variables were then varied one level at a time to estimate their effects on the probability of the alternative of interest, keeping all other variables at the level of the index individual. Index individuals were created for the three alternatives of most interest which were; purchasing hospital cover because of lifetime health cover, joining after the introduction of lifetime health cover, and leaving after the introduction of lifetime health cover. 4. Results The goodness of fit of the multinomial logit and multinomial probit models are summarised in Table 3. The unrestricted multinomial probit fitted the data better than the multinomial probit model restricted to homoskedastic and uncorrelated error terms. The likelihood ratio test found a significant difference between the models (LR chisq (44, 14) p < .001). The estimates in the unrestricted model (not shown) indicated significant heteroskedasticity but no significant correlation of the error terms. We therefore proceeded with the multinomial probit as the most appropriate model for the analysis. 8 DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 TABLE 3 NEAR HERE The characteristics of the three index individuals are summarised in Table 4 along with their predicted probabilities for each choice alternative. TABLE 4 NEAR HERE Joined because of LHC The index individual for joining private health insurance because of Lifetime Health Cover was a 40 year old married man with one child aged 5-14 years, a non-smoker with no long-term health conditions, in a professional position with tertiary qualifications, with an annual wage of $100,000, whose partner is not working and with no financial assets. The full details of the LHC index individual are listed in Table 4. The estimated probability of joining because of LHC for the index individual is 36.1%, much higher than the overall sample rate of 6.2%. The probability of joining prior was also higher for this individual than for the sample rate(57.8% versus 38.5%). TABLE 5 NEAR HERE The effect of age on the probability of joining because of LHC holding all other variables at the sample mean, are shown in Figure 1 and the effects of changing the levels of the index individual are shown in Table 5. To provide a comparison with those who joined prior Table 5 also shows the changes in probability of having joined prior for each change in the level of the LHC index individual. In summary individuals who had a higher probability of having purchased private hospital cover in 2000 because of LHC were distinguished in 2001 by the characteristics listed below. ⎯ Aged 31-49 years ⎯ 1 school-aged child ⎯ No financial assets ⎯ A single income between $60k and $100k ⎯ Described their financial circumstances as "just getting by" ⎯ Took average or no financial risks ⎯ Exercised Regularly ⎯ Lived in regional Australia ⎯ Were born in Asia or the Pacific. Variables in the model with negligible effects on the probability of joining because of LHC, included smoking status, having a long term disability or health problem. Occupation or qualifications, reporting being financially worse in the 12 months prior to 2001, or any changes in income or financial assets following 2001. Joined After 2000 The index individual for joining private hospital cover after the introduction of Lifetime Health Cover (Joined After 2000) was a 29 year old female with partner and no children, a non-smoker, with no long-term health conditions, in a professional occupation. The full details of the Joined After index individual are listed in Table 4. 9 DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 The estimated probability of having joined after 2000 for the index individual was 22.4%. The effect of age on the probability of joining after 2000 holding all other variables at the sample mean, are shown in Figure 2 and marginal changes based on the index individual are shown in Table 6. In summary individuals who had a higher probability of having purchased private hospital cover after 2000 were distinguished by the characteristics listed below. ⎯ Turned 30 years of age after 2000, ⎯ Were single in 2001 ⎯ Had no children in 2001 ⎯ Had no financial assets in 2001 ⎯ Were on benefits in 2001 but not in 2002 ⎯ Had a long-term illness or disability ⎯ Were born overseas and/or were from a non-English speaking background. Variables with negligible effect on joining private hospital cover after 2000 included smoking status, region of residence, having a recent illness in the family and changes in financial assets after 2001. Left After 2000 The index individual for leaving private hospital cover after the introduction of the lifetime health cover policy is a 35 year old female, in a working couple with 3 children, the youngest under 5 years old. She smokes regularly and has no long-term illness or disability. Her individual wages are $50,000 and her partner's wages are $70,000. The full details of the index individual are shown in Table 4. The estimated probability of the index individual being in the group that left private hospital cover after 2000 is 46.3%. Figure 3 shows the effect of age on leaving hospital cover after 2000, with all other variables held at the sample mean. Effects based on the index individual are shown in Table 7. In summary individuals who had a higher probability of leaving private hospital cover after 2000 were distinguished by the characteristics listed below. ⎯ Younger age ⎯ Single ⎯ A regular smoker ⎯ No financial assets in 2001 ⎯ Took no financial risks ⎯ Worsening financial circumstances prior to 2001 ⎯ Worsening financial circumstances from 2001 to 2002 ⎯ Being in a non-professional occupation ⎯ Living in a major city ⎯ Overseas born form Africa and the Middle East. Variables with negligible effect on leaving private hospital cover after 2000 included having a disability or long-term health condition and self-assessed prosperity. 10 DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 5. Conclusions Around half of the sample had private hospital cover in 2004, compared with 45% in the Australian population as whole. At least thirty-nine percent of the sample held private health insurance prior to 2000, compared with an actual insurance rate of 30% in the Australian population at that time. The higher insurance rate in the HILDA sample may indicate that loss to follow-up is related to lower probability of purchasing private health insurance. As expected, age was found to be a very strong predictor of health insurance decisions related to the introduction of the Lifetime Health Cover policy. In the HILDA sample those who took up private hospital cover in 2000 as a response to Lifetime Health Cover had higher mean household wages than other insured groups. However this effect disappeared after controlling for other factors. Instead it appeared that those who took up insurance in response to LHC were in fact somewhat less well-off than those who had already taken up insurance prior to the policy. This could be explained in part by the younger age of those who took insurance in response to LHC, who were mostly working age adults. This group may be at a stage where they have greater incomes on average, which are accompanied by greater financial demands than older respondents who