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101.
Francis MH 《Annals of health law / Loyola University Chicago, School of Law, Institute for Health Law》2012,21(2):329-82, 5 p preceding i
Over the past century, medical advancements have resulted in tremendous health gains for Americans. Although the federal government has played a prominent role in ensuring that new treatments are safe and effective, questions about which medical treatments work best under which circumstances have largely remained unanswered. Thus, the federal government's recent major investments in comparative-effectiveness research have potential to play a significant role in helping both patients and health care providers navigate the vast array of available treatment options, as well as in improving the quality, efficiency, and delivery of health care system-wide. Yet, the controversial nature of the government's foray into comparative-effectiveness research also suggests that the path toward realizing these goals may be treacherous. This Article describes the rationales for federal support of comparative-effectiveness research and potential models for that involvement, analyzes the federal government's recent investments in the research, and concludes with predictions about the probable outcomes of these investments. While increased federal support for comparative-effectiveness research is unlikely to achieve all of the benefits anticipated by its supporters, it is a crucial step toward ensuring that Americans are able to take full advantage of the benefits of medical innovation 相似文献
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This article attempts to explore the post-Cold War international system in which regional orders intermingle their influence. It pays special attention to regional conflicts in East Asia in the new era and what roles global powers could play to maintain regional stability. I will first examine the characteristics of the new global order after the end of the bipolarity. I will then focus on American foreign policy in the new international system in the context of its dealing with major global events that have strategic implications for its relations with other major global powers. As to discussions of regional orders, this article focuses on East Asia, where conflicts between states have not evaporated despite the relaxation of the global Cold War confrontation. What makes this area special is the involvements of many great powers and less-powerful nations that could somehow easily manipulate the seniors into the conflicts to their favour. While the regional order in East Asia is being shaped by the post- Cold War international order, the regions peace and conflicts will in turn significantly influence global order. Finally, I will argue that dealing with problems in East Asia should acquire involvements of powers that would give necessary momentum to the existing participants to solve conflicts by the means of multilateralism. The European Union (EU) is often forgotten for its role in contributing to world order, and the EU should be taken seriously by the powers in East Asia as a possible player in maintaining the regional peace. I conclude that both global and regional security depend on continuing US unipolarity, strengthened by the co-operation of the EU in the form of multilateralism. By the same token, US unilateralism without a EU counter-balancing it, only invites potential challengers, such as China, to threaten the USs preponderant position, thereby destabilising world peace.This article was supported by a research project (NSC-P3-2414-H-004-018) of the National Science Council, Taiwan, which is gratefully acknowledged. 相似文献
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Francis G. Castles Herbert Obinger Stephan Leibfried 《Politische Vierteljahresschrift》2005,46(2):215-237
This paper examines the impact of federal state structures on welfare state development in the six classic OECD federations since the 1880s. Starting from the widely acknowledged assumption in comparative public policy research that depicts federalism as an impediment to the expansion of the Leviathan, we demonstrate that federalism has facilitated as well as impeded social policy development. Development is contingent on several time-dependent factors, including the degree of democratization, the type of federalism, the stage of welfare state development and early distribution of social policy responsibility. Federalism also has had an impact on patterns of benefit provision, and we identify a variety of bypass strategies by which the six federations were able to overcome their built-in constitutional rigidities. These institutional changes had a lasting structural impact on the emerging patterns of social security. Overall, federalism has contributed to a status quo bias in social policy, not only because it delayed the early consolidation of national social programs but also, more recently, because it has protected the welfare state against retrenchment. 相似文献
108.
Developing new measures of welfare state change and reform 总被引:1,自引:0,他引:1
Francis G. Castles 《European Journal of Political Research》2002,41(5):613-641
Abstract. Since the publication of Gøsta Esping–Andersen's The Three Worlds of Welfare Capitalism (Esping–Andersen 1990), which built its typologies on a rich database of detailed programme characteristics, it has been generally accepted that measures of social expenditure are an inferior, and even a misleading, source of information concerning the character of welfare state development. The problem is, however, that the kinds of detailed programme data Esping–Andersen used are not routinely available, while the quality of social expenditure data has been improving rapidly, culminating in the Organisation for Economic Cooperation and Development's (OECD) now regularly updated and highly disaggregated Social Expenditure Database (SOCX). This article explores the possibility of using SOCX to devise measures of the extent, structure and trajectory of welfare state change and reform in 21 OECD countries over the period 1984 to 1997. On the basis of these measures, it suggests that there has been almost no sign of systematic welfare retrenchment in recent years and only limited evidence of major structural transformation or programmatic reorientation. 相似文献
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Africa's history of economic development and growth has been characterised by failed experiments, poor planning and impractical orthodoxies. This left the continent at the mercy of states and ruling elites who were unable to meet the challenges of both rising expectations from their citizens and the imperatives of sound policy design and implementation. Difficult existential conditions, including rising levels of poverty and bad governance, have been compounded by the vagaries of the international environment and Africa's peripheral position in its political economy and division of labour. Auspicious growth indicators over the last decade, fuelled mainly by global commodity demand and improved macro-economic management, have recently been undermined by the global financial crisis. The crisis has again exposed the continent to the spectre of depressed growth, with serious implications for state capacity and social welfare. This article examines the main ideological fault-lines, development challenges, and external factors that have characterised Africa's economic development and concludes that the future of the continent will remain one of this century's great challenges. 相似文献
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