Herceptin, Pharmac and the New Zealand District Health Boards: keeping abreast of the Code of Health and Disability Services Consumers' Rights?

In an era of resource limitations, the problem of matching public expectations with health care provision will always be difficult. In New Zealand there has been recent debate surrounding the potential funding by the Pharmaceutical Management Agency (PHARMAC) of an expensive chemotherapy agent called Herceptin (trastuzumab). Taking the proposed funding options in turn, this article looks at the obligations PHARMAC and the New Zealand District Health Boards might then be subject to with respect to the legislation and the Code of Health and Disability Services Consumers' Rights, and the impact this might have on a health system already subject to resource constraints.     

The Analysis of Black Powder Substitutes Containing Ascorbic Acid by Ion Chromatography/Mass Spectrometry*†

Abstract: Black powder substitutes containing ascorbic acid are a group of low explosives that utilize ascorbic acid as the fuel. The analysis of these powders is complicated by the degradation of ascorbic acid which occurs rapidly in solution and may also occur as the powder ages. Aqueous extracts of both intact powders and postblast residues were analyzed by an existing ion chromatography/mass spectrometry (IC/MS) method used at the Bureau of Alcohol, Tobacco, Firearms and Explosives. Results have shown that while ascorbic acid itself is not detected in this method, its diagnostic degradation products (threonic acid, monohydrated diketogulonic acid, and oxalic acid) can be identified. In addition, anions from the inorganic oxidizers (perchlorate and nitrate) and combustion products such as chloride, chlorate, and nitrite, can be identified within the same experiment. While this IC/MS method shows promise, future modifications are necessary because of limitations in identifying threonate in postblast residues, as well as coeluting compounds observed in postblast residues.     

Banishment and the Post-Industrial City: Lessons from Seattle

Seattle deploys several mechanisms by which individuals’ presence in particular spaces can constitute a crime. Through a range of means, police in Seattle are given wide authority to question and arrest those who appear as human manifestations of the “disorder” that is of concern to many. Importantly, these programs accentuate the power of criminal law by mobilizing other forms of law, most notably civil law and administrative law. This legally-hybrid structure works to accentuate the police’s power notably. Yet increased police power does not actually work to reduce “disorder” to any appreciable extent. For this reason, and others, we suggest that different approaches to addressing social marginality represent more promising avenues for cities like Seattle to explore.     

The President and Representative Bureaucracy: Rhetoric and Reality

Policy makers have long recognized the importance of achieving a representative federal bureaucracy, but the four most recent presidents have expressed divergent views about policies designed to achieve this goal. Meanwhile, there have been widespread perceptions among federal employees that the administrations' ideologies have had a direct impact on the opportunities of minorities, women, and white men for advancement. Using government-wide data from 1979 to 1996, this article examines whether such employment opportunities have varied in the manner suggested by these perceptions. We find little evidence of a correlation between the president's views on affirmative action and minority and female representation in the overall federal workforce. Moreover, the curtailment of promotion opportunities during the Reagan and Clinton administrations has affected all groups nearly equally. Potential presidential influence has been more notable in the representation of women and minorities in politically appointed and career senior executive jobs. We conclude that equal employment opportunity and affirmative action policies have remained basically intact during the 18-year period, but that recent court decisions, along with efforts to reduce the size of government, may slow progress toward achieving a representative bureaucracy.     

Implementing PBB: Conflicting Views of Success

A modern budget reform, performance‐based budgeting (PBB) emphasizes the measurement of government performance by agencies and public servants. In this article we define PBB as requiring strategic planning regarding agency mission, goals and objectives, and a process that requests quantifiable data that provide meaningful information about program outcomes. Performance‐based budgeting requirements are now pervasive in the states. Of forty‐seven states with PBB requirements, thirty‐one have legislated the process to be conducted, while sixteen have initiated the reform through budget guidelines or instructions.¹What remains unknown, yet of vital interest to state administrators, their staff, legislators, and citizens, regards implementation status of PBB systems. How many states are utilizing a PBB process as prescribed by law or administrative directive? And if PBB has been implemented, has it been successful regarding improvement of agency effectiveness and decision making about spending? Perhaps most importantly, has PBB influenced appropriation decisions?. This research is based on responses to a mail survey of executive and legislative budgeters regarding the PBB system established in their state. Results discussed in this article consider budgeters’ response about PBB implementation status and effectiveness as conducted. We find that there are differing perceptions across the branches of government regarding both the extent of PBB implementation as well as its success. Results show that states with better‐known PBB systems have not necessarily realized greater success in terms of effectiveness from this budget reform than states with less popularly known systems, at least as perceived by the budgeters included in this article.