Sharing governmental authority: Blue Cross and hospital planning in New York City.

Hospital planning in New York has been since the 1930s an intensely political process with high stakes. The leaders of Blue Cross and their allies used the hospital planning process in the city and the state as a means to extend and protect corporate authority in what they took to be the public interest. When Blue Cross was established in the 1930s, its leaders used the mechanisms of formal planning as part of their solution to pressing problems in the organization and distribution of hospital services. In the decade after World War II, Blue Cross had an immense impact on hospital planning in New York as a result of its growth and its underwriting policies. Conflicts between Blue Cross and state regulators beginning in the 1950s led to a new formulation of the politics of planning. Blue Cross became a partner with the state in regulating hospitals. The state and Blue Cross behaved as co-regulators until the 1980s. The interpretation in this paper revises the earlier accounts of health politics in New York by Law (1976) and Alford (1975).     

Seeking common ground: a history of labor and Blue Cross.

In recent years, voluntary health insurance costs have become a major source of friction in labor-management negotiations. What was once a "fringe" has led to job actions, strikes, and intensive bargaining. We examine the history of labor's participation in New York Blue Cross from the 1930s to the recent past and show that labor's participation in the plan was crucial to Blue Cross's success in the plan's early decades. By the late 1950s, serious tensions developed over rate increases and the participation of labor in Blue Cross governance. Ultimately, the issue was one of the control over what was provided by the plans and who would pay for the costs of care. We posit that labor was never able to achieve an important role in the control of the third-party payer, and in the antilabor environment of the 1980s this proved detrimental to labor's interests.     

A cure for the Blues: resolving nonprofit Blue Cross conversions

This Article analyzes the issues involved in converting nonprofit Blue Cross organizations to for-profit status. These issues have arisen in the context of litigation regarding the "reorganization" of Blue Cross and Blue Shield of Missouri ("BCBSMo"). BCBSMo had reorganized by creating and transferring a majority of its business to a new for-profit subsidiary. Missouri consumer groups and state regulators characterized the "reorganization" as a conversion requiring BCBSMo to transfer its assets to a foundation dedicated to charitable health purposes. BCBSMo, however, denied that it had any obligation to leave behind its assets in the nonprofit sector. The BCBSMo litigation raises issues common to most conversions of nonprofit healthcare organizations, particularly conversions of nonprofit Blue Cross plans. This Article provides a road map for state regulators and the public to follow in ensuring that the public interest is fully protected in such conversions.     

The failure of environmental regulation in New York

This study uses public-domain documents to describe the complicity of government actors (including current and former environmental regulators) with organized criminals, in facilitating crimes against the environment within two waste industries of New York State. Qualitative analysis results indicate that a combination of changing market forces, inadequate environmental regulation, and various failed policies and practices of the New York Department of Environmental Conservation can explain the presence, activities, and resilience of organized crime in the construction and demolition debris disposal, and also medical waste incineration industries, as well as provide some preliminary recommendations for preventing further regulatory failure in that state.     

论加强中央集权与强调政策执行自治权的两面性——对布莱尔时期新工党政策执行的思考

布莱尔执政时期比任何以前的工党政府更加坚持政府改革,注重提供公共服务的质量。“公共服务的提供”已经成为新工党的执政重点。与传统的自上而下公共服务提供方式和保守党政府时期强调“市场化”方式不同，新工党革新与改善政策执行的方法是基于“两面性”的基础之上——加强中央的集权与控制．同时强调给予政策直接执行者更多的自治权与自主性。本文旨在对布莱尔执政时期所进行的公共服务改革进行总结和分析，以期对研究布朗政府政策执行有一定的借鉴意义。     

Panopticism and financial controls

This article examines financial controls, including accounting and auditing, as an anti-corruption methodology in public administration. Part I places accounting and auditing in the context of the anti-corruption project, the reformist pursuit of corruption-free government. Part II presents a case study of the evolution of anti-corruption accounting and auditing strategies in New York City. Part III examines the impacts of more comprehensive and intrusive financial controls for contemporary public administration.     

The public presentation of Blue Cross, 1935-1965.

