Retiree medical plan design: determining the philosophy, communicating the need

Much has been written, both in benefit-related journals and in the general press, about the recent statement, FAS 106, issued by the Financial Accounting Standards Board (FASB). This statement requires most employers to begin accounting for retiree health care benefit costs for active employees as well as current retirees, creating a significant negative financial impact. Most of the attention has been focused on getting the numbers that will tell the extent of the impact resulting from FAS 106. The next step has been to review retiree medical coverage to see how the affected companies can change it to reduce their liability. Although the urge is strong to adopt a quick-fix solution, employers can greatly benefit by reviewing their benefit philosophies and making plan decisions that make sense for them. This article discusses key questions that can help focus the issue on company philosophies and lays out a framework for determining suitable plan designs that can also help companies manage the retiree medical liability.     

Poisson regression with misclassified counts: application to cervical cancer

"Errors in disease classification can give misleading inferences for covariate effects when the probability of error is itself related to the covariates. More accurate inferences are possible using supplemental data on both true and fallible disease counts at various covariate levels. We present a method for incorporating such supplemental data into disease rate regression and use it to show that, although observed intercountry differences in European cervical cancer mortality rates are exaggerated by errors in death certification, they are not completely explained by such errors." The data concern Belgium, England and Wales, France, and Italy.     

1990 census round: meeting users' needs is seen as key to successful dissemination

"Dissemination and marketing of census products were...major topics at the Thirteenth Population Census Conference of census directors from the Asian-Pacific region, held in Honolulu in December 1990. Drawing upon papers presented at the conference,...this article describes technological developments and marketing techniques being used in the region to increase the demand for census information."     

Family ties and economic stability concerns of migrant labour families in Jordan

74 labor migrant families from various socioeconomic classes in Amman, Jordan were interviewed to examine changes in relationships among family members, extended family, and neighbors and their concerns about economic stability in the host country, Jordan, and the world market. Another purpose was to determine how current migration policies of the Arab oil-producing countries which prohibit labor migrants from bringing their families to the host country affect labor migration among families. The families consisted of either those who did or did not accompany the labor migrant. Overall labor migration affected unaccompanied families more than accompanied families, e.g., only 19% of the unaccompanied families reported increased family unity compared with 56% of accompanied families. Problems within unaccompanied families increased in 43% of the cases but in only 6% of the accompanied families. Many of these problems resulted in children dropping out of school which reflected the control fathers had within the family, separation, or divorce. Yet labor migration reduced family ties with extended family members and neighbors almost equally for both groups. Accompanied families were not as concerned about economic stability in Jordan as unaccompanied families (38% vs. 50%). Perhaps these families tended not to invest remittances received from the labor migrants working in Arab oil-producing countries in Jordan. Both groups were quite concerned about the economic stability in the host countries (66% and 72%, respectively) and the world market (59% and 62%, respectively), however. Since family unity suffers when families do not accompany labor migrants, it is suggested that oil-producing nations that depend on foreign labor should guarantee family unity as a human right.     

The effects of regulatory tools on organizational populations

One of the main activities of regulation is the control of market development by influencing the number of firms in an industry, their entry into an industry, and their exit from an industry. Population ecology is used as a framework for explaining both the direct and indirect effects of regulatory activity on entry, exit, and market structure. This framework is then used to derive specific propositions about regulatory effects on entry, exit, and market structure in the health maintenance organization industry.     

The seasons of a CEO's tenure

This article proposes a model of the dynamics of the CEO's tenure in office. The central argument is that there are discernible phases, or seasons, within an executive's tenure in a position, and that these seasons give rise to distinct patterns of executive attention, behavior, and, ultimately, organizational performance. The five delineated seasons are (a) response to mandate, (b) experimentation, (c) selection of an enduring theme, (d) convergence, and (e) dysfunction. The theoretical and practical implications of the model are discussed.     

From QA to TQM

In the decade from 1950 to 1960, two quality-related processes--medical audit and total quality management--were being developed, one directly in the health care field and the other in the manufacturing sector. These processes remained isolated from each other until the mid-1980s. Each would have a separate but major effect on the health care industry.     

Survey provides overview of profession's responsibilities

At the end of 1990, the Physician Executive Management Center, Tampa, Fla., undertook a survey of College members to determine levels of compensation and benefits and to provide a glimpse at the roles and responsibilities of physician executives. The results of the survey have recently been published by the Management Center. In this article, the roles and responsibilities of physician executives for the overall sample are summarized.     

Regulation of board-and-care homes: research to guide policy

Information about board-and-care homes reported in the media and in federal committee hearings indicates that they are shoddy and exploitative environments that do not provide adequate care. Research done in board-and-care homes in recent years, however, demonstrates that they can provide adequate care and a satisfying environment for some of the people they serve. Policy at the federal, state, and local levels should be guided by both the need to assure the health and safety of board-and-care residents and the needs of residents and operators identified in scientific studies.