Medicaid physician fees and the quality of medical care of Medicaid patients in the USA

When enacted in 1965, the original Medicaid legislation sought to finance access to mainstream medical care for the poor. I use data on visits to office-based physicians from the National Ambulatory Medical Care Survey in four years—1989, 1993, 1998 and 2003—to test the extent to which this goal has been achieved. Specifically, I test whether this goal has been achieved more in states that pay higher fees to physicians who treat Medicaid patients compared to states that pay lower fees. By comparing the treatment of Medicaid patients to that of privately-insured patients and by using state fixed effects, I am able to estimate the effects of changes in the generosity of Medicaid physician payment within a state on changes in access to care for Medicaid patients, therefore separating Medicaid’s effect on access to health care from any correlation between the Medicaid fee and other attributes of the state in which a patient lives. Using this method, I examine the effect of Medicaid fees on whether or not an office-based physician accepts Medicaid patients, on the fraction of a physician’s practice that is accounted for by Medicaid, and on the length of visit times with physicians. Results imply that higher Medicaid fees increase the number of private physicians, especially in medical and surgical specialties, who see Medicaid patients. Higher fees also lead to visit times with physicians that are more comparable to visit times with private pay patients.

Households’ precautionary behaviors—the effects of the introduction of National Health Insurance in Taiwan

By reducing risk of large out-of-pocket medical expenses, comprehensive social health insurance may reduce households’ motivation to engage in precautionary behaviors such as saving, procurement of private insurance, and spousal labor-force participation. We use the natural experiment provided by the 1995 introduction of National Health Insurance in Taiwan to examine these effects, using pre-existing differences in access to health insurance (tied to the household head’s and spouse’s joint employment status) to identify the effects of increasing insurance coverage. We find that comprehensive health insurance has a statistically significant and large effect on household savings, but no significant effects on purchase of private accident insurance and spousal employment.

The scoring rules in an endogenous election

Plurality rule is mostly criticized from being capable of choosing an alternative considered as worst by a strict majority. This paper considers elections in which the agenda consists of potential candidates strategically choosing whether or not to enter the election. In this context, we examine the ability of scoring rules to fulfil the Condorcet criterion. We show for the case of three potential candidates that Plurality rule is the only scoring rule that satisfies a version of the Condorcet criterion in two cases: 1) when preferences are single-peaked and, 2) when preferences are single-dipped.

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Your Money or Your Life: Managing Health,Managing Money

Using the Panel Study of Income Dynamics, this paper examines the relationship between non-collateralized debt (NCD) and health behaviors. The results reveal that households whose members tend to lead less healthy lifestyles are more likely to hold NCD. There are three possible underlying hypotheses that may explain these relationships: (a) common factors, such as preferences, shaping both debt and poorer health behaviors; (b) poorer health and health behaviors causing debt; and (c) debt causing poorer health behaviors. Our findings are not consistent with a causal relationship between health behaviors and NCD. It is likely that other factors, such as time preferences, risk aversion and self-control may underlie the observed correlation.

Imagined interactions,family money management patterns and coalitions,and attitudes toward money and credit

This study explores the imagined interactions college students have with their parents about money and credit, their attitudes toward credit and money, the ways they say their parents deal with financial decisions, and the communication coalitions regarding finances they perceive existing within their family. Students’ imagined interaction pleasantness is greatest when parents jointly form a plan for paying off credit card debt and lowest when parents argue. When family coalitions exist, students report more frequent imagined interactions. Imagined interaction frequency and pleasantness are related to credit and money attitudes.

Financial Issues Associated with Having a Child with Autism

Data from the Family Experiences with Autism Survey are used to identify factors associated with financial problems in families that have a child with autism. Likelihood of financial problems was positively associated with use of medical interventions, having unreimbursed medical or therapy expenses, and having relatively lower income. Use of speech and language therapy was negatively associated with likelihood of financial problems. Many survey respondents forfeited future financial security and even experienced bankruptcy to provide needed therapy for a child with autism. Specific ways that financial advisors can help families that have a child with autism are outlined.

Why Social Capital Subverts Institution Building in Risky Settings

This article considers the problem of fostering confidence in institutions in a post-war context. Situated in post-war Bosnia, this article examines interactions between citizens and representatives of municipal governments on newly established local planning committees to demonstrate that an individual's confidence in an institution and his/her trust in a social intimate who works in that institution are sociologically different phenomena with correspondingly different outcomes for institution building. Contrary to the assumption that increased social capital and interpersonal trust positively affect democratic institutions, this article shows that interpersonal trust may actually undermine the development of institutional confidence.

Reduced prizes and increased effort in contests

We study the general class of two-player public-policy contests and specify the asymmetry condition under which a more restrained government intervention that reduces the contestants’ prizes has the “perverse” effect of increasing their aggregate lobbying efforts.

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The inverse plurality rule—an axiomatization

Under the ‘inverse plurality rule’, voters specify only their least preferred alternative. Our first result establishes that this rule is the only scoring rule that satisfies the minimal veto condition (MV). We then prove that the inverse plurality rule is characterized by MV and the four well known conditions that characterize scoring rules; namely, Anonymity (A), Neutrality (N), Reinforcement (RE) and Continuity (CO). Our new characterization result is related to the characterizations of approval voting and of the widely used plurality rule. We finally show how the axiomatization of the inverse plurality rule can be extended to the axiomatization of elementary scoring rules (vote for t-alternatives scoring rules). We are indebted to two anonymous referees for their most useful comments.

