Changes in corporate organization of the health care system

Health care financing has undergone numerous structural changes over the years. Change continues while extreme growth seriously affects the health care focus. The author examines the multiclass system and health financing trends. Restructuring techniques are also discussed.     

Technology-transfer strategies of DOE's conservation programs

This paper examines the process by which R&D results funded by the Office of Conservation and Renewable Energy (CE) of the US Department of Energy (DOE) have generated commercial applications. It looks at examples of technology-transfer procedures and activitees across three of CE's component offices that correspond to the major energy end-use sectors: transportation, buildings, and industry. On the surface, the conservation programs would appear to have little strategic consistency and, therefore, lack the clear leadership many seek in a technology-transfer program. However, as an alternative to strategic consistency, one may tailor the technology-transfer approach of each program to its unique circumstances. This paper presents case studies of such tailoring, in which the diversity of approaches mirrors the complexity of the energy end-use markets and the private-public interests that must be negotiated to successfully commercialize energy-saving innovations. The paper discusses the lessons learned about the conditions requiring adaptive design and the structures and practices that have been proven effective.     

R&D spinoffs: Serendipity vs. a managed process

This paper describes some of the spinoff benefits that can result from R&D projects, and categorizes them in terms of the dimensions of market and technical newness. These dimensions are discussed with reference to two types of spinoffs: 1) alternative market applications, when the results of an R&D project are subsequently applied to a market or use that differs from the originally intended application, and 2) second-generation technologies, when the technology that was the subject of an R&D project is significantly altered or enhanced in unanticipated ways through subsequent R&D. Examples from the Department of Energy's Energy-Related Inventions Program are integrated into the results of literature review to illustrate key concepts, including core technologies, degrees of market and technology newness, technology robustness, and the nature of connections linking spinoffs to prior R&D investments. The paper concludes by discussing spinoffs as a managerial strategy.     

As outcomes measurement and management become widespread, providers should beware of legal pitfalls

Until new statutes and court decisions clarify the law applicable to outcomes research, providers will continue to face new questions. In the meantime, paying careful attention to satisfying the requirements of existing laws protecting peer review information will put providers in the best position to minimize their exposure. Providers should review their current outcomes measurement and management systems to ensure that (1) they are structured to take full advantage of the confidentiality protections available under state law, and (2) appropriate access to outcomes data for those who need it is clearly provided for in the relevant documentation.     

Book reviews

Hélène Carrère d'Encausse, Une Révolution, une victoire. L'union soviétique de Lénine à Staline 1917–1953. Paris: Editions Richelieu, 1972. 446 pp. 60 F.

Joel C. Moses, Regional Party Leadership and Policy‐Making in the USSR. (Praeger Special Studies in International Politics and Government.) New York: Praeger Publishers, 1974, and London: Pall Mall Press, 1975. xv+263 pp. £8.00.

Robert J. Osborn, The Evolution of Soviet Politics. Homewood, Ill. and London: The Dorsey Press, 1974. xiii+574 pp. $10.95.

Robert H. Donaldson, Soviet Policy toward India: Ideology and Strategy. (Russian Research Center Studies, 74.) Cambridge, Mass.: Harvard UP, 1974. x+338 pp. £7.50.

Lloyd G. Churchward, Contemporary Soviet Government. Second Edition. London: Routledge & Kegan Paul, 1975. 368 pp. £6.95.

Otto Ul?, Politics in Czechoslovakia. San Francisco and Reading: W. H. Freeman, 1975. xi+181 pp. £4.70.

Ivan Volgyes (ed.), Environmental Deterioration in the Soviet Union and Eastern Europe. (Praeger Special Studies in International Politics and Government.) New York: Praeger, 1974, and London: Pall Mall Press, 1975. xiii+168 pp. $14.00. £6.00.

Rolf Freund, Investitionskriterien als Mittel zur Realisierung eines Entwick‐lungspfades. Dargestellt am Beispiel der UdSSR. Berlin: Osteuropa‐Institut an der Freien Universität Berlin, 1974. v+202 pp. DM 12.00.

László Szamuely, First Models of the Socialist Economic Systems. Principles and Theories. Budapest: Akadémiai Kiádó, 1974. 109 pp. £2.60.

Iain F. Elliot, The Soviet Energy Balance. Natural Gas, Other Fossil Fuels, and Alternative Power Sources. (Praeger Special Studies in Economics and Development.) New York: Praeger Publishers, 1974, and London: Pall Mall Press, 1975. xv+277 pp. £8.00.