I explore the public presentation of Blue Cross, examining in detail the political, cultural, and institutional messages that shaped its advertising. Blue Cross advertisements had the twin purpose of attempting to increase the number of its own subscribers while criticizing the idea of a national health insurance policy. These twin aims did structure the Blue Cross campaigns but may well have worked at cross-purposes.     

Building Bridges for Babies in Foster Care: The Babies Can't Wait Initiative

In 2001, the New York State Permanent Judicial Commission on Justice for Children, chaired by New York State's Chief Judge Judith Kaye, developed the Babies Can't Wait Initiative to maximize the well‐being and permanency prospects of infants in foster care. This court‐based innovation became a path to healthy development for babies in foster care, a bridge to unprecedented collaboration among the New York City Family Court, child welfare system, and service providers and merged knowledge about child development with court and child welfare practice. This article tells the story of the Babies Can't Wait Initiative—its creation, implementation, successes, and lessons.     

Blue Cross/Blue Shield-sponsored prepaid individual practice

The HMO is no longer a fledgling idea in the Blue Cross/Blue Shield System. There are 45 Blue Cross/Blue Shield Plans throughout the country which sponsor a total of 54 HMO programs with about 1,040,000 members. Among those 54 programs are staff models, group models, Individual Practice Associations (IPAs), and other structures. This analysis is confined to the Minnesota affiliate corporation, "HMO Minnesota."     

政府权力市场化的经济法规制

政府是经济发展和社会运行的调控者和参与者。政府权力的行使是实现民生和发展目标的重要路径,但存在自利属性和权力市场化倾向,主要表现为投资行为的越位、经济角色的错位、公共产品供给的缺位。这些问题产生的主要根源是制度供给不力或不足,使政府较容易利用掌握的公共行政权力谋取利益。经济法因其法益目标和干预手段的特殊性,天然地具有对权力行为进行调适的能力。故而,在考量和整合多重利益范畴的基础上,构建完善的经济法规制策略,是克服政府权力市场化的可行路径。     

城市拆迁的利益博弈与规制思路

在我国的城市化进程中,城市拆迁实质上是一场艰苦的＂利益博弈＂;从博弈的结果看,有相当一部分被拆迁人的私人利益受到了严重侵害,而假借公共利益之名的政府利益、开发商利益却得以不同程度的增加。城市拆迁已经造成了严重的利益冲突及社会冲突,亟待从根本上予以解决。鉴于政府利益异化、政府角色冲突是引发该问题的主要原因,本文提出了以约束政府不当行为为中心的规制思路,即应充分运用政治及法律手段,对城市拆迁中各级政府滥用公共利益的违法违规行为进行严格约束。     

Capture and culture: organizational identity in New York Blue Cross.

This article explores the changing corporate culture of New York's Blue Cross and Blue Shield plan in its first fifty years. As the plan grew, corporate culture evolved over four sequential phases: the plan first had the character of an experiment, then that of a movement, a business, and, most recently, a corporate agglomerate. Accompanying this evolution has been an identity crisis, as the need to adapt to a turbulent environment has challenged the plan's settled understanding of its core values, namely, voluntarism, community, and cooperation.     

新型农村合作医疗框架中政府角色的理性定位

基于农村合作医疗的公共利益属性,政府参与农村合作医疗建设是其必须承担的义务,这也是被实践证明的事实。20世纪50年代,政府以"引导者"身份号召建立农村合作医疗制度;21世纪初,政府以"主导者"身份全面参与新型农村合作医疗制度建设。今后,若要实现新型农村合作医疗可持续发展,必须对政府准确定位。随着社会建设理念的强化以及政府职能转变的深化,以法律形式将政府定位为"指导者",并以此身份参与新型农村合作医疗制度建设,是新型农村合作医疗持续、健康、稳步发展的关键。     

公用事业特许与政府规制——中国水务民营化实践的初步观察

水务民营化,某种意义上是基础设施领域“公私伙伴关系”的重构,由于水务行业在特定地区内的规模经济效应和自然垄断特征,因此有必要通过招标投标的形式展开缔约前的竞争,并对公用事业特许协议的延展、终止与变更,也适用特别的规则。而出于公共性确保的需要,政府还要对特许后的公用事业予以后续规制,这主要包括价格规制、质量规制、对普遍服务义务和公众参与及知情权保障的要求等四个方面。     

