Executive federalism and Medicaid demonstration waivers: implications for policy and democratic process

Executive federalism emphasizes collaboration between the executive branches at the national and state levels to transform grant programs through the implementation process. In this regard, Medicaid demonstration waivers loomed large during the presidencies of Bill Clinton and George W. Bush. This article documents and compares the volume and substance of section 1115 Medicaid waiver activity under the two presidencies. From the perspective of policy performance, Medicaid demonstration waivers provide modest support for the view that states serve as laboratories for policy learning in the health care arena. More broadly, the waivers have not yielded a major solution to the problem of the uninsured and are unlikely to do so. At the same time, they have not (as some have suggested) been a subterranean force for the erosion of Medicaid. To the contrary, these waivers have often enhanced health services for low-income people; above all, they have helped preserve Medicaid as an entitlement by undercutting support for those seeking to convert the program into a block grant. From the perspective of the democratic process, we find that Congress has been a more significant player in shaping waivers than the executive federalism model suggests. While the decision processes surrounding Medicaid waivers often fall short of democratic standards with respect to transparency and opportunities for public input, they still compare favorably to certain alternatives.     

Toward a phenomenology of terrorism: implications for research and policy

The central theme of this paper is that the phenomenology of perception can contribute to conceptualizing terrorism, in terms of both a research orientation and policy applications. This means that counter-terrorism needs to be grounded in a holistic perspective that has meaning from the point of view of those engaged in terrorism. A critique of the “war on terror” counter-terrorism practices is followed by a discussion of phenomenology and its implications for a holistic perception of counter-terrorism. Four cases are presented that show how a phenomenological approach can facilitate counter-terrorism study and policy.     

From rehabilitation to retribution: Examining public policy paradigms and personnel education patterns in corrections

The literature is saturated with discussions of how public policy paradigm shifts over the past several decades have affected everything from escalating prison populations to accelerating tax burdens. However, observers have not examined whether the transition from the medical model to the justice model has influenced the educational qualifications of custodial staff. Theoretically, one might assume that a treatment focus demands higher educational standards than a control orientation. The evidence presented herein largely refutes that assumption. In addition, there is some doubt as to whether advancing educational achievements will continue. Reasons for the dissonance between public policies and the educational credentials of line-level operational personnel are discussed, along with potential future implications.     

The curious case of Housing First: the limits of evidence based policy

Evidence Based Policy has been articulated and practiced in Europe, particularly under the ‘New Labour’ policies of the former Labour government in the United Kingdom. In the United States, the impact of research on policy has been inconsistent due to differing relationships between researchers and policy makers. This paper gives an overview of evidence based policy and presents critiques based on its reliance on positivist methods and technical approach to policy making. Using these critiques as a framework, the paper discusses the case of Housing First, a policy adopted by the Bush Administration in order to address the problem of chronic homelessness. The case is an example of research driven policy making but also resulted in a progressive policy being promoted by a conservative administration. In discussing the case, the paper elaborates on the relationship between evidence and policy, arguing that evidence based policy fails to integrate evidence and values into policy deliberations. The paper concludes with alternative models of policy decision making and their implications for research.     

Environmental policy integration and bilateral development assistance: challenges and opportunities with an evolving governance framework

The aim of this article is to examine progress so far, as well as current challenges and opportunities for EPI in bilateral official development assistance (ODA). A short review of progress shows that effectiveness has so far been limited. Although there has been intense donor activity in relation to stating commitment to the EPI principle and developing a wide range of processes, institutions, and tools, a large part of ODA still is likely to have directly harmful impacts on the environment. The implications for EPI of the emerging governance framework for ODA, namely, the principles stipulated in the 2005 Paris Declaration on Aid Effectiveness, are then discussed. Both challenges and opportunities are presented, and these are empirically illustrated with a case study of the integration of climate change adaptation in ODA. Finally, this article proposes that at least four special conditions apply to EPI in the bilateral ODA context as compared with domestic EPI: two or more jurisdictions, electorates, and governments are involved; a negotiation context characterized by sovereign states but with a potential power asymmetry; potential conflicts of interest and equity concerns in cases where environmental objectives refer to global environmental problems primarily caused by developed countries; and a policy-making process characterized by a comparatively wide span of both strategic and operational decisions, where EPI can take on very different meanings. The initial exploration presented in this article suggests that these conditions hold, and that, as a consequence, EPI arguably involves more ‘high-politics’ decisions and questions than in a domestic policy context.     

