Ideas and inducements in mental health policy.

Between 1946 and 1963, federal officials sought to change the national practice of providing mental health care, away from state-run mental institutions and toward outpatient care based in local communities. These policy makers relied on two policy instruments, ideas and inducements. Both instruments contributed to unexpectedly significant changes in federal, state, and local policy. I conclude that a policy instrument framework helps to disentangle the strands of successful public management, and that it is useful to think of ideas as policy instruments that offer leverage on policy outcomes.     

Evaluating the benefits and costs of the job corps

Social programs have a wide variety of effects and often have the explicit objective of improving the economic status of the people they serve. In order to be useful to policymakers, benefit—cost analysis of social programs should explicitly take account of these two important program features. The approach used in this analysis of the benefits and costs of the Job Corps does this and provides a useful methodology for evaluating other social programs. According to the analysis, the program has substantial net value for society as a whole as well as for the average Corpsmember.     

Economic globalization, job insecurity and the populist reaction

A striking change in the political party systems of many established democracies in recent years has been the rise to electoral and political prominence of right-wing populist parties. Moving beyond the usual anti-statism and racism attitudinal explanatory foci, this article posits that popular support for these parties is associated with the job insecurity that populist party leaders have attributed to deepening international economic integration, or economic globalization. The conceptualization of job insecurity is discussed and its expected relationship to the mercantilism of right-wing populist parties clarified. The hypothesis is tested in the specific context of support for Pauline Hanson’s One Nation Party in the 1998 election to the Australian federal House of Representatives. The article concludes with a consideration of the wider implications of its findings.     

Mortal Beings: How Evolution Helps Us Understand Illness and Aging

In these two books, biological anthropologist Richard Bribiescas and developmental psychologist David Geary address sex differences in health and aging from the perspectives of evolutionary biology and psychology. Bribiescas explores the aging process in men and describes why and how men age differently from women, with earlier mortality and greater susceptibility to the diseases of aging. Geary provides a comprehensive survey of the animal and human literature on sex differences in vulnerabilities to the effects of stress on psychological and physical traits. Both authors focus on the role of Darwinian sexual selection as the source of different health outcomes for men and women. These works make valuable contributions to our understanding of why humans get sick and age and argue convincingly for approaching medical research with a greater sensitivity to the role played by biological sex in poor health.     

Impact of job location on relationship between job satisfaction and self‐esteem of employees: Evidence from the Indian BPOs

Does job location impact on job satisfaction and self‐esteem? To answer this question, a sample of 298 responses was drawn from business process outsourcing employees working in four different locations in two south Indian states. The study conducted in both rural and urban locations witnessed that the job location (rural/urban) has a significant impact on job satisfaction and self‐esteem despite similar job demands and resource support conditions for all the respondents. Results show a very large divergence in self‐esteem between rural and urban settings and some divergence across genders. Location of delivery centres in smaller towns could thus be an effective solution for the high turnover experienced at urban delivery centres handling data capture and such low end processing.     

Medicaid matters: children's health and Medicaid eligibility expansions.

In the late 1980s, a series of federal laws were enacted which expanded Medicaid eligibility to more of the nation's children. States had a great amount of discretion in how fast and how far these expansions were implemented. As a result, there was great variation among the states in defining who was eligible for the program. This variation provides a rare opportunity to disentangle the effect of Medicaid from a child's socioeconomic status. Using data from the National Health Interview Survey, we address whether the Medicaid expansions improved the health and functional status of children. Econometric models were developed using fixed-effects regressions, and were estimated separately for white, black, and Hispanic children. White children experienced statistically significant reductions in acute health conditions and functional limitations. Black and Hispanic children showed some evidence of improved health conditions and functional status, but this evidence is inconclusive in the study sample. This may be due to differences in their access to appropriate health services or to the smaller sample size of minorities in each geographic area. The findings are also relevant to the implementation of the Children' Health Insurance Program (CHIP), the latest federal effort to expand access to health care to poor and near poor children. In many states, CHIP is being implemented in whole or in part through further Medicaid expansions.     

Coexistence of public and private job agencies: Screening with heterogeneous institutions

In response to the analysis of bureaucracies and the finding of inherent inefficiencies, public choice theory argues for an increase in competition by contracting out government services and deregulation. The paper explores the effect of coexisting public and private employment services in a model with private information of the worker about her ability and unobservable effort choice. The employer's use of an efficient unemployment exchange and an efficient private agency may lead to optimal screening with first best contracts. This is due to the assumption that good types of workers lose more human capital than bad types in periods of unemployment or mismatch. In contrast to standard screening contracts, a bad type of worker earns an information rent if the employment exchange is inefficient, but the employer chooses not to use the private agency for good types.     

Combatting program fragmentation: Local systems of vocational education and job training

As the number of local institutions that train individuals for employment has grown, policymakers have become concerned about possible duplication and wasteful competition. Potential solutions to this perceived problem typically revolve around strategies for encouraging greater coordination among local education and training agencies. Yet little is known about either the extent of duplication in local communities or about interactions among institutions. To begin to fill this gap, we conducted comparative case studies of eight communities. We found little service overlap or competition. Instead, using a variety of mechanisms, local institutions have established clear divisions of labor and have linked themselves in well-defined, though largely informal, systems. The present study concludes with a discussion of how state and federal policy might facilitate the creation and maintenance of effective local systems of work-related education and training.     

Information, market government, and health policy: a study of health data organizations in the states.

Information is essential to the success of market-oriented policies. Information on health care costs and quality is collected and distributed by state governments through health data organizations (HDOs) to enhance competition and lower costs in the medical industry and to improve consumer choice among medical alternatives. This article examines the information collected, produced, and distributed by state health data organizations in Colorado and Pennsylvania. Findings reveal that information was not the objective determinant of choice and competition as market-oriented policy designers had hoped. Nor did market-oriented bureaucracies produce and distribute data readily accessible for public choice. Instead, information produced and distributed by these HDOs was the result of political and bureaucratic exercises that conform much more to classic interest group policymaking and captured bureaucracies than to contemporary market-oriented government ideals. The findings underscore the extraordinary difficulties facing federal-level policy designers as they contemplate introducing market-oriented health care policies on the national level.