The political management of managed care: explaining variations in state health maintenance organization regulations

In the 1990s, strong incentives for managed care organizations to control costs, once regarded as a fortuitous confluence of interests, came to be seen as antithetical to consumers' interests in quality of care. In response to this change in political climate, many states have greatly increased their regulatory control of managed care organizations since the mid-1990s. This activity is surprising in an era when public policy on health care issues is usually described as frozen, gridlocked, and/or stalemated as a result of intense activity on the part of organized interests. We take advantage of the variation in state regulations of health maintenance organizations (HMOs) to discover why some governments are able to address policy problems that are often perceived as intractable in a political if not in a true policy sense. From the history of HMOs, the backlash against managed care, and state responses to that backlash, we first extract a number of hypotheses about state regulatory activity. We then test these hypotheses with data on regulatory adoptions by states during the late 1990s and the early 2000s. Last, we discuss the findings with special attention to the role of politics in health care.     

How ‘Vulnerable’ young people describe their interactions with police: building positive pathways to drug diversion and treatment in Sydney and Melbourne,Australia

This article describes findings from an Australian mixed method study, and explores young people’s perceptions of police. We focus on the nature of positive experiences, and the potential for positive encounters to improve outcomes for young offenders affected by problematic alcohol and other drug use. Buber’s concept of dialogical interaction is used to articulate the components of a positive experience and how this increases police legitimacy. In doing so, we demonstrate that, despite negative experiences, young people can be sympathetic to the tensions of modern policing, and can envisage police as positive role models. As such, police can enhance outcomes for ‘vulnerable’ young people through more respectful interactions.     

Internal Validation of RapidHIT®ID ACE Sample Cartridge and Assessment of the EXT Sample Cartridge*†

A new rapid DNA solution, the RapidHIT^®ID, can accommodate two different sample cartridges, ACE, for the analysis of a single swab and EXT, for the analysis of DNA extracts. An efficient internal validation designed for low‐throughput rapid DNA is described. An evaluation of the EXT sample cartridge is also described. Each cartridge generated profiles with sufficient data quality to meet CODIS eligibility in fewer than 120 min. The results exhibited 100% correlation when compared to conventional DNA typing methods. Precision, reproducibility, stochastic, mixture, and contamination experiments produced expected results. Sensitivity of the ACE sample cartridge was acceptable for buccal swab analysis. The sensitivity of the EXT sample cartridge is discussed. The ACE validation and the EXT evaluation utilized a minimalist, cost‐saving, efficient design to generate a validated RapidHIT^®ID instrument capable of producing genetic profiles from both extracted forensic DNA samples and buccal swab samples within 120 min.     

Unwanted cohabitation agreements

Given the predominant role in American law of cohabitation agreements in protecting cohabitants, this Article presents an informal study that measured attitudes toward such agreements. The results confirm the literature findings that people generally are not inclined to want cohabitation agreements upon cohabitation. Further studies might explore the reasons for the unpopularity of cohabitation agreements and the ways to improve the protection of cohabitants, and this Article offers potential considerations.     

Preventing construction deaths: The role of public policies

Are stronger direct financial incentives or regulatory enforcement effective in reducing fatalities in the construction industry? We examine two important policies—state workers' compensation (WC) programs and federal and state Occupational Safety and Health Administration (OSHA) activities—which embody those strategies. We examine their impact by looking at state-level fatality rates in the construction industry from 1992 to 2016. Setting aside highway crashes and violence, the majority of employee deaths occur in construction. We find that states which exempt small firms from the requirement to buy WC insurance have higher fatality rates. When eligibility for compensation is restricted by longer waiting periods, fatality rates are substantially higher. More frequent federal or state OSHA inspections and, especially, consultation visits are associated with lower fatality rates, but higher average penalties are not. Limited variation in these policies over our sample period, especially for WC, makes these results suggestive rather than definitively causal.