民营化、规制改革与新行政法的兴起——从公交民营化的受挫切入

我国当下公交民营化改革普遍受挫的背后隐藏着异常复杂的政府规制课题。作为公私部门合作治理的有益尝试,特许经营是我国公交民营化改革的基本路径。面对公交领域特许经营的诸多困境,地方政府应当尽快实现由"冲锋陷阵"的执行者向"身居幕后"的保障者的角色变迁,在坚守法治精神和契约规则的基础上切实担负起后民营化阶段的规制责任,努力促进公共福祉的提升。在公私合作的崭新背景下,通过对具体行政领域规制过程的观察和政策面的关怀,以回应真实世界为己任的新行政法已然兴起。     

政府对新闻自由管制标准管窥

新闻自由与政府管制是一对矛盾的统一体 ,没有政府管制的新闻自由会导致对公共利益和私人利益的侵害 ;没有新闻自由的政府管制会导致专制与独裁。对新闻自由的管制 ,最重要的是确定管制标准。美国的新闻自由管制标准主要有“明显且即刻危险原则”和“逐案权衡原则”。我国宜在区分“公言论”与“私言论”的基础上 ,分别借鉴“明显且即刻危险原则”和“逐案权衡原则”确立对新闻自由管制的标准。     

Whose business is your pancreas? Potential privacy problems in New York City's mandatory diabetes registry

This article examines a recent New York City health regulation that mandates the compilation and storage of individual medical data from nearly all diabetics in a centralized registry. The authors distinguish this novel registry from prior health registries and scrutinize its potential to compromise individual privacy. In order to address privacy and other concerns, the authors offer suggestions for changes to the current statutory framework of the registry that will also be useful when considering the creation of similar public health registries in other cities.     

法律控制的成本分析——以对通奸和黄色短信的法律控制为例

受国家支付能力的限制,法律控制的范围不应过度扩展。在理论上,法律控制的合理边界应当确定在边际控制收益与边际控制成本恰好相等的位置上。因此,为了节省公共资源的投入,国家就要被迫限定法律的控制的范围,甚至会有意保留一些法律空白,许多有害行为因此可以"逍遥法外"。通奸和手机传播黄色短信就属此类有害行为。     

从旭普林公司案看我国法院对国际商事仲裁的监督

运用国际商事仲裁的一般理论和国际商事仲裁立法与实践,结合我国法院就国际商会国际仲裁院仲裁庭根据该院仲裁规则就德国旭普林公司案在我国上海作出的仲裁裁决所实施的司法监督,探讨了国际商事仲裁裁决与涉外裁决、外国裁决和《纽约公约》项下的非本国裁决之间的联系与区别。由此认为本案项下的裁决,既不是我国裁决,也不是外国裁决,而是《纽约公约》项下的非内(本)国裁决。     

实现自由与秩序的良性平衡——对流浪乞讨问题的宪法学分析

收容遣送制度的废止和救助管理办法的建立并没有完全解决许多城市所面临的流浪乞讨问题,因而当今中国各大城市仍然需要在宪法和法律规定的范围内处理这一问题。本文从美国对相关问题的宪政经验出发,探讨地方立法所必须遵循的宪法学原则。和美国类似,中国宪法虽然没有提到乞讨或露宿的权利,但也规定了和这类问题相关的公民基本权利。结合中国和美国的相关宪政经验,本文认为政府并不是绝对不可对乞讨和露宿行为进行限制,而是必须保证这些限制符合宪法的基本要求。第一,它们所针对的是行为,而不是流浪者或乞丐身份。第二,政府只有在具备合法的公共利益的情况下才能限制这些行为。第三,有关规定不得为执法人员提供不受控制的自由裁量权。最后,要实现自由与秩序的平衡,必须建立独立的宪法解释机构,通过司法过程界定公民权利与地方权力的边界。