were already insured. The multivariable analysis indicates that when comparing age peers in similar circumstances, those who were better off financially had already taken up insurance prior to the introduction of the policy. This could explain why those who took up PHI in response to the LHC policy deadline perceived themselves as less prosperous compared with those who had already purchased insurance. There is therefore some evidence that the LHC policy deadline succeeded in attracting more middle income earners among working age adults into PHI than previously. In many respects however, those who joined because of LHC were very similar to those who joined prior. The group who joined because of LHC may have planned to purchase PHI at a later stage, and so were particularly motivated by the deadline to bring their decision forward and avoid a future penalty. The characteristics of the group who have purchased hospital cover after 2000 however, indicates that the ongoing effect of the policy has been to attract more younger childless couples or singles to purchase hospital cover, at least over the short- term. If the impact of LHC were a response to the deadline and advertising rather than the premium penalty (Ellis & Savage, 2005) then the rate of young people joining around age 30 should drop over time, as the memory of the 2000 campaign fades and the LHC premium penalty comes to be seen as the normal state of affairs. We found that declining financial circumstances were the major reason for dropping hospital cover since the introduction of the LHC policy. It has been suggested that disillusionment with the value of hospital cover is a major reason for dropping PHI since 2000. Although we do not have information about when the recent leavers first purchased insurance, the younger age of the leavers indicates that many in this group may have taken up private hospital cover as a response to Lifetime Health Cover policy, but dropped the cover because of financial difficulties rather than for any other reason. The inclusion of another round of Private Health Insurance questions in future waves of HILDA would help clarify many of these findings and answer further questions raised by this analysis. 11 DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 References Butler JR, 2002, Policy change and private health insurance: did the cheapest policy do the trick? Australian Health Review 25(6):33-41. Dawkins P, Webster E, Hopkins S, Yong J, 2004, Recent private health insurance policies in Australia: health resource utilization, distributive implications and policy options, A Report Prepared for the Department of Premier and Cabinet, The Government of Victoria Doiron D, Jones G, Savage E, forthcoming, Healthy, Wealthy and Insured? forthcoming, The Role of Self-Assessed Health in the Demand for Private Health Insurance, Health Economics Ellis RP, Savage E, 2005, Run for Cover Now or Later? The impact on premiums, threats and deadlines on supplementary private health insurance in Australia. Working paper 2005-020 Department of Economics, Boston University, Boston. Fiebig DG, Savage E, Viney R, 2006, Does the reason for buying health insurance influence behaviour? CHERE Working Paper 2006/1, CHERE, Sydney, 2006. Lu M, Savage E, 2006, Do financial incentives for supplementary private health insurance reduce pressure on the public system? Evidence from Australia, CHERE Working Paper 2006/11, CHERE, Sydney, 2006. Palangkaraya A, Yong J, 2005, Effects of Recent Carrot-and-Stick Policy Initiatives on Private Health Insurance Coverage in Australia. The Economic Record, Vol. 81 (254) :262-272. Schofield D, Fischer S, Percival R, 1997, Behind the decline: The changing composition of private health insurance in Australia, 1983-95, NATSEM Discussion Paper No. 18 Vaithianathan R, 2004, A Critique of the Private Health Insurance Regulations, The Australian Economic Review, vol. 37, no. 3, pp. 257–70 Walker A, Percival R, Thurecht L, Pearse J, 2005, Distributional impact of recent changes in private health insurance policies, Australian Health Review 29 (2): 167- 177 12 DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 Tables Table 1: Distribution of private hospital cover choice categories in 2004 (Wave4) N Sample % Joined prior to lifetime health cover 3,539 38.5% Joined in 2000 in response to LHC 567 6.2% Joined after the introduction of Lifetime Health 448 4.9% Cover Dropped after the introduction of Lifetime Health 424 4.6% Cover Left prior to the introduction of Lifetime Health 1,857 20.2% Cover Never held private hospital cover 2,361 25.7% Table 2: Comparison of selected demographic, financial, family and health variables in 2001 (Wave1) across private hospital cover groups Joined Joined Joined Left HILDA WAVE1 variables before LHC after Left After before Never Total N 3,539 567 448 424 1,857 2,361 9,196 % 38.5% 6.2% 4.9% 4.6% 20.2% 25.7% 100.0% Mean age (years) 49.3 42.4 36.7 41.8 53.0 39.8 46.2 Female (%) 55.0 50.8 55.4 55.2 54.8 51.3 53.7 Major city (%) 63.7 62.3 69.2 59.2 46.0 51.9 57.1 Couple with children 36.2 51.2 27.5 31.8 25.6 33.6 33.7 Single no children 18.3 16.6 31.5 31.1 29.4 34.7 25.9 Tertiary qualification (%) 27.7 34.7 32.8 16.8 8.8 13.1 20.3 Smoker (%) 13.1 16.6 20.8 29.4 25.5 35.8 22.6 Long term health problem/disability (%) 18.7 13.1 17.2 24.5 35.2 23.4 23.1 Self-assessed health good or better (%) 87.9 88.9 92.1 85.6 74.9 81.2 83.7 Born in Australia 79.2 77.4 70.8 79.3 77.8 71.7 76.5 Self-reported finance worse prior 12 mths (%) 2.4 2.5 1.6 7.8 4.1 3.3 3.2 Household wages ($) $60,130 $70,241 $61,341 $46,763 $25,717 $32,599 $46,179 Individual benefits $1,886 $1,159 $1,995 $3,171 $5,787 $5,116 $3,523 Change in house wages 2001-02 ($) $345 $3,183 $6,939 -$4,576 -$297 $634 $559 Change in household benefits 2001-02 ($) $396 $307 -$553 $1,077 $628 $511 $452 13 DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 Table 3: Goodness of fit summary for multinomial logit, and multinomial probit models (multinomial probit estimated with 200 simulations) Multinomial probit Multinomial probit Multinomial logit (restricted) (unrestricted) N 8,686 8,686 8,686 parameters estimated 330 330 344 Log likelihood -10211 -10286 -10264 AIC 21081 21231 21215 McFaddens R-square 0.216 .210 .212 Table 4: Characteristic of index individuals and probabilities of each choice for selected alternatives Variable LHC index individual Joined After index individual Left After index individual Age 40 years old 29 years old 35 years old Sex male female female Region major city major city major city Relationship partner partner partner Individual wages I $100,000 $60,000 $50,000 Individual benefit $0 $0 $0 Disability no disability no disability no disability Language English only English only English only Qualifications tertiary Diploma diploma Country of birth Australia Australia Australia Change in household wages $20,000 increase in household $25,000 increase in household $40,000 decrease in 2001 to 2002 wages wages household wages Change in household benefits no change in household no change in household $10,000 increase in 2001 to 2002 benefits benefits household benefits Change in household $50,000 increase in household $40,000 increase in household no change in household financial