Modeling health insurance expansions: effects of alternate approaches.

Estimates of the costs and consequences of many types of public policy proposals play an important role in the development and adoption of particular policy programs. Estimates of the same, or similar, policies that employ different modeling approaches can yield widely divergent results. Such divergence often undermines effective policymaking. These problems are particularly prominent for health insurance expansion programs. Concern focuses on predictions of the numbers of individuals who will be insured and the costs of the proposals. Several different simulation-modeling approaches are used to predict these effects, making the predictions difficult to compare. This paper categorizes and describes the different approaches used; explains the conceptual and theoretical relationships between the methods; demonstrates empirically an example of the (quite restrictive) conditions under which all approaches can yield quantitatively identical predictions; and empirically demonstrates conditions under which the approaches diverge and the quantitative extent of that divergence. All modeling approaches implicitly make assumptions about functional form that impose restrictions on unobservable heterogeneity. Those assumptions can dramatically affect the quantitative predictions made.     

Health care and the labor market: learning from the German experience

Many observers have begun to question the U.S. reliance on an employment-based private health insurance system. In thinking about the future of this system, it is instructive to examine the German experience. The German health insurance system is almost entirely organized and financed around the labor market. In recent years, the German labor market has changed in several ways. Among other changes, more German women now work, the proportion of retirees in the population has increased, the share of manufacturing in employment has declined, and the economy has become more open. These labor market changes have made it more difficult to organize health insurance around employment in Germany. Recent changes in the German health insurance system have, to some extent, decoupled health insurance from employment. This decoupling is likely to continue as the labor market changes further. We explore the implications of this experience for the United States.     

Discrepancies in Adolescent Romantic Couples' and Observers' Perceptions of Couple Interaction and their Relationship to Depressive Symptoms

We examined discrepancies in adolescent romantic couple members' and observers' perceptions of couples' conversations in order to further understand adolescents' romantic interactions and their association with adolescents' depressive symptoms. We used a video-recall procedure to assess 61 adolescent romantic couples' perceptions of their videotaped conversations with each other. Our results suggest that although couple members and outside observers agreed that adolescent romantic couples' conversations were generally harmonious, adolescent dating partners and observers perceived couples' communications in systematically different ways and perceived inequalities in their interactions. Perceptions of discrepancies in power were more salient in females' perceptions. Both males and females perceived themselves more positively than their partners. Finally, discrepancies in couple members' perceptions of their conversations were somewhat associated with their mental health. Boys who viewed themselves more favorably than their girlfriends viewed them exhibited fewer depressive symptoms. Girls who perceived fewer inequalities between themselves and their boyfriends showed fewer depressive symptoms.     

Psychological mindedness and abstract reasoning in late childhood and adolescence: An exploration using new instruments

This study introduces two new measures of psychological mindedness, applying them in a study of the growth of abstract thinking in children and adolescents in a developmental design. The capacity to achieve psychological understanding of the self and of others involves comprehension of the motives, attitudes, and characteristics of the self and others. Psychological mindedness toward the self (PS) and toward others (PO) may be seen as complex cognitive capacities that should show a pattern of related development in childhood. Three groups of 60 fifth, eighth, and twelfth graders completed two measures of formal operations and two instruments to assess the two components of psychological mindedness. We find that psychological mindedness and abstract thinking both increase significantly with age, although the relationship between them is complex and varies with gender and age. Because the development of abstract reasoning skills does not correlate with the development of psychological mindedness in a simple way, a more complex model is necessary, taking age and gender differences into account. Performance on the two measures of psychological mindedness is found to be largely unrelated, suggesting that these are two different psychological skills. Implications of these findings are discussed, with special reference to education, peer counseling, and psychotherapy.Received Ph.D. from University of Michigan and psychoanalytic training from The Michigan Psychoanalytic Institute. Main research interests are psychoanalytic theory, the therapeutic alliance, and insight and self-observation.Received Ph.D. from University of Michigan. Main research interests are adolescent development, peer counseling, short-term psychotherapy, and the psychology of women.Received M.A. from The University of Michigan. Main research interests are infant mental health and attachment theory.Received M.A. from The University of Michigan. Main research interests are gender identity and children of divorce.Received B.A. from The University of Michigan. Main research interests are gender issues and adolescent development.     

New Vision for Old Ties

On the 40th anniversary of the normalization of China -U.S. diplomatic relations, a diverse group of diplomats, athletes, entrepreneurs and economists has advocated a more creative approach to resolving trade tension between the two largest economies in the world, with the bottom line that the bilateral relationship had endured in the past and would continue to do so in today's era of greater engagement.     

Does state AFDC generosity affect child SSI participation?

This article examines the extent of interactions or spillovers between the Supplemental Security Income (SSI) and Aid to Families with Dependent Children (AFDC) programs for children. In the early 1990s, the Social Security Administration substantially relaxed child eligibility criteria for SSI benefits. Since the changes, the number of U.S. children receiving cash and medical benefits through SSI tripled to nearly 1 million. The article describes a family's decision to participate in SSI and/or AFDC, and uses state‐level data for three years before, and three years after, the Zebley decision to estimate the effect of state program generosity on child program participation. The expansions in child SSI eligibility increased child SSI participation and contributed to increased total program participation by children in the early 1990s. Child SSI participation increased more in states with lower AFDC payments and higher state SSI supplementation payments. These results suggest that families use SSI and AFDC as substitutes. At least 32 percent of the Zebley increase in SSI is likely attributable to the SSI–AFDC benefit gap for the median AFDC benefit state. © 2000 by the Association for Public Policy and Management.     

A simple technique for imaging the human skeleton using a flatbed scanner

A simple technique for imaging the human skeleton with a flatbed scanner is presented using the auricular surface of the ilium as an example. A flatbed scanner with resolution capabilities of 600 dpi or greater allows for images of human bones. The auricular surface of the ilium was selected to demonstrate this technique as it is a fairly three-dimensional area that can be difficult to record photographically. Fifty left ilia of various ages at death from the Athens Collection were selected from which three observers (SCF, CE, and IM) scored the morphology of the auricular surface using a well-established aging method. Observations were taken of the dry bone, of digital photographs of the bone, and of scanned images of the bone, and in that sequence. Results indicate that scores of scanned images are equivalent or better than digital images of the same ilia. This technique allows for sharing data electronically with ease.