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Because of the Medicaid program's high cost and rapid growth, state governments see it as an attractive target for cost-control strategies. The usual ways that budgeters contain spending do not work well on the Medicaid program. Cutting the Medicaid budget is likely to have unintended consequences for state revenues and spending. States can best cope with Medicaid's cost by developing a system-wide strategy of meeting their citizens' health and human-service needs. 相似文献
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Relatively little is known about when, why, and how some jurisdictions “double down” on policy priorities, rapidly adopting multiple measures tackling the same issue. Rapid policy expansion can emerge in fast‐evolving, uncertain, and contested policy arenas in which pressures for policy making are not satisfied, and even may be strengthened, by initial policy innovation. This article analyzes local government policy making on high‐volume hydraulic fracturing by New York State municipalities from 2008 to 2012. Policy path dependence, peer influence, and policy design appear to play a critical role in determining whether public officials respond to these pressures with policy expansion. Initial policy innovations can open windows for policy participants to secure additional measures that strengthen or enlarge the scope of action. Public officials and stakeholders seeking particular policy outcomes should take a long view of the policy process while simultaneously remaining alert for opportunities afforded by pressurized policy dilemmas. 相似文献
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Policy Sciences - We know relatively little about the conditions that encourage people to jump into the political fray as policy entrepreneurs, advocates who devote substantial time, energy, and... 相似文献
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Gwen Adshead 《Legal and Criminological Psychology》2014,19(1):1-12
Respect for justice has traditionally been an essential principle of health care ethics. However, many bioethical accounts of justice focus only on distributive justice, and how resources for health care should be allocated. In this article, I will argue that the practice of forensic mental health care requires clinicians to engage with justice in three additional and different ways: justice as liberty and fairness; retributive justice and protection of the vulnerable; and justice as the promotion of virtue. I will argue that British forensic psychiatry favours retributive and protective justice; in contrast to a libertarian approach to forensic practice in the United States. I discuss how respect for justice as support for virtue complements therapeutic work with offenders, which aims at the development of pro‐social character. I will conclude that without respect for justice as virtue, there is a danger that clinical forensic psychiatry risks doing harm to patients and bringing the profession into disrepute. 相似文献
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Dee Wood Harper David N. Khey Gwen Moity Nolan 《American Journal of Criminal Justice》2013,38(4):589-601
This paper looks at the connection between spatial patterns of robbery within the framework of routine activities theory. This theoretical perspective sees robbery (and other crimes) as occurring when three factors converge: suitable targets, motivated offenders and guardianship. The Eighth and part of the First Police Districts of New Orleans become target rich environments during periods of time when large numbers of tourists and conventioneers are in the city. The city certainly has the neighborhoods of highly concentrated poverty and disorganization that tend to be criminogenic and produce motivated offenders. The spatial distribution of robbery is hypothesized to be a function of the presence or absence of guardianship. In order to test this hypothesis two types of data are examined: robberies (simple, armed, both successful and attempted) that occurred during the convention and tourism season and patterns of deployment and patrol in these areas. Preliminary results indicate that simple tourist/conventioneer robbery victimizations tend to be concentrated within tourist attraction areas while aggravated tourist/conventioneer robbery is concentrated in places that are primarily residential and where there are no attractions and no concentrated police presence. This is also an area of ingress and egress for people from perimeter neighborhoods of highly concentrated poverty and disorganization. 相似文献