assets 2001 to 2002 financial assets financial assets financial assets Married previous 12 mths not recently married not recently married not recently married Family illness or injury recent family illness recent family illness recent family illness previous 12 mths Lost a job lost a job lost a job lost a job Previous 12 mths Financially worse previous 12 Not financially worse the last 12 Not financially worse the last 12 financially worse the last 12 mths mths mths mths No of resident children 1 child no children 3 children Age of youngest resident youngest child 5-14 yrs youngest child < 5 yrs child Partner's wage partner's wages $0 partner's wages $80,000 partner's wages $70,000 Regular smoker non-smoker non-smoker smoker Own financial assets no financial assets negative financial assets positive financial assets $0- <-$10,0000 $10,000 Partner's financial assets no financial assets negative financial assets positive financial assets <-$10,0000 $0-$10,000 Financial risk behaviour takes average financial risks takes high financial risks takes no financial risk Self-assessed prosperity considers self very prosperous considers self very prosperous considers self poor Exercise exercises 3 times weekly exercises less than weekly exercises less than weekly Probabilities of each private health insurance choice alternative estimated from multinomial probit Joined Prior 0.578 0.702 0.258 Joined because of LHC 0.361 0.047 0.015 Joined After 0.039 0.224 0.004 Left After 0.008 0.014 0.463 Left Prior 0.006 0.010 0.248 Never 0.007 0.003 0.015 14 DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 Table 5: Variables that demonstrate changes in the probability of purchasing private health insurance because of LHC (base is index individual in Table 4, except where indicated): change in probability of LHC is compared with change in probability of Left Prior Level Reference level Change in Change in (LHC index probability probability individual) LHC Left Prior Female Male -0.043 0.049 No children 1 child -0.022 -0.013 3 children -0.086 0.075 Youngest Child < 5 yrs Youngest Child 5-14 -0.037 0.044 Age 50 Age 40 -0.077 0.107 Age 29~ -0.124 -0.144 Regional Australia Major city 0.049 -0.061 Non-English speaking English only 0.047 -0.059 background Born Asia/Oceania # Australia 0.037 -0.128 Born Africa/Middle East# -0.036 -0.032 Wages $0 $100,000 -0.054 -0.157 Wages $160,000 -0.030 0.051 Wages $180,000 -0.042 0.066 Wages $200,000 -0.055 0.081 Wages $220,000 -0.067 0.095 Wages $240,000 -0.079 0.109 Wages $300,000 -0.115 0.150 Partners wages $60,000 $0 -0.045 0.045 Partners wages $80,000 -0.061 0.065 Partners wages $100,000 -0.078 0.085 Partners wages $120,000 -0.094 0.104 Partners wages $140,000 -0.110 0.123 Partners wages $160,000 -0.126 0.141 Couple's financial assets No financial assets -0.095 0.123 (neg) < -$20,000 Couple's financial assets -0.179 0.221 (pos) $80,000-$100,000 No family illness/disability Recent family illness -0.046 0.026 Just married~ -0.117 0.048 Getting by financially Very prosperous 0.078 -0.084 Exercise < 1 weekly 3 times weekly -0.062 0.047 # base = LHC Index individual from Non-English speaking background ~ base = LHC Index individual no children 15 DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 Table 6: Variables that demonstrate changes in the probability of joining private health insurance after 2000 (base is index individual in Table 4, except where indicated) Level Reference level Change in (Joined After probability index individual) Born Asia/Oceania# Australia 0.183 Born Africa/Middle East# 0.101 Born Europe# 0.086 Non-English speaking background English 0.059 Disability or long-term illness No disability 0.044 1 child no children -0.082 Single ~ With partner 0.038 40 year old 29 years -0.171 No financial assets < - $20,000 0.119 Wages $140,000 $60,000 -0.032 Wages $160,000 -0.041 Wages $180,000 -0.049 Wages $200,000 -0.058 Wages $220,000 -0.066 Wages $240,000 -0.074 Wages $260,000 -0.082 Partner's wages $150,000 $80,000 -0.034 Benefits $10,000 Benefits $0 0.047 Increase benefits $10,000 2001 to 2002 No increase -0.038 Tertiary qualification Diploma 0.031 Other qualification 0.052 School only 0.069 Manager Professional -0.037 Trade -0.038 Service -0.036 Clerk -0.043 Production job * -0.090 Elementary job * -0.039 Agricultural worker ^ -0.044 Not lost job last 12 months Lost job -0.038 Financially worse off last 12 months Not worse -0.054 No exercise < 1 weekly -0.047 Takes no financial risk High risk 0.042 # base = Index individual from Non-English speaking background ^ base = Index individual from remote area ~ base = Index individual no children, no partner's wages or financial assets * base = Index individual school only 16 DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 Table 7: Variables that demonstrate changes in the probability of leaving private hospital cover after 2000 (All other variables held at the level of the index individual in Table 4 unless otherwise indicated) Level Reference level Change in probability Non-English speaking English speaking -0.065 background Born Asia/Oceania# Born Australia 0.054 Born Africa/Middle east# 0.147 Wages $120,000 $50,000 -0.040 Wages $140,000 -0.062 Wages $160,000 -0.089 Wages $180,000 -0.118 Wages $200,000 -0.148 Wages $220,000 -0.179 No children 1 child -0.028 Single ~ Partner 0.038 Professional -0.063 Regional Major city -0.031 Remote -0.031 Not lost job last 12 months Lost job -0.049 Age 45 Age 35 -0.133 Age 60 * -0.153 Couple's financial assets (pos) $0-$20,000 -0.124 $60,000-$80,000 Couple's financial assets (neg) -0.093 < -$20,000 Financial assets $0 0.032 Non-smoker Smoker -0.058 No change in benefits 2001 to $10,000 increase -0.047 2002 Not financially worse last 12 mths Financially worse -0.160 No change in household wages $40,000 decrease -0.035 2001 to 2002 Exercise 3 times weekly < 1 weekly -0.051 No exercise -0.035 Takes high financial risk Takes no risks -0.062 # base = Index individual from Non-English speaking background * base = Index individual no children ~ base = Index individual no children, no partner's wages or financial assets 17 DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 Figure 1 Marginal effect of age on the probability of Joined Because of Lifetime Health Cover, all other variables held at the sample mean 0.2 0.18 0.16 0.14 Probability 0.12 0.1 0.08 0.06 0.04 0.02 0 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56 58 60 62 64 66 68 70 age Figure 2 Marginal effect of age on the probability of Joined After 2000, all other variables held at the sample mean 0.4 0.35 0.3 Probability 0.25 0.2 0.15 0.1 0.05 0 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56 58 60 62 64 66 68 70 age 18 DRAFT ONLY For Discussion HILDA Conference Melbourne University July 2007 Figure 3 Marginal effect of age on the probability of Left After 2000, all other variables held at the sample mean 0.2 0.18 0.16 0.14 Probability 0.12 0.1 0.08 0.06 0.04 0.02 0 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56 58 60 62 64 66 68 70 age 19
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As expected, beach was busy on a Sunday afternoon when we were there. There were construction at a section on the beach. Beach was great ! It feels so nice walking on shallow...
