‘‘With the greatest respect and fidelity:’ a Cherokee vision of the ‘Trust’ doctrine”

The trust relationship is the conceptual/philosophical framework against which all relations between the federal government and indigenous groups are conducted. Yet despite the centrality of this concept, federal policymakers have no consistent or agreed upon definition of what the trust relationship actually entails (Wilkins, 1997). And, more importantly, indigenous conceptions of trust have rarely been assessed. This article analyzes and advances one tribe's—the Cherokee—perspective on trust. In focusing on how the Cherokee perceive trust, this section emphasizes that from an indigenous viewpoint the trust relationship embodies a complex and sophisticated understanding that both the tribe and the United States have reciprocal responsibilities to maintain positive relations towards one another. The leaders of the Cherokee people—one of the more diverse indigenous groups— understood in the federal government's actions, whether these were expressed in treaties, policy statements, congressional laws, or court decisions, that the federal government was pledged to protect Cherokee property and sovereignty, would act with utmost integrity in its legal and political dealings with the people, and would insure that the United States political and judicial representatives would act in a moral manner regarding the tribe's rights. Notwithstanding the federal government's tremendous variety of treaty and trust violations, the Cherokee conception of trust is regenerative from generation to generation. This breathes new life into a seasoned concept and offers hope for the often difficult political/legal relations between the federal, state, and tribal governments. And here we beg leave to ask of our father that, in future transactions of a public nature between the United States and our nation, the American Government will not require of our nation any thing which, as our protectors and guardians, they will not, after due deliberation, advise us to comply with; and having no doubt of the magnanimity and benignity of the Government, we shall return home satisfied, and report to our nation the result of our mission to this. With the greatest respect and fidelity, we subscribe our names (Going Snake, et al., 1817, p. 147)     

The social consequences of the AIDS epidemic: a challenge for the social sciences

The Social Science Research Council is analyzing the social consequences of the AIDS epidemic from the viewpoint of developing society's coping mechanisms and policies. Since neither drugs nor vaccines for AIDS are available, the National Academy of Sciences and the Institute of Medicine have urged that social service research be directed at the areas of education and policy and also at discrimination against AIDS patients and high-risk minorities, such as homosexuals and intravenous drug users. Education is essential in order to effect behavioral changes among these groups as well as to forestall panic among the public. The AIDS epidemic comes at a time when public health emphasis was shifting from communicable disease to chronic degenerative disorders, and problems, such as the possible need for isolation wards are reappearing. Moreover, the total cost of caring for AIDS sufferers is expected to be between 8 and 16 billion pounds sterling by 1991. As AIDS patients become unemployed, they lose their insurance benefits, and the cost of their care reverts to Medicaid and state revenues. Research needs to be done as to the degree to which voluntary health agencies will be able to help. The AIDS epidemic also affects civil rights. Some federal agencies and the armed forces screen applicants for AIDS seropositivity. The army, which traditionally has recruited from inner city minorities, has found that up to 2% of applicants are HIV seropositive, and foreign governments are beginning to object to the stationing of US soldiers in their countries. Answers must be provided for all of these and other social issues if we are to cope with the social effects of the AIDS epidemic.     

The Organization of Health Policy Functions in the German Federal Government

This article gives an account of the organizational history of the German federal ministry of health (and its predecessors) since the beginnings of public policy intervention in health care. In doing so it analyses the role of ministerial organization and examines the functional and political rationale underlying acts of reorganizing the tasks and resources of federal ministries. This analysis has two sides: the first concerns the expressive function of organizational form, as revealing something about the scope and perceived importance of the policy field, while the second interrogates the policy‐shaping role of organization and the political influence of the federal health ministry in health policy‐making. The article thus considers the organizational location of health issues in the central executive from the perspective of what it reveals about government goals and priorities. Then it examines possible policy implications. It looks at resources and the size of the ministry as a first attempt to learn something about the ministry's political weight. The question of policy implications draws our attention away from organization and resource allocation and back to a focus on policy‐making and policy outcomes. The final section therefore examines substantive policy implications that might have emanated from the organizational consolidation of the federal health ministry. It concludes that one such policy implication might be the erosion of the social insurance model as a regulatory idea in health‐care services and financing.     

A New National Health Agenda: Providing the Public With Accurate Information

For decades the recommendations provided by federal agencies have been decidedly one-sided, focusing on the dangers of obesity and need for weight loss. Therefore the public has been presented with incomplete and inaccurate information, which has stagnated our understanding of health. The primary objective needed for a new national health agenda is for the government to provide the public with complete and accurate information about health, weight, and dieting. In order for federal agencies and congress to promote a new national health agenda that reflects a more accurate understanding of the research, the author recommends the following policy changes: (1) the recognition of the health threat imposed by the thinness pursuit and eating disorders, (2) the promotion of weight stability rather than weight loss, (3) ensuring that the conclusions of federal agencies are neutral rather than serving special interest groups, (4) the protection of the consumer from harmful diet programs and drugs, and (5) the providing of public education campaigns emphasizing physical and psychological health rather than efforts for advancing such a national health-centered agenda.     

