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.     

The State of American Federalism, 1996-1997

Federalism enjoyed political and popular salience during theperiod 1996–1997 as the so-called "Devolution Revolution"began to be implemented and analyzed in the United States. Whilethere were a few examples of important Revolutionary efforts,the federal government continued to hold much of the power andsignificance it has achieved over the past sixty years. Evenin the area of welfare policy, where in 1996 there were historicreforms enacted to end the federal entitlement, the federalgovernment maintained a significant presence that made the ideaof devolution of welfare policy responsibility some what questionable.Nevertheless, states continued to lead in policy innovationin areas ranging from education to health, and the U.S. SupremeCourt continued to question the limits of federal power. Thepast year illustrated, once again, the complexity of our federalsystem and how difficult it is to reform federalism—particularlywhen it involves a shift in power and creates the perceptionof winners and losers.     

Two Decades of Change: A Ranking of Key Issues Affecting Intergovernmental Relations

This article describes the results of a 1981 survey of 1,000randomly selected scholars of American government and politicswho were asked to rank the most significant intergovernmentalevents and trends of the past twenty years. Responses were receivedfrom almost 40 percent of these scholars; no significant returnbiases were detected. These scholars ranked civil rights andvoting rights acts as the most significant events of these decades.General Revenue Sharing and the reapportionment cases were rankedsecond and third in importance. The increased flow of federaldollars to states and local governments was ranked the mostimportant trend affecting intergovernmental relations, followedby the increased public disaffection with government and thegrowing dependence of local governments on state and federalaid. The Vietnam War and the inflationary spiral it initiatedwas ranked as the most significant social event affecting thecourse of intergovernmental relations, followed closely by theenergy crisis and the beginnings of the "Great Society." Thearticle also examines the effects of party identification, age,year of degree, government experience, region, and city sizeon scholarly attitudes toward these events and trends. Whilethe overall rankings were not dramatically altered, partisanship,region, and city size all were factors found to be noticeablyrelated to scholarly rankings of these important events andtrends.     

Adolescent Depressed Mood in a Multiethnic Sample

This research assessed whether there is an impact of race-ethnicity on depressed mood among adolescents, independent of socioeconomic status, whether gender differences in depressed mood are apparent within all race-ethnicity subgroups, and whether pubertal development influences depressed mood in a similar manner within gender and race-ethnicity subgroups. A three-stage, area probability sampling frame was utilized to select adolescents, ages 12–17 years, for an in-person interview. Depressed mood was assessed by the Children's Depression Inventory. Compared to Whites, African Americans, or Asian Americans, Latinos reported more symptoms of depressed mood, a finding that was independent of socioeconomic status. Advancing puberty was associated with depressed mood only among females, but the timing of pubertal changes, relative to ones peers, was related to depressed mood among both males and females, and among Latinos.     

The State of American Federalism, 1997 - 1998

Although it was a relatively quiet year for the courts and congressionalaction, 1997–1998 saw several developments that may significantlydefine federalism in the coming years. The 1998 federal budgetis projected to show a surplus, ending decades of deficit financinginWashington, D.C., but also raising questions about the budget'sfiscal impact on federalism and intergovernmental relations.Devolution took a back seat in Washington, D.C., as concernsabout managed care, education, and internet access led to proposalsfor increased federal involvement in state and local affairs.The states continued their implementation of welfare reformand launched other programs in health, environment.     

Intervention and Empire: John Stuart Mill and International Relations

It is surprising that John Stuart Mill's international thought, which focuses on intervention and empire, has not attracted the attention it warrants. It is particularly surprising that Mill has been largely overlooked by the English School, whose members acutely appreciate the contributions of classical political philosophers to international discourse. Galvanised by his introspection on his life, especially the impact of interference in his psychological and intellectual development, to his analysis of the impact of Britain on India's princely states and intervention in civil wars, Mill identified timeless problems intrinsic to international relations whilst profoundly appreciating the tensions they generated in the form of perverse effects, unintended consequences and moral hazard. Contemporary international relations are replete with examples of the unforeseen and unforeseeable developments that attend intervention and interference. If a concern of the English School is the tormenting decisions that fall to statesmen, Mill provides an understanding of the considerations that vastly complicate such decisions.