ON FORCING AND FREEDOM: A REPLY TO CARTER

Its still a free country. Lots of people think the legislature has taken your liberties away. It ain't done nothin' of the sort It's only passed laws providin' that you go to jail if they catch you exercising those liberties. Hell, it's still a free country! (Gramp Wiggins in Gardner, 1943, p.52.)     

THE HEALTH CARE FINANCIAL CRISIS: REORGANIZATION AND EVIDENCE-BASED MEDICINE AS A RESPONSE TO AN "UNHOLY TRINITY"

The key issues of the health care system are often conceptualized as involving three basic dimensions: 1) the quality of health care provided, 2) access to the health care system, and 3) the cost of health care. Following two decades of rapidly escalating health costs throughout advanced industrial societies, the relationships among these three dimensions now constitute what has been called an “unholy trinity” in that improvements along one dimension will almost inevitably provoke problems in terms of one or both of the others. This symposium examines two distinct types of reform that have been developed in response to the crisis in health care costs. The first focuses upon attempts to reorganize existing institutions in order to make them more effective and cost‐efficient. The second considers the move toward “evidence‐based medicine,” that is, more critically evaluating health care outcomes to make sure that treatments are effective and cost‐efficient.     

A SOP TO THE "OI POLLOI": CAPITAL, LABOUR AND THE REFORM OF NEW SOUTH WALES MARITIME ADMINISTRATION 1867 TO 1914

Abstract: In 1867 NSW maritime services were rationalised by the formation of a Marine Board comprising government appointees and elected representatives of shipowners. Following several scandals relating to Marine Board administration and an inquiry by the new Public Service Board sitting as a Royal Commission, the Marine Board was replaced in 1899 by a Navigation Department. In 1900 Sydney wharfage was nationalised in response to the bubonic plague outbreak of 1899 and placed under the control of a Sydney Harbour Trust. This dual structure persisted throughout the pre-war period. Calls came from the Greater Sydney movement for wharfage to be placed under the control of an enlarged city council, and from the labour movement of trust tenants and employees for the trust to operate on non-commercial principles. These pressures were successfully resisted by the trust commissioners, despite the presence of a Labor government after 1910. In their administration the commissioners of the Trust favoured capital, but their image of technocratic impartiality enabled them to constrain Labor governments and to carry through substanial extensions of state activity when this was in the interests of capital as a whole.