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141.
Concern over the rising cost of medical care has focused policy attention on methods of paying physicians. Unfortunately, limits placed on fees paid by public medical care financing programs, Medicare and Medicaid, adversely affect those programs' primary objective: making office-based physicians' services available to the poor and the elderly at affordable prices. This suggests that a second policy instrument, controls on physicians' private charges, may be needed. The Economic Stabilization Program (ESP) provides the only recent U.S. experience with a system which constrained both physicians' private charges and public payments. Using Medicare and Medicaid claims data for a large sample of California physicians, we simulate what physicians' private charges and supplies of services to Medicare assignment and Medicaid patients would have been in the absence of ESP. The simulations suggest that without ESP, private charges would have been higher and the quantities of services provided to poor and elderly patients lower than were actually observed. We believe, therefore, that the ESP experience supports the argument that controls over both public and private fees are needed in order to simultaneously contain costs of and maintain access to physicians' services by Medicare and Medicaid beneficiaries.The research for this paper was supported by Contract No. 600-76-0054 from the Social Security Administration, USDHEW. We wish to thank our colleagues Judith Feder, John Holahan, William Scanlon, and Judith Wagner for their helpful comments. James Bluck provided excellent research assistance. The findings and opinions expressed in this paper are solely those of the authors, and do not necessarily reflect the positions of either The Urban Institute or The Department of Health, Education, and Welfare. 相似文献
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The purpose of this article is twofold: (1) to summarize the theoretical frame-work, methodological orientation, and gender-differentiated findings of our ongoing study of the personality context, prospective and concurrent, for depressive symptoms at age 18; and (2) to report new longitudinal relations between preadolescent play constructions (at age 11) and depressive tendencies reported seven years later. Eighty-seven 18-year-olds completed the Center for Epidemiological Studies Depression Scale (CES-D). Seven years earlier, at age 11, the subjects were observed in a play construction situation. Six psychologically coherent, reliable play composite variables were generated from the codings of videotapes and related longitudinally, in a hierarchical polynomial regression design, to the later CES-D scores. Among preadolescent girls, concern with morality and loss foretold, linearly, depressive experiences. The quadratic regression function explained additional variance: relative to girls receiving intermediate CES-D scores, girls earning loworhigh scores were seen as more overcontrolling of impulse, more angry, and more concerned with loss. Among preadolescent boys, only curvilinear relations were obtained. Relative to boys receiving intermediate CES-D scores, boys earning loworhigh CES-D scores were seen during preadolescence as more undercontrolling of impulse, more angry, and more concerned with loss as theme. The implications of these findings are discussed.This study was supported by National Institute of Mental Health Grant MH 16080 to Jack Block.Received Ph.D from University of California at Berkeley in 1984. Major research interests include socio-emotional development in adolescence, developmental psychopathology, and cross cultural perspectives on development.Received Ph.D from Stanford University in 1950. Major research interests include logitudinal analyses of personality and cognitive development, personality theory, and personality assessment. 相似文献
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This preliminary note reports clinical interviews at the Oregon State Penitentiary with 22 children, ages 5 through 15, visiting their imprisoned fathers. A majority of these children were found to be socially isolated. All the children placed a high value on the prison visits, but also demonstrated a variety of conflicted feelings about their incarcerated father. These findings highlight the need for more data on children and families of imprisoned parents and for consistent and well-conceptualized policies of family visitation. 相似文献
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Journal of Youth and Adolescence - Theory suggests that behavioral undercontrol mediates the effect of parental substance disorder on offspring substance use, but no studies have tested... 相似文献
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Jack J. Barry 《Contemporary Politics》2012,18(3):303-324
Scholars of democracy promotion foreign aid often claim it has substantially increased, yet they shy away from explaining by how much, nor investigate comparative trends in giving. This paper attempts to fill this void by addressing the following: (1) Has democracy promotion aid increased since the end of the Cold War? (2) Has the ‘assumed’ trend of increasing aid persevered through the difficulties encountered in democratizing Iraq? (3) Did aid increase from states that supported the invasion of Iraq compared to states that did not? The author's analysis purports that the answer is yes to the first two, yet it is harder to draw conclusions regarding Iraq. Another finding, contrary to claims in the scholarly literature, in terms of percentage and overall spending, the USA gives more democracy promotion aid than the EU. The author hopes this work stimulates research into the role of democracy promotion in the Arab Spring to consider historical trends in giving. 相似文献
150.
Jack Clarke 《European Security》2013,22(1-2):117-138
The attacks of 11 September 2001 created a new paradigm for domestic security in the United States. The struggle against terrorism, particularly catastrophic terrorism, became the government’s most important priority. In the wake of these attacks, the Department of Homeland Security was established, with broader powers of enforcement, set forth in new legislation such as the Patriot Act. This new focus on homeland security will have a secondary effect on the efforts of the US to deal effectively with a range of soft security threats in that it will increase attention to those concerns, particularly as they are seen as enablers of terrorism. The establishment of the Department of Homeland Security is the largest reorganization of the US government in over 50 years, and will necessitate a reordering of the inter-departmental relationships on security matters as well as those critical to soft security cooperation with friends and allies abroad. Although the new department has absorbed many aspects of enforcing the nation’s laws, other functions key to soft security remain spread throughout other US government agencies. A comprehensive understanding of this new order will be key to enhancing the international struggle against soft security threats. 相似文献