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We really enjoyed the beach. Dolphins swimming and we watched them put on a show for a while. Every thing clean. Wishing grandkids where with us. A lot of people but not over crowd. Very relaxing
As expected, beach was busy on a Sunday afternoon when we were there. There were construction at a section on the beach. Beach was great ! It feels so nice walking on shallow water. Great place to look for shark teeth on shore!! There is a small place where you can get a snack. Music was also being played. There...
Nice beach off the Esplanade, although a lot of construction equipment on sand - not sure if it was due to construction or beach remediation. nice shelling along shoreline.
First time to Venice Beach--the work being done to save the beach was making great progress the week we were there. Kinda interesting how they're doing it. Enjoyed time at the beach and returned for sunset. So Pretty !
Lovely spot. Sometimes crowded. Food available throughout the day. Free music some evenings. Free yoga on the beach - 2 sessions in the morning and one at sunset.
When the Gulf is calm and you want the children to enjoy Florida take the Family to Venice Beach, walking... making sand castles with your children ....or better yet the GRANDCHILDREN
******Please NOTE the Beach is being refurbished from off shore
but there's plenty of sand to LOVE
Not too busy, close to downtown with a snack area,
Don't forget to look at shark teeth ...... Watch the people around and you will understand.
Those are millions years old .... Really nice with children
This beach was great, clean, not too crowded, my wife and sister-in-law had a great time looking for sharks teeth, you can rent a scoop with handle for sifting for 5 bucks at sharkys. They each found about 20 sharks teeth. A friend told us the traffic down here was better, took 40 min from Bradenton, was 1:00 to drive...
What is not to like? Clean, spacious, white sand, crystal blue waters, Sharkys is nearby, ample parking, and hunting for sharks' teeth can keep kids occupied all day. One of my favorite beaches in Florida is Venice Beach for all of these reasons. It is truly a beautiful place to relax without the crazieness of South Beach. This is a...
This is a nice beach. Got here early to get parking. The lot was pretty full at 9:30am. Just as we got to the beach a very large yoga class was dispersing. Public restroom by parking lot. Also a convenience store at the end of the lot. Nice, quiet beach. Got pretty crowded. There were dozens of baby sting rays...
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Nike athlete and star striker Christin Press takes us on the field.
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15 E Hazel Dell Ln
Springfield, IL 62712-0217
Springfield, IL 62712-0217
Tel: (217)585-5122
At The Hope School Learning Center, all students have an Individualized education plan, which includes goals such as self-help skills and daily living activities.
A strong emphasis is placed on the development of communication skills.
In addition to using pictures and sign languages, language activities include the use of specially designed Augmentative / Alternative Communication equipment, adapted computer access or other assistive technology equipment.
School Overview
|School Type
|Special Education School
|Grades Offered
Student Body
|Total Students
|154 students
|Student Body Type
|% Students of Color
State avg.: 32%
Academics and Faculty
|Total Classroom Teachers
|21 teachers
|Student : Teacher Ratio
National avg.: 13:1
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SpringfieldConcordia Lutheran School
2300 E Wilshire Rd
Springfield, IL 62703
(217)529-3309(Lutheran Church -- Missouri Synod)0.8 mi | 103 students | Gr. PK-8
SpringfieldLittle Flower Catholic School
900 Stevenson Dr
Springfield, IL 62703
(217)529-4511(Roman Catholic)1.9 mi | 330 students | Gr. K-9
SpringfieldSt. Patrick Catholic School
1800 S Grand Ave E
Springfield, IL 62703
(217)523-7670(Roman Catholic)3.1 mi | 66 students | Gr. K-9
SpringfieldGrace Baptist Academy
2812 S Walnut St
Springfield, IL 62704
(217)522-2881(Baptist)3.2 mi | 12 students | Gr. 1-12
SpringfieldBlessed Sacrament
748 W Laurel St
Springfield, IL 62704
(217)522-7534(Roman Catholic)3.8 mi | 450 students | Gr. PK-8
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Bitterness lies beneath Vietnam's celebration
Monday 01 May 2000
Vietnam mounted a triumphal display of communist pageantry yesterday to celebrate the 25th anniversary of the end of the Vietnam War but the festivities came amid disquiet about the future.
