Controlling Internal Controls

Two recent examinations of management practices in three federal departments provide contemporary evidence of the need to incorporate procedures like those of the Sarbanes-Oxley Act in the public sector. Although each department established what appeared to be well-designed internal controls, all lacked sufficient monitoring and assessment of the efficacy of those controls. By requiring senior management to attest to the strength of their control mechanisms, as required by the newly revised OMB Circular A-123, the quality of this monitoring should improve. Findings from a recent study of private-sector implementation of these reforms are described, along with suggestions for public administration research and practice at all levels of government.     

The relevance of basic needs for political and economic development

This article addresses the “basic needs’ approach to development policy from the perspectives of the political and economic development literature. The central questions concern the compatibility of a basic needs approach with political and economic development and the impact of development on population welfare. Will a basic needs approach weaken or strengthn the processes of legitimation and state consolidation in developing systems? What impact will it have on participation and democracy? What will be the impact of such an approach upon attempts to industrialize and diversify production? While there are no definitive responses to these concerns the literature suggests that the approach has real potential value both for improving “human capital” and strengthening economic development, and for developing locally based political institutions.     

Book review

Veronica Doubleday, Three Women of Herat. London: Jonathan Cape, 1988, ix + 222 pp., glossary, illustrative chapter headings, colour photographs; L12.95. ISBN 0–224–02440‐X.     

Society as emergent and more than rational: An essay on the inappropriateness of program evaluation

In considering the efficacy of program evaluation researchers have not put language in proper perspective. They have not acknowledged that information gained from applied research is partly determined by situational factors, that language is selective and goal-oriented, justifying activity as often as it describes it, or that some important action cannot be expressed. The importance of language distinguishes applied social assessment from the natural science models of research from which it was derived. Examples from a wide range of applied situations are used to illustrate that, as an anticedent-consequent model of objective quantified assessment, evaluation is also inconsistent with the complex, resourceful, emergent social processes it is intended to measure. Three alternatives to quantification are discussed to illustrate interventions that may be made when the disadvantages of program evaluation outweigh the advantages.Preparation of the paper was supported by National Institute of Mental Health post-doctoral training grant 5T222-MH00180. Comments and requests for reprints should be sent to Nancy Cochran, Department of Mental Health and Developmental Disabilities, State of Illinois, 160 N. LaSalle Street, Chicago. Illinois 6061.     

Medicare reimbursement for hospice care: ethical and policy implications of cost-containment strategies

In several areas of health policy, current concern over rising costs has generated considerably political support for reforms that many in the business have advocated unsuccessfully on philosophical, ethical, or humanitarian grounds for years. Thus, for example, the spiraling cost of caring for the mentally ill and the developmentally disabled in an institutional setting has breathed new life into proposals to bring these groups out into the community where they can live more independently--and more cheaply. But this overlap of quality and frugality goals is only partial. Although alliances with cost-cutters can bring reform, health policy reformers are discovering that they may have to accept a lot of bathwater along with the baby. Medicare reimbursement for hospice care, authorized by Section 122 of PL 97-248, the Tax Equity and Fiscal Responsibility Act of 1982, provides one recent example of this dilemma. This article discusses the results of a survey--conducted by the Office of the Inspector General of the Department of Health and Human Services--to discover how many hospices would seek certification for reimbursement by Medicare, how many patients would be served, and the consequences of this legislation for cost, access, and quality of service.