The Medicare approach: political choice and American institutions

The most significant health reform in American history was the passage of Medicare in 1965, but this was an accomplishment born of defeat. Medicare was designed and understood by its early promoters as an approach to health reform, not simply as a discrete program for a distinct target population. Although Medicare incrementalism has tended to be shunted aside when the opportunities for health reform are most promising, the final years of the Johnson administration reveal previously underappreciated efforts to expand Medicare eligibility to large new population groups and offer insights into the continuing potential of Medicare incrementalism in our own time.     

Determining the Source of Equine Bloodstains by Dinucleotide Repeats*

Abstract: A novel multiplex of independent dinucleotide tandem repeat (DTR) loci was previously described that is capable of not only discriminating human and equine DNA, but of identifying a single equine source. We report a case in which a bloodstained syringe and two needles were found during inspection of a barn by inspectors of the Pennsylvania Racing Commissions. Using the multiplex and single‐locus detection, all 21 equine DTR markers were detected in a suspect horse and two evidence samples, indicating the evidence samples came from the suspect animal. Only six markers were detected in the third evidence sample because the volume of blood was limited. Following whole‐genome amplification and single‐locus PCR, the third evidence sample detected a total of 17 markers and the likelihood of identity (probability from suspect horse/probability from a random pacer) was 7.0 × 10⁶. The DTR multiplex has some technical limitations, but it is already practical for casework.     

Statistical Inference After Model Selection

Conventional statistical inference requires that a model of how the data were generated be known before the data are analyzed. Yet in criminology, and in the social sciences more broadly, a variety of model selection procedures are routinely undertaken followed by statistical tests and confidence intervals computed for a “final” model. In this paper, we examine such practices and show how they are typically misguided. The parameters being estimated are no longer well defined, and post-model-selection sampling distributions are mixtures with properties that are very different from what is conventionally assumed. Confidence intervals and statistical tests do not perform as they should. We examine in some detail the specific mechanisms responsible. We also offer some suggestions for better practice and show though a criminal justice example using real data how proper statistical inference in principle may be obtained.     

Proof of a Sentient Knower: Utpaladeva’s <Emphasis Type="Italic">Ajaḍapramātṛsiddhi</Emphasis> with the <Emphasis Type="Italic">Vṛtti</Emphasis> of Harabhatta Shastri

Utpaladeva (c. 900–950 C.E.) was the chief originator of the Pratyabhijñā philosophical theology of monistic Kashmiri ?aivism, which was further developed by Abhinavagupta (c. 950–1020 C.E.) and other successors. The Aja?apramāt?siddhi, “Proof of a Sentient Knower,” is one component of Utpaladeva’s trio of specialized studies called the Siddhitrayī, “Three Proofs.” This article provides an introduction to and translation of the Aja?apramāt?siddhi along with the V?tti commentary on it by the nineteenth–twentieth century pa??it, Harabhatta Shastri. Utpaladeva in this work presents “transcendental” arguments that a universal knower (pramāt?), the God ?iva, necessarily exists and that this knower is sentient (aja?a). He defends the Pratyabhijñā understanding of sentience against alternative views of both Hindu and Buddhist schools. As elsewhere in his corpus, Utpaladeva also endeavors through his arguments to lead students to the recognition (pratyabhijñā) of identity with ?iva, properly understood as the sentient knower.