The impact of health maintenance organizations and competition on hospitals in Minneapolis/St. Paul

The Healthcare Educational and Research Foundation (HERF) in Minneapolis undertook a two-year research project to study the effects of health maintenance organizations (HMOs) and competition on the hospital industry in Minneapolis/St. Paul. This article summarizes HERF's major findings surrounding three key questions: (1) do the HMOs in Minneapolis/St. Paul use fewer hospital resources relative to conventional payers?; (2) do recent overall community trends in inpatient use suggest evidence of hospital utilization-reducing effects attributable to HMOs?; and (3) given the highly visible competitive process among Minneapolis/St. Paul providers, do hospital cost and revenue data suggest any evidence of cost-containment? The findings (based on data through 1982) indicate that for comparable patients, Twin Cities HMOs appear to use fewer medical care resources per hospitalized patient. There was, however, no clear evidence of community-wide, utilization-reducing effects directly attributable to the "competitive effect" of HMO introduction and development in the market. In addition, there was no empirical evidence that HMOs (which had enrolled 25 percent of the consumer market by 1982), or other large buyers of inpatient services, have selected hospitals on the basis of price as hypothesized by competition advocates.     

Between hermeneutics and semiotics

Translated by David Pellauer from the French, Entre herméneutique et sémiotique,Nouveaux Actes Sémiotiques (Vol.II, 1990, forthcoming).     

Underlying patterns in a current economic development model

Public officials may subjectively use a variety of elements, including economic characteristics and political considerations, in their selection of locations and allocation of resources for economic development. Policy capture is a method that determines the impartial weighting of a broad number of elements which influence these decision makers as they operationalize programs. Non-political criteria that may influence the selection of sites for local economic development provide the basis of the analysis conducted in this paper. Public officials at various levels of responsibility assessed the chances of creating jobs for disadvantaged residents (employment success) for a variety of hypothetical areas chosen as an enterprise zone. Their responses give insight into policy decisions. There is a comparison of both individual responses and groups of respondents to the hypothetical data as well as to actual zones that were recently selected. Concluding remarks will discuss these results and the application of this method for enterprise zones and other policy analyses.We wish to acknowledge the extensive helpful suggestions of the editor and two anonymous reviewers.     

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.