Competition, Productivity and the Cult of 'More is Good' in the Australian Health Care Sector

Economic policy discussions emphasise growth, the maximisation of output, efficiency and the pursuit of rational self-interest. Many policymakers, bureaucrats and managers in health care have been influenced by economists who believe that competition and the marketplace will provide maximum output and efficiency. Thus, for some, health care involves treating more and more patients for the same money. They argue for strategies such as reducing waste, lowering costs, increasing inpatient throughput and introducing competition between providers, especially hospitals, in order to stimulate productivity to achieve their aim. Yet in health care more is not necessarily good. Embracing the culture of the marketplace in a predominantly publicly funded system runs the risk of failing to distribute health care services equitably, and leads to more inappropriate and unnecessary care. An approach that merely strives to treat more patients and lower costs should be rejected in favour of a health system that values effectiveness, health outcomes, quality and the public good, and is patient-centred not delivery system-centred.     

The iteration deficit in responsive regulation: Are regulatory ambassadors an answer?

One reason that regulation is difficult is that repeated encounters between regulator and regulatee are rare. We suggest diplomacy as a model for reconfiguring regulatory institutions in response. Ambassadors for Regulatory Affairs who would be agents for all state regulatory agencies could be based in most large firms and small and medium enterprises that pose unusual regulatory risks. In rural towns, police would be trained as regulatory ambassadors. Just as a US Secretary of State can launch a “diplomatic surge” in Myanmar from 2009, so regulatory surges are possible in market sectors of high risk or high opportunity. We propose strategies of indirect reciprocity as a way in which reciprocity that is only episodic in these strategic ways can promote more general responsiveness. Indirect reciprocity is reciprocity that we do not personally experience, but learn from the experience of a culture. This means that so long as we sustain regulation as a relational as opposed to a purely technocratic process, indirect reciprocity might civilize regulatory compliance in an historical process informed by the theories of Elias and Putnam.     

恢复性司法的功效

恢复性司法不仅成为处理犯罪问题的较好方式,还成为帮助村落社会成为更加尊重权利、学习如何成为民主社会的一种方式.恢复性司法最大的前景不在于它比法院审理或者辩诉交易更有直接效果,而在于较之传统的刑事司法,是对犯罪有效干预的承载工具.有越来越充分的证据表明,恢复性司法本身对于减少重新犯罪有直接效果.有关恢复性司法的文献越来越有力地说明,还能够通过更多的正义和当地社区更多地参与决策来减少犯罪.     

Tripartism: Regulatory Capture and Empowerment

The features of regulatory encounters that foster the evolution of cooperation often also encourage the evolution of capture and corruption. Solutions to the problems of capture and corruption—limiting discretion, multiple-industry rather than single-industry agency jurisdiction, and rotating personnel—inhibit the evolution of cooperation. Tripartism—empowering public interest groups—is advanced as a way to solve this policy dilemma. A game-theoretic analysis of capture and tripartism is juxtaposed against an empowerment theory of republican tripartism. Surprisingly, both formulations lead to the conclusion that some forms of capture are desirable. The strengths from converging the weaknesses of these two formulations show how certain forms of tripartism might prevent harmful capture, identify and encourage efficient capture, enhance the attainment of regulatory goals, and strengthen democracy. While the case we make for tripartism is purely theoretical and general in its application to all domains of business regulation, our conclusion is a call for praxis to fish out the contexts in which the theory is true or false.     

Learning to Manage Shame in School Bullying: Lessons for Restorative Justice Interventions

Shame management is purported to be part of the healing process that is a goal of restorative justice. However, the development of shame management capacities and how they are engaged in conflict resolution remains a relatively understudied phenomenon. This study examines how shame management (acknowledgment and displacement) is employed by children as they move into and out of cultures of school bullying. The analysis is based on self-reported changes in bullying experiences of 335 Australian children over a three-year period. Children were classified into bully, victim, bully-victim, nonbully-nonvictim, or residual conflict groups. Shame displacement and bullying tolerance accompanied transition into bullying. Shame acknowledgment and control of bullying marked desistence from bullying. Effects of shame management and social control were not uniform across groups. Findings indicate that interventions to change behaviour need to be flexible and responsive to prior bullying experiences so specific risk and protective factors can be targeted. This study demonstrates that responsiveness to context, building socially responsible relationships, and adaptive shame management are all integral to behaviour change, supporting the use of restorative justice as a way of dealing with school bullying as well as other forms of harm.     

Pathways to Sexual Risk Taking Among Female Adolescent Detainees

Sexual risk taking among female delinquents represents a significant public health problem. Research is needed to understand the pathways leading to sexual risk taking among this population. This study sought to address this issue by identifying and testing two pathways from child maltreatment to non-condom use among 329 White and 484 African American female adolescent detainees: a relational pathway and a substance use coping pathway. The relational pathway indicated that child maltreatment would be related to non-condom use via depressive self-concept and condom use self-efficacy. The substance use coping pathway suggested that depressive self-concept and alcohol-based expectancies for sexual enhancement would mediate the relationship between child maltreatment and non-condom use. As hypothesized, the relational pathway variables were associated with one another in the expected directions; however, evidence of mediation was not found. Support for mediation was found for the substance use coping pathway. Exploratory across group comparison analysis indicated that the relational pathway was significant for White girls whereas the substance use coping pathway was significant for African American girls. Limitations and implications for future research are discussed.