An epidemiological assessment of problematic contacts to members of Congress

In order to assess the nature of threat assessment activity pertaining to members of Congress, 4387 cases involving threatening and other problematic contact were analyzed. The cases were studied regarding subject characteristics, articulated motives, as well as several aspects of contact behavior in relation to approach behavior. Approachers were significantly less likely to have articulated threat language prior to or during their contacts and were also less likely to have stated a policy grievance (foreign or domestic) as the source of their concern. Further, approachers were substantially more likely to have expressed help seeking requests as part of their prior and approach-related contacts and were less likely to have had racial or sexualized content within their contacts. Approachers were also significantly more likely to have had a criminal record as well as displayed symptoms suggestive of major mental illness. Subjects engaging in approach behavior were also less likely to have used an alias, were less likely to be a direct constituent of the target and were more likely to have contacted multiple congressional targets. The implications for threat assessment activity are discussed.     

Will physician unions improve health system performance?

In the public debate over the extension of collective bargaining rights to independent physicians, union proponents' primary argument has been that patients would benefit from allowing physicians to bargain collectively with health plans. This article examines the likely effects of physician unions on the U.S. health care system. Specifically considered are likely effects on economic efficiency, quality, access, and cost. Under none of these criteria are physician unions likely to improve health system performance, particularly when compared with available alternative strategies for dealing with problems identified by union proponents.