Exemptions from Compulsory Income Management: A Short “History of the Present”

The historical study of exemptions has focused on escape from protectionist policies designed to control and monitor Aboriginal people in Australia — restricting their freedom of movement, intruding into their family life, and reducing their ability to participate on equal terms in the labour force. In this paper, we consider a contemporary policy — income management — which primarily restricts the freedom to dispose of personal income and has targeted Aboriginal people and communities, both directly and indirectly. Provisions for individual exemptions have been incorporated inconsistently within the many iterations of income management, and Aboriginal people are significantly less likely than others to be granted an exit from this form of financial control. The study reported here is an example of mixed-methods social research, rather than an historiography. We use techniques of historical comparison to illuminate contemporary practices and identify the ongoing influence of settler-colonial governance in the lives of Aboriginal people.     

Health system performance reporting in Canada: Bridging theory and practice at pan‐Canadian level

Public reporting is increasingly used to enhance accountability and transparency and stimulate performance improvement in the public sector. In Canada performance reporting in the health sector is still in development, and involves a large number of actors. This article reports on the results of a recent intervention by the Canadian Institute for Health Information (CIHI) to develop a platform for pan‐Canadian performance reporting ( http://www.yourhealthsystem.cihi.ca ). It describes approaches taken to: develop a conceptual framework; engage the public in the definition of performance reporting priorities; and select indicators for public reporting. This article also discusses conceptual, methodological and operational challenges as well as a proposed evaluation strategy.     

A shrinking state? Politics,economics and private health care in Thailand

This article explores the political and economic forces involved in the development of privatization policies within the health care sector in Thailand. It is suggested that many of the motivating factors behind private sector growth are outside of the health sector; the general macroeconomic environment and tax incentives have stimulated private sector expansion. Within the Ministry of Public Health a preoccupation with improving care in rural areas and an unclear policy line on the private sector has facilitated this expansion. Only recently has private sector growth come to the policy agenda. During this lag period a number of interest groups have developed. It will be difficult to overcome these entrenched interests in order to change policy direction. Meanwhile, problems of rapid cost inflation and inequity face the Thai health care system. Although this case study focuses upon the health care sector in Thailand it would appear relevant both to other sectors and to other countries. The relationship between development models based upon pro-private, pro-market tenets and the establishment of a satisfactory social policy is questioned.     

Adolescent males with urogenital anomalies: Their body image and psychosexual development

Three midadolescent males with major congenital urogenital anomalies and multiple surgical repairs are described. Each patient had suffered repeated profound insults to body image concepts and gender identity from infancy onward, now clearly reflected in his psychosocial behavior and in figure drawings. Of major importance is the total lack at any time of counseling and emotional support as a part of comprehensive management. A plea is made for awareness of the psychological effects of such disorders and the need for long-range therapeutic planning from early childhood through adolescence to develop sound compensatory modes of coping with this stress.Formerly fellow in adolescent medicine, New York University Medical Center, at the time the material for this report was collected. Received his M.D. and pediatric training at Boston University School of Medicine and Boston City Hospital. Research interests include comprehensive health care for adolescents and the effects of illness on adolescent psychological development.Received his Ph.D. in psychology from Heed University, Miami, Florida, and training in psychology and child development at New York University. Research interests include the psychological effects of hospitalization on children and youth, minimal brain dysfunction, and developmental assessment in infancy.Received her M.D. from the University of Rochester, pediatric training at University of Minnesota Hospitals and Babies Hospital, New York City, and training in adolescent medicine at Beth Israel Hospital, New York. Research interests include psychological effects of illness and hospitalization in adolescents, legal rights of minors, and adolescent sexuality.