The Social Conditions for Nanomedicine: Disruption, Systems, and Lock-in

Here we consider two ways that nanomedicine might be disruptive. First, low-end disruptions that are intrinsically unpredictable but limited in scope, and second, high end disruptions that involve broader societal issues but can be anticipated, allowing opportunity for ethical reflection.     

In Pursuit of the Public Interest

What does the injunction “serve the public interest” really mean for public managers, and why is it important? By way of an answer, this analysis systematizes different perspectives on the public interest and offers a multifaceted formulation of the public manager’s duty. It is a process involving the exploration of two concerns—democracy and mutuality—in the current time frame and two others—sustainability and legacy—in the future time frame.     

Medicaid in the 1990s: Trends, Innovations, and the Future of the "PAC-Man" of State Budgets

Rapidly escalating health-care inflation and congressionallymandated expansions have led to large increases in spendingfor Medicaid, the federal-state program of health care for thepoor. These increases came at a time when state budgets werealready under recession-induced stresses. In addition, 1991brought new pressures for Medicaid spending from the courtsand closer federal scrutiny and control over revenues used forthe program's state "match." Yet the Medicaid picture is farfrom bleak. Diversity, innovation, and an emerging stale policyrole also characterize the program in ways that epitomize thestrengths and weaknesses of the American intergovernmental system.     

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