Inching toward incrementalism: federalism, devolution, and health policy in the United States and the United Kingdom

In the United States, the recently enacted Patient Protection and Affordable Care Act of 2010 envisions a significant increase in federal oversight over the nation's health care system. At the same time, however, the legislation requires the states to play key roles in every aspect of the reform agenda (such as expanding Medicaid programs, creating insurance exchanges, and working with providers on delivery system reforms). The complicated intergovernmental partnerships that govern the nation's fragmented and decentralized system are likely to continue, albeit with greater federal oversight and control. But what about intergovernmental relations in the United Kingdom? What impact did the formal devolution of power in 1999 to Scotland, Wales, and Northern Ireland have on health policy in those nations, and in the United Kingdom more generally? Has devolution begun a political process in which health policy in the United Kingdom will, over time, become increasingly decentralized and fragmented, or will this "state of unions" retain its long-standing reputation as perhaps the most centralized of the European nations? In this article, we explore the federalist and intergovernmental implications of recent reforms in the United States and the United Kingdom, and we put forward the argument that political fragmentation (long-standing in the United States and just emerging in the United Kingdom) produces new intergovernmental partnerships that, in turn, produce incremental growth in overall government involvement in the health care arena. This is the impact of what can be called catalytic federalism.     

European educational policy on shifting sand?

European integration makes educational policy even more important, especially as an instrument to forge the future of Europe. This growing consciousness is a motivation to critically analyse and compare the educational policies of the countries of the European Union. This investigation is only realistic on condition that the research objectives are clearly set out. Therefore, the following questions guide the article: 1. Concerning the ‘facts’: – Can the history of European educational policies provide us with a taxonomy to distinguish ‘types’ of educational policy? – What are the main changes concerning both structures and role conceptions in the field of educational policy? – Is educational policy autonomous or is this policy influenced by other leading sub-systems? – What is the impact of supra-national organisations on educational policies? – Are educational policies in the EU visibly influenced by (new?) underlying ‘ideologies’? – What are the main current policy issues in the EU-countries? 2. Concerning the ‘trends’: Is it possible to deduce certain ‘trends’ from the comparative analysis of the mentioned ‘facts’? 3. Concerning the ‘critical analysis’: – Does the literature on educational policy analysis provide us with ‘critical interpretation schemes’? – What will the outcome be if the discovered ‘facts’ and ‘trends’ are confronted with such-like schemes? The article concludes with some critical recommendations concerning the future of educational policy in the EU.     

Social junk,social dynamite and the rabble: Persons with AIDS in jail

The issues surrounding AIDS in corrections have forced administrators to develop policy which accurately reflects the realities of the AIDS crisis. Moreover, administrators must base their policy decisions on available research findings, much of which is generated by government agencies and research policy groups. Whereas this research does serve the proper function of guiding policy, it is somewhat removed from the theoretical implications that AIDS has to societal reaction and social class. This article introduces a theoretical framework comprised of Irwin’s (1985) concept of the rabble and Spitzer’s (1975) notes on social junk and social dynamite. In addition to discussing this framework as it relates to social metaphors and social control, the implications to correctional policy are also be presented. The author gratefully acknowledges Marie Mark for her assistance in preparing the final version of this article.     

