Breaking gridlock: the determinants of health policy change in Congress

Prior to the 2010 health care reforms, scholars often commented that health policy making in Congress was mired in political gridlock, that reforms were far more likely to fail than to succeed, and that the path forward was unclear. In light of recent events, new narratives are being advanced. In formulating these assessments, scholars of health politics tend to analyze individual major reform proposals to determine why they succeeded or failed and what lessons could be drawn for the future. Taking a different approach, we examine all health policies proposed in the U.S. House of Representatives between 1973 and 2002. We analyze these bills' fates and the effectiveness of their sponsors in guiding these proposals through Congress. Setting these proposed policies against a baseline of policy advancements in other areas, we demonstrate that health policy making has indeed been far more gridlocked than policy making in most other areas. We then isolate some of the causes of this gridlock, as well as some of the conditions that have helped to bring about health policy change.     

Insanity, methamphetamine and psychiatric expertise in New Zealand courtrooms

The use of methamphetamine in New Zealand has increased significantly over the last decade. Due to the potential of methamphetamine to induce, exacerbate and precipitate psychotic symptoms, this drug has also taken centre stage in several criminal trials considering the sanity of defendants. Highly publicised and often involving contested expert evidence, these criminal trials have illustrated the limits of using psychiatric expertise to answer legal questions. This article considers the implications of such cases in light of material from a qualitative study that aimed to generate insights into the difficulties forensic psychiatrists and their instructing lawyers face when providing expert evidence on the relationship between methamphetamine, psychosis and insanity. It reports material from 31 in-depth interviews with lawyers and forensic psychiatrists and observation of one criminal trial that considered the relationship between methamphetamine and legal insanity. The findings are correlated with the clinical and medico-legal literature on the topic and subjected to scrutiny through the lens of "sanism". The article concludes that the continued use of forensic psychiatry to meet the legal objectives of insanity, where methamphetamine is involved, has the potential to reinforce sanist attitudes and practices.     

Book reviews

Anthony Giddens, THE CONSEQUENCES OF MODERNITY (Stanford, California: Stanford University Press, 1990). Anthony Giddens, MODERNITY AND SELF‐IDENTITY: SELF AND SOCIETY IN THE LATE MODERN AGE (Stanford, California: Stanford University Press, 1991)

Robert B. Westbrook, JOHN DEWEY AND AMERICAN DEMOCRACY (Ithaca, NY: Cornell University Press, 1991)

David Harvey, THE CONDITION OF POSTMODERNITY: AN ENQUIRY INTO THE ORIGINS OF CULTURAL CHANGE (Oxford: Blackwell, 1989)

Robin Blackburn, ed., AFTER THE FALL: THE FAILURE OF COMMUNISM AND THE FUTURE OF SOCIALISM (London and New York: Verso, 1991)

Andrew Hacker, TWO NATIONS: BLACK AND WHITE, SEPARATE, HOSTILE, UNEQUAL. (New York: Charles Scribner's Sons, 1992)

Ridgeway, James, BLOOD IN THE FACE: THE KU KLUX KLAN, ARYAN NATIONS, NAZI SKINHEADS AND THE RISE OF A NEW WHITE CULTURE (New York: Thunders Mouth Press, 1991)

Gene H. Bell‐Villada, THE CARLOS CHADWICK MYSTERY: A NOVEL OF COLLEGE LIFE AND POLITICAL TERROR. (Albuquerque, NM: Amador Publishers, 1990)     

Resistance in hopeles’: Assimilating queer theory

This paper seeks to assimilate Queer Theory, i.e. to bring it within the gambit of a ‘mainstream’ or ‘dominant’ space: the academy. It does so by historicising Queer Theory, and investigating, if not what it is, then at least what it has been. This makes it possible to engage critically with Queer Theory, Suggesting that Queer Theory has often employed tropes of assimilation, the paper turns to another cultural site at which such language is popular—science fiction—in order to investigate the assumption of these metaphors. It goes on to suggest some of the assumptions about cultures which underlie these metaphors. Finally, it points to other sites in Queer Theory which undermine these assumptions, and provide other ways—quite uninterested in assimilation—in which to think Queer.     

The changing geography of metropolitan opportunity: The segregation of the poor in U.S. metropolitan areas, 1970 to 1990

Abstract

This analysis uses census tract data to measure the segregation of the poor in U.S. metropolitan areas in 1970, 1980, and 1990. Two measures of segregation are used: the indices of dissimilarity and isolation.

In 1990 the mean dissimilarity of the poor in the 100 largest U.S. metropolitan areas was 36.1, which is substantial but below the 60.6 dissimilarity of blacks. The 1990 isolation of the poor was 21.0. From 1970 to 1990, the dissimilarity of the poor increased by 11 percent, and the isolation of the poor rose by 9 percent; in contrast, racial segregation declined. Exploratory regression analyses reveal that income segregation in metropolitan areas was significantly greater in 1990 and increased more from 1970 to 1990 in the Northeast than in the South and West. Midwest areas generally were not significantly different from Northeast areas in 1990 segregation levels or in changes from 1970 to 1990.     

Punk Subculture in Mexico and the Anti-globalization Movement: A Report from the Front

This article explores some strands of the current movement against capitalist globalization. It examines the affinity between punk subculture and autonomous politics taking the Mexican punk scene as an example. Based on participant observation it describes what Bourdieu would call the habitus of punk in Mexico. Recorded music, subcultural style and political ideas arrive into this habitus where they are selectively adopted. Thus, attempts to articulate punk in Mexico to the "anti-globalization" movement are somewhat different than in the United States and Canada.     

The agricultural crisis in Egypt

The paper probes the historical origins of and current responses to the agricultural problems of Egypt. Much of the difficulty stems from the fact that the class structure, the distribution of resources, and the social bases of both Nasser's and Sadat's regime have blocked either the mobilization of the peasantry on the one hand or the provision of decentralized incentives on the other. After a brief assessment of Nasser's land reforms, price policies, and investment strategy, the current responses of changing crop patterns and mechanization are assessed. Such a strategy seems unlikely to succeed, but no other obvious alternative strategy is at hand.