Actuarial status of the HI (hospital insurance) and SMI (supplementary medical insurance) Trust Funds

This article is adapted from the 1987 Annual Reports of the Medicare Board of Trustees. It presents a summary of the current financial and actuarial status of the Hospital Insurance (HI) and Supplementary Medical Insurance (SMI) Trust Funds. The Board found that the present financing schedule for the HI program is sufficient to ensure the payment of benefits over the next 12-14 years if the intermediate (II-A and II-B) assumptions underlying the estimates are realized. Although steps have been undertaken to reduce the rate of growth in payments to hospitals, the Board urges Congress to take remedial measures to bring future HI program costs and financing into balance. The Board found the SMI program to be actuarially sound but recommends that Congress take action to curtail the rapid growth in that part of Medicare.     

Government administration in a small microstate: Developing the Cayman Islands

The Cayman Islands use some of the increasingly familiar methods of resolving administratively the problems of smallness. The country's development and administrative performance depend on human resources which need to be planned in order to reduce dependence on outsiders, especially among the middle ranks of technical and professional staff. Education and training for the public service in the Cayman Islands is inadequate. Control of the administration is weak, especially among the independent boards and commissions, and there is a need for appeal procedures when the principles of natural justice have been breached. Political manipultion in personnel matters adversely affects performance, and there is a need for an effective civil service association to deal with other abuses. The problems of public administration are solved by scaling down the role of government in favour of private enterprise and against the provision of social welfare.     

Achieving a negotiated compensation agreement in siting: The MRS case

Theoreticians claim that negotiated compensation plans could overcome local resistance to nuclear waste (or other less than desirable) facilities, and the Nuclear Waste Policy Act of 1982 gives the Department of Energy considerable flexibility to negotiate with and compensate states in which it locates waste storage. DOE's monitored retrievable storage (MRS) proposal is the first attempt under the NWPA to site nuclear waste operations, and both DOE and one local community tried the negotiated compensation approach with some success. State and regional leaders chose to oppose the project rather than to negotiate, however. The limited experience to date suggests that local reluctance to negotiate is a generic weakness of the compensation approach to siting and must be given greater attention.     

Introduction to special issue

As regards prognosis, none of these cases, however exhausted, are really hopeless whilst life exists: and, for the most part, the prognosis may be considered favourable. (Gull, 1873)Received M.D. Ph.D. from Albert-Ludwig University in Freiburg, Germany. Research Interests are depressive disorders, eating disorders, in particular anorexia nervosa, and more recently women's health.     

Turn-taking in mother-adolescent conversations about sexuality and conflict

The current study examined the nature and style of mother-adolescent conversations, how these conversations differ by subject matter, and dyadic and individual differences. Thirty-one mother-adolescent dyads (17 boys, 14 girls) with a child between the ages of 11 and 14 had a nonstructured conversation, and conversations about conflict and sexuality. They also completed questionnaires on beliefs about acquired immunodeficiency syndrome (AIDS). Conversations were measured for turn taking, total number of words, and conversational dominance, as well as nonverbal measures of affiliation, shame, and contempt. Conversations about sexuality involved less turn taking, fewer words, and more mother dominance than nonstructured conversations. Conversations about conflicts involved less turn taking but more words than nonstructured conversations. Some gender and age differences were found. More interactive conflict conversations contained higher levels of affiliation, and lower levels of child shame than conversations with fewer turns or higher mother dominance. In addition, children in more interactive dyads possessed a larger percentage of their mother's AIDS knowledge, and worried about AIDS a moderate amount.This research was supported by National Institutes of Child Health and Human Development Grant No. HD27035.Received M.A. from UCLA. Current research interests include parent-adolescent relationships, adolescent peer relations, and adolescent sexuality.Received Ph.D. from Rutgers, The State University of New Jersey. Major research interest is in parent-adolescent communication and emotional development.Received Ph.D. from Boston University. Major research interest is in parent-child affective communication.     

WHISTLEBLOWER PROTECTION IN THE USA: LESSONS LEARNT AND TO BE LEARNT

Abstract: In the 1970s, both Australia and the United States instituted legal reforms aimed at promoting greater accountability among public servants. Prompted by growing awareness of the need to encourage and protect federal government whistleblowers, Congress enacted whistleblower protection measures in the Civil Service Reform Act of 1978. Although the notion of open government in Australia has never been extended to include whistleblowing by public servants, probing the issue of whether or not United States whistleblower protection can serve as a reform model in the search for more effective legal mechanisms for ensuring government accountability can provide lessons and insights of value to Australian public administrators. Analysis of the role and impact of the Office of the Special Counsel and the Merit Systems Protection Board as established under the Civil Service Reform Act reveals many difficulties associated with whistleblower protection. Research has substantiated the jurisdictional ambiguities, administrative and procedural deficiencies and lack of sanctioning power which plague this reform effort. Similar deficiencies also impede the protection of parliamentary witnesses in Australia. Evaluation of whistleblower protection leads to the conclusion that reform models in either country for ensuring government accountability must not be judged solely through examination of statutory provisions. There must also be in place strong stabilising factors such as political unity, economic comfort, social discipline, civic virtue and public service ideology in order to achieve the common public service goal of rendering governmental decision-making more accountable to persons affected by it and open to review by independent decision makers.