Health care report cards: implications for vulnerable patient groups and the organizations providing them care

Standardized public reporting on the quality of health care (report cards) offers an opportunity to empower purchasers and consumers so that they can make choices that can result in better health care for less money. However, not all population subgroups are equally well served by the publication of such data. In particular, vulnerable patient groups such as the poor, the less educated, the chronically sick, and members of ethnic or linguistic minorities may find issues of importance to them largely neglected. In addition, the way that report card data are collected, analyzed, and presented may further marginalize the experiences of these groups who in any case are already underserved by the health system. This observation also has important implications for health care providers who serve primarily large numbers of vulnerable patients. The differential impacts of report card data on vulnerable patient groups (and their providers) need to be addressed by researchers and policy makers if access issues are not to be damaged further by the providers' pursuit of quality and value.     

The problem of Defence Intelligence

Abstract

The following article argues that defence intelligence in general, and Britain’s Defence Intelligence (DI) organization in particular, represents an area in intelligence studies that is significantly under-investigated. It makes the case that the significance of understanding defence intelligence and DI lies not only in a general lack of illumination but also because DI is subject to and prompts a range of difficulties and challenges that are either especially acute in the defence context or have ramifications for the wider intelligence community that remain to be fully appreciated. Particular attention is given to DI’s remit being divided between Ministry of Defence and national requirements, problems of fixed-sum resourcing an intelligence function with national responsibilities that is subordinate to Departmental spending structures and priorities, fraught positioning of defence intelligence in Departmental line management and, finally, a chronic lack of public or official interest or scrutiny. The article concludes that the UK’s experience has echoes elsewhere, notably in the US, and that wider international study of defence intelligence is both long overdue and may have implications for understanding of national and wider intelligence institutions and processes.     

Geoffrey Vickers and lessons from the Ministry of Economic Warfare for cold war defence intelligence

Abstract

Geoffrey Vickers is the forgotten man of British intelligence. As the UK’s economic intelligence supremo at the Ministry of Economic Warfare and the Foreign Office between 1941 and 1945, Vickers transformed the craft of economic intelligence in both strategic and operational spheres. In the policy arena he was the driving force behind the economic and industrial planning of civil administration of liberated Europe. Vickers was also an intelligence theorist of the first rank whose legacy survived in his holistic conception of economic intelligence, its centrality to decision-making in peace and war, and the scope and evolution of the Joint Intelligence Bureau and defence intelligence.     

Constructing the sex trafficker: spectral figures and sexual violence in California’s Proposition 35

This article examines the development, framing, and implementation of Proposition 35, the ‘Californians Against Sexual Exploitation Act.’ The 2012 ballot initiative, described variously as a measure against human slavery, human trafficking, and sex trafficking secured more votes than any other initiative or candidate in a single statewide election in California history. We argue that the measure exemplifies a disjuncture in the articulation of feminist politics against sexual violence, labor exploitation, and criticisms of the carceral state. The rise of the sex trafficker as a ‘spectral’ subject of contemporary political discourse shapes a broader ideological framework that permits a distinct set of political actors and interests to widen their institutional and political authority and to marginalize competing claims about the roots of sexual violence and labor exploitation. Proposition 35, which targets a ‘spectral’ figure abstracted from institutional context and relations of power, expands the carceral state in the name of protecting vulnerable women while also excluding long-standing feminist solutions to sex and gender-based violence.     

Environmental policy integration and the architecture of global environmental governance

This article discusses environmental policy integration—a concept so far mainly applied to domestic and European politics—at the global level. The article distinguishes between integration of institutions, of organizations, and of their bureaucracies, and it addresses both internal integration (within the environmental policy domain) and external integration (between environmental policies and non-environmental policies). The overall focus is on one set of policy reform proposals that have been salient in the global environmental governance debate for the last decades: the question of whether the creation of a world environment organization would improve the effectiveness, legitimacy, and efficiency of global environmental governance. We revisit this debate and explore the options for organizational change, including clustering, upgrading, streamlining, and hierarchical steering, with a focus on whether the reform proposals can bring about environmental policy integration. We conclude that in the longer term, upgrading of the UN Environment Programme to a UN specialized agency, with additional and increasing streamlining of other institutions and bureaucracies, offers the most potential for environmental policy integration and does not appear to be unrealistic.     

