Medical liability and health care reform

We examine the impact of the Affordable Care Act (ACA) on medical liability and the controversy over whether federal medical reform including a damages cap could make a useful contribution to health care reform. By providing guaranteed access to health care insurance at community rates, the ACA could reduce the problem of under-compensation resulting from damages caps. However, it may also exacerbate the problem of under-claiming in the malpractice system, thereby reducing incentives to invest in loss prevention activities. Shifting losses from liability insurers to health insurers could further undermine the already weak deterrent effect of the medical liability system. Republicans in Congress and physician groups both pushed for the adoption of a federal damages cap as part of health care reform. Physician support for damages caps could be explained by concerns about the insurance cycle and the consequent instability of the market. Our own study presented here suggests that there is greater insurance market stability in states with caps on non-economic damages. Republicans in Congress argued that the enactment of damages caps would reduce aggregate health care costs. The Congressional Budget Office included savings from reduced health care utilization in its estimates of cost savings that would result from the enactment of a federal damages cap. But notwithstanding recent opinions offered by the CBO, it is not clear that caps will significantly reduce health care costs or that any savings will be passed on to consumers. The ACA included funding for state level demonstration projects for promising reforms such as offer and disclosure and health courts, but at this time the benefits of these reforms are also uncertain. There is a need for further studies on these issues.     

MMPI-2 and MMPI-2-Restructured Form Validity Scales: Complementary Approaches to Evaluate Response Validity

Responsible forensic assessment is dependent on an appreciation for how validity scales differ from one another and function across different evaluation contexts. The primary goal of this review is to evaluate whether there is sufficient empirical support to provide expert testimony using MMPI-2 or MMPI-2-RF validity scales. Towards this goal, we briefly describe the development of MMPI-2 and MMPI-2-RF validity scales and review empirical studies that support interpretative strategies. We describe and illustrate with case examples how the respective sets of MMPI-2 and MMPI-2-RF validity scales utilize complementary strategies to detect over- and under-reporting of psychological, cognitive, and physical symptoms. Additionally, the review describes standards for expert psychological testimony and illustrates how MMPI-2 and MMPI-2-RF validity scales are particularly well suited to assess symptom validity and psychological status in secondary-gain settings.     

Observing Environmental Destruction Stimulates Neural Activation in Networks Associated with Empathic Responses

The negative impacts of environmental disruption disproportionately affect marginalized and underprivileged communities; thus, the degree to which society is complicit in allowing unchecked environmental destruction to occur has important social justice applications. Although decades of research have sought to understand factors which determine acceptance of environmental destruction, most of this research has been based on self-report surveys. In the present work, we used neuroimaging techniques to examine the neural correlates of environmental concern. To do this, we compared responses to observing suffering dogs with responses to observing suffering ecosystems. Our results extend previous findings which had shown largely overlapping neural response patterns to observing animal and human suffering. Critically, we found activation in regions previously identified as active in empathy processes in response to viewing harm to ecosystems (i.e., without any animals present in the images). We also found relative differences in response patterns between the two types of stimuli: witnessing harm to environments (vs. dog suffering) led to reduced activation in some regions, but similar activation in others. We discuss these findings in terms of their potential implications for behavioral interventions and possibilities for continued neuroimaging research examining neural responses to environmental ecosystems and other nonhuman entities.     

Female owners versus female managers: Who is better at introducing innovations?

The Journal of Technology Transfer - This paper uses firm-level survey for more than 100 countries to examine whether firms’ female managers or female owners were better at bringing...     

Retention and retirement: The case of the U.S. military

The military retirement system provides an immediate, lifetime, inflation-protected annuity to personnel who complete 20 or more years of service. The cost of this system has risen substantially in the past 15 years, and the system's actuarial costs now comprise almost one-third of total military manpower costs. Because of its importance in the total military compensation system, the military retirement system exerts a significant influence on the age structure of the force and on personnel turnover patterns. This article evaluates the relative efficiency of the current retirement system by comparing it with two recently proposed alternatives, one by a presidential commission and one by the Department of Defense. It estimates the impact of these proposed alternatives on the military personnel force structure and on manpower costs. It is concluded that these alternatives would provide a force as capable as today's force at significantly lower cost.Order of authorship determined alphabetically. This paper presents results of analysis conducted while Enns and Nelson were associated with the Department of Defense and Warner was on the staff at the Center for Naval Analyses. The views presented herein are those of the authors.     

Practice and Privilege: Social Change and the Structure of Large Law Firms

Despite dramatic changes in size and specialization, large law firms have remained remarkably unchanged in other respects. Introducing research on major Chicago law firms, this article examines how large law firms have changed so much by changing so little. It proposes a theory of law firm growth emphasizing the relationship between changes in the market for sophisticated legal services and changes in the approach law firms have taken to organizing their practices. The author discusses the organizational structure of large law firms, giving particular attention to the various roles that lawyers play in such firms. After speculating on trends affecting large law firms, he points to implications of these trends for law and social change.     

Barcelona 2002: law, ethics, and human rights. Juggling individual and collective concerns with respect to HIV/AIDS policies

Efforts to prevent the spread of HIV infection sometimes give rise to tensions between individual and collective rights. This article, based on a presentation by Nelson Varas-Díaz (abstract TuOrG1171), explores these tensions in the context of the laws and policies of eight Latin American countries: Costa Rica, Dominican Republic, Ecuador, Guatemala, Honduras, Nicaragua, Panama, and Puerto Rico. The article describes five elements of the response to HIV/AIDS in which tensions between individual and collective rights have surfaced: the participation of people living with HIV/AIDS on national commissions; the ability of HIV-positive persons to access antiretroviral medications; HIV-antibody testing practices; the confidentiality of health information; and the rights and duties of people living with HIV/AIDS. The article concludes that the success of programs designed to prevent the spread of HIV infection depends on the ability of societies and governments to balance the tensions between individual and collective rights.