Social Antecedents of Medical Fraud and Over-Servicing: What Makes A Doctor Criminal?

Medical fraud and overservicing are estimated to cost the Australian community between $130 and $200 million per annum, a figure far greater than the national cost of burglary and almost the same as the total property loss from all conventional crime. An examination of the social antecedents of medical fraud and overservicing suggests that the predisposition of some doctors to engage in these practices occurs because of the following: (1) medical training and professional socialization that orientate student doctors away from altruistic health issues towards narrower self-interested professional concerns; (2) career expectations of a high pattern of material consumption that are often frustrated by an increasingly competitive medical market place; and (3) professional medical organizations that lobby for national health policies which reflect the mercenary self-interest of doctors rather than the health interest of the nation.     

Effects of Marriage and Children on Financial Risk Tolerance: A Synthesis of Family Development and Prospect Theory

Family development and prospect theory were used as a framework to predict variability in individuals' subjective financial risk tolerance within distinct family structures. Gender, age, and income were expected to interact with the main effects of family structure (marital status and children). Theory-generated hypotheses were examined in Study 1 (data from university housing respondents, n = 76) and Study 2 (the 1998 Survey of Consumer Finances, n = 4,305). One family structure main effect (child presence) was significant for investment risk tolerance in both studies. Family structure interactions (marital status × age and child × income) were significant for employment risk (Study 1), and child × age was significant for investment risk in Study 2.     

Risk Compensation or Risk Reduction? Seatbelts,State Laws,and Traffic Fatalities*

Objective. The risk compensation hypothesis suggests that drivers enjoying greater safety will drive more recklessly and thereby impose greater risks on nonoccupants. We provide a test of the risk compensation hypothesis in the context of state seatbelt laws and belt use rates. Methods. Fixed‐effects models with policy and demographic variables are estimated using annual state data from 1985 to 2002 to test the effect of seatbelt laws and seatbelt use rates on logged fatality rates for occupants, pedestrians, motorcyclists, and all nonoccupants in separate models. Results. Contrary to the risk compensation hypothesis, the results indicate that both occupants and nonoccupants enjoy greater safety due to state mandatory use laws and increased safety belt use rates. Conclusion. Overall, seatbelt laws and the higher belt use these laws induce do not increase nonoccupant risk exposure. If anything, these laws and the accompanying increase in belt use result in safer driving behavior.     

How faith‐based social service organizations manage secular pressures associated with government funding

This article reports selected findings from a qualitative case study of two faith‐based social service organizations to address two questions: (1) How does government funding influence the religious characteristics of faith‐based social service organizations? (2) How do government‐funded, faith‐based social service organizations manage the tensions arising from both secular and religious contexts? The findings suggest that the adaptation of secular institutional practices is not as inevitable as some have feared. Rather, the two organizations studied showed convincingly that their faith traditions and values were alive and widely evident throughout their organizations. Three key strategies emerged as means for maintaining religiousness in the face of secular pressures: (1) Religious identities were perceived as given rather than chosen, and therefore were not negotiable; (2) religious values provided strong justification for seeking relationships with others who do not share their faith; (3) the religious worldview blurred religious and secular distinctions so that secular technologies and practices could comfortably be utilized.     

NATURAL HEALTH DISCOURSES AND THE THERAPEUTIC PRODUCTION OF CONSUMER RESISTANCE

Social critics of the natural health movement charge that it indoctrinates consumers in a therapeutic consumerist ideology. This "dominated consumer" thesis ignores that socially situated individuals must negotiate a plethora of institutionally specific power structures aiming to classify and govern their identities. Accordingly, resistance toward specific institutional constructions of identity can be produced through marketplace ideologies. I explore this understudied ideological effect by analyzing the narratives of women who are using natural health alternatives to resist their ascribed medico-administrative identities. Natural health's therapeutic ideology enables these women to contest the degenerative implications of their medical diagnoses and, conversely, to reconstruct their chronic illnesses as an opportunity for discovering their inner regenerative potential and expanding their spiritual horizons. This analysis has implications for prior studies suggesting that resistance toward the technocratic and bureaucratic aspects of conventional medicine exemplifies a Foucauldian "care of the self." I argue that a postmodern adaptation of Foucauldian theory is needed to address the complex interrelationships among the care of the self, medical consumerism, and the therapeutic ideology of the natural health marketplace.     

Dementia Problem Behavior and the Production of Informal Caregiving Services

Informal caregivers of individuals with Alzheimer's disease spend a considerable amount of time providing care. In this paper, we use Grossman's health production and Becker's time allocation models to develop a model of informal care provision to elderly dementia patients. In our model, time inputs produce caregiving services, which provides utility to the caregiver, but reduces leisure. We assume that time is less productive of services on the margin as the disease progresses. In this framework, an increase in patients' disease severity does not necessarily increase informal caregiver time input. The cost of formal care establishes a reservation price for informal caregiving. When the costs of informal caregiving rise above this reservation level, the patient is institutionalized. We test empirically the effect of deterioration in the patients' condition, proxied by both disease severity and dementia problem behavior, on informal caregiving time. We find that dementia-related problem behaviors and functional limitations significantly increase inputs of informal caregiving time. Patients' problem behavior exerts a modifying effect on functional limitations, and patients' comorbidities have no effect on informal caregiving time.     

On the Evolution of Competitive Balance: The Impact of an Increasing Global Search

The Coase theorem maintains that where free-market precepts exist, the allocation of property rights does not impact the distribution of resources. An application to Major League Baseball suggests that institutions such as free agency and the reverse-order amateur draft would not impact player distributions and therefore would not impact competitive balance. The present study finds that the distribution of wins is generally consistent with the precepts of the Coase theorem and therefore suggests a course for those who wish to alter the level of competitive balance: Major League Baseball should increase its focus on expanding the size of its labor pool. (JEL O15 , L83 , C22 )