Control versus consent in long-term care case management programs: implications for public policy

Case management programs for long-term care include the dual public policy goals of providing access to services and ensuring the efficient and effective application of public funds. We will use a paradigm for social policy development that proposes a conflict between control and consent motives of social policy makers. Illustrations of the limitations and positive elements of control versus consent as applied to case management will be presented.

We will discuss how the tension between these approaches can be used to develop policy that balances the goals of access and cost-effectiveness.     

Employment versus empowerment: A case study of the nature of women's work in Ecuador

This research re‐evaluates the female marginalisation thesis through an examination of the changing nature of work in Latin America and of women's incorporation into paid employment. We combine labour market segementation theory, which explains the emergence of low level occupations in terms of capitalist restructuring, with feminist theory, which explains why women become concentrated in inferior positions. We operationalise this reconceptualisation through an empirical analysis of women's and men's relative occupational position across economic sectors and through time in Ecuador. A key finding is that women's and men's occupations are differentiated in terms of control over economic resources and control over the labour process and that this worsens over time.     

The role of government in economic development: the chinese experience

This study examines the role of government in China's economic reform and development years. The study first provides a literature review about major functions government played in the modern economic system and the importance of government policies to economic development. It then evaluates the experience of the Chinese government in the process of reform and development by focusing on five major roles: (a) promoter of growth, (b) manager of economy, (c) distributor of income, (d) regulator of industry, and (e) protector of citizen and business. The implications of the Chinese experience are discussed.     

Managing economic crises: The role of the state in Bahrain and Kuwait

Bahrain and Kuwait adopted sharply divergent responses to the economic crisis in the Gulf during the 1980s. The Bahraini government reduced the level of state intervention in the local economy, opened up opportunities for private investment and relied on the operation of the unregulated market; Kuwait's government, on the other hand, imposed a greater degree of state supervision over domestic economic affairs and expanded central planning to allocate resources to the most profitable enterprises. Two influential bodies of neo-Marxist writing on the state—the state-derivation school and the writings of Claus Offe—have difficulty accounting for these differences. A more adequate explanation for Bahraini and Kuwaiti policy can be formulated in terms of the strength of each country's indigenous rich merchant community relative to that of the ruling family/central administration and the political activities of the labor movement in each amirate. Fred H. Lawson is associate professor, Department of Government, Mills College, Oakland, CA 94613. He received his Ph.D. from UCLA in 1982 and has also taught at the University of North Carolina and Smith College. His most recent publications include “Political-economic trends in Ba'thi Syria: a reinterpretation,”Orient 29 (December 1988) and “Libéralisation économique en Syrie et Irak,”Maghred/Machrek 128 (April–May 1990). He is currently exploring the connection between class conflict and foreign policy in contemporary Syria and Iraq.     

Economic partnering with the poor: why local governments should work with community-based development organizations to promote economic development

Much of conventional economic development ends up as a transfer of wealth from the public sector to successful firms. Instead, local governments would be better off working to support the efforts of community-based development organizations to expand the economic pie for those most in need. Suggestions are made of ways to bring about equity development programs that would help those most in need rather than merely subsidizing established businesses.     

The role of capital accumulation in economic development

In an open dual economy, the reallocation of factors to the industrial sector is accelerated whenever the region can sell its industrial product on a world market, or can invest at a level greater than domestic savings, by borrowing abroad. The industrialization is slowed, however, by any increase in the demand for ‘backward'‐sector products, as for example, when such products are demanded as inputs into the industrial production process. In the model presented here, these industrial input requirements are an important determinant of the growth of per capita income and, especially, the borrowing‐lending position of a developing region.     

The public costs of private blessings: Fundamentals of the economic role of government

The main thrust of this overview is to demonstrate how the shift of government authority over time—from a defense of the realm against foreign intruders to an adjudication of conflicting citizen claims—has created a new set of problems and challenges for the modern state in search of development. It is argued that the power of the state expands as traditional forms of economic rivalries and class claims weaken, and as recourse to legal decision-making becomes widely accepted by all social and economic sectors. Government has proven better able to satisfy existing claims than at initiating new forms of social relations. Experiences in a variety of economic structures thus argue for a continued interplay of public and private, federal and personal claims. Irving Louis Horowitz is Hannah Arendt Distinguished Professor of Sociology and Political Science at Rutgers University, New Brunswick, NJ 08933. Among his major works on development theory and practice areThree Worlds of Development: The Theory and Practice of International Stratification (Oxford University Press, 1965, 1972), andBeyond Empire and Revolution: Militarization and Modernization in the Third World (Oxford University Press, 1982). He was founding editor ofStudies in Comparative International Development.     

