Health care technology assessment: A policy planning tool

Health care technology has developed more rapidly than have the tools to aid decisions regarding that technology's assessment, acquisition and allocation. This article proposes theoretical and technological bases for formulating and analyzing policies for technology assessment. A computerized procedure for measurement and reporting of judgmental sources of technology assessment is presented, accompanied by a pilot study illustrating how the procedure can be used for both research and practical applications.     

Health care finance in the US: Past,present, and future

Presently the US is the only major industrialized nation that does not insure universal access to health care for all of its citizens. Although the US spends one out of every eight dollars on health care, over one-eighth of all Americans lack basic health insurance coverage. Another concern is health care cost inflation. The quest for comprehensive health care coverage for all Americans began shortly after the turn of the century and has received varying degrees of support since then. Since the historical course of health policy in the US has followed an evolutionary rather than revolutionary course, unless consistent policies are developed to rationalize the incentives facing consumers, providers, and insurers, alike, the future path of American health policy will continue to be characterized by disjointed incrementalism. National health insurance can provide decision makers with a tool to structure and focus the American health care system. In order for cost control measures to be effective they must be coordinated with measures to promote universal access, and vice versa. NHI can be a catalyst to focus attention on the dual goals of access to care and cost containment.     

Children and armed conflict: looking at the future and learning from the past

Children are currently being recruited to an increasing extent by armed groups, assuming both ancillary and combat roles. Academic research on this phenomenon has grown in scope over the last few years. However, the current research lacks a comparative perspective. As a result, we presently have a very restricted perspective of the state of the art on the subject of child soldiering, making it difficult to recognise research areas that urgently require further investigation. The ambition of this article is twofold: first, to explore the existing state of child soldier studies across disciplines, and second, to encourage potential research by highlighting three relatively underdeveloped research areas.     

Strategic management and public organizations: Lessons from the past and prescriptions for the future

The 1990s have become a decade of reflection and rethinking of foundational concepts in the field of public administration. Public adminstrationists are attempting to bring the best of management approaches to bear on the problems facing public organizations. Strategic management has been widely used in the private sector since the 1960s, and has gained increased acceptance in the public sector since the 1980s. It is a management approach that synthesizes much of what management theorists have long recognized as essential to effective management practice. This article traces the development of strategic management and examines what has been learned from the past that will improve future implementation efforts in public organizations.     

Donors,State Building and Corruption: lessons from Afghanistan and the implications for aid policy

This article critically analyses the state-building agenda from a governance and aid policy perspective, and from an anti-corruption viewpoint in particular, highlighting potential problems with both theoretical and practical applications of state building in a development context. Inconsistencies and contradictions between the state building and anti-corruption work have not been adequately explored or reconciled. In particular, the article explores these tensions using the example of the Performance-Based Governors' Fund (pbgf) in Afghanistan, where some donors are looking to reduce corruption in local government, encouraging often ‘warlord’ governors to run their administrative offices with integrity. The article argues that the pbgf approach—with its themes of being realistic, going for indirect strategies over the long term and building integrity rather than fighting corruption, provide important lessons for the anti-corruption community as a whole, both at the level of theory and practice.     

Policy analysis: past,present, and future

This article reviews three themes in the past, present and future of policy analysis—policy analysis as a paradigm for policy advice, the fragility of public policy analysis organizations, and the emergence of ideologically based policy analysis organizations. The policy sciences have evolved from the rational model and the efficiency emphasis to an increased sensitivity to political factors in policy settings and to softer forms of analysis as legitimate ways of understanding policy issues. The article traces the growth of policy analysis staff in both the legislative and executive branches of the Federal Government. The article closes with a consideration of the implications for policy analysis education of the trends described above.

Commenting on the state of policy analysis is like trying to describe Southern California. Continuing claims and counter claims have been made about the area's demise. Yet, people from many backgrounds continue to flock to it and proclaim native status. Observers agree there is something important there but they warn that its future is potentially imperiled.

This is a selective roadmap to the past and present of policy analysis with some added perspectives on its future.⁽¹⁾ Three themes are developed in the discussion. One is the durability of policy analysis as a paradigm for policy advice. The second is that, despite this durability, government policy analysis organizations are fragile entities. The third is the challenge to policy analysis brought about by ideologically oriented policy movements. Rather than drawing a tight boundary around policy analysis, this discussion defines the field as those activities which are undertaken, ostensibly at least, in support of decision making about prospective actions for addressing public problems. The key distinguishing points are that the activities—whether labeled policy analysis, policy research, policy design, implementation analysis, program analysis, regulatory analysis, or something else—are: (1) decision oriented, (2) problem driven, and (3) forward 10oking.⁽²⁾ Specifically excluded from this categorization are both retrospective evaluations and traditional academic research. As the diverse set of labels listed above suggests, policy analysis presently comes in many forms and is produced in a variety of institutional settings.     

