Health insurance without provider influence: the limits of cost containment

In our previous paper, we showed that market forces can play a significant role in controlling health care costs and that a considerable amount of cost containment effort was pursued by third-party insurers in Oregon in the 1930s and 1940s. Although physicians were able to thwart this cost-control effort, a 1986 Supreme Court decision, FTC v. Indiana Federation of Dentists, found that a boycott of insurers by dentists violated Section 5 of the Federal Trade Commission Act. Further investigation of recent developments, including the recent Wickline v. California decision, indicates that the primary barriers to cost containment today are not obstructive tactics by providers or provider-controlled health insurance plans. Rather, the primary barriers are increases in the development and diffusion of new technology and society's apparent preference for paying for new tests and procedures regardless of economic efficiency.     

Public Attitudes Toward Social Spending in the United States: The Differences Between Direct Spending and Tax Expenditures

This paper uses a survey experiment to examine differences in public attitudes toward ‘direct’ and ‘indirect’ government spending. Federal social welfare spending in the USA has two components: the federal government spends money to directly provide social benefits to citizens, and also indirectly subsidizes the private provision of social benefits through tax expenditures. Though benefits provided through tax expenditures are considered spending for budgetary purposes, they differ from direct spending in several ways: in the mechanisms through which benefits are delivered to citizens, in how they distribute wealth across the income spectrum, and in the visibility of their policy consequences to the mass public. We develop and test a model explaining how these differences will affect public attitudes toward spending conducted through direct and indirect means. We find that support for otherwise identical social programs is generally higher when such programs are portrayed as being delivered through tax expenditures than when they are portrayed as being delivered by direct spending. In addition, support for tax expenditure programs which redistribute wealth upward drops when citizens are provided information about the redistributive effects. Both of these results are conditioned by partisanship, with the opinions of Republicans more sensitive to the mechanism through which benefits are delivered, and the opinions of Democrats more sensitive to information about their redistributive effects.     

A Psychosocial Risk-Targeted Intervention to Reduce Work Disability: Development, Evolution, and Implementation Challenges

Research has been consistent in showing that certain psychosocial variables can increase the risk for prolonged work disability. Four psychosocial variables have emerged as robust predictors of disability across a wide range of debilitating health and mental health conditions. These include catastrophic thinking, symptom exacerbation fears, disability beliefs, and perceived injustice. The Progressive Goal Attainment Program (PGAP) is a psychosocial risk-targeted intervention that was developed to reduce psychosocial barriers to work resumption in individuals with debilitating health or mental health conditions. This paper describes the conception, developmental process, and the evolution of the PGAP. Research studies are summarized that have played a significant role in the developmental trajectory of the PGAP. Some of the legal and legislation-relevant challenges that were faced in the development and implementation the PGAP are discussed.     

Japan,the US,and the emergence of multilateralism in Asia

APEC's founding and subsequent development has been seen as primarily driven by the ‘middle’ and smaller powers of Asia, such as Australia and the ASEAN countries, with Japan as a secondary, if supportive, and the US as a passive and reluctant, player. This article, while acknowledging Australia's essential leadership in the founding process, uses new evidence about it to revise views of Japan and the US's roles in APEC. I argue that the former played a more major role in APEC's founding and that the latter was more positive in its thinking about that forum than has been acknowledged. This should force us to rethink the politics of APEC, paying more attention to how the political economy and relationship of the two major powers in the region influence the patterns of cooperation and conflict in it. It should also lead us to reconsider the efficacy of the major theories of international relations that might be used to explain APEC's politics and development.