How many physicians are enough?

Although it is difficult to ascertain whether or not the nation faces an oversupply of physicians in the coming decades, there is no doubt that a health care system can be operated more effectively with a taut supply of medical personnel than with a loose supply. The perception of severe specialty and geographic imbalance, which informed national health policy during the 1960s and 1970s, has been modified by evidence of a significant redistribution in the supply. Increasing numbers of practitioners are likely to effect further escalation in the costs of physician services and total expenditures for health care, even if--in conformity with classical laws of supply and demand--individual physicians' incomes and the relative economic advantage of the profession were to decline. Since the objective of improved access has to a considerable extent been realized, the principal benefit of the loosened supply in the future will be to facilitate the initiation of innovative practice modes and alternative health care delivery systems that offer the potential of improved efficiency and quality.     

Purchasing power of U.S. Social Security benefits abroad, 1970-82

This article examines whether the small number of Social Security beneficiaries living abroad enjoy a higher standard of living than they would with the same benefits if they lived in the United States. The article addresses this question using two methods. First, absolute comparisons of U.S. dollar purchasing power abroad are made using "purchasing power parities," a method recently developed to allow international comparisons of real standards of living. Second, the effects of changes in Social Security benefit levels, exchange rates, and rates of inflation on the relative value of benefits abroad are measured. Both methods show considerable instability in purchasing power of Social Security benefits in the 1970's. Although beneficiaries in 1970 generally could live better abroad than in the United States, this advantage eroded considerably during the 1970's, followed by some improvement in 1981-82.     

Reviews

Terry L. Thompson & Richard Sheldon, eds, Soviet Society and Culture: Essays in Honor of Vera S. Dunham. Boulder, CO: Westview Press, 1988, xiii+290 pp., £21.00.

Michael Rywkin, Soviet Society Today. New York: M.E. Sharpe, 1989, xii+243 pp., $35.00 h/b, $12.50 p/b.

David Lane, Soviet Society Under Perestroika, London: Unwin Hyman, 1990, xv+401 pp., £40.00 h/b, £12.95 p/b.

Catherine Merridale, Moscow Politics and the Rise of Stalin: The Communist Party in the Capital, 1925–32. London: Macmillan, 1990, xv+328 pp., £47.50.

Roger Pethybridge, One Step Backwards, Two Steps Forward: Soviet Society and Politics under the New Economic Policy. Oxford: Clarendon Press, 1990, xi+453 pp., £48.00.

Francois Heisbourg, ed., The Strategic Implications of Change in the Soviet Union. London: Macmillan, 1990, vi+227pp., £40.00.

Neil Fodor, The Warsaw Treaty Organisation: a Political and Organizational Analysis. London: Macmillan, 1990, 235 pp., £40.00.

Gerald Segal, The Soviet Union and the Pacific. Boston, MA: Unwin Hyman, 1990, xiii+236 pp., £30.00 h/b, £10.95 p/b.

Philip S. Gillette & Willard C. Frank, Jr, eds, The Sources of Soviet Naval Conduct. Lexington, IN: Lexington Books, 1990, xvii+297 pp., $39.95.

Sylvia Woodby & Alfred B. Evans, Jr, eds, Restructuring Soviet Ideology: Gorbachev's New Thinking. Boulder, CO: Westview Press, 1990, 226 pp., £22.50.

Nikolai N. Petro, ed., Christianity and Russian Culture in Soviet Society. Boulder, CO: Westview Press, 1990, xi+244pp., £17.95 p/b.

David A. Dyker, Yugoslavia: Socialism, Development and Debt. London: Routledge, 1990, xi+201 pp., £30.00.

Agnes Heller & Ferenc Fehér, From Yalta to Glasnost. The Dismantling of Stalin's Empire. Oxford: Basil Blackwell, 1990, viii+288 pp., £35.00.

Elemer Hankiss, East European Alternatives. Oxford: Clarendon Press, 1990, xiv+319 pp., £35.00.