Health care reform content and process:propositions from the states

Health care reform and cost containment have become central campaign and policy issues in the United States. Although focus now centers on federal health care reform policy, state governments have been actively introducing health care reform legislation. Some of the health care reform initiatives on the state level have influenced deliberations on the federal level and President Clinton's health care reform initiatives will spur further state experimentation regardless of legislative success in Congress, In 1992 nearly all 50 states had either legislation introduced, or special task forces assigned that addressed health care reform issues. This exploratory research compares the content and process of health reform in four states that attempted major reform in 1992—Florida, Washington, Michigan, and Wisconsin—and draws propositions for state reform based on comparisons of content and process. The four states chosen represent geographic diversity and a balance between legislation seeking partial change and legislation calling for universal health care reform. The principal reform bills in each state are compared and assessed on the degree to which they address eight reform elements; high tech medicine, administration, tort reform, long-term care, regulation, insurance mandates, small business insurance, and insurance portability. These initiatives are also compared on a series of reform process variables that relate to the political process for adopting reform: degree of health sector support, type of political strategy used, reform champion, degree of cooperation among policy stakeholders, and timing of initiative. Based on these four cases the phased/partial approach seems to have a greater chance for legislative success than immediate universal reform. Florida's partial, consensus-building approach resulted in the only signed bill of the four states. Washington's bill, which also took a partial approach, passed the state senate before ultimate defeat in 1992 and eventual passage in 1993. Neither of the more ambitious universal health care reform packages introduced in Wisconsin or Michigan got out of committee. Although some of the plans were thorough, none adequately addressed the tradeoff between increasing access to care and containing costs. In addition, this study will demonstrate that universal health care legislation, does not necessarily equate to comprehensive health care reform. The propositions derived from this research have implications for future state health care reform efforts, as well as for federal health care reform policy in terms of the substantive content of reform proposals and the political process by which they are advanced.     

Asian immigration to Australia: past trends and future prospects

Recent trends in immigration trends to Australia from Asia are analyzed, and future prospects are considered. Concerns about the ethnic composition of the population due to different levels of Asian immigration are emphasized, as are the policy options available to affect immigration levels.     

Innovation in local government: past,present, future

This article discusses the heightened importance of innovation in local government. It examines driving forces of innovation, as well as strategies for implementing innovation. Frameworks are discussed for studying innovation, and an overview of symposium articles is provided. The article concludes with policy implications and directions for future research.     

民族主义政党的发展历史、政策调整及前景

在亚非拉地区的广大发展中国家,民族主义政党是主要的政治力量.民族主义政党晚于西方资本主义政党的产生和发展,大多以民族主义为旗帜,以寻求民族独立解放、民族发展富强为宗旨目标.民族主义政党产生的历史背景、发展轨迹与西方国家近现代政党有很大不同,即使在民族主义政党之间,意识形态和政策主张也千差万别.     

Competition and health care policy: experience and expectations

Since 1970 federal policymakers have tried to strengthen competition and incentive-based market forces as alternatives to regulation in containing health costs. The effort to stimulate the growth of health maintenance organizations (HMOs) throughout the country has had limited results, and federal plans to promote competition by enacting changes in the health insurance market have so far come to little. Coalitions in some localities have shown growing interest in flexible HMO variants, however, and the intellectual force of the HMO critique of mainstream practices remains strong. Moreover, the federal government has shown new interest in prospective reimbursement of hospitals--a proposal that draws from both HMOs--competition--and hospital rate-setting programs--regulation--the element of prospectivity.     

继往开来 再创辉煌

中国青少年犯罪研究会自1982年成立以来,在党和政府的亲切关怀下,在社会各界的大力支持下,紧紧围绕党和国家工作大局开展青少年犯罪研究,充分调动广大会员开展学术研究的积极性和主动性,各项研究工作蓬勃发展,至今为止,累计发展了3000多名会员,22个省、自治区、直辖市建立了青少年犯罪研究会;组织召开了14次全国性学术讨论会,20多次区域性专题研讨会;受全国人大、国务院相关部门的委托,组织开展了多次大规模的调研,承担多项国家重点科研课题;组织编写、出版了《中国青少年犯罪学》、《青少年犯罪研究丛书》、《中国青少年犯罪研究年鉴》等著…     

Public policy and management issues in Taiwan's development

This symposium examines the experience of Taiwan's development and focuses on the role of government and the importance of public policy and management to the development. The symposium introduction paper consists of three sections addressing the following issues. First, the introduction section offers reasons for studying Taiwan's development experience. The second section provides an overview of the literature related to the relationship between government and economic development. Finally, the last section summarizes the major issues and findings emphasized in each symposium paper.