Choosing Healthplans All Together: a deliberative exercise for allocating limited health care resources

CHAT (Choosing Healthplans All Together) is an exercise in participatory decision making designed to engage the public in health care priority setting. Participants work individually and then in groups to distribute a limited number of pegs on a board as they select from a wide range of insurance options. Randomly distributed health events illustrate the consequences of insurance choices. In 1999-2000, the authors conducted fifty sessions of CHAT involving 592 residents of North Carolina. The exercise was rated highly regarding ease of use, informativeness, and enjoyment. Participants found the information believable and complete, thought the group decision-making process was fair, and were willing to abide by group decisions. CHAT holds promise as a tool to foster group deliberation, generate collective choices, and incorporate the preferences and values of consumers into allocation decisions. It can serve to inform and stimulate public dialogue about limited health care resources.     

Reconciliation in Times of Impunity: Challenges for Social Justice

In human history there is no lack of malice, revenge, or savagery. The twentieth century has seen 33 million military deaths. Victimization deaths are estimated at six times that number, at 205 million people. The past decade has seen people enslaved, tortured, raped, and persecuted as members of political, racial, ethnic, or religious groups in Latin America, Eastern Europe, Asia, and Africa. Yet we have not seen meaningful prosecution of crimes that have occurred on a massive scale. Former United Nations High Commissioner for Human Rights José Ayala Lasso has stated that a person stands a better chance of being tried and judged for killing one human being than for killing 100,000. This paper examines reconciliation in the aftermath of protracted, deadly, wide scale conflict characterized by impunity when crimes against individuals, groups, and humanity go unpunished. It describes the relevance of moral exclusion theory to conflicts in which dehumanization and violence are normalized, and it argues that impunity is an urgent matter for psychology and social justice research.     

Decentralisation and poverty: conceptual framework and application to Uganda

In order to shed further light on the discussion about decentralisation‐poverty linkages in developing countries, this article introduces a conceptual framework for the relationship between decentralisation and poverty. The framework takes the form of an optimal scenario and indicates potential ways for an impact of decentralisation on poverty. Three different but interrelated channels are identified. Decentralisation is considered to affect poverty through providing opportunities for previously excluded people to participate in public decision‐making, through increasing efficiency in the provision of local public services due to an informational advantage of local governments over the central government and through granting autonomy to geographically separable conflict groups and entitling local bodies to resolve local‐level conflicts. Based on the experience with decentralisation in Uganda, it is shown that these channels are often not fully realised in practice. Different reasons are singled out for the Ugandan case, among them low levels of information about local government affairs, limited human capital and financial resources, restricted local autonomy, corruption and patronage, high administrative costs related with decentralisation and low downward accountability. Copyright © 2007 John Wiley & Sons, Ltd.     

Rural China and the WTO

China's entry into the World Trade Organization has been applauded for the benefits it will confer on China's economy and for granting recognition to China's modernizing efforts. The scrutiny of the outside world will force China to regularize many of its practices, such as legal and economic practices. But most of the discussion of the WTO has focused on a very limited segment of China's society. This article considers the realities of rural Chinese life, warning that the consequences of China's increased pressure to reform may be more negative than positive and that the prospect for rural China is far from clear.     

Narcissistic Features in Young Adolescents: Relations to Aggression and Internalizing Symptoms

Recent research and theory suggest narcissistic features contribute to aggression in adults. The present study examined the association of narcissistic features with aggression and internalizing symptoms in 233 students of 5th–8th grade at three inner-city schools. A factor analysis of the Narcissistic Personality Inventory in this sample revealed three factors: Adaptive Narcissism, Exploitativeness, and Exhibitionism. Regression analyses were used to predict the association of these three narcissistic features with self-, teacher-, and peer-reported aggression and self-reported internalizing symptoms. Results indicate narcissistic exploitativeness positively predicted self-reported proactive aggression, and narcissistic exhibitionism positively predicted internalizing symptoms. Narcissism and self-esteem interacted to predict teacher-reported aggression and self-reported internalizing symptoms. Results are discussed in the context of existing theories of narcissism, threatened egotism, and self-perception bias.     

Hard times for citizenship: Women's movements in Chile and Mexico

This article comparatively analyses the cases of Mexico and Chile to understand how women's movements contest the meaning of citizenship in various national contexts. We also assess the consequences that different movement strategies, such as ‘autonomy’ versus ‘double militancy’, have for movements' citizenship goals. To explain the different outcomes in the two cases, we focus on the nature of the democratic transition, the internal coherence of women's movements, the nature of alliances with other civil society actors, the ideological orientation of the newly democratized state, the form of women's agency within the state, and the nature of the neoliberal economic reforms. We argue that a serious problem for women in both Chile and Mexico is the fact that governments themselves are deploying the concept of citizenship as a way to legitimate their social and economic policies. While women's movements seek to broaden the meaning of citizenship to include social rights, neoliberal governments employ the rhetoric of citizen activism to encourage society to provide its own solutions to economic hardship and poverty. While this trend is occurring in both Chile and Mexico, there are some features of the political opportunity structure in Chile that enable organized women to contest the state's more narrow vision of democratic citizenship. In Mexico, on the other hand, the neoliberal economic discourse of the current government is matched by a profoundly conservative ideological rhetoric, thereby reducing the political opportunities for women to forward a gender equality agenda.     

Privatizing Federal Credit Programs: Why Sallie Mae?

The federal government subsidizes lending to a number of borrowers—notably students, farmers, and homeowners. Government‐sponsored enterprises issue the securities that channel capital to many of these privileged borrowers. One of the largest of these enterprises, the Student Loan Marketing Association (Sallie Mae), is scheduled to be wholly privatized by September 30, 2008. What explains the privatization of this enterprise? To identify distinctive features of Sallie Mae that permitted or abetted privatization, we investigate the structure, related capital market innovations, and growth of three government‐sponsored enterprises. We conclude that a unique structural feature of Sallie Mae may explain the pace of privatization. The core asset of Sallie Mae, the student loan, is guaranteed and subsidized by the government. The case of Sallie Mae is an instructive yet poorly understood example of how the federal government can leverage private‐sector assets and incentives to achieve public policy missions.     

Moral Virtue and the Limits of the Political Community in Aristotle's Nicomachean Ethics

The recovery of Aristotle's view of the political community as guardian of the common good and moral educator has fueled a continuing debate about civic education and virtue. In focusing on the relation of virtue to the common good and that of the individual, however, this debate has obscured Aristotle's insight into virtue's status as an independent end. I argue that by taking account of this dimension of virtue, Aristotle's discussion of the particular moral virtues in the Nicomachean Ethics clarifies the nature and limits of civic education and shows that the full question of the human good emerges only with an investigation of the political community's highest and noblest pedagogic aims.