Thousands of veterans, serving troops and children hailed the victory in a two-hour celebration in Ho Chi Minh City, formerly Saigon. Revolutionary music and folk songs boomed through loudspeakers as trucks carried past floats of Ho Chi Minh, the former leader. Officials paid tribute to the 3 million Vietnamese soldiers and civilians killed; 58,000 US troops also died.
While the theme of the 20th anniversary of the war's end was reconciliation, five years later Hanoi has sharpened rhetoric about US brutality.John McCain, who competed with George Bush Jr this year for the Republican presidential nomination, suggested on Friday that the "wrong guys won". Hanoi retorted by accusing the US of "horrendous crimes". The exchange exposed the bitterness that remains despite efforts to foster relations between Hanoi and Washington. The White House indicated that President Bill Clinton may visit in November, when he will be in South-East Asia for a trade summit.
Mr McCain, who spent five years as a prisoner in Vietnam after his plane was shot down, said such a visit may be premature. "I still bear them ill-will," he said after visiting the site of the "Hanoi Hilton", where he was held. "Not because of what they did to me but because of what they did to some of my friends, including killing some of them".
In Washington the anniversary of the fall of Saigon passed with muted observances at the Vietnam veterans' memorial, a wall bearing the names of the American dead. Veterans were at the wall at dawn on Saturday to wash it. They included Michael Lay, 52, who served as a medic in the US Army. "I feel like I've just cleaned up my guys. Close your eyes, and 25 years is only a breath away."
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Masters Tickets…There's Still Time
If you're new to our course, you may want to subscribe to our RSS feed. Thanks for visiting!There's only nine days left to The Masters so there isn't much time left to get those tickets but all hope is not lost. A quick search of eBay, Stub Hub or Cheap Seats will show there are some tickets available, if you're willing to lay out some serious, serious cash. Monday practice rounds are going for $350 while a Wednesday ticket which… Continue Reading


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On the anniversary of the passing of JoePa, this is the house that Joe Built. We will be forever grateful for the contributions he made to Penn State and the community, as well as all the wonderful young men that he helped to shape. His reach was far beyond the football field. He was and remains a shining example of "success with honor" Thanks, Joe. It was an honor to have you in our midst.
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1950 Bentley MK VI '50 Bentley MK IV, right hand drive, 2 tone black and yellow with tan interior, sunroof, excellent same elderly owner for... More
Talk about a sweetheart, WOW WHAT A FIND! 1953 Chevrolet Bel Air 2 door sedan finished in the period correct Baby Blue with a... More
Free Shipping For a Limited Time* 1952 Packard 200 Deluxe Check out this stunning 1952 Packard 200 Deluxe. The Packard 200 Deluxe, for 1952, had some... More
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Here is a prime example of a 1953 Kaiser-Frazer Henry-J Corsair Deluxe built in the Willow-Run, Michigan assembly plant in early 53. This vehicle... More
1951 Chevrolet Bel Air two door hardtop,just out of lengthy storage.The body has had some previous repair,done many years ago,but it has an excellent... More
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I have always wanted one of these Jeepsters. Now I own one. I went to look at a '57 Ford Thunderbird and I missed... More
1950 Ford 2dr sedan, great straight body and paint, new chrome bumeprs, new grill and wood in bed, nicely redone int and orig flathead v8,... More
1950 Packard 4 Door. 8 cyl, standard trans with overdrive. Nice paint and original interior. No rust, very solid.... More
1952 MGTD replica from Fiberfab, & finished in 1986 & titled as a 1986 Composite. with a reconditioned rear engine VW engine, & w... More
vin #HDK43/19444, best design and function of the MG sports cars, orange exterior, black interior, black top, black side curtains, black tonneau cover, black... More
1950 Mercury, suicide doors, 7k miles on rebult flathead v8, 3 speed o/d, rechrome front and rear bumpers, 92,xxx on car, nice paint, newer... More
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Grand Pineapple Beach Negril - All Inclusive, Negril
Situated on the beach in the heart of Negril, Grand Pineapple Beach Negril - All Inclusive is close to Times Square Mall, Throne Room, and Negril Hills Golf Club. Additional attractions near this all-inclusive resort include Royal Palm Reserve and Kool Runnings Water Park.
Property Features.
At this all-inclusive property meals and beverages at onsite restaurants and bars are included in room rates. Taxes and gratuities, recreational activities, and entertainment may be included. Charges may apply for dining at some restaurants, special dinners and dishes, some beverages, and other amenities.
Grand Pineapple Beach Negril - All Inclusive has a full-service spa and an outdoor pool. Wireless Internet access is available in public areas (surcharges apply). Event space measures 693 square feet (62 square meters). This beach resort offers a restaurant and a bar/lounge. Additional amenities include spa services, a terrace, and gift shops/newsstands. For a surcharge, guests have access to a roundtrip airport shuttle (available on request).
Rooms open to furnished balconies or patios. The 65 air-conditioned guestrooms at Grand Pineapple Beach Negril - All Inclusive include safes and coffee/tea makers. Complimentary wireless high-speed Internet access is provided. Rooms are equipped with flat-screen TVs with cable channels. Bathrooms offer hair dryers and complimentary toiletries. Additional amenities include irons/ironing boards and blackout drapes/curtains. Housekeeping is offered daily.
Great value for the money. I was there for 9 days and was very happy with this resort. I…
Highly recommend! Great location and staff ! Great food !
