Tension, compression, and shear: directions, stresses, and outcomes of health care cost control

"Control" of health care costs is often portrayed as a struggle between external, "natural" forces pushing costs up and individuals, groups, and societies trying to resist the inevitable. This picture is false. Control includes strenuous efforts by some to raise costs, and by others to resist those increases, and/or to transfer costs to someone else. But all such forces originate in the purposes and interests of individuals and groups. Health care cost control is a struggle among conflicting interests over the priorities of a society, and claims of "inevitability" are simply part of the political rhetoric of that struggle. International experience supports certain conclusions. First, there is no basis for the claim that limits on expenditure growth must threaten the health of (some members of) a society. Second, there is a substantial variety of experience with cost control. Failure in the United States is often presented as evidence of the impossibility of control, but most other countries have succeeded. Finally, control requires the direct confrontation of interests, with substantial build-up of stress. Advocates of expansion are more successful if they can transform compressive forces into efforts to shift the burden onto someone else. Pressures from providers in every country for "privatization" and/or payment by users reflect this recognition of economic interest.     

The establishment of the presence and group classification of sperm in mixed stains by isoelectric focusing

The article deals with experimental data on design of the method used for detection of sperm, blood and vaginal secretions according to isoelectric points of acid phosphatases, differential diagnosis of ABO group antigens in "mixed" stains as well as detection of phenotype of red cell acid phosphatase by isoelectric focusing method.     

The population in a sociopolitical system in crisis: Mexico before the Revolution

The author reviews some of the literature on the Mexican Revolution in order to assess the impact of demographic change on the outcome of that conflict. Consideration is given to urbanization, spatial distribution, literacy, industrial growth and the employment opportunities it provided, and land conflicts caused by population growth. (SUMMARY IN ENG)     

The link between demographic events: a study of nuptiality patterns

The author examines links between the timing of various major life events (including women's age at marriage and the spacing of children) and the economic and urban development of a society, using Mexico as an example. The focus is on marriage patterns. She finds that nuptiality influences rural-urban migration for women, as do age and socioeconomic factors and husband's employment status. Data are from the Mexican Fertility Survey for the period 1976-1977. (SUMMARY IN ENG)     

The metropolitan character of urbanization in Mexico, 1900-1988

The author analyzes trends in urbanization in Mexico during the twentieth century, with a focus on the impact of rapid industrialization since 1982. Sections are included on the interrelations among economic development, industrialization, and urbanization; stages, levels, and measures of urbanization; the development of the city system in Mexico; and stages in the growth of Mexico City. (SUMMARY IN ENG)     

Tollison costs and technological innovation: The case of environmental regulation

This paper departs from the Tullock cost paradigm that views competition for monopoly privilege as a welfare-inimical process that wastefully dissipates preexisting producers' surplus and, occasionally, leads to inefficient increases in costs and counterproductive uses of scarce resources. The potential availability of rent-seeking may bring about the elimination of inefficient regulatory regimes that retard or prevent the introduction of cost-reducing innovations. Air quality management is but one area in which innovation rent-seeking holds promise for concrete welfare gains. Researchers may wish to focus on institutional mechanisms designed to overcome the transactions costs and free rider disincentives to the formation of a coalition to seek innovation rents. An example of such a mechanism might be a joint venture that requires all venture members to engage in lobbying and to contribute to collective research efforts. These unaddressed questions await future research.The authors are grateful for the insightful comments of Gordon Tullock, Robert D. Tollison, Michael T. Marlow and J.R. Clark. The usual caveats apply. The views expressed herein are solely those of the authors and should not be taken to represent the views of their employers.     

Are you ready for the cure?

The Clinton health-care plan will soon be unveiled. Here is an inside look at what it contains so far.     

The satisfaction with life scale: Psychometrics properties in an adolescent sample

The Satisfaction With Life Scale (SWLS) was developed in the United States as a multiitem scale for the overall assessment of life satisfaction as cognitive-judgmental process, rather as a measurement of specific satisfaction areas (e.g., health, energy). The present study attempted to extend the applicability of the SWLS by investigating specific aspects of reliability and validity in a different cultural context (Portugal) with adolescents. In line with previous American findings, reliability figures were found to be favourable. SWLS scores were affected by sex and sociocultural level. In addition, SWLS scores showed to be predictably associated with psychological measures: loneliness, social anxiety, shyness, self- concept, and physical attractiveness. The variables that best predicted satisfaction were overall self-concept, loneliness, and physical attractiveness.Received a Ph.D. in normal and abnormal anthropology from École des Hautes Études en Sciences Sociales (Paris) in 1980 and a Ph.D. in Social Psychology from Faculty of Psychology (Porto) and an Aggregation in Psychology from Faculty of Psychology (Coimbra) in 1990. Research interests include migration and cross-cultural social migration.The author wishes to thank the anonymous reviewers for their helpful comments on an earlier version of this paper.