Changing housing policy: women escaping domestic violence

Domestic violence has risen up the political agenda, as women's action has inspired changes in police, social work and legal practice. At the same time, one of the oldest pieces of legislation that protected women from violence - the Homeless Persons Act of 1977 - has been transmuted into the Housing Act of 1996. This legislation was introduced by a Conservative government, which was anxious to reduce the rights of homeless people to secure permanent accommodation, on the grounds that these rights gave incentives to pregnancy, lone parenthood and economic migrants. New Labour have softened the Housing Act to give more scope to local authorities to respond to homelessness. This article asks: What are the implications of changing homelessness rights under this legislation and subsequent regulations for women's ability to escape violent relationships and find long term solutions to the housing needs which domestic violence creates? How new is New Labour policy as expressed in housing regulations and its policy Green Paper?     

Corporate violence against canadian women: Assessing left-realist research and policy

Canadian researchers, especially feminists, have shown, that male violence against women in both intimate relationships and public places is a significant social problem. Compared to the amount of rigorous work done on this important issue, an equally if not more serious problem for women—corporateviolence—has been given little empirical, theoretical, and political attention The primary purpose of this paper is to articulate how, some left realist survey techniques and policy proposals can contribute to the study, prevention, and control of corporate violence against Canadian women in the industrial workplace. The authors conclude this article by pointing to a few pitfalls of realism which must be add ressed before it can be effectively applied in the Canadian context.     

Interaction of criminological research and public policy

We examine here some of the interactions of research and policy over the past several decades. The “rehabilitation period” was effectively terminated by nulleffect evaluations of various rehabilitation techniques. The “just deserts-utilitarian period” was fed by research estimates of the deterrent and incapacitative effects of criminal justice activities. The more recent “overt politicization period” saw the earlier attempt to bring rational and theory-based perspectives to policy development replaced by much stronger emphasis on political concerns. We explore possible ways to reestablish the research-policy connections. This paper was prepared for the Plenary Session,Journal of Quantitative Criminology 10-Year Anniversary, 1995 Annual Meeting of the American Society of Criminology, Boston, MA.     

Public policy and criminology: An historical and philosophical reassessment

This article briefly reviews the history of the relationship between criminological research and public policy in order to explore more fully the nature of the links between social science and policy. A postpostivist critique leads to the conclusion that the distinction between science and policy, fact and value has been overdrawn. This article presents a methodology for accommodating postpostivist thought, thereby linking policy with criminology more effectively. Viewing criminology as part of a policy hermeneutic provides a way of managing the tension involved in a science/policy link that moves beyond the debate among policy pragmatists (Wilson), scientific purists (Cressey), and methodological incrementalists (Gottfredson).     

The Siren’s Song: Federalism and the Cops grants

The federalization of crime control has become a focal point for criminal justice researchers. Because the federal government is limited in how it can affect crime, it often assumes the role of funding agent to state or local governments and places restrictions on the use of these monies. Generally, no consideration is given to state or local concerns. As a result, national crime control policy often becomes mired in issues of federalism. One unintended consequence is the creation of a Siren’s Song, where state and local agencies simply pursue funding dollars to expand their budgets rather than to adopt beneficial policies or make meaningful changes. This paper illustrates this point by examining the federal “100,000 Cops” initiative in one rural West Virginia jurisdiction.     

The form and context of federalism: meanings for health care financing

This article examines the meaning of federalism for health care financing (HCF) and is based on two considerations. First, federal institutions are embedded in their national context and interact with them. The design and performance of HCF policy will be influenced by contexts, the workings of the federal institutions, and the interactions of these institutions with different elements of the context. This article unravels these influences. Second, there is no unique model of federalism, and so we have to specify the particular form to which we refer. The examination of the influence of federalism and its context on HCF policy is facilitated by using a transnational comparative approach, and this article examines four mature federations: the United States, Australia, Canada, and Germany. The relatively poor performance of the U.S. HCF system seems associated with the fact that it operates in a context markedly less benign than those of the other national HCF systems. Heterogeneity of context appears also to have contributed to important differences between the United States and the other countries in the design of HCF policies. An analysis of how federalism works in practice suggests that, while U.S. federalism may be overall less favorable to the development of well-functioning HCF policies, the inferior performance of these policies is to be principally attributed to context.     