George Blazyca & Ryszard Rapacki, eds, Poland into the 1990s: Economy and Society in Transition. London: Pinter, 1991, x+148 pp., £27.50.

Michael D. Kennedy, Professionals, Power and Solidarity in Poland: A Critical Sociology of Soviet‐Type Society. Cambridge: Cambridge University Press, 1991, xiv+421 pp., £45.00, $59.50.

Graham Smith, ed., The Nationalities Question in the Soviet Union. London: Longman, 1990, x+389 pp., £22.50 h/b, £12.95 p/b.

James Muckle, Portrait of Soviet School under Glasnost. Basingstoke: Macmillan Press, 1990, ix+205 pp., £35.00.

Piers Beirne, ed., Revolution in Law: Contributions to the Development of Soviet Legal Theory, 1917–1938. Armonk, NY: M. E. Sharpe, 1990, xiii+202 pp., $49.95.

Richard M. Connaughton, The Republic of the Ushakovka: Admiral Kolchak and the Allied Intervention in Siberia, 1918–20. London: Routledge, 1990, ix+193 pp., £30.00.

Vitaut Kipel & Zora Kipel, eds, Byelorussian Statehood—Reader and Bibliography. New York: Byelorussian Institute of Arts and Sciences, 1988, 398 pp.     

Genetic markers in human bone: I. Deoxyribonucleic acid (DNA) analysis.

Deoxyribonucleic acid (DNA) was isolated from a number of spongy and compact human bone tissue specimens, and the yield was estimated on a "per milligram of starting tissue" basis. DNA was, in addition, isolated from a number of corresponding blood and bone tissue specimens. Spectrophotofluorometry and ethidium bromide visualization on minigels were used to estimate the quantity and degree of degradation of DNA. The DNA from several blood-bone pairs is shown to give concordant restriction fragment length polymorphism (RFLP) typing results by two different typing protocols with five different single-locus probes. DNA from several additional blood-bone pairs is shown to give concordant results for human leucocyte antigen (HLA)-DQ alpha phenotypes following polymerase chain reaction (PCR) amplification and hybridization to specific allele-specific oligonucleotide (ASO) probes, and for the variable numbers of tandem repeats (VNTR) length polymorphisms 3' to the human apolipoprotein B (APOB) gene following PCR amplification with specific primers and analysis of the products by electrophoresis and ethidium bromide visualization.     

A guide to the EEOC's final regulations on the Americans with Disabilities Act

The Equal Employment Opportunity Commission (EEOC) recently issued its final regulations on the Americans with Disabilities Act (ADA). Although the regulations offer some guidance for employers on how to comply with the Act, they fail to provide specific answers to the many complicated compliance questions that will surely arise. Further, the regulations are almost totally silent on certain critical issues related to insurance, workers' compensation, and potential conflicts between ADA obligations and terms of collective bargaining agreements. The EEOC has essentially left the resolution of many important ADA questions to case-by-case determination and the litigation process.     

Selective pregnancy reduction: medical attitudes, legal implications, and a viable alternative

"Selective pregnancy reduction" is a medical procedure used to reduce a multiple pregnancy, often a multiple pregnancy induced by in vitro fertilization or drug therapy. In such instances, healthy embryos are sacrificed in order to maximize the chances of survival of the remaining embryos or to allow the mother to choose the number of babies she wishes to deliver. Physicians appear to rely on Roe v. Wade in assuming the legality of the procedure, although such an assumption may be erroneous. Rather than continue to implant an excessive number of pre-embryos, the American Medical Association and the Association of Obstetrics and Gynecology should adopt guidelines similar to those established by the Voluntary Licensing Authority in London, which limit the number to be inserted to a maximum of three. Careful ultrasound monitoring could ensure that no more than three embryos implant when fertility drugs are used. Such practices would help physicians avoid the many moral, ethical, legal, and philosophical problems caused by selective pregnancy reduction.