The role of substitutes in policy analysis: acute care services in state Medicaid programs

Using four acute care equations (inpatient, physician, outpatient, and clinic) from a larger model of Medicaid, this research examines the "contents" of policy outcomes. This closer examination of outcomes brings to light the interactions between redistributive programs and services and the role of substitutes and complements in state-level policy analysis. (A substitute is a benefit or service that can be used instead of another to produce a similar outcome; a complement is a benefit or service that is likely to result in the use of another benefit or service.) Support is found for the inclusion of these theoretical constructs in policy analysis. Regarding Medicaid, the author concludes that physician, outpatient, and clinic services all complement hospital services; that physician and outpatient services substitute for one another; that state AFDC and SSI policy decisions have a greater impact on utilization than Medicaid-specific eligibility and service decisions do; and that the factors driving utilization (supply, demand, etc.) vary dramatically across acute care settings. The implications for Medicaid policymaking are also discussed.     

Crooked Timber or Bent Twig? Isaiah Berlin's Nationalism

Isaiah Berlin is often regarded as one of the sources of contemporary liberal nationalism. Yet his own attitude to nationalism, and its relation to his liberalism, remains unexplored. He gave conflicting definitions of nationalism in different places, and although he frequently contrasts more benign with more malign forms of nationalism, the terms in which he draws the contrast also vary. In Berlin's most explicit account, nationalist doctrine is presented as political, unitary, morally unrestricted and particularist, but these four dimensions are separate, and on each of them alternative nationalist positions are available. Berlin's account of the sources of nationalism is also ambiguous: his analysis of the Jewish condition in European societies and his support for Zionism contrasts with his diagnosis of the origins of German nationalism. Comparing Berlin with later liberal nationalists, we see that his liberalism prevented him from presenting a normative political theory in which liberal and nationalist commitments were successfully combined. Such a theory can indeed be developed, but the challenge that emerges from Berlin's writing is to explain how real-world nationalism can be kept within liberal limits.     

Some Evidence of a Pluralistic Discipline: A Narrative Analysis of Public Administration Symposia

This article investigates the discipline of public administration as it is manifested in symposium articles published during the period 1985–99. What was the field trying to accomplish? The method of investigation is narrative analysis. Using specific discourse markers (method, substantive contents, and authorial intentions), the authors found a wide variety of purposes and projects in the symposia investigated. The condition of public administration, they conclude, is distinguished by a radical pluralism—a striking absence of any singular conception of public administration scholarship.     

Reform or Resistance? Local Government Responses to State-Mandated Ethics Reform in Kentucky

Although several studies have examined state and federal regulationof political corruption andethics reform, few studies have extendedtheir focus to local governments. In this study, we examinethe local government response to stale-mandated ethics reformin Kentucky during the 1990s. Based on a quantitative analysisof local government ethics codes in 288 cities, we concludethat local compliance with state-mandated ethics reform hasbeen largely driven by local political factors. Cities withrelatively developed democratic institutions, characterizedby high levels of electoral competition and a strong media presence,were significantly more likely to construct strict ethics ordinances,as were cities reflecting moralistic political cultural values.     

Centripetal forces in spatial voting: On the size of the Yolk

The yolk, the smallest circle which intersects all median lines, has been shown to be an important tool in understanding the nature of majority voting in a spatial voting context. The center of the yolk is a natural ‘center’ of the set of voter ideal points. The radius of the yolk can be used to provide bounds on the size of the feasible set of outcomes of sophisticated voting under standard amendment procedure, and on the limits of agenda manipulation and cycling when voting is sincere. We show that under many plausible conditions the yolk can be expected to be small. Thus, majority rule processes in spatial voting games will be far better behaved than has commonly been supposed, and the possible outcomes of agenda manipulations will be generally constrained. This result was first conjectured by Tullock (1967).