Consumer-sponsored prepaid group practice: restructuring the health care system

The traditional separation of health care delivery and financing systems is breaking down as various new types of health care facilities are established and as payment continues to be a major concern. Group Health Cooperative of Puget Sound (GHC) was organized as a prepaid group practice system responsive to consumers. Costs, methods of payment and delivery of care are interrelated and are all influenced by consumer ownership. GHC has been refining its benefit programs since 1945. Strategies for controlling use and costs focus on improved provider management and on flexibility. This article explains how the structure of GHC benefits the consumer.     

Interest in political campaigns: The influence of question order and electoral context

A split-ballot experiment shows that, when people are asked how interested they are in following political campaigns, their response depends not only on the order in which the question is asked, but also on the broader electoral context in which it is posed. When asked how interested they were in following the political campaigns immediatelyafter a question about whether or not they voted in the (1982) election, people were more likely to think they were interested in the campaign, especially if they claimed to have voted, than if they were asked about it immediatelybefore the question on whether or not they voted. This order effect, however, appears to depend onwhen the questions are asked. If asked within a few weeks after the election, there is little or no order effect. But later, as the memory of the campaign fades, the order of the questions makes a sizable difference in the results. This order effect also seems to be more pronounced among better-educated respondents, suggesting that they are more likely to feel pressured by a social norm to vote and to express an interest in political affairs, not only in real life, but in the survey interview as well. The paper concludes with a brief discussion of the implications for the design of the interview schedule used in the American National Election Studies.The research reported in this paper was supported by a grant from the National Science Foundation (SES81-11404).     

Defining risk

Risk is the focal topic in the management of many activities and technologies. For that management to be successful, an explicit and accepted definition of the term risk is essential. Creation of that definition is a political act, expressing the definers' values regarding the relative importance of different possible adverse consequences for a particular decision. Those values, and with them the definition of risk, can change with changes in the decisionmaker, the technologies considered, or the decision problem. After a review of the sources of controversy in defining risk, a general framework is developed, showing how these value issues can be systematically addressed. As an example, the approach is applied to characterizing the risks of six competing energy technologies, the relative riskeness of which depends upon the particular definition used.     

How Surrogate Impact Panels Function in the Context of Intimate Partner Violence: A Mixed-Methods Study

ABSTRACT

Intimate partner violence (IPV) continues to be an urgent social problem, despite decades of intervention and prevention efforts. Restorative justice programs (e.g., victim impact panels) may be a useful addition to intimate partner violence (IPV) intervention, but it is unclear how these panels operate and to what extent they are consistent with restorative justice models. This naturalistic study of IPV surrogate impact panels used ethnographic observation of panels (n = 18), archival analysis of audience responses to the panel (N = 287), and focus groups and interviews (k = 4) with IPV survivors, an audience member, and batterer intervention providers to investigate these gaps. Findings suggest the panels manifest interactional processes consistent with restorative justice principles. Implications, limitations, and future aims of research on these panels are discussed.     

Stuck in the Middle: Taiwan's Semiconductor Industry,the U.S.-China Tech Fight,and Cross-Strait Stability

The Trump administration has worked to restrict the People's Republic of China's ability to manufacture and acquire semiconductor chips since 2018. Caught in the crossfire of this burgeoning tech war is Taiwan, which is home to Taiwan Semiconductor Manufacturing Company (TSMC), the world's largest semiconductor chip manufacturer. With the United States banning companies that use U.S. technology in their chip manufacturing process from doing business with Huawei, TSMC can no longer do business with the Chinese tech company, one of its most important clients. Until the Trump administration announced the license restriction on Huawei, TSMC had managed to walk the fine line of doing business with both China and the United States, without riling either. This article argues that the TSMC example is indicative of how great power competition between the two countries will play out for the foreseeable future. TSMC has announced that it will build a new factory in Arizona as it faces Chinese firms poaching its employees and Chinese actors hacking its systems and code for trade secrets—all actions demonstrating how great power competition will play out for tech dominance. Avoiding direct live-fire conflict, China and the United States will work to restrict the other's actions and development by forcing important tech companies, such as TSMC, into picking a side.     

Fresh Thinking on U.S. Engagement with Africa: Probing the Limits of Engagement

The Biden administration faces the opportunity to reset U.S. policy towards Africa and possesses a variety of tools to use in doing so, including traditional diplomacy, economic statecraft, development assistance, and military engagement. With the increased militarization of U.S. foreign policy over the past few decades, there is an unfortunate tendency to default to military engagement when confronted with even remote threats to U.S. national security interests, and Africa is no exception. With vital security interests in Africa, it can be argued that military engagement should be limited in its application and targeted to those situations that do not lend themselves to solution through traditional diplomacy or development assistance.     

Assessing Civil-Military Relations and the January 6th Capitol Insurrection

The events of January 6, 2021, when violent rioters attacked the Capitol building in Washington in order to disrupt validation of the 2020 presidential election, forced an unprecedented reckoning with the state of American politics. Members of Congress struggled to account for the rhetoric that gave rise to the event; law enforcement grappled with the challenge of holding accountable those who perpetrated the violence; and journalistic outlets wrestled with reporting a complex web of conspiracy theories and disinformation that gave rise to the insurrection. But for senior military leaders, the question was how to explain the troubling presence of active duty servicemembers and veterans in the first attack on the American seat of government in two centuries. The result is a profound and urgent discussion in U.S. civil-military relations.