Changes in corporate organization of the health care system

Health care financing has undergone numerous structural changes over the years. Change continues while extreme growth seriously affects the health care focus. The author examines the multiclass system and health financing trends. Restructuring techniques are also discussed.     

The R and D contract and democratic theory

The purposes of this essay are to describe how federal research and development policy has altered authority relationships and to suggest a new concept of legitimacy in accord with the changed conditions. Research and development (R and D) creates an indeterminate future. Thus, the politics of research and development incorporates an apparent contradiction : political leadership demands that jobs be done which require creative and unpredictable actions on the part of private organizations, while it also demands that contractors be held responsible for fulfilling goals efficiently, avoiding deleterious secondary consequences, and refraining from abuses of power. The paradox can be resolved by creating norms of responsibility that allow for judgments on how a job is done rather than what is to be done. New institutions for technological assessment to check on unintended consequences of projects and citizen review boards to estimate the quality of life engendered by projects may provide such norms of responsibility.