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On the influence of extreme parties in electoral competition with policy-motivated candidates

We study and compare equilibrium platforms in models of unidimensional electoral competition with two and four policy motivated parties. We first analyze the plurality game, where the party getting the most votes is elected and implements its proposed platform. Restrictions on the set of credible announcements are needed to get existence of equilibria. Comparing equilibria with two and four parties, we obtain that moderate parties react to the introduction of extreme parties by proposing the same or more extreme equilibrium platforms. We then study the proportional system, where the policy implemented is a weighted sum of the proposals, with the voting shares as weights. Here, the existence of extreme parties leads moderate ones to choose more centrist platforms. We finally test the robustness of our results with respect to, first, the enlargement of the strategy space to entry decisions and, second, to asymmetric distributions of voters' blisspoints.

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The Social Construction of Deviant Behavior in Homeless and Runaway Youth: Implications for Practice

This study examined the social construction of deviance in a sample of homeless and/or runaway youth in metropolitan Phoenix. In depth semi-structured interviews with 14 youth were conducted, and the data were transcribed and analyzed using a qualitative research computer program. The findings from the study point to an emerging theory, which suggests that ambiguous local policies relevant to homeless youth (e.g., trespassing, loitering) resulted in their selective enforcement by local security and police. Respondents described the ways that they adapted their behaviors to the environmental stressors resulting from these policies. Implications for practice are discussed.

Implicit Behavioral Mimicry: Investigating the Impact of Group Membership

Two experiments investigated the impact of group membership on non-conscious behavioral mimicry. Female participants viewed videotapes of female confederates who rubbed their faces whilst describing a picture. The extent to which the participant mimicked this face rubbing behavior was assessed from video footage taken using a hidden video-camera. Experiment 1 showed greater mimicry of a member of an in-group than of a member of an out-group. Experiment 2 showed both explicit and implicit liking of a target group to predict the extent of mimicry of a member of that group. There was a positive relationship between implicit liking and mimicry but a negative relationship between explicit liking and mimicry. Results are discussed in terms of processes underlying mimicry.

Changing College Students’ Financial Knowledge, Attitudes, and Behavior through Seminar Participation

This pilot study examined the influence of Credit Wise Cats, a financial education seminar presented by Students in Free Enterprise, on the attitudes, knowledge, and intentions toward financial responsibility of college students (N = 93). Findings suggest that the seminar effectively increased students’ financial knowledge, increased responsible attitudes toward credit and decreased avoidant attitudes towards credit from pre-test to post-test. At post-test, students reported intending to engage in significantly more effective financial behaviors and fewer risky financial behaviors. Finally, demographic factors (e.g., gender and employment status) predicted students’ financial knowledge, attitudes, and behaviors. These results suggest that a seminar format may be useful in reaching a wider audience of college students and, thus, warrants future longitudinal evaluation.

Nonprofit Isomorphism: An Australia–United States Comparison

This paper examines the organizational structures of nonprofit organizations in Australia and the United States. Using random samples of nonprofits drawn from the two organizational populations, the analysis compares the extent of structural resemblance or isomorphism in each. It detects similar levels of isomorphism for several structural characteristics. The paper interprets this finding as reflecting expectations for nonprofit organizations that stretch worldwide.

A Historical Perspective on High School Students’ Paid Employment and Its Association with High School Dropout

Discussions about the role of paid employment in high school students’ lives usually involve untested assumptions about historical trends in the frequency, intensity, and selective nature of students’ employment behaviors. Using several nationally representative data sources, we find few changes in rates of employment or hours worked per week among adolescents since 1940 or among students since 1980. We observe important changes in recent decades in racial/ethnic and gender differences in employment and intensive employment. Finally, we observe that the relationship between students’ intensive employment and high school completion has been stable and persistently significant since the late 1960s.

Shame,the Affective Side of Secrets: Commentary on Barth’s Hidden Eating Disorders

This paper expands on the ideas presented by Barth’s article on hidden eating disorders. The topic of eating disorders continues to be an important focus of clinical work. Applying constructs related to the experience of shame, I explore the way that feelings of shame may impact an exploration of eating disorders by the patient and clinician.

What is child care? Lessons from time-use surveys of major English-speaking countries

This paper examines the definition and measurement of time devoted to child care in the diary-based surveys administered by the United States, Canada, Australia, and Great Britain. Detailed analysis of the relationship between measures of care activity and supervisory care in the American Time Use Survey (ATUS) illustrate the larger conceptual issues at stake.

Efficient nonanthropocentric nature protection

This paper analyzes nature protection by a social planner under different ‘utilitarian’ social welfare functions. For that purpose we construct an integrated model of the economy and the ecosystem with explicit consideration of nonhuman species and with competition between human and nonhuman species for land and prey biomass. We characterize and compare the efficient allocations when social welfare is anthropocentric (only consumers have positive welfare weights), when social welfare is biocentric (only nonhuman species have positive welfare weights) and when social welfare is nonanthropocentric (all species have positive welfare weights). Not surprisingly, biocentric social welfare calls for suspending all economic activities. It is more important, however, that both anthropocentrism and nonanthropocentrism make the case for nature protection through different channels, though. Our analysis suggests that one may dispense with the concept of nonanthropocentric social welfare provided that in the anthropocentric framework the consumers' intrinsic valuation of nature is properly accounted for.

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Raising the Status of the Cashier: Latina–White Interactions in an Ethnic Market

Using a Latino-owned and -operated ethnic market in southern California as an ethnographic research site, we analyze and compare the interactions between foreign-born, Latina cashiers and their Latino and White customers. We ask two main questions: what is the nature of cashier–customer interactions, and what do they tell us about the social hierarchy in which they are embedded? While most studies of service interactions find that intraracial encounters are friendlier than interracial ones, the results of this study prove otherwise. We find that the Latina cashiers are routinely friendlier, more deferential, and extend the length of the interaction with their White customers. We conclude that Latina cashiers deliberately provide better service to their White customers because they feel that the patronage of White, middle-class shoppers raises their occupational status as well as the status of their workplace.