Blue Cross/Blue Shield-sponsored prepaid individual practice

The HMO is no longer a fledgling idea in the Blue Cross/Blue Shield System. There are 45 Blue Cross/Blue Shield Plans throughout the country which sponsor a total of 54 HMO programs with about 1,040,000 members. Among those 54 programs are staff models, group models, Individual Practice Associations (IPAs), and other structures. This analysis is confined to the Minnesota affiliate corporation, "HMO Minnesota."     

Walking the Thin Blue Line

ABSTRACT

While the proportion of female officers in law enforcement is increasing, upper level administrative positions continue to be held overwhelmingly by male officers. This paper attempts to provide a fuller depiction of the barriers women may encounter within police departments resulting from the dynamics associated with the ‘tokenism’ phenomenon. It is concluded that tokenism-combined with factors such as family commitments and organizational structures-plays a large role in determining upward mobility, serving to reduce the frequency of the promotion of women to higher rank/supervisory positions in police departments.     

New York's Blue Cross and Blue Shield, 1934-1990: the complicated politics of nonprofit regulation.

The story of New York Blue Cross is one of complex interaction with state and federal regulators and also with hospitals, the medical profession, commercial insurers, and the public, who make up the regulatory environment. Negotiation, cooperation, and adaptation among parties whose goals and assumptions were partly parallel characterize the relationships. As we can see from New York Blue Cross's origins and its role in the development and administration of certificate-of-need legislation, Medicare, insurance practice and regulation, and hospital rate setting, this story does not represent the capture of government by a special interest, nor the gradual souring of a public interest organization, nor disinterested and distant government regulation.     

Vertical restraints among hospitals, physicians and health insurers that raise rivals' costs. A case study of Reazin v. Blue Cross and Blue Shield of Kansas, Inc. and Ocean State Physicians Health Plan, Inc. v. Blue Cross and Blue Shield of Rhode Island

Two recent district court opinions consider whether affiliations among hospitals, doctors and health insurers--through contract or ownership--violate the antitrust laws. This Article applies a raising rivals' costs framework to the facts of those cases in order to assess whether the practices at issue were unreasonable.     

The Analysis of Metameric Blue Fibers and Their Forensic Significance

Abstract:  Metamerism is a phenomenon where two or more colored items with different colorant chemistries appear to the observer to be the same color. Those differences should result in different UV-visible spectra. Additionally, the literature on color science states that metameric samples will have spectra that intersect at three or more loci. Metameric samples of blue textile fibers, which were created using different coloring agents or different relative concentrations of the coloring agents, were studied to demonstrate that they could be differentiated by obtaining their spectra between 350 and 800 nm using UV-visible microspectrophotometry. However, while some of the metameric samples tested did intersect at three or more loci, others did not intersect at all. In the spectra that did intersect, no correlation was found between either the dye chemistries or the relative component concentrations.     

Examining exclusionary conduct of HMOs and PPOs: a case comment on Northwest Medical Laboratories v. Blue Cross and Blue Shield of Oregon.

As the climate of the health care industry has changed to one of cost-containment and competition through the growth of HMOs and PPOs, health care providers have become the subjects of antitrust litigation. One such case, Northwest Medical Laboratories v. Blue Cross and Blue Shield of Oregon, involved a medical laboratory and a radiology center who claimed that they were victims of an illegal group boycott after defendant's pre-paid health plan denied them preferred provider status. The Oregon Court of Appeals, using the traditional antitrust analysis applied to other industries for decades, failed to consider the intricacies that exist within the health care industry. This result led to an inaccurate market share computation and an inadequate rule of reason analysis. This Comment examines the shortcomings of the Northwest Medical opinion and argues that, in applying the antitrust laws to the health care industry, courts in future cases must recognize and respect the unique features of the business of providing health care.     

Sensitivity of the Luminol Test with Blue Denim

Abstract: An article appearing in this journal in 2000 suggested that the sensitivity of the luminol test performed on denim fabric is usually no greater than at a 1:100 dilution of blood. This study shows that the luminol test may be unambiguously interpreted at substantially greater dilutions of blood. In this study, four different types of denim were tested by spraying a swatch of fabric with a typical formulation of the luminol reagent. Testing was conducted of dilutions of blood up to 1:1000, all of which showed distinct chemiluminescence. Diluted blood was applied to denim material in the form of a random number. A successful test was obtained only when a “blind” observer, i.e., an observer who was uninformed of the number, correctly reported the number.     

