Paying for Medicare: benefits, budgets, and Wilbur Mills's policy legacy

Medicare features an unusually complex financing design. The Hospital Insurance Trust Fund pays for Part A of Medicare (hospital stays), while the Supplementary Medical Insurance Trust Fund finances Part B (doctor visits, outpatient care, and certain home health services). At a time when Medicare policy is generating debate, this article takes a new analytical look at the origins and consequences of the program's peculiar bifurcated structure. Addressing historians of the U.S. welfare state as well as contemporary health policy reformers, the article focuses on the crucial role of legendary Ways and Means Committee chair Wilbur Mills in Medicare's enactment in 1965. The central theme of the article is that fiscal conservatism and a commitment to budgetary restraint constitute important elements of Medicare's original political understanding. Contrary to analysts who argue that Medicare's financing design has produced "perverse" effects, we argue that it has served a valuable social function by encouraging policy makers to confront periodically the costs of one of the largest and fastest-growing federal programs. An argument can be made that Medicare's original division requires modification in order to integrate health care delivery changes of the past few decades. It is crucial, however, for reformers not to lose sight of the policy goals, including fiscal rectitude, that motivated the adoption of Medicare's bifurcated structure in the first place.     

Perceptions of child rearing and self-concept development during the early adolescent years

In order to investigate the relationship between aspects of child rearing and adolescent self-concept, 130 males and females in grades 7, 8, and 9 completed Schaefer's Children's Report of Parental BehaviorInventory (CRPBI) and Coopersmith's Self-Esteem Inventory. Correlations between the Acceptance/Rejection dimension of the CRPBI and the various self-esteem subscores were positive. Correlations between the self-esteem scores and the Psychological Autonomy/Psychological Control dimension of the CRPBI were negative. The correlations were stronger for perceptions of mothers' as opposed to fathers' child-rearing practices. Analyses of variance indicated that ninth-graders perceived their parents as less accepting than seventhor eighth-graders. High self-esteem adolescents perceived their parents as more accepting, as using less psychological control, and as not being overly firm in making and enforcing rules and regulating the adolescents' behavior. The results support the contention that optimal self-concept development takes place in an atmosphere of acceptance that allows the adolescent autonomy and the opportunity to learn competencies.This study is based in part on a Master's thesis submitted by the first author to the Graduate School, Syracuse University, in partial fulfillment of the requirements for the M.S. degree.Department of Psychology, Syracuse University. Major research interests are family influences on the adolescent.Department of Psychology, Syracuse University. Major research interests are adolescent selfconcept and identity development and sex roles.     

Gender differences and patterns of arrest across two generations of Cuban immigrants in the United States

The present study is based on a secondary-data analysis of a subsample of Cuban immigrants residing in the United States. While there are no significant differences in arrest rates between U.S. natives of Cuban descent and their foreign-born counterparts, life transitions have a differential impact on behavioral outcomes when young men and women of Cuban ancestry are compared. Job instability increases the risk of arrest for men, while being a single parent increases the risk of arrest for women. Growing up in a two-parent family and marriage have crime protective effects for men, while religiosity decreases the probability of arrest for women. In both subsamples, having a family member arrested was the strongest predictor of one’s arrest status in early adulthood.