Wilton Marion Krogman, Ph.D. (1903-1987): the end of an era

Dr. Wilton Marion Krogman was one of the major founders of physical and forensic anthropology in the United States. His extraordinary career spanned nearly six decades, and he was universally admired and respected for his scholarship, teaching, research, wit, and humanity. While studies based on human skeletal remains have long been used to assist the medicolegal system, the late Dr. Krogman can be credited with uniting these areas into the discipline of forensic anthropology. His "Guide to the Identification of Human Skeletal Material" (1939) in the F.B.I. Law Enforcement Bulletin became the foundation of this discipline; his monumental book The Human Skeleton in Forensic Medicine (updated with the author in 1986) solidified its establishment. The purpose of this paper is to pay tribute to this great man and outline his influence on the development and advancement of forensic anthropology.     

Is medical care different? Old questions, new answers

This paper examines whether changes in medical markets may be making them more like other markets. The emergence of HMOs and other managed care systems appears to have increased the consumer's potential ability to make better comparative judgments about the price and quality of medical care, and also seems to have made medical care more like other goods. However, the evidence that medical care is a "reputation good" suggests that it is, in this respect, different from other goods. Finally, the social concerns about medical care use necessarily make medical care different.     

Effects of positional restraint on oxygen saturation and heart rate following exercise

This report assesses the effects on peripheral oxygen saturation and heart rate that positional restraint induces when a person is prone, handcuffed, and "hog-tied." Peripheral oxygen saturation and heart rate were monitored at rest, during exercise, and during recovery from exercise for 10 adult subjects. The effects of positional restraint produced a mean recovery time that was significantly prolonged. Consequently, the physiological effects produced by positional restraint should be recognized in deaths where such measures are used.     

PPS waivers: implications for Medicare, Medicaid, and commercial insurers

This paper compares the Medicare prospective payment system (PPS) to four all-payer rate-setting systems that operated under HCFA waiver authority. The study examines the experience of Medicare, Medicaid, and commercial insurers under the two approaches. Data from several American Hospital Association surveys and from Medicaid 2082 report forms are analyzed. The paper concludes that the all-payer waiver programs have been as successful as PPS in controlling the rate of growth in Medicare costs. In addition, Medicaid programs are more successful in controlling their outlays in all-payer rate-setting environments than when they "go alone." Finally, there is no evidence to suggest that hospitals can increase charges in response to greater financial need under either PPS or the state waivers. Nevertheless, it appears that commercial insurers are better able to compete with Blue Cross plans in all-payer rate-setting states than elsewhere.