The development of policy on international student welfare and the question of crisis response

The global market in international education has grown almost without interruption over several decades. Increases in international student enrolments in Australia have been among the most impressive in the world, though they declined between 2010 and 2013. The decline was attributable to exchange rate movements and changes to student visa regulations, though an additional factor lay in reputational fallout from a series of violent physical attacks on Indian students, mostly in 2009. In response, Australian federal and State governments undertook diplomatic trips to India, established a raft of public inquiries to investigate the broader question of international student welfare, and made policy changes. Utilising the literature on public policy “crises”, this paper presents government responses to the 2010–2013 downturn in terms of managing a “long‐shadow crisis” (Boin et al., The Politics of Crisis Management: Public Leadership Under Pressure; Cambrtidge University Press, 2005), which typically emerges quickly but has major political consequences, is only seen to be resolved incrementally, and calls for policy change rather than fine‐tuning in response. The adequacy of the policy response to the crisis is not discussed. The article suggests that the crisis and the response acted to elevate the status of international education as an area of policy in general, though not as a mainstream area of social policy.     

In the Eye of the Storm: Civil Servants and Managers in the UK Department of Health

In the wake of the 2008 financial crisis, the UK government faces some tough choices over public expenditure, and these choices will have important implications for both the future of health policy and the way in which health services are managed. In this article, we examine the organization and leadership of the UK Department of Health and weigh its suitability to meet such challenges. We find an organization that is culturally split between public servants and managers, highly reliant on the ability of its key personnel to bridge these divides, and extremely responsive to the political goals of government ministers. We explore the modern DH using three types of evidence. First, the history of the department shows clear political efforts to reduce civil service discretion and focus the DH on the management of the English NHS. Second, the recent organizational structures of the DH show a bifurcation between policy direction and NHS management tasks. Third, an analysis of the top ranks of the department since 2005 shows the implementation of political preferences that are consistent with managerialism but inconsistent with the perceived characteristics of traditional civil servants. The result is a department which has changed just as frequently as the health service it oversees – a department which has been moulded by successive ministers into one for the management of the NHS. Our findings raise important questions about the value and purpose of long‐term organizational knowledge in policy formulation.     

Performance measurement: the new accountability

Over the years, "accountability" in the human services has focused upon issues such as the legal framework, organizational management, financial responsibility, political concerns, and client inputs and expectations. Within the past decade, the meaning of "accountability" has been extended to the more dynamic organizational functions of "efficiency" and " effectiveness." Efficiency and effectiveness increasingly must be put to the tests of performance measurement and outcome evaluation. Forces outside the social work profession, including, among others, federal expectations and initiatives and the increased implementation of the concept of managed care, will ensure that efficiency and effectiveness will be central and highlighted concerns far into the future. This "new accountability" is demanded by the stakeholders in the nonprofit sector and by federal requirements built into the planning, funding, and implementation processes for nonprofits and for-profits alike.     

Handicapped by old and new traps: Hungary's health care reform

Since the early 1980s, grave challenges have faced Hungarian health policy. The health status of the population stagnated between the mid-1960s and mid-1970s, and has dramatically deteriorated since then. In the 1980s the multidimensional crisis of the health care system deepened. Its overhaul must embrace every component: policy-making, ownership, financing, management, service structure, patient rights, medical education, etc. The main purpose of this paper is to describe how health policy has (or has not) responded to these challenges. First it summarizes the inheritance of the state-socialist regime, then it outlines the recent changes in social insurance legislation, and finally it compares official goals with the way the reform is actually proceeding. The paper is intended to discuss the connection between health care reform and the historic transformation of the political regime and the economy.     

Social Legislation in Australia

Despite strong public interest in law reform by both state and federal governments, very little has been written about social legislation in Australia. Discussions about social legislation frequently proceed with each participant assuming an individual and subjective definition of social legislation; rarely is there agreement about the role and purpose of social legislation. This paper examines some writings on social policy in an effort to provide a definition of social legislation; a basis for identifying legislation as ‘social’ is provided. It is argued that for legislation to be social it must have a distributional character. Further consideration is given to the role of social legislation and the motivations for introducing legislative measures to deal with social ills. Attention is focused on approach, rights and tokenism in social legislation.     