Comment on Kartell v. Blue Shield of Massachusetts, Inc.: an antitrust analysis of Blue Shield's reimbursement schemes

In Kartell v. Blue Shield of Massachusetts, Inc., the First Circuit held that Blue Shield's reimbursement practice known as the "ban on balance billing" did not constitute an unlawful restraint of trade in violation of the antitrust laws. Underlying the First Circuit's decision was deference to what it viewed as efforts by Blue Shield and by the Commonwealth to promote cost containment. This Comment argues that, to the contrary, under an appropriate analysis of antitrust law, the practices employed by Blue Shield did constitute unreasonable restraints of trade on the physicians' service industry in Massachusetts, given Blue Shield's market dominance in the Commonwealth. The Comment also argues that such inhibition of the competitive functioning of this industry is unwise, and that costs should instead be contained by effectuating the antitrust laws and encouraging the development of competitive forces within this industry.     

Capture and culture: organizational identity in New York Blue Cross.

This article explores the changing corporate culture of New York's Blue Cross and Blue Shield plan in its first fifty years. As the plan grew, corporate culture evolved over four sequential phases: the plan first had the character of an experiment, then that of a movement, a business, and, most recently, a corporate agglomerate. Accompanying this evolution has been an identity crisis, as the need to adapt to a turbulent environment has challenged the plan's settled understanding of its core values, namely, voluntarism, community, and cooperation.     

Seeking common ground: a history of labor and Blue Cross.

In recent years, voluntary health insurance costs have become a major source of friction in labor-management negotiations. What was once a "fringe" has led to job actions, strikes, and intensive bargaining. We examine the history of labor's participation in New York Blue Cross from the 1930s to the recent past and show that labor's participation in the plan was crucial to Blue Cross's success in the plan's early decades. By the late 1950s, serious tensions developed over rate increases and the participation of labor in Blue Cross governance. Ultimately, the issue was one of the control over what was provided by the plans and who would pay for the costs of care. We posit that labor was never able to achieve an important role in the control of the third-party payer, and in the antilabor environment of the 1980s this proved detrimental to labor's interests.     

Thinking About Prison Release and Budget Crisis in the Blue Grass State

As of 2003, nearly every state in the country is in budget crisis, looking to cut spending or raise taxes, or both. Kentucky is currently facing a severe budget crisis and is seeking ways to lower its prison costs. We interviewed prisoners, parolees, and correctional staff. Our focus is on reentry and structural problems contributing to parole failure. The discussion is organized around the following themes: the lack of meaningful prison programs, preparing for release from prison, problems finding employment, the parolee relationship with parole officers, the need for protection from minor parole violations, loss of credit for good time served on parole, and the lack of economic resources. Based on our findings, 10 recommendations are offered that, if implemented, would serve to lower the prison population, and save the taxpayers millions of dollars. While the research was conducted in one state the discussion may be generalized to apply to many states.     

Black and Blue Bloods: Protecting Police Officer Families from Domestic Violence

Officer‐involved domestic violence (OIDV) is a national problem, with police officer families having higher rates of domestic violence than non–police officer families. OIDV is also an underresearched problem with few studies or proposed solutions. Many victims of OIDV do not report their abuse precisely because their abuser is a police officer, whom they fear is in a unique position to protect him/herself from any legal consequences. Often, OIDV complaints are not investigated properly in a nonbiased manner. While a handful of police agencies around the country have developed specific policies and procedures to deal with OIDV, Washington State has enacted legislation that requires its police agencies to adopt OIDV‐specific policies. The International Associations of Chiefs of Police (IACP), an organization that addresses various issues confronting law enforcement, has also developed a model policy on OIDV. This Note proposes that, in light of the Washington legislation and the model policy proposed by the IACP, each state should enact a statute that requires its police agencies to develop policies on OIDV. This Note also outlines a specific set of procedures that such statutes should, at a minimum, require its police agencies to adopt, ranging from educating police officers on domestic violence to developing guidelines on responding to and investigating OIDV complaints.     

左琴科《一本浅蓝色的书》的两种改造

迫于时代的政治"大势",苏联幽默作家左琴科在其作品《一本浅蓝色的书》中做了"自我改造".改造之一是将他之前创作的幽默小说大量改写,变揭露为歌颂;改造之二是他在作品中大兴文体革新,将历史纳入文学,通过历史与现实的对照,无情揭示了现实的本相.因而改造的结果是,左琴科有意无意地坚守了自己的"道",作品也获得与"自我改造"宗旨既一致又矛盾的复杂意蕴.