Employment-based health benefits: analysis of the April 1993 Current Population Survey

The April 1993 CPS differs from the March 1993 CPS in a number of respects. The April 1993 CPS supplement surveys only workers, whereas the March CPS examines the noncash benefits received by all Americans. The April CPS asks workers about health coverage in the week in which the questions were fielded, whereas the March CPS asks about coverage in the preceding year. In April 1993, there were 112.5 million civilian American workers between the ages of 18 and 64 with jobs. Eighty-two million (73 percent) of them worked for an employer that sponsored a health insurance plan, and 65 million (58 percent of all workers) participated in their employer's health plan. About one-third of workers at firms with fewer than 10 employees had employers who offer health benefits; about one-quarter of all of the workers in these firms participated in their employer's plan. Conversely, 94 percent of workers at firms with more than 1,000 employees had an employer who sponsored health benefits, and over 77 percent of these workers participated in their employer's plan. There are 16.5 million American workers whose employers sponsored health benefits but who did not participate in these benefits. Over one-half of these workers (8.5 million) chose not to be covered. Another 36 percent of these workers (5.9 million) did not participate because they were ineligible or denied coverage. Over 66 percent of the ineligible workers did not participate because they were part-time, contract, or temporary workers. Another 26 percent had not yet completed a probationary period. Among the reasons that those who chose not to participate in their employer's coverage, the vast majority (75 percent) stated they were covered by another health care plan. Twenty-nine percent stated that they chose not to purchase coverage because it was too costly or that they did not need or want the coverage. In 1993, there were 16.7 million workers with no health insurance coverage. The vast majority of these workers (95 percent) were employed by private employers. Sixty-six percent of the workers with no health insurance coverage were self-employed or worked for firms with fewer than 100 employees.     

Interrupted stories, interrupted lives

In attempting to manage their practices efficiently, doctors may not allow seriously ill patients enough time to sort out their feelings and raise important questions. What is at stake here is not information about prognosis and treatments but the very survival of the soul.     

The model of place utility revisited

"The purpose of this paper...is twofold: first, to specify a way of calculating place utility so that potential migrants could move to the place where overall place utility is maximized; and second, which is more important, to reveal how decision-makers in the real world, who are acting within 'bounded rationalities'...,make their decisions on where to migrate. This study is supported by an empirical survey of recent Chinese immigrants to Edmonton [Canada].... The findings reveal that when people evaluate different places, they do not necessarily look for the one that generates the highest overall value or utility across all properties.... The study further indicates that the assumption underlying most microeconomic models (that maximizing utility or benefit is the ultimate rule for choosing one location out of several) has not been verified." (SUMMARY IN FRE AND SPA)     

DO RESPONDENTS REALLY "MARK ALL THAT APPLY" ON SELF-ADMINISTERED QUESTIONS?

An experiment was conducted to assess the effect of using "markall that apply" question instructions on survey reporting aspart of the field test for the Second Follow-up of the NationalEducation Longitudinal Study of 1988 Eighth Graders (NELS:88).Mark-all-that-apply instructions were compared with instructionsasking respondents to indicate "yes" or "no" to each responseoption on responses to three items dispersed throughout thequestionnaire and consisting of different topics and numbersof response options. For the three items, significantly fewerresponse options were selected with the mark-all-that-applyinstructions than with the yes/no instructions, but becauseexternal validity criteria were not available, overreportingto the yes/no instructions cannot be ruled out. Instructiondependentprimacy effects, predicted under the hypothesis that respondentswould engage in more superficial processing when given the mark-all-that-applyinstructions, were not found.     