Enter dates to check prices
Hotel Info: 866-539-8117
- Beachside Double Manor Building
- Gardenside Double Manor Building
- Gardenside Double
- Beachside Double
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At a glance
Key facts
Hotel size
- This hotel has 65 rooms
- This hotel is arranged over 2 floors
- Check-in time starts at 3 PM
- Check-out time is noon
Required at check in
- Credit card or cash deposit required
- Government-issued photo ID required
Travelling with others
- Pets not allowed
Extra people
- Roll-away beds available, charges may apply*
- WiFi in public areas *
- Free WiFi in rooms
- Airport shuttle (available on request) *
Other information
- All-inclusive
Nearby Three Star Negril hotels
In the hotel
- Restaurant
- Bar/lounge
- Beach sun loungers
- Beach towels
- Outdoor pool
- Full-service spa
- Spa treatment room(s)
- Kayaking on site
- Sailing on site
- Scuba diving on site
- Snorkeling on site
- Ecotours nearby
- Golfing nearby
- Rafting nearby
- Conference space size (feet) - 693
- Conference space size (meters) - 62
- One meeting room
- 24-hour front desk
- Dry cleaning/laundry service
- Garden
- Terrace
In the room
- Air conditioning
- Coffee/tea maker
- Iron/ironing board
- Blackout drapes/curtains
- Furnished balcony or patio
- Private bathroom
- Free toiletries
- Hair dryer
- Flat-screen TV
- Cable TV channels
- Free WiFi
- Daily housekeeping
- In-room safe
- Connecting/adjoining rooms available
- Access via exterior corridors
Top Negril hotels
Recently reviewed hotels in Negril
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"What a gem in Negril! Couldn't ask for a more relaxing, friendly place!"Mar 3, 2015
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"Situated on the beach, the Negril neighborhood is a wonderful winter get-a-way destination. The employees are some of the most pleasant I have had the pleasure to meet.Food in the…"Feb 25, 2015
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"I stayed at the Westender Inn for two nights as I was in town for a wedding. The wedding I was coming for was for only 3 nights at an all inclusive resort in Negril. Three nights…"Feb 18, 2015
Nearby hotels
Special features
All inclusive
This resort is all-inclusive. Onsite food and beverages are included in the room price (some restrictions may apply).
Grand Pineapple Beach Negril - All Inclusive, Negril's small print
Also known as
- Gardens Beach
- Pineapple Negril
- Hotel Grand Pineapple Beach Negril
- Grand Pineapple Beach Negril Giamaica
- Negril Gardens Beach Resort
- Grand Pineapple Beach Negril Negril
- Grand Pineapple Beach Negril
- Grand Pineapple Beach Negril All Inclusive
- Negril Gardens
- Negril Grand Pineapple Beach Negril
The property has connecting/adjoining rooms, which are subject to availability and can be requested by contacting the property using the number on the booking confirmation.
We have included all charges provided to us by this hotel. However, charges can vary, for example, based on length of stay or the room you book.


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VIDEO: Blast levels Texas plant; up to 15 dead, 160 injured
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VIDEO: Blast levels Texas plant; up to 15 dead, 160 injured
A huge explosion at a fertilizer plant in West, Texas, left as many as 15 people dead and more than 160 injured as the earthquake-like blast sent fire and embers into the air and leveled scores of
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Comments about 'Letter: Mobile gas trucks could help in Sandy aftermath'
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- Most recommended
Power generators would work fine to supply electricity to the gas station.
If a gas station wanted to remain open without waiting for government people to save them, or to avoid waiting for the power company, they could always get some solar panels set up and run their business using those.
The only question is if they have phone and internet service to process credit/debt card transactions.
- 11:52 a.m. Nov. 6, 2012
- Like (1)
- Report abuse
Mobile fuel trucks are on scene right now. Roads had to be cleared of debris to
allow them to get there, but the administration and FEMA started them rolling
soon after the storm passed. There just aren't enough of them.
One question -- are all those folks out there Democrats? If any are Republicans, why weren't they prepared?
- 12:51 p.m. Nov. 6, 2012
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£525 pcm
3 bedroom cottage to rent Glamis Road, Kirriemuir, DD8 5BU3 bedroom mid terraced traditional stone built cottage with off-street parking in quiet location close to most amenities. Large enclosed garden with shed. Gas central heating and double glazing. Recently redecorated and recarpeted throughout. EPC rating 'D'. Landlord Registration No. 363526/12... More details ›
£475 pcm
3 bedroom terraced house to rent South street, Kirriemuir, DD8 5DGTraditional mid terrace refurbished 3 bedroom cottage with delightful large mature garden, summer house and outhouse. £550 deposit. Council Tax Band 'B' Landlord Registration More details ›
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2 bedroom maisonette to rent Knowehead Crescent, Kirriemuir, DD8Unfurnished, spacious two bedroom upper cottage flat in popular area within walking distance of town centre, Webster's Academy and Southmuir Primary School. Recently recarpeted throughout and tas... ** Property Reference: 57216 ** More details ›
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text: Meta Battle Subway PokeBase - Pokemon Q&A Login Register All Activity Questions Unanswered Tags Users Ask a Question Rules Chat User Timothy Wall Recent activity All questions All answers Answers by Timothy –3 votes 471 views What Pokemon make good weather tanks/stallers? answered Dec 28, 2012 0 votes 75,734 views What is a good Roserade moveset? answered Nov 2, 2012 0 votes 958 views How do I get to newmoon island in platinum? answered Aug 15, 2012 0 votes 10,008 views Can you catch celebi in soul silver without the event? answered Jul 18, 2012 0 votes 82,657 views Good moveset for Kingdra? answered Jun 30, 2012 0 votes 129,151 views What is a good moveset for Gliscor? answered Jun 29, 2012 0 votes 104,423 views What is a good move set for Gallade? answered Jun 29, 2012 0 votes 249,400 views What is a good moveset for Tyranitar? answered Jun 29, 2012 0 votes 21,206 views What is a good moveset for Hitmontop? answered Jun 29, 2012 Useful Meta Posts How to change your username How to add a user avatar Why was my post hidden? The points system Question etiquette Flags vs Downvotes Anime FAQ


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Terry signs new one-year Chelsea deal
Chelsea defender John Terry has signed a new deal with the Blues, keeping him at Stamford Bridge until the end of the 2015/16 season.
Falcao scores twice and assists one for Colombia
Manchester United striker Radamel Falcao scored two goals in five minutes as he returned to international duty with Colombia on Thursday.
VIDEO: Ten footballers that Arsenal, Chelsea and Tottenham have their eye on during the international break
For many, the March international break serves as an inconvenient gap in the domestic calendar just as the Premier League was charging towards its business end.
