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In this study we explore whether HMO-induced competition has contained expenditures in Minneapolis/St. Paul hospitals. Specifically, we assessed the impact of HMOs on revenue, cost, and net income per admission in Twin Cities hospitals from 1979 to 1981. Some HMOs have obtained negotiated discounts from hospitals. We found that hospitals which gave larger discounts did not have lower costs per admission. This finding suggest that discounts do not force hospitals to operate more efficiently. In addition, hospitals with a large share of patients from HMOs or government Medicare and Medicaid programs did not have lower costs per admission than other hospitals during the years from 1979 to 1981. This finding casts doubt on the claim that discounts are justified by lower costs for HMO or government patients. Finally, neither HMO market share nor discounts had an adverse effect on hospital profits. During the three years studied, hospital profits in the Twin Cities showed an upward trend. This study concludes that if competition is to succeed it must encompass more than HMOs. HMOs may be important, but they are only one agent in the market. Thus, public policy created to induce competition must go beyond the simple stimulus of HMO growth.  相似文献   
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Pantomime Dames     
The British Broadcasting Corporation's television show Snog, Marry, Avoid (SMA) states its mission is, ‘to reveal a nation of stunning natural beauties who are currently hiding behind layers and layers of slap’ [BBC. 2008. Snog, Marry, Avoid Season One. United Kingdom: Remarkable Television]. This article considers SMA as a useful text for deconstructing contemporary norms of femininity. I utilise queer and affect theory perspectives from Berlant [2011. Cruel Optimism. Durham, NC: Duke University Press], Halberstam [1998. Female Masculinity. Durham, NC: Duke University Press, 2012; Gaga Feminism: Sex, Gender, and the End of Normal. Boston, MA: Beacon Press] and Puar [2007. Terrorist Assemblages: Homonationalism in Queer Times. Durham, NC: Duke University Press] to reveal the queer dimensions of the excessive femininity represented in the show. Berlant's work illuminates attachments to particular stylings, to understand where ‘cruel optimism’ operates. Further, I apply the idea of ‘queening’ as an inverse reference to Halberstam's ‘kinging' [Halberstam, J. 1998. Female Masculinity. Durham, NC: Duke University Press, 259]. Lastly, Puar's ideas are used to analyse the affective dimensions of excessive feminine embodiment in order to consider how this involves a queering of the body. This article departs from recent feminist scholarship on the rise of raunch culture and post-feminism. Rather than focusing on the participants of SMA as symptoms of a problematic hypersexual culture, I argue for seeing these contemporary young women's excessive femininity as queer, that is, as troubling the boundaries of gender ‘normality’.  相似文献   
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This article examines the place of occupational pluralism in the adaptive family economy of rural shipyard workers in nineteenth-century Weymouth, Nova Scotia. The concept of the adaptive family economy emphasizes that families attempt to maximize economic well-being by diversifying the employment opportunities of family members. For most shipyard workers, shipbuilding was a part-time activity that complemented seasonal farming and lumbering activities. The role of space, land ownership, and the characteristics of workers reveal certain economic and sociocultural features that are associated with pluralism, including larger family size, the use of land for farming and security of food production, and the importance of job location for participation in pluralist activities. These features stand more clearly revealed by examining them within the larger economic and cultural context of shipbuilding, farming, and lumbering in the Confederation era.  相似文献   
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This article examines the debate within corporate governance about the appointment of female non‐executive directors (NEDs). The first part tracks the diversity story that corporate governance tells about itself from the Cadbury Report (1992) to the Davies Report (2011). The second sets out the evidence used to support the argument that female appointments enhance profits and corporate profile. The third part presents the authors' empirical analysis of FTSE 100 companies and female nonexecutive board membership, and concludes that there is little evidence that companies with female board membership display different characteristics from those without. Industry sector emerges as a significant factor in female appointments. The idea that women should be appointed to boards to increase corporate profitability and profile is not strongly supported by this analysis. A social justice argument based upon the right of woman to equal economic participation opportunities provides a much superior articulation of the need for boardroom diversity.  相似文献   
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