Stark II and physician compensation models: integrating business and legal issues

In March of 2004, the Centers for Medicare & Medicaid Services released new regulations that interpreted the Federal Physician Self Referral Act, otherwise known as Stark II. The new regulations, commonly referred to as the Phase II regulations, must be carefully considered when structuring physician compensation models. Stark II generally holds that physicians may not make a referral for designated health services to an entity with which they have a direct or indirect financial relationship. This Article outlines the provisions of Stark II that are applicable to physician compensation methodologies. In addition, the authors evaluate hypothetical transactions involving physician groups seeking viable compensation schemes and explore the validity and risks of each.     

Neo-liberalism and the Decline of Democratic Governance in Australia: A Problem of Institutional Design?

This paper is a preliminary attempt to evaluate changing patterns of democratic governance, at least in Westminster-style parliamentary settings, and possibly more generally. It has two specific purposes: first, to propose a paradigm for evaluating the empirical evolution of democratic governance; and second, to illustrate the explanatory potential of this paradigm through a mini-case study of changing patterns of governance in one particular polity. The conceptual framework is drawn from March and Olsen's eponymous study (1995) from which polar ('thick' and 'thin') forms of democratic governance are derived. Four conjectures about its evolution are then explored. First, in its mass party phase, the pattern of democratic governance approximated the 'thick' pole. Second, the subsequent evolution of democratic politics has been in the direction of the 'thin' (minimalist or populist) pole. Third, the cause of this shift was a failure to adapt political institutions to changing citizen identities, which was masked by the ascendancy amongst political elites of the neo-liberal account of governance. Fourth, the paper considers the means by which democratic governance might be renewed. The approach is applied to explain changes in Australian politics over recent decades.     

Pathologies of Accountability: ICANN and the Challenge of "Multiple Accountabilities Disorder"

Accountability is a core concept of public administration, yet disagreement about its meaning is masked by consensus on its importance and desirability. This article proposes a five-part typology of accountability conceptions. Transparency, liability, controllability, responsibility, and responsiveness are defined as distinct dimensions of accountability, providing an improvement on the current state of conceptual fuzziness. The typology provides a vocabulary for the core argument: that conflicting expectations borne of disparate conceptions of accountability undermine organizational effectiveness. This phenomenon—labeled multiple accountabilities disorder—is illustrated with a case study. ICANN, the Internet Corporation for Assigned Names and Numbers, is a nascent organization charged with administering the Domain Name System, the Internet's address directory. In its four-year history, ICANN has been the object of much criticism. Conflicting accountability expectations have been a source of difficulty for ICANN's leaders as they have steered the organization through its early years.     

The Misquantification of Probative Value

D. Davis and W. C. Follette (2002) purport to show that when "the base rate" for a crime is low, the probative value of "characteristics known to be strongly associated with the crime ... will be virtually nil." Their analysis rests on the choice of an arbitrary and inopposite measure of the probative value of evidence. When a more suitable metric is used (e.g., a likelihood ratio), it becomes clear that evidence they would dismiss as devoid of probative value is relevant and diagnostic.     

Reviewers for Volume 27

Editorial Board

Reviewers for Volume 27     

The business firm model of party organisation: Cases from Spain and Italy

Abstract. Discussion of new forms of party organisation have largely focused on the ways in which institutionalised parties have adapted to pressures towards 'catch–all' or 'electoral–professional' behaviour. This article examines the ways in which new parties respond to these pressures. A model of the 'party as business firm' is generated from rational choice assumptions and it is suggested that such a model can emerge when new party systems are created in advanced societies. Two cases of political parties which resemble the business firm model in important ways are analysed in order to gauge the consequences of this type of party organisation: UCD in Spain and Forza Italia in Italy. On the basis of this analysis it is argued that business firm parties are likely to be electorally unstable and politically incoherent, and also prone to serving particularistic interests.     

What Makes a State Advocacy Structure Effective? — Conflicts Between Bureaucratic and Social Movement Criteria

State "advocacy structures"—agencies nominally designated to advance the status of collective social movements in public policy and society—must operate under conflicting criteria for "effectiveness." While government actors likely measure effectiveness as the ability to manage a policyissue—advancing policy influence by prioritizing and packaging demands —collective movements additionally or primarily emphasize structures' performance as representatives of the priorities and diversity of movements. This consequently leads to differing evaluations of agency "effectiveness." A case study of the Ontario Women's Directorate (OWD) analyzes the inherent conflicts and tensions between these two roles, particularly under repeated changes in government. The experiences of the OWD and other advocacy structures suggest that conflicting criteria are inherent and unavoidable in such institutions.