Olympic Stadium reprieve is possible providing Leyton Orient pay the price
Published: 18 November 2013
Updated: 08:23, 19 November 2013
A House of Lords report today resurrected Leyton Orient's hopes of ground-sharing the Olympic Stadium with West Ham but it remains to be seen whether the League One club can come up with an economically viable solution to use the facility.
A parliamentary select committee on the Olympic and Paralympic legacy said Orient should at least be granted occasional use of the stadium if a fee can be agreed.
The committee's recommendations to the Government will be considered carefully but it has no power to enforce changes. Following the publication of the report, Orient now need to propose a solution that will not cost the taxpayer money. The decision not to allow Orient to groundshare was taken by the London Legacy Development Corporation, whose chief executive Dennis Hone said that it would "cost the public sector money to open the gates to Leyton Orient in a 60,000-capacity stadium because of the club's relatively low existing gates".
West Ham plan to turn the venue into a 54,000-seater stadium in time for the 2016-17 season but Orient's average attendance in League One this season is only 5,296.
The House of Lords report read: "The ongoing dispute over the stadium has been a disappointing distraction. We urge those concerned to think further on how the two most local football clubs might work together, including whether any difficulties can be ameliorated through wider community use of the stadium, which may include its occasional use by Leyton Orient if appropriate financial arrangements can be agreed."
Lord Harris, who chaired the 12-strong committee, said today: "We think it may be possible for it to work in a different way but it has got to be economically viable. You can't open up a huge stadium if there are not enough people going in it to be worthwhile. The most effective use of the stadium has to be in the national interest."
Lord Harris criticised the behaviour of West Ham and Orient during the dispute. He said: "We were slightly disappointed about the rather playground behaviour of some of the football clubs around the future use of the Olympic Stadium."
West Ham and Orient would not comment on Harris's remarks that the two clubs were acting "like children squabbling over who goes down the slide first as far as the stadium is concerned".
Meanwhile, former West Ham skipper Lucas Neill has been offered no guarantees he will captain Australia at the World Cup.
Neill was captain under previous coach Holger Osieck, who was sacked after 6-0 friendly defeats by Brazil and France last month.
There have been calls for Neill, who joined the Hammers in 2007, to lose the captaincy but although he will have the armband for tomorrow's friendly against Costa Rica, new coach Ange Postecoglou said: "They [these decisions] are all one-offs — who is guaranteed about being around next time in any position?"
Top stories in Sport
Sport in Pictures
Are Short Term Loan Companies More Responsible than the Public's Perception of Them?
The short term loan industry has undergone a serious clean-up operation, or has it?
Crowdfunding: The end-end solution for business success.
Calling all entrepreneurs! See how crowdfunding can provide you with a full-circle, end to end solution for your business.


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A&T Chevrolet has been serving as your local Sellersville Chevrolet dealership since 1984. We offer a large selection of new and used Chevy cars, trucks, and SUVs for customers in Souderton, Montgomery County & Sellersville, Bucks County at highly competitive prices. The staff in our financing, service and parts departments strive to exceed your expectations every time and we will take care of you both before and after the sale. Visit our hours and directions page for directions from Souderton or anywhere in Western Pennsylvania.
Serving as your Souderton and Doylestown Chevrolet Dealership
Souderton and Doylestown Chevrolet shoppers can find the full line of cars at A&T Chevrolet. You can find the powerful Camaro or the Malibu and Impala's perfect balance of comfort and performance. If you're looking for great gas mileage see the Cruze, Spark and all electric Volt. We also have the iconic Corvette and sporty Sonic. Sellersville Chevy truck customers can find all the three Silverado models at our dealership. One of these rugged trucks is sure to have the features you are looking for and the durability you expect. Souderton Chevrolet shoppers can find the Tahoe SUV and more nimble Traverse and Equinox crossovers.
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Our Sellersville Chevy dealership in Bucks County has an enormous selection of used cars, trucks and SUVs for you to choose from. Each one is meticulously inspected by our service department to make sure it will meet your needs. Our inventory is updated every day so you know that the vehicle you see on our website is the one you will find at the dealership. If you are an expanding company or a small business making the next step come and see the Express Cargo Van, Express Passenger Van and Express Cutaway. They are sure to meet your needs and you won't find a better price. Contact us for details or get a commitment-free quote for any of our vehicles online.
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U.S. Army eyes big cost cut in 5-year Apache deal with Boeing
WASHINGTON, Oct 13 (Reuters) – The U.S. Army on Monday said
it expected to secure a 10-percent or greater cost reduction as
part of a five-year agreement with Boeing Co for more
Apache AH-64 attack helicopters that it hopes to negotiate for
fiscal year 2017 and beyond.
U.S. Army Colonel Jeff Hager, Apache program manager, told
reporters the Army still needed approval from Pentagon leaders
to proceed, but such a deal would provide greater stability to
Army leaders, Boeing and the larger industrial base.
U.S. Army says it faces huge equipment, training risks with budget cuts
WASHINGTON (Reuters) – The U.S. Army warned on Monday that mandatory budget cuts due to resume in fiscal 2016 would be devastating to a service that is already facing huge risks as it tries to keep forces ready for battle, replace aging equipment and respond to crises around the world.
"We have to have a national security debate … because there is too much going on," U.S. Army Chief of Staff General Ray Odierno told reporters at the annual Association of the U.S. Army (AUSA) conference.
U.S. Air Force probed for scrapping costly planes bought for Afghans
WASHINGTON (Reuters) – A U.S. government watchdog agency is asking the Air Force to explain why it decided to destroy 16 aircraft initially bought for the Afgan air force and turn them into $32,000 of scrap metal instead of finding other ways to salvage nearly $500 million in U.S. funds spent on the program.
John Sopko, special inspector general for Afghanistan reconstruction, asked Air Force Secretary Deborah James to document all decisions made about the destruction of the 16 C-27J aircraft that were stored at Kabul International Airport for years, and what the service planned to do with four additional planes now in Germany.
