Health care and the labor market: learning from the German experience

Many observers have begun to question the U.S. reliance on an employment-based private health insurance system. In thinking about the future of this system, it is instructive to examine the German experience. The German health insurance system is almost entirely organized and financed around the labor market. In recent years, the German labor market has changed in several ways. Among other changes, more German women now work, the proportion of retirees in the population has increased, the share of manufacturing in employment has declined, and the economy has become more open. These labor market changes have made it more difficult to organize health insurance around employment in Germany. Recent changes in the German health insurance system have, to some extent, decoupled health insurance from employment. This decoupling is likely to continue as the labor market changes further. We explore the implications of this experience for the United States.     

Discrepancies in Adolescent Romantic Couples' and Observers' Perceptions of Couple Interaction and their Relationship to Depressive Symptoms

We examined discrepancies in adolescent romantic couple members' and observers' perceptions of couples' conversations in order to further understand adolescents' romantic interactions and their association with adolescents' depressive symptoms. We used a video-recall procedure to assess 61 adolescent romantic couples' perceptions of their videotaped conversations with each other. Our results suggest that although couple members and outside observers agreed that adolescent romantic couples' conversations were generally harmonious, adolescent dating partners and observers perceived couples' communications in systematically different ways and perceived inequalities in their interactions. Perceptions of discrepancies in power were more salient in females' perceptions. Both males and females perceived themselves more positively than their partners. Finally, discrepancies in couple members' perceptions of their conversations were somewhat associated with their mental health. Boys who viewed themselves more favorably than their girlfriends viewed them exhibited fewer depressive symptoms. Girls who perceived fewer inequalities between themselves and their boyfriends showed fewer depressive symptoms.     

Psychological mindedness and abstract reasoning in late childhood and adolescence: An exploration using new instruments

This study introduces two new measures of psychological mindedness, applying them in a study of the growth of abstract thinking in children and adolescents in a developmental design. The capacity to achieve psychological understanding of the self and of others involves comprehension of the motives, attitudes, and characteristics of the self and others. Psychological mindedness toward the self (PS) and toward others (PO) may be seen as complex cognitive capacities that should show a pattern of related development in childhood. Three groups of 60 fifth, eighth, and twelfth graders completed two measures of formal operations and two instruments to assess the two components of psychological mindedness. We find that psychological mindedness and abstract thinking both increase significantly with age, although the relationship between them is complex and varies with gender and age. Because the development of abstract reasoning skills does not correlate with the development of psychological mindedness in a simple way, a more complex model is necessary, taking age and gender differences into account. Performance on the two measures of psychological mindedness is found to be largely unrelated, suggesting that these are two different psychological skills. Implications of these findings are discussed, with special reference to education, peer counseling, and psychotherapy.Received Ph.D. from University of Michigan and psychoanalytic training from The Michigan Psychoanalytic Institute. Main research interests are psychoanalytic theory, the therapeutic alliance, and insight and self-observation.Received Ph.D. from University of Michigan. Main research interests are adolescent development, peer counseling, short-term psychotherapy, and the psychology of women.Received M.A. from The University of Michigan. Main research interests are infant mental health and attachment theory.Received M.A. from The University of Michigan. Main research interests are gender identity and children of divorce.Received B.A. from The University of Michigan. Main research interests are gender issues and adolescent development.     

New Vision for Old Ties

On the 40th anniversary of the normalization of China -U.S. diplomatic relations, a diverse group of diplomats, athletes, entrepreneurs and economists has advocated a more creative approach to resolving trade tension between the two largest economies in the world, with the bottom line that the bilateral relationship had endured in the past and would continue to do so in today's era of greater engagement.     

Aligning Ideologies and Institutions: Reorganization in the HIV/AIDS Services Administration of New York City

How effective was organizational reform implemented inside one critical New York City health agency? Specifically, we examine the extent to which the reorganization of the HIV/AIDS Services Administration (HASA) into the Medical Insurance Services Administration (MICSA) achieved three goals: (1) realizing synergies among the component MICSA programs; (2) cross‐fertilizing ideas among MICSA agencies; and (3) facilitating HASA operations through the lens of organization change theory. Qualitative methods including interviews, site visits, and document analysis triangulate the effects of the reorganization. Implications for organization change literature are explored, especially highlighting where more theoretical and empirical studies are needed.     

Stray bullets and “mushrooms”: Random shootings of bystanders in four cities, 1977–1988

Bystanders killed by bullets not specifically intended for them have long been a very small part of the homicide problem. But the frequency of press accounts of such killings and woundings has apparently increased nationally in recent years. To test this impression, we compiled all shootings of bystanders hit at random and reported in the published indexes of theNew York Times, theLos Angeles Times, and theWashington Post for 1977–1988, as well as a key word computer search of stories in theBoston Globe. We found a rapid increase in both bystander woundings and killings since 1985 in all four cities. The base rate was quite low, and total bystander deaths appear to comprise less than 1% of all homicides in these cities. Nonetheless, the numbers were large enough to show that most bystanders reported shot in New York and Los Angeles are victims of random shootings into crowds, rather than single stray bullets striking a lone individual mushroom. The reverse was true in Boston and Washington, with the effect of much lower rates of bystanders reported shot in those cities.