Labour migration and the work permit system in the United Kingdom

"The aim of this paper is to examine the effects of the work permit today [in the United Kingdom], using official data. It first reviews the operation of the [labor migration] system and describes the main schemes incorporated. Then, it uses data for 1984-88 to describe the general characteristics of labor immigration through the schemes. Finally, by means of a small random sample of applications and issues, it presents details on particular aspects of the immigration. It demonstrates that current labour immigration through the system is selective: most of those entering with long-term permits are highly skilled, well paid, and moving within the internal labor markets of large transnational corporations." (SUMMARY IN FRE AND SPA)     

The appointment-keeping habits of managed care patients

Among the controversies surrounding the provision of health care in a managed care environment is the belief that patients, because they have no particular allegiance to a single physician, are more casual in regard to their keeping appointments. To test this proposition, the authors conducted a study at a California independent practice association, comparing the habits of managed care patients with those of other types of patients. The findings, although based on a limited sample, suggest that managed care patients do indeed have a greater tendency to be appointment no-shows.     

Defining the health care product to ensure quality and manage costs

The frenzy of health care reform activity now led by the Clinton Administration's American Health Security Act of 1993 might end in the worst of all possible outcomes: a new government entitlement program financed by business and a global budget. Unbridled entitlement could drive utilization of benefits to the maximum and, with a budget cap, guarantee rationing. So far, the administration has talked about expanding access and controlling costs--not about the health care product. Given the threat that change poses for vested interests, time will undoubtedly lapse before final implementation of a new system. Unless physicians involved in health management seize the opportunity during this window of opportunity to help shape the future of health care delivery, the likelihood of preserving the U.S. health care delivery system as we know it will be dim indeed.     

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.     

The case. Bad care, good care, and spiritual preservation

A cancer patient learning to walk again finds that his relationships with his two physical therapists affect his recovery. One woman gives hope as well as instruction. He advises healers to meet their patients as equals, "to take down as many barriers as they can, give away as many distancing privileges as possible."