Resilience among older caregivers in rural Namibia: The role of financial status,social support and health

Background: Namibia has one of the highest human immunodeficiency virus (HIV) prevalence rates and one of the highest rates of orphanhood in the world, and older caregivers provide much of the care to Namibians living with HIV and acquired immune deficiency syndrome (AIDS) (UNAIDS, 2014). In this study, the authors explore how financial status, social support, and health were related to the resilience of caregivers caring for people affected by HIV and AIDS in rural northern Namibia, Africa. Method: Data were collected through a structured interview from (N = 147) caregivers from the Zambezi region. Results: Findings from this study show that employment and physical health were significantly associated with increased resilience in older caregivers. Discussion: Our findings point to the need for employment assistance and health services to improve the resilience of caregivers caring for people living with HIV and AIDS. We conclude that there is a need for more vigorous concerted efforts from public and private sector practitioners and policy makers to create more sustained formal employment opportunities and intervention programs aimed at improving the overall health of older HIV caregivers, especially those residing in rural HIV endemic communities in developing countries.     

Question worth 20 million lives: Why federal housing assistance has not had its Obamacare

The equitable character of a policy determines its progressiveness, yet some domestic policies are more equitable than others. The question of how and why this is the case is addressed by studying federal housing and health policies in the United States, a critical case known for its rampant inequalities in both sectors. Although social equity is a fundamental aspect of welfare provision, explaining differences in coverage and government support among policy areas remains a weakness in the literature. This comparative historical analysis shows that both housing assistance and health care suffered from inequities almost as early as their inception. But a progressive reform took shape with the Affordable Care Act (ACA) and extended coverage to 20 million people formerly uninsured. This essay tackles an unsolved puzzle: Why has such grand policy reform never taken place in housing where more than 20 million people are eligible for assistance but do not receive help? We found that it is largely explained by housing assistance distinctiveness with regard to its weak constituency, racial connotation and low public concern. We conclude with the analytical payoffs of studying social equity, both for political scientists and observers of social affairs.     

试析美国金融危机中的政府行政干预

金融危机是市场经济发展过程中的一个现象。宪政秩序是美国政府行政行为需要遵循的框架,政府行政干预是解决经济危机的有效手段,金融立法是政府行政干预的行为依据。创新必须要有监管,稳健的金融立法是稳定金融市场、防范金融危机的有效工具。金融立法应考虑效率与安全的平衡,有利于金融的长期发展。不同国家有不同的历史文化传统和现实政治经济情况,会选择不同特色的社会制度和行政运行机制,这是一个自然的过程。     

慈善概念的移植何以未完成:一个政策过程的分析

寻求法律移植与习俗的有机统一无疑是中国法律现代化最为重要的问题。由于缺乏微观政策过程的分析,对这一问题的探讨大多停留在宏观层面。本文从法律现代化和法律多元主义的理论视角出发,以《慈善法》中“慈善”概念的形成为例,探讨了法律移植与习俗如何通过立法体制影响法律的形成。研究发现,习俗通过回应性立法的制度安排以及立法者的双重身份被纳入到决策中。法律移植的慈善概念则通过法律专家与立法者的深度互动产生作用。然而,立法过程中提案与审议的分离以及政治官僚制的决策模式使得形式理性法律的建构面临双重消解。因此,促进立法体制的优化才能实现立法中形式理性与价值理性的有效融合。     

The Impact of a Restructured Canadian Welfare State on Atlantic Canada

The Canadian welfare state, like welfare states elsewhere, has undergone significant reform and restructuring. This paper examines what has occurred and the impact it has had on Canada's poorest and most underdeveloped region, the Atlantic provinces of Nova Scotia, New Brunswick, Prince Edward Island and Newfoundland. Although the central and western regions have also experienced a reduction in federal expenditures, no other region has been more negatively affected by federal fiscal and social policy reform and downsizing. Health care and education have experienced the worst cuts. The significant loss of federal government transfers to this region has ruptured a historic social contract. This in turn has triggered a radical restructuring and downsizing of provincial and municipal public administrations, commensurate with job losses in important sectors of the labour market, such as universities, hospitals and schools. In the last five years the rate of unemployment and poverty has risen sharply, personal and household incomes have declined, and entire communities are on the brink of extinction owing to out-migration. The irony, however, is that for Atlantic Canadians the retrenchment of the federal state has led to greater public willingness to consider social democratic political parties and policy alternatives that are not only different from prior fare, but which do not represent a flight to a rather unsatisfactory past.     