The impact of migration on gender roles: findings of field research in Turkey

Findings are based on a sample of four types of Turkish women affected by migration: 1) pioneer women who emigrated on their own (33 persons); 2) followers with wage work experience, who joined or left with husbands (44 persons); 3) followers without wage work experience (39 persons); and 4) women left behind when husbands migrated (45 persons). These women are compared to a non-migrant control group (54 persons). Sample surveys were conducted in three sites, which varied in levels of industrial development, economic diversification, and urbanization (Ankara, Kisehir, and eight rural villages in the province of Kisehir). The sample includes returnees registered with the Social Insurance Institute and persons located by the chain inquiry method. Prior research supports the importance of including typologies based on family types, marriage types, levels of education, and experience with wage work. This study confirms that pioneer women were more likely to have romantic marriages, to have nuclear families, to have higher educational levels, and to have prior wage work. Analysis of the 116 women with migration experience shows that 75% migrated during 1968-74. 22% migrated after 1980. 51% were returnees during 1983-85, and many received retirement benefits. Almost 65% spent 10 or more years abroad. 56% were aged under 24 years. 85% were married at the time of emigration. 61% viewed their migration experiences as improving their maturity and ability to handle affairs compared to nonmigrant women. 88% became housewives after returning. 27% of return migrants and 82% of nonmigrants had never had their own bank accounts. 69% of return migrants and only 22% of nonmigrants reported movement outside the home without permission. 63% of migrants and 39% of nonmigrants would cast political votes independently of their husbands. Migrating women exercised more independent behavior but retained traditional responsibility for housework. The greatest differences were between women with wage work and women without or with migrating husbands. Followers without wage work were the most disadvantaged. Migration is viewed as a significant factor in determining gender roles among Turkish women.     

Gambling and the Law®: Endless fields of dreams

This article examines the current trends of proliferation of commercial gaming, especially in the United States, in the context of the third wave of legalization of gambling that has been experienced since the founding of the nation. The author looks at the historic foundations of the spread of casino-style gambling, and notes the types of casino gaming that have led the way in the current expansion. He also points out why it is reasonable to expect that this wave too may come crashing down, as general acceptance of wide-spread casino gaming in America may indeed be short-lived.Gambling and the Law^® is a registered trademark of I. Nelson Rose.     

Corporate compliance programs: risk management for the future

The Department of Justice has estimated that the government loses $100 billion annually in health care fraud. Consequently, the government's health care fraud enforcement activities with respect to all health care providers and suppliers continue to grow. Last year alone, the government collected more than $8 billion in settlements, fines, and penalties involving health care fraud. Recent settlements with the government have begun to include corporate compliance programs that require continued government oversight of the health care organization as an essential part of the settlement. The first section of this article describes the legal significance of health care companies' having corporate compliance programs. The second section provides a sample list of topics that should be included in any corporate compliance program. Finally, we describe various issues related to the creation and implementation of corporate compliance programs.     

A hospital protocol to resolve complaints against staff physicians

Complaints of discrimination or harassment in the workplace have become almost commonplace in recent years, increasing in both frequency and variety. In the hospital setting, this trend is manifested in allegations against members of the medical staff by hospital employees as well as by patients or their families. Whether real or fancied, such allegations are reflective of a potentially disruptive undercurrent of organizational tensions. Left unresolved, they can erode the essential partnership between staff physicians and other members of the health care delivery team. Unsatisfactory patient experiences may also damage the reputation of the institution and thereby undermine its viability. With either group of complainants, allegations of malfeasance that are not resolved at the source in a timely manner are far more likely to result in expensive, time-consuming, and potentially damaging litigation.     

A model of numbers of births in three countries,with persistent forty-year cycles

This paper describes a model which relates fertility to partner availability, an aspect of relative cohort size. Partner availability is affected by the tendency for males to reproduce at a later age than females. For women born at a time of rising birth rates, there is a shortage of slightly older men as potential partners. Women born when birthrates are falling enjoy a surplus of older men from which to choose. This model is believed to be the first non-linear demographic feedback model involving feedbacks through marriage squeezes in which empirically estimated values of the parameters imply persistent limit cycles. The deterministic model makes births in each five-year period a function of births in previous five-year periods. The form of the function is chosen to model the effect of partner availability upon entry into reproductive relationships, and therefore on age-specific fertility. Marriage rates are not modeled directly. The model was developed from data for more than a century from England and Wales, New Zealand, and the US. The demographic transition is modeled with a logistic function and age-specific fertility rates are estimated using lognormal distributions. The stepwise inclusion of a partner availability estimate in the model showed that it accounts for 29% of otherwise unexplained variance. Projected future births stabilize in sustained or limit cycles with periods a little longer than 40 years, and amplitudes of at least 7% of the mean. The necessary conditions for cycle persistence are outlined on a graph of maximum and minimum fertility parameters.