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.     

The metropolitan character of urbanization in Mexico, 1900-1988

The author analyzes trends in urbanization in Mexico during the twentieth century, with a focus on the impact of rapid industrialization since 1982. Sections are included on the interrelations among economic development, industrialization, and urbanization; stages, levels, and measures of urbanization; the development of the city system in Mexico; and stages in the growth of Mexico City. (SUMMARY IN ENG)     

C. Reviews: general

THE HISTORY OF AL‐TABARI. VOL. III: THE CHILDREN OF ISRAEL. Translated by WILLIAM M. BRINNER. Albany, N.Y., SUNY Press, 1991. xii, 194 pp. $44.00 (hb), $14.95 (pb).

THE HISTORY OF AL‐TABARI. VOL. XXXIII: STORM AND STRESS ALONG THE NORTHERN FRONTIERS OF THE ‘ABBASID CALIPHATE. Translated by C.E. BOSWORTH. Albany, N.Y., SUNY Press, 1991. xix, 239 pp. $57.50 (hb), $18.95 (pb).

THE AWAKENING OF PERSIA: THE REIGN OF NASR AL‐DIN SHAH 1848–1896. By A.J. ABRAHAM. USA, Vande Vere Publishing, 1992. 64pp. $18.95.

THE EMERGENCE OF KURDISH NATIONALISM AND THE SHAIKH SAID REBELLION, 1880–1925. By ROBERT OLSON. Austin, University of Texas Press, 1992.

THE ARAB BUREAU: BRITISH POLICY IN THE MIDDLE EAST, 1916–1920. By BRUCE WESTRATE. University Park, PA, Pennsylvania State University Press, 1992. xvi, 240 pp. $35.

DIE TÜRKEI UND ÄGYPTEN IN DER WELTWIRTSCHAFTSKRISE 1929–1933. By CAMILLA DAWLETSCHIN‐LINDER. (Studien zur modernen Geschichte, 40). Stuttgart, Franz Steiner Verlag, 1989. xviii, 187 pp. 20 tables, 6 diagrams. DM 68‐.

EGYPT FROM INDEPENDENCE TO REVOLUTION, 1919–1952. By SELMA BOTMAN. Syracuse, Syracuse University Press, 1991.

EXPULSION OF THE PALESTINIANS: THE CONCEPT OF ‘TRANSFER’ IN ZIONIST POLITICAL THOUGHT 1882–1948. By NUR MASALHA. Washington, DC, Institute for Palestine Studies, 1992. iii, 235pp. $24.95 (hb), $11.95 (pb).

TRANSITION TO SELF‐GOVERNMENT: PRACTICAL STEPS TOWARD ISRAELI‐PALESTINIAN PEACE. Report of a study group convened by the American Academy of Arts and Sciences, ANN MOSELY LESCH, principal author. Indiana University Press, 1993. 160pp. £22.50 (hb), £9.99 (pb).

GREATER SYRIA: THE HISTORY OF AN AMBITION. By DANIEL PIPES. New York and Oxford, Oxford University Press, 1990. viii, 240pp.

IBN SAUD: FOUNDER OF A KINGDOM. By LESLIE McLOUGHLIN. Basingstoke, Macmillan in association with St Antony's College, Oxford, 1993. 240pp. £40.00.

THE DESPAIRING DEVELOPER: DIARY OF AN AID WORKER IN THE MIDDLE EAST. By TIMOTHY MORRIS. London, Tauris, 1991.

A MODERN CULTURAL HISTORY OF BAHRAIN. By SAMI A. HANNA. Bahrain, National Council for Culture Arts and Literature, 1991. 107pp.

THE ECONOMIC CONSEQUENCES OF THE GULF WAR. By KAMRAN MOFID. London, Routledge, 1990. xxiv, 177pp.

EARLY ARABIC POETRY: MARATHI AND SU'LUK POEMS, Vol. 1. Edition, translation, and commentary by ALAN JONES. (Oxford Oriental Institute Monographs, 14.) Reading, Ithaca Press, 1992. ix, 270 pp. Map. £25.00.

RELIGION, LEARNING AND SCIENCE IN THE ‘ABBASID PERIOD. Edited by M.J.L. YOUNG, J.D. LATHAM and R.B. SERJEANT. (The Cambridge History of Arabic Literature.) Cambridge, Cambridge University Press, 1991. xxi, 587pp. £ 60.00 (hb).

THREE SHADOW PLAYS. By MUHAMMAD IBN DANIYAL. Edited by PAUL KAHLE. Critical apparatus by DEREK HOPWOOD. Introductory Essay by MUSTAFA BADAWI. (E.J.W. Gibb Memorial, New Series, 32.) Cambridge and Warminster, Gibb Memorial Trust/Aris and Phillips, 1992. 154pp. in Arabic and 30pp. in English. £12.00.

GENRE AND LANGUAGE IN MODERN ARABIC LITERATURE. By SASSON SOMEKH. Wiesbaden, Harrassowittz, 1991.

DER ARABISCHE DIALEKT DER JUDEN VON ‘AQRA UND ARBIL (Semitica Viva, 5.) By OTTO JASTROW. Wiesbaden, Harrassowitz, 1990. 438pp. DM 112.‐

1 For technical reasons, the symbol ‘e’ has been substituted for the ‘inverted e’ of the original throughout this review. [—Ed.]

WADAAN: REINFORCING READING/WRITING/FIRST LEVEL ARABIC COURSE, Vol.4. By DIONISIUS A. AGIUS, and PARWEEN N. ARIF. Leeds, University of Leeds, 1991. 65 pp.

HAYYAN BINA: KITAB AL‐TAMARIN. DRILLS/FIRST LEVEL ARABIC COURSE, Vol.5. By DIONISIUS A. AGIUS. Leeds, University of Leeds, 1991. 111 pp.

MUGHAMARAT ‘AJIBA FI QISAS MUFIDA: THIRD LEVEL ARABIC COURSE BOOK 1. By PARWEEN N. ARIF and DIONISIUS A. AGIUS. Leeds, University of Leeds, 1991. 64 pp.

UNVEILING ISLAM. By ROGER DU PASQUIER. Cambridge, Islamic Texts Society, 1992. viii, 157pp. £6.95.

CULTURAL SCHIZOPHRENIA. By DARYUSH SHAYEGAN. London, Saqi Books, 1992. vii, 188pp.     

Are you ready for the cure?

The Clinton health-care plan will soon be unveiled. Here is an inside look at what it contains so far.     

The struggle over retiree medical benefits: who's on top?

Over the past decade, there has been an explosion of litigation addressing an employer's right to unilaterally amend or terminate medical benefits provided to retirees. The sheer volume of these cases and the variety of facts and legal theories have combined to obscure the patterns and trends that actually are emerging from this litigation. This article will describe the context of the struggle over retiree benefits and discuss those leading decisions in which the federal courts of appeals have established their rules for deciding retiree benefits cases.