The role of agriculture in economic development: Visible and invisible surplus transfers

The financial surplus of agriculture has been central to theories of the role of agriculture in economic development. Morrisson and Thorbecke (MT) have used a constant‐price social accounting matrix (SAM) framework to measure rigorously the financial surplus of agriculture and decompose the mechanisms of surplus extraction. History and theory have, however, stressed the role of prices as an invisible transfer mechanism in addition to the visible transfers identified in the SAM framework. We extend the MT approach by defining and measuring the real surplus of agriculture and decomposing the mechanisms of surplus extraction between visible and invisible financial transfers. Using an archetype computable general equilibrium model for poor African nations, we trace the generation, transfer, and use of an agricultural surplus created by a productivity gain in agriculture. This shows that prices indeed play an overwhelmingly important role in transferring a surplus from agriculture to the benefit of the rest of the economy.     

Measuring the role of liquid assets in consumption: A cross country view of the world economic periphery

A new non‐traditional identity for the role of liquid assets in consumption in terms of income distribution effect is developed and analyzed. It is contended that in the case of developing countries with increasing monetization of the economy, the rapidly accumulating liquid assets relative to income indicate a highly skewed distribution of income which in turn is conducive to their saving behaviour. The argument is theoretically presented and statistically tested for two major developing regions of the world, Asia and Latin America. By using cross country data, their regional consumption functions are constructed, the long term elasticities are estimated and the aggregate consumption expenditures for three years are generated.     

Suicidality of chronic schizophrenic patients in long-term community care

In the provision of mental health care for chronic schizophrenic patients, the specific problems and requirements of long-term community care of suicidal behavior is an area of research not yet fully explored. This study focuses on a 4 1/2-year prospective assessment of normative and subjective needs for care related to this specific area for a cohort living in the Dresden region (Germany). One significant result of this study shows the constant high level of needs for care in the area of suicidal behavior imposed on community services by 30-40% of this diagnostic group. Furthermore, the study identified a special high-risk subgroup for suicides as well as specific needs for care. This subgroup is characterized by clinical reasons for the index hospitalization (suicidal risk or attempt) as well as by psychopathological features (suicidal thoughts and higher levels of anxiety/depression) 1 month after release from index hospitalization. Four items of care were rated as potentially effective for addressing suicidality in the community setting: clinical assessment, increased supervision or systematic recording of (suicidal) behavior, medication, and a sheltered environment. Because these care measures are provided, the percentage of unmet normative needs for the area of suicidal behavior was rather low. Due to limitations of the instrument used for assessment of normative needs, the Needs for Care Assessment (NFCAS), the care measures most frequently provided do not define a quality standard of community care for this problem. A subjective needs assessment differing from the normative approach has to be integrated in establishing guidelines for effective community care.     

An exploration of citizens' professionalism in coproducing social care services

Citizens' involvement in public service delivery challenges the principles of professionalism as such citizens are amateurs. However, there is little evidence of the (non)integration of these principles by citizen coproducers and how this affects professionalism in public service delivery. This article focuses on two principles of professionalism: expertise and accountability. The theoretical framework further reviews the coproduction literature on what can be expected of citizens with regard to these principles and elaborates on the concept of amateurism. The concepts of professionalism and amateurism form the framework for the analysis of citizen coproducers' identity. Empirically, this paper presents two case studies of social services in the European context. The results show that these citizen coproducers to a certain extent create a professional identity, tend to stay away from integrating accountability, and introduce elements of amateurism. The presence and guidance of public servants in coproduction can ensure accountability and streamline amateurism.     

Training transformational leaders: a call for practicing empowerment in the classroom

This article is based on the premise that organizations are in dire need of transformational leaders who will imbue them with the values and practices necessary to survive and grow in the 21st century. Unfortunately, our educational system is not doing very much to prepare our students to successfully perform this transformational role. We suggest that the reason for this deficiency lies in the fact that too many faculty practice traditional bureaucratic pedagogies which neither models nor develops the values and skills students need to become transformational leaders. Furthermore, the extensive use of these practices serves to limit student involvement in the teaching-learning process and decreases student motivation to perform high quality work. Therefore, this article will discuss how faculty can model transformational leadership by empowering their students. We have found that this approach creates stimulating classes which increase student feelings of ownership, self-efficacy, and motivation. Moreover this experience helps prepare students to be the transformational leaders our world so desperately needs.     

Service quality and the optimum number of members in intermunicipal cooperation: The case of emergency primary care services in Norway

Intermunicipal cooperation (IMC) is often used as a mean to reap scale benefits. Most studies on the effects of IMC focus on cost savings, while service quality is overlooked. In this study, the focus is set on input quality in a service characterized by high asset specificity and need for redundancy: emergency primary care. We analyze how mode of governance affect performance by (1) measuring whether IMC versus single-municipal production affects input quality and (2) identifying optimum scale of operation; effect of the number of participants in the cooperation on input quality. The findings indicate that cooperation weakens the input quality of medical workforce, but that this negative effect is balanced out as the number of participants increases, indicating that cooperation needs to reach a certain size to achieve optimum scale of operation. Concerning equipment, both cooperation in general and an increasing number of participants decrease the input quality.