Custody decisions in Alabama before and after the abolition of the tender years doctrine

This study investigated the impact of the abolition of the tender years doctrine on custody decisions in divorce cases. This doctrine supported the presumption that the mother is the more suitable parent for young children. In March of 1981, the Supreme Court of the State of Alabama found this doctrine to be unconstitutional. To assess the hypothesis that this ruling had a significant effect on custodyrelated decisions, a sample of court records for divorce cases in an Alabama county was examined as representative of the state on a number of key variables. Overall, no significant differences were found on indicator variables for the comparisons before and after the ruling. There was neither an increase in custody grants to fathers nor an increase in custody requests by fathers.     

Tension, compression, and shear: directions, stresses, and outcomes of health care cost control

"Control" of health care costs is often portrayed as a struggle between external, "natural" forces pushing costs up and individuals, groups, and societies trying to resist the inevitable. This picture is false. Control includes strenuous efforts by some to raise costs, and by others to resist those increases, and/or to transfer costs to someone else. But all such forces originate in the purposes and interests of individuals and groups. Health care cost control is a struggle among conflicting interests over the priorities of a society, and claims of "inevitability" are simply part of the political rhetoric of that struggle. International experience supports certain conclusions. First, there is no basis for the claim that limits on expenditure growth must threaten the health of (some members of) a society. Second, there is a substantial variety of experience with cost control. Failure in the United States is often presented as evidence of the impossibility of control, but most other countries have succeeded. Finally, control requires the direct confrontation of interests, with substantial build-up of stress. Advocates of expansion are more successful if they can transform compressive forces into efforts to shift the burden onto someone else. Pressures from providers in every country for "privatization" and/or payment by users reflect this recognition of economic interest.