Rational planning and responsiveness: the case of the HSAs

American government in the twentieth century has been faced with a serious value conflict between the need for rational allocation of scarce resources through planning, and the need to be responsive to a diverse society. Two ideal types of planning correspond to these two values. Rational planning emphasizes the importance of the planner's expertise in achieving the "best" path to socially defined goals. Advocacy planning emphasizes the importance of responsiveness to group interests since all planning decisions are basically a matter of value choice. Citizen participation in planning often combines elements of these two models, embodying the value conflict in planning agency procedures. Health systems agencies are examined as a typical case of such planning. Their failure to build a constituency is viewed as a consequence of role conflict reduction strategies by representatives who did not know whether to play the planner or the advocate role, and how to play either.     

Book reviews

The Imaginary War: Understanding the East‐West Conflict By Mary Kaldor. Oxford: Basil Blackwell. 1990. 290 pp. £19.95.

The Nonsuperpowers and South Africa ‐ Implications for U.S. Policy. By Richard J. Payne. Indiana University Press. 336 pp. $35.00.

Elites and the Idea of Equality: A Comparison of Japan, Sweden, and the United States. By Sidney Verba, Steven Kelman, Gary R. Orten, Ichiro Miyake, Joji Watonuki, Ikuo Kabashima, G. Donald Ferreer, Jr. Harvard University Press. 276 pp. £10.25.

Controlling the Sword: The Democratic Governance of National Security By Bruce Russett. 261 pp. £17.95.

America's Germany: John J. McCloy and the Federal Republic of Germany By Thomas Alan Schwartz. Harvard University Press: 1991. 404 pp. £23.95.     

Rethinking the admissibility of medical treatises as evidence.

This Article examines the issues and questions which underlie the debate over the admission of "medical treatises" into evidence. The admissibility of this type of evidence is at issue most often in litigation involving complex medico-legal issues. This article outlines the evidentiary basis for admission of medical treatises and discusses the quality of medical treatises in an effort to determine what value to the fact-finder these treatises actually hold. The authors contend that there is an inherent untrustworthiness associated with medical treatises, but do not go so far as to suggest that medical treatises should never be admitted. The Article concludes that there is a need for greater caution in determining admissibility and recommends safeguards to better guarantee trustworthiness and reliability.