Organizing knowledge spillovers when basic and applied research are interdependent: German biotechnology policy in historical perspective

The German biotechnology lag illuminates the difficulties of finding appropriate organizational forms of R&D for “embryo” innovations requiring the continued involvement of basic research scientists even after innovation has advanced to the stage of commercial product development. The analysis charts the German policy shift from largely unsuccessful “corporatist” networks (1970s and 1980s) to more promising “emergent” networks (1990s) as organizational vehicles for conducting biotechnology innovation. A constant of German R&D policy for most of the 20th century, and one underlying the initial reliance on corporatist networks in biotechnology, was the tendency to exclude universities from major R&D initiatives and rely instead on specialized research institutes. The structural inflexibilities of universities, combined with the early successes of many specialized research institutes from the 1880s on, led to path-dependent reliance on the latter for 20th-century reforms of the German national innovation system.      

Implications of changing social policy for the medicalization of deviance

Conclusion Since medicalization of deviance is ade facto rather than explicit social policy, it is affected by policy changes in the medical and criminal justice systems. I have pointed to some of the implications of changing social policy on medicalizing deviance. In summary, it appears likely that social policies such as decriminalization, decarceration, the production of more physicians and the enactment of national health insurance may encourage more medicalization. On the other hand, increased individual responsibility for health, the fiscal crisis in medical costs, and the punitive backlash may discourage medicalization and promote some demedicalization. What seems clear from this vantage point, however, is that medicalization of deviance, with few exceptions, remains a residual product of other social policies and its consequences are usually overlooked in policy deliberations. Since medicalization has important social consequences [32], it should be afforded consideration in policy discussions.My thanks to my collaborator Joseph W. Schneider and to Michael L. Radelet and David F. Greenberg for comments on earlier drafts of this paper.     

Bringing science to life in Australia: the need for a new approach in human health biotechnology policy

This paper discusses the development of the biotechnology industry in the context of Australia’s industrial and policy structure. The paper outlines the size and structure and ‘stage’ of development of the biotechnology sector in Australia and argues for a policy approach that recognises the specific dynamics of the industry sector as it presently stands. It argues that government in a small country with a patchy industrial structure and where the local market is highly regulated and dominated by public sector institutions must play a central but more sophisticated policy role in the development of effective mechanisms for both knowledge generation and transfer in the emerging biomedical sciences.     

Towards rational and evidence-based crime policy

Rational crime policy constitutes a basic goal for society. If, however, evidence-based, cost-efficient crime prevention is the standard, there is little indication that current policies—including programs, laws, and court decisions—are rational. To support that assessment, this article uses an evaluation research perspective to highlight five prominent problems with extant crime policies: (1) a lack of empirical assessment of the need for them; (2) a range of design issues, including gaps between crime theory and policy, and, most notably, the pursuit of silver bullet solutions; (3) a range of implementation issues, including disjunctures between ideal and actual practice; (4) the lack of rigorous impact evaluations and the sometimes misplaced emphasis on them; and (5) a scarcity of cost-efficiency analyses for guiding investment decisions. It then discusses the implications of these problems and suggests steps that can be taken to place crime policy on a more evidence-based foundation.     

Consumer Racial Profiling and Perceived Victimization: A Phone Survey of Philadelphia Area Residents

This paper explored the perceived prevalence of consumer racial profiling (CRP) (also known as “Shopping While Black”) among residents in Philadelphia. Based on data collected from a random digit dialing (RDD) phone survey, the authors examined the characteristics of those persons who believed they had been profiled in retail establishments. The research found that African Americans were ten times more likely than non-African Americans to believe they had been profiled in a retail establishment. As for gender differences, males were nearly two times more likely than females to report that they had been experienced CRP. Educated respondents were more likely than those with less education to report having experienced CRP. There were no significant findings regarding income. The authors conclude by noting the policy implications of the research findings. This project was jointly funded by Penn State’s Africana Research Center and Penn State Harrisburg’s School of Public Affairs. The authors thank Auden Thomas, Stephanie Hintz, and the interviewers from Penn State Harrisburg’s Center for Survey Research who assisted in the completion of this project.