Actuarial status of the HI (hospital insurance) and SMI (supplementary medical insurance) Trust Funds

This article is adapted from the 1987 Annual Reports of the Medicare Board of Trustees. It presents a summary of the current financial and actuarial status of the Hospital Insurance (HI) and Supplementary Medical Insurance (SMI) Trust Funds. The Board found that the present financing schedule for the HI program is sufficient to ensure the payment of benefits over the next 12-14 years if the intermediate (II-A and II-B) assumptions underlying the estimates are realized. Although steps have been undertaken to reduce the rate of growth in payments to hospitals, the Board urges Congress to take remedial measures to bring future HI program costs and financing into balance. The Board found the SMI program to be actuarially sound but recommends that Congress take action to curtail the rapid growth in that part of Medicare.     

Interaction orders of drug dealing spaces: local orders of sensemaking in a poor black American place

Based on ethnographic data, this essay analyzes the social order properties of a poor urban street, in a small city in the northeast United States, on which drug dealing is the principle occupation. Rather than treating drug dealing as an agent of disorder, we focus on the order properties of drug dealing and the ordered character of the local code of conduct that develops around it. Like Sudhir Venkatesh (American Journal of Sociology 103:82–111, 1997) we examine the interface between drug dealing and the neighborhood. However, in this small urban space the drug dealers are not outsiders, rather, they are long term residents: established insiders who are well integrated into community life. As such their work practices and the requirements they place on behavior in public spaces impact the neighborhood in comprehensive ways. We detail the phenomenon Elijah Anderson called the “code of the street” (Anderson 1999) as a set of practices and social markers, a local Interaction Order (Goffman, American Sociological Review 48:1–17, 1983; Rawls, Sociological Theory 2:136–149, 1987), that furnishes basic day to day sensemaking tools for residents (Rawls 2009). We propose that this order has a constitutive character that furnishes stable expectations (Garfinkel 1963, 1967) for meaningful social action and identity in the neighborhood. In a context of industrial decline and urban poverty, drug dealing careers constitute a major socialization factor, that touches everyone here—especially children.     

Reconnecting Systems Maintenance with Social Justice: A Critical Role for Conflict Resolution

With roots in both the field of labor-management negotiation and the civil rights movement of the 1950s and 1960s, practitioners and theorists of conflict resolution have been guided by two main theories concerning the objectives of alternative dispute resolution. On the one hand is the objective of systems maintenance, with an emphasis on stability and rational decision making. On the other hand is the objective of social justice, which emphasizes changing social institutions and organizations to support the protection of basic human rights and needs. This article analyzes the assumptions of both objectives and concludes with recommendations for how to make the goals of systems maintenance and social justice mutually supporting.     

Some Minor Reflections on Conflict Resolution: The State of the Field as a Moving Target

Based on several recent meetings between the scholarly and practice communities of the conflict resolution field, the author observes that our understanding of what we consider to be conflict resolution is changing rapidly, and that the context of a particular dispute is often determining. To continue to build knowledge in the field, scholars and reflective practitioners should examine such topic areas as the nature of practice; differences between in-house and external mediation; expectations of all parties about change and outcomes; and the ethics of intervention.     

Enhancing Community Leadership Negotiation Skills to Build Civic Capacity

Most intra‐ and interorganizational decision making entails negotiations, and even naturally talented negotiators can improve with training. Executive trainings for managers and leadership programs for publicly elected officials, public managers, and nongovernmental organizations frequently include negotiation modules. These efforts, however, have yet to reach community leaders who also need to develop their negotiation skills. We propose that members of disadvantaged low‐income communities who lack educational and economic opportunities, and are less able to advocate for their own interest, need to build and strengthen their civic capacity, including their negotiation skills, to become more effective parties to decisions affecting them. While many professionals and executives have access to training, such opportunities are less accessible to the leaders of these disadvantaged communities. Although such leaders draw from their own heuristic knowledge, skills, and abilities, they could also benefit from sharpening their negotiation skills. We propose that the multidimensional understanding of their community that members accumulate through direct experience is indispensable, nontransferable to outsiders, and not teachable through in‐class activities. Leaders with the ability to leverage knowledge and assets to connect effectively to community insiders as well as to outside people, institutions, and resources, however, possess some specific inherent personality traits as well an understanding of social structures, strategies, and agency, which can be taught and learned. Such skills as how to conduct negotiations around the table and away from it and how to identify community members who can help and how to rally them are also teachable. The cases were chosen to illustrate the knowledge, skills, and abilities (KSAs) that make these leaders effective in and beyond their communities. We highlight those KSAs that we think are teachable in the framework of a negotiation module in community leadership training to enhance civic capacity for community betterment.     

Actuarial status of the HI and SMI Trust Funds

This article is adapted from the 1986 annual reports of the Medicare Board of Trustees. It presents a summary of the current financial and actuarial status of the Hospital Insurance (HI) and Supplementary Medical Insurance (SMI) Trust Funds. The Board found that the present financing schedule for the HI program is barely sufficient to ensure the payment of benefits through the late 1990's if the intermediate (II-A and II-B) assumptions underlying the estimates are realized. Although steps have been undertaken to reduce the rate of growth in payments to hospitals, the Board urges Congress to take remedial measures to bring future HI program costs and financing into balance. The Board found the SMI program to be actuarially sound but recommends that Congress take action to curtail the rapid growth in that part of Medicare.