File-sharing and downloading: goldmine or minefield?

Legal context: Major copyright owners have been slow to rise to the challengepresented by illegal file-sharing and downloading. In recentyears, they have scored a number of significant Court victoriesagainst file-sharers, but the recent decision in Promusicaev Telefónica, in which the ECJ held that the right tothe protection of industrial property does not necessarily outweighthe right to privacy, indicates that rights holders may benefitfrom a more creative and co-operative approach to file-sharing. Key points: The author provides an analysis of the Promusicae decision,along with a summary of the statutory position in the UK. Thisis also accompanied by a review of the recent internationallitigation landscape on file-sharing and a review of currentattitudes towards addressing illegal filesharing, includingrecent proposals from the British Government and the EuropeanParliament and new models of co-operation between rights holdersand file-sharing service providers. Practical significance: The Promusicae decision will disappoint copyright owners. TheECJ decision left it to Member States to determine whether thereshould be an obligation to disclose personal data in order toprotect copyright, so long as the interpretation of the lawattempts to reconcile the parties' competing rights and principlesand demonstrates proportionality. Copyright owners will, therefore,have to tailor enforcement strategies to individual Member States.This will hamper their ability to take action against individualinfringers efficiently. In addition to litigating against infringers,however, they may benefit from the new models of co-operationbetween copyright owners and file-sharing services which areemerging.     

EU update

This is the latest edition of Baker & McKenzie's column on developments in EU law relating to IP, IT and telecommunications. This article summarises recent developments that are considered important for practitioners, students and academics in a wide range of information technology, e-commerce, telecommunications and intellectual property areas. It cannot be exhaustive but intends to address the important points. This is a hard copy reference guide, but links to outside websites are included where possible. No responsibility is assumed for the accuracy of information contained in these links.     

Does the Millennium Challenge Corporation reinforce capitalist power structures or empower citizens?

In development practice, how does ‘mutual benefit’ accrue, and to whom? China criticises America for perpetuating capitalist power relations and claims it can seek a new geopolitical order based on South–South cooperation. Meanwhile, there has been an extraordinary shift of emphasis towards the private sector as a driver of development, but this shift is attracting increasing criticism. The Millennium Challenge Corporation (MCC) – the only development agency to grow in influence under the Trump administration – is evaluated in the light of these two key themes. Neither China nor the private sector is successful in achieving ‘mutual benefit’ for ordinary citizens – both replicate existing power inequalities. As with the rise of both China and the private sector, the MCC also enmeshes developing countries further into the existing neoliberal capitalist structures. However, the advantages of the agency should not be dismissed outright, as its Ruling Justly and Investing in People indicators can enhance the capacity of citizens to challenge these power structures themselves.     

Do we need to categorize it? Reflections on constituencies and quotas as tools for negotiating difference in the global food sovereignty convergence space

ABSTRACT

Convergence – as an objective and as a process – designates the coming together of different social actors across strategic, political, ideological, sectoral and geographic divides. In this paper, we analyze the global food sovereignty movement (GFSM) as a convergence space, with a focus on constituencies and quotas as tools to maintain diversity while facilitating convergence. We show how the use of constituencies and quotas has supported two objectives of the GFSM: alliances building and effective direct representation in global policy-making spaces. We conclude by pointing to some convergence challenges the GFSM faces as it expands beyond its agrarian origins.     

Realistic yet humanitarian? The comprehensive plan of action and refugee policy in Southeast Asia

The 1989 Comprehensive Plan of Action (CPA) has recently beendescribed as a successful example of how to manage large protractedrefugee flows. However, this article revisits the circumstancessurrounding the CPA used to resolve the prolonged Indo-Chineserefugee crisis to highlight that part of its development waslinked to the fact that Southeast Asian states refused to engagewith proposed solutions, which did not include repatriationfor the majority of the Indo-Chinese asylum seekers who weredeemed to be ‘non-genuine’¹ (UNGA, 1989a) refugees.This resulted in the CPA often forcibly repatriating ‘non-genuine’refugees, particularly near the end of its program. This articlereviews the CPA in order to assess whether its practices andresults should be repeated. Received for publication September 18, 2006. Accepted for publication October 10, 2007.