Practitioner fraud and abuse in medical benefit programs: government regulation and professional white-collar crime

Physicians who defraud and abuse medical benefit programs provide a unique group of lawbreakers for scientific study. They could be considered to epitomize white collar criminals given their exceedingly high socioeconomic status and power as a professional group. Using official reports and documents, as well as interviews with enforcement and program personnel at both state and federal levels, this study examines the problem of physician fraud and abuse in Medicare and Medicaid. Major areas relevant to understanding this phenomenon and its control are presented and policy implications of present knowledge in the area are discussed.     

Enforcing ethics in social work

The attention paid by the social work profession to ethical issues has waxed and waned since the formal inauguration of the profession in the late 19th century. For the first half century of the profession's life, relatively little attention was devoted to problems of professional ethics, though social work's literature was filled with discussions of value-laden issues that arise in practice. In recent years, interest in professional ethics has increased substantially. This article discusses the growth of interest in professional ethics, the formulation of the social work code of ethics, the adjudication of grievances in social work, and the strengths and limitations of the profession's code.     

Consumer-sponsored prepaid group practice: restructuring the health care system

The traditional separation of health care delivery and financing systems is breaking down as various new types of health care facilities are established and as payment continues to be a major concern. Group Health Cooperative of Puget Sound (GHC) was organized as a prepaid group practice system responsive to consumers. Costs, methods of payment and delivery of care are interrelated and are all influenced by consumer ownership. GHC has been refining its benefit programs since 1945. Strategies for controlling use and costs focus on improved provider management and on flexibility. This article explains how the structure of GHC benefits the consumer.     

Interest in political campaigns: The influence of question order and electoral context

A split-ballot experiment shows that, when people are asked how interested they are in following political campaigns, their response depends not only on the order in which the question is asked, but also on the broader electoral context in which it is posed. When asked how interested they were in following the political campaigns immediatelyafter a question about whether or not they voted in the (1982) election, people were more likely to think they were interested in the campaign, especially if they claimed to have voted, than if they were asked about it immediatelybefore the question on whether or not they voted. This order effect, however, appears to depend onwhen the questions are asked. If asked within a few weeks after the election, there is little or no order effect. But later, as the memory of the campaign fades, the order of the questions makes a sizable difference in the results. This order effect also seems to be more pronounced among better-educated respondents, suggesting that they are more likely to feel pressured by a social norm to vote and to express an interest in political affairs, not only in real life, but in the survey interview as well. The paper concludes with a brief discussion of the implications for the design of the interview schedule used in the American National Election Studies.The research reported in this paper was supported by a grant from the National Science Foundation (SES81-11404).