The elderly's access to health care services: The crude and subtle impacts of Medicare changes

Medicare, the federal government's health insurance program for the aged and disabled, has been subjected to a number of legislative and regulatory changes since 1981 aimed at reducing the costs of the program. About a third of the cutbacks have been in activities that directly increase patient cost sharing. Other changes, while aimed at improving efficiency, may also shift costs onto program beneficiaries. This paper estimates the differential impacts of such program changes by age and income of elderly Medicare enrollees and discusses the likely resulting impact on their access to care. Surprisingly, such equity concerns have been largely overlooked in the policy debate concerning cost containment under Medicare.     

Education and identity: Thoughts on the social origins of anorexia

Anorexia nervosa is often said to be a condition which afflicts mainly middle-class girls. This paper suggests that it is not social class but a high level of educational attainment which is associated with the onset of anorexia.The effect of education is analysed in terms of it's influence on the identity -formation of the young woman. Anorexia can be seen as an attempt to rescue a spoilt identity.     

When Loving Means Hurting: An Exploration of Attachment and Intimate Abuse In a Community Sample

Intimate relationship abuse can be understood by considering two critical tenets of attachment. First, attachment fulfills a basic need for survival. Thus, the tenacity of the attachment bond is independent of relationship quality. Second, individuals whose attachment needs have been frustrated may strike out violently to regain proximity to the perceived loss of an intimate partner. We examined how individual differences in attachment were associated with women's and men's relationship abuse. A telephone survey assessed levels of psychological and physical abuse in 1249 Vancouver residents. Of these, 128 completed an attachment interview exploring their interpersonal relationships. Hierarchical regressions revealed that attachment variables contributed significant variance to prediction of both receipt and perpetration of psychological and physical abuse, with preoccupied attachment acting as an independent predictor. There was no evidence that gender moderated these associations. The findings suggest that attachment preoccupation in either partner may increase likelihood of abuse in couples.     

The Political Economy of Growth: Democracy and Human Capital

Democracy is more than just another brake or booster for the economy. We argue that there are significant indirect effects of democracy on growth through public health and education. Where economists use life expectancy and education as proxies for human capital, we expect democracy will be an important determinant of the level of public services manifested in these indicators. In addition to whatever direct effect democracy may have on growth, we predict an important indirect effect through public policies that condition the level of human capital in different societies. We conduct statistical investigations into the direct and indirect effects of democracy on growth using a data set consisting of a 30-year panel of 128 countries. We find that democracy has no statistically significant direct effect on growth. Rather, we discover that the effect of democracy is largely indirect through increased life expectancy in poor countries and increased secondary education in non poor countries.     

Polygraph testing for deception in Australia: effective aid to crime investigation and adjudication?

Polygraph testing--or the monitoring and analysing of selected physiological measures of an individual who is being interviewed, for the purpose of detecting deception--is controversial in Australia. Considerable mythology surrounds this method of detecting deception. Embedded in popular perceptions of crime fighting and utilised in high-profile criminal cases in Western Australia, Victoria and Queensland, polygraph testing is also explicitly prohibited from being used in crime investigation in New South Wales. Unlike in the United States, polygraph testing has not hitherto routinely been used by government departments and authorities as a preemployment screening tool, but is increasingly being offered in the private sector in Australia. This article examines the current scope of polygraph testing in Australia, describes different approaches to testing, briefly reviews recent information relating to validity and evaluates State legislation prohibiting the use of polygraph testing for specified purposes in New South Wales. Consequent to the continuing controversy regarding the accuracy of polygraph testing in detecting deception (and, conversely, truth-telling), it is argued that the emerging use of polygraph testing is problematic and common law principles rendering the results of such testing inadmissible in court do not constitute sufficient safeguard against inappropriate and intrusive testing. Future research should identify specific polygraph testing techniques and consider the most socially beneficial way of regulating this emerging area of practice.     

Delegating divisible sovereignty: Sweeping a conceptual minefield

Delegating sovereignty to international organizations (IOs) is both increasingly common and controversial. I address the sources of current controversies in three claims. First, although alleged otherwise, sovereignty is eminently divisible. From practice, indivisibility should not be a barrier to delegating to IOs. Second, it is intuitive that longer chains of delegation will be more likely to fail. Yet, it is not the length of the chain per se that matters as whether identifiable conditions for successful delegation are satisfied. Third, although “delegation” is often used to refer to both, delegating and pooling sovereignty are distinct activities. Much of the concern with IOs is really about pooling rather than delegating sovereignty.