U.S. Navy underscores need for 'lasting fix' for F-35 engine issue
WASHINGTON, Oct 9 (Reuters) – The U.S. military needs a
"lasting" fix to the engine issue that grounded the F-35 fighter
fleet for several weeks this summer, given the importance of the
most advanced U.S. fighter jet for decades to come, a top U.S.
Navy official said this week.
Rear Admiral Mark Darrah, chief engineer for the Navy's
Naval Air Systems Command, said the Navy was working closely
with F-35 maker Lockheed Martin Corp, engine
manufacturer Pratt & Whitney, which is a unit of United
Technologies Corp, the Air Force and the Pentagon's F-35
US Navy uses prototypes, in-house know-how to speed weapons work
WASHINGTON (Reuters) – The U.S. Navy this month launched "AIRWorks," an initiative modeled on Lockheed Martin Corp's Skunk Works and Boeing Co's Phantom Works divisions that aims to develop new weapons more quickly to meet U.S. military needs.
AIRWorks completed several projects over the past year even as it took shape. They included bulletproofing V-22 tiltrotor aircraft built by Boeing and Textron Inc for the Air Force, and adding rockets to the Fire Scout unmanned helicopter built by Northrop Grumman Corp for the Navy.
Foreign sales may offset U.S. cost of Raytheon radar-US Air Force
WASHINGTON, Oct 7 (Reuters) – The U.S. Air Force said
foreign sales of 50 to 100 of the new long-range radar systems
to be developed by Raytheon Co could help lower the cost
of U.S. purchases in coming years.
Dave Allen, the Air Force's lead engineer for the
next-generation radar program, said in an interview on Tuesday
that the program was designed from the start with "anti-tamper"
features and other equipment to enable easier exports.
Raytheon eyes deal with Qatar on Patriot system before year-end
WASHINGTON, Oct 7 (Reuters) – Raytheon Co expects
Qatar and the U.S. government to complete a long-awaited
multibillion-dollar agreement on a "significant" number of
Patriot missile defense systems before year end, a senior
company official told Reuters on Tuesday.
Tim Glaeser, vice president with Raytheon's integrated
defense systems business, gave no exact details on the cost and
number of Patriot batteries involved, but said he expected the
two sides to reach a deal within the next four to eight weeks.
Raytheon wins deal for next-generation U.S. Air Force radar
WASHINGTON, Oct 6 (Reuters) – Raytheon Co beat out
Lockheed Martin Corp and Northrop Grumman Corp
for a contract to build a next-generation long-range radar
system for the U.S. Air Force, the U.S. Defense Department said
on Monday.
The award marks another significant win for Raytheon in the
radar market, a deal valued at around $1 billion, and kicks off
the next phase of a program begun in 2009, when the Air Force
funded work on full-scale prototypes by all three companies.
Boeing to build some 777X parts in St. Louis: sources
PARIS/WASHINGTON (Reuters) – Boeing Co (BA.N: Quote, Profile, Research, Stock Buzz) plans to start building some parts of its 777X commercial airliner at the company's huge defense business facility in St. Louis, a move that will add hundreds of jobs in several years, according to sources familiar with the decision.
The news comes days after Boeing announced plans to shift defense services and support work out of Washington state, a separate and unrelated decision that could also add hundreds of jobs to the St. Louis area, the sources said on Monday.
NATO general calls for 'more bang for the buck' from arms makers
WASHINGTON, Oct 2 (Reuters) – A top NATO general on Thursday
said the alliance needed "more bang for the buck" when it comes
to defense equipment, and urged arms makers to work on making it
easier for countries to use laser-guided missiles and other
weapons on a range of platforms.
Danish Army General Knud Bartels, chairman of NATO's defense
committee, told U.S. defense writers that industry needed to
look beyond pure profits and find ways to help NATO buy weapons
more efficiently under the alliance's new "smart defense"
initiative, including possible bulk buys across member states.


text:
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text:
Tag » craftacular
Neck Candy: Designer Cléo Férin at Craftacular London!
BY Chloé Burrow in DIY on Nov 18, 2011
Last Day to Apply for BUST Magazine Craftacular and Food Fair Holiday 2011!
BUST Magazine Craftacular and Food Fair Holiday 2011 Applications Close on Monday!
Call For Vendors: BUST Magazine Craftacular and Food Fair Holiday 2011 NYC!
BUST Magazine Craftacular at World Maker Faire NY Photo Gallery
On Newsstands Now: Apr/May 2015
Trending on BUST
Upcoming Events
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Mon Apr 06 @ 7:00PM - 11:00PM
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Sun Apr 12 @ 3:00PM - 07:00PM


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Things to do when the internet is down. | Now I understand why I see so many people acting as strangely as they do.
Things To Do When The Internet Is Down... Stagger outside and become confused and disoriented by the "real world" lololol
Things To Do When The Internet Is #funny commercial ads #interesting ads #funny commercial #funny ads #commercial ads| http://weddingideas4951.blogspot.com
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Accept the fact that the Internet is down. In case you're stealing your neighbors' wifi. Try to remember their birthdays and use those dates as passwords. Try using a frying pan to strengthen the Wi-Fi signal.


text:
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Crafty Ideas for Easter for the Kids from Happythought
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Karadai Nombu Adai Recipe Cooking Show
Mrs.Sheela cooks Karadai Nombu Adai, typical south indian delicacy. She specializes in simple south inidan brahmin cooking.
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Rumble Tumble you can watch this recipe in a simple and delicious way so try this out and enjoy.
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Pumpkin halwa Recipe Cooking Show
Pumpkin halwa or dumroot recipe is prepared for the Diwali so try this out and enjoy.
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Nope, you haven't been smoking too much sticky icky icky and don't need to rub your eyes. The members of Korn, who've always been hip-hop-friendly, are looking a bit different in their new video. Lil' Jon, Snoop Dogg, Xzibit, and David Banner have kicked out the regular crew and are showing how rock really rolls on this dark, mini-Marilyn Manson monster.
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