Explaining individual level support for organ procurement policy

The demand for human organs for transplantation – both from live and deceased donors – has become a public health issue in the United States, as thousands of Americans die each year due to the lack of a needed transplant. The current policy basis for organ procurement is voluntarism as federal organ procurement policy, based on the 1984 National Organ Transplant Act (NOTA), prohibits the exchange of human organs for “valuable consideration.” While an increasing number of policy analysts, including some ethicists, have advocated for financial incentives to induce more donations, a variety of factors – such as the legislative status quo, ongoing ethical concerns, and uncertain public support – have resulted in little use of financial incentives. We argue that a better understanding of public opinion is an important prerequisite for any move toward the use of financial incentives. Consequently, we develop and test a model to explain individual level attitudes toward legalizing and regulating the sale of human organs for transplant. We find that political ideology, gender, age and geographic region are important predictors of support.     

The Evolution of Penal Policy in Canada

This paper reviews the evolution of penal policy in Canada in recent years. In many respects, Canada occupies a unique position with respect to criminal justice. The principal influence on penal policy development has been the United States, yet at the same time developments in the United Kingdom have also been important. One result is that policy development in recent years has tended to follow a middle path between the more extreme and radical American route (that has given rise to policies such as "three strikes" legislation) and the more conservative European reforms. Canada's policies with respect to punishment have been affected by a number of influences, including: the presence of advocacy groups; the reporting by the news media of high-profile tragedies such as the Montreal massacre of fourteen young women; the restrictions of budgetary constraints; and the intervention of several federal elections in which crime became an important electoral issue. In this respect, penal policy development in Canada echoes trends in other jurisdictions. The federal government, which is responsible for policy development (but not the administration of those policies) has attempted to pursue a dual-track policy. One branch of this policy has sought to reduce the use of imprisonment and thereby cut criminal justice expenditures. The other track has sought to placate public and political pressure on the government by introducing more repressive penal policies, including severe minimum penalties and higher maximum penalties for young offenders. This paper reviews recent developments in the critical areas of sentencing and parole, and draws some general conclusions about criminal justice policy development in this country.     

Usury and the problem of exchange under capitalism: a late-nineteenth-century debate on economic rationality

Examining the ambiguous concept of usury, this article retraces political battles over the epistemic framings of the everyday economy in the nineteenth century. It takes a comparative approach to the legal and economic debates on usury in the Habsburg and the German empires in the wake of the economic crisis of the late 1870s, when new laws against usury were introduced. In the respective debates, diverging political interests and class attitudes pitted different conceptualizations of economic exchange against each other. At stake were the diverse forms of commensuration and valuation scales in received credit practices. The new legislation on usury centred on the notion of a usurer’s victim who supposedly was incapable of rational economic action and thus in need of civilization. By way of conclusion, this article relates the story of nineteenth-century usury legislation to current debates among historians on capitalism and the emergence of the economy as a bounded entity. It argues for more analytical attention to historical conflicts over modes of exchange as they came to the fore in the debates on usury, and discusses the implications of this perspective for the history of economic liberalism.     

Food, Social Policy and the Environment: Towards a New Model

Food policy is high on the public policy agenda, but still suffers from a lack of overview and integration. The paper reviews examples of policy limitations where tighter and more explicit links could usefully be made between environmental, social and public health considerations. The paper proposes a new ecological health approach to public policy. This offers marked advantages over the present "productionist" approach to food policy. With this old policy regime in crisis, the paper reviews current moves towards adoption of the ecological health model in Britain, Europe and globally.     

Implementation and Politics

An investigation of the relationship between state socioeconomic and political structural variables and state noncompliance with the requirements of federal public welfare grant policy during the period 1970-1972 is reported. The major finding is that the more affluent and politically competitive states are most likely to engage in noncompliance. These are the states that historically have provided the most generous welfare benefits. In addition, those states that expericnce frequent changes in directors of the department of public welfare are more likely to engage in noncompliance. The discussion suggests that state welfare policy is more complex than is revealed by aggregate or average expenditures. Other elements such as decisions about compliance with federal grant requirements must be considered, and the complexity of the choices and possible trade-offs confronting state officials should be recognized.     

Portuguese healthcare reforms in the context of crisis: External pressure or domestic choice?

As a result of the recent economic crisis, in 2011, Portugal signed a Memorandum of Understanding with the European Central Bank, the European Commission, and the International Monetary Fund (the “Troika”). In exchange for Troika's financial assistance, the Memorandum required the implementation of a specific set of reforms targeted at the healthcare sector. The literature on policy reforms in the context of crisis and conditionality argues that governments have restricted room to manoeuver in responding to external pressure. We challenge this view, finding that even in cases of conditionality and strong external pressures, crisis can be used as a window of opportunity for reforms substantially shaped by domestic policy choices. In the case of Portuguese health reforms, these choices were based on pre‐existing reform plans aimed on resolving country‐specific deficiencies of the healthcare system and were enabled by the two main political parties' strategies of tacit cooperation and blame avoidance. The article emphasizes the need for more fine‐grained analysis of welfare reforms in the crisis that pays equal attention to the institutional characteristics and the political context of the affected countries.