Principal Agency Theory and Health Care Utilization

This article uses a principal agent framework to examine the role that monitoring costs faced by an insurer have on health care utilization. We compare hospital lengths of stay for fee-for-service and capitated patients in low and high monitoring cost situations. Monitoring costs associated with a particular procedure are assumed to be high when there is large variation across patients in hospital lengths of stay. The empirical results indicate that differences in utilization between fee-for-service and capitated patients increase as monitoring costs increase. However, we do not find that fee-for-service reimbursement is used less in the difficult to monitor situations. (JEL I1 )     

Drifting down the gulf stream: navigating the cultures of disability studies

This paper explores the divergent theoretical developments in the UK and US disability studies and posits some explanations for these differing trajectories. History, politics, space, place and the search for identity have all played important roles. These emergent and hotly debated developments add a wealth of material to the epistemological project. The recent collections by Barnes et al. (2002) Disability studies today, and Snyder et al. (2002) Disability studies: enabling the humanities, will be used as pivotal works. However, the question remains as to what explanatory power discourses developed within western metropolitan national cultures have for exploring the experience of disability in cultures on the peripheries. This analysis is being undertaken by an English born academic, who has been living in Australia for over 20 years and has been keenly watching and participating in the transatlantic battles over the past decade.     

Traditional Gift Giving Among Pacific Families in New Zealand

The Pacific population in New Zealand is socially disadvantaged and over-represented in adverse social and health statistics. A cohort of 1,376 mothers of Pacific infants were asked about traditional gift commitments and the effect that these commitments had on the financial situation in their household. Sixty-two percent reported that they and/or their partner usually gave to their family or church, with 66.5% of this group giving to family in New Zealand, 58% to family in the Pacific Islands, and 75.9% to their church. Fifty-nine percent of these mothers reported that this gift commitment made their household financial situation more difficult. Factors significantly associated with gift giving are discussed, together with implications of these findings for Pacific families living New Zealand.     

Recovering from Illness or Recovering your Life? Implications of Clinical Versus Social Models of Recovery from Mental Health Problems for Employment Support Services

Although valuable research has been undertaken in the United States little is yet known about the processes engaged in by supported employment projects for people with mental health problems. The study reported here explored these processes using semistructured interviews with employment project clients, their project workers and workplace managers. Of five projects involved in the research, two exemplified radically different approaches, one implicitly underpinned by a clinical model of recovery and the other by a social recovery model. In this article we draw on data from the seven cases studied from these projects to describe the two approaches and to consider their strengths and limitations. We conclude that approaches based on the social recovery model hold more promise, although such approaches would be enhanced through greater liaison with mental health professionals. In addition, funding structures are required that take account of job retention rates, rather than placement rates alone.     

The sexual division of dieting: women's voices

This article reports the findings of focus group research on Australian women who have engaged in dieting practices to lose weight. There have been few qualitative sociological studies on dieting, despite it being a common practice among western women. From the empirical data in this study three distinct themes emerged: women participate in the perpetuation and reinforcement of the thin ideal; women clearly trade-off health in the pursuit of dieting to lose weight; and the dominant discourse of the thin ideal is not only mediated in various ways, but is also contested by a reverse discourse of size acceptance. A sociology of food and the body enables the discourses in the area of dieting women to be deconstructed, offering an insight into the gendered context of food, which has implications for the sociology of health and illness.     

Marrying the social and the biological? A rejoinder to Newton

Marrying the biological and the social raises a complex series of issues that defy easy answer or simple resolution. In this brief rejoinder to Newton's (2003 ) recent paper in this journal –‘Truly embodied sociology: marrying the social and the biological?’– I take up some of these issues through: (i) a restatement of my own position in these debates and the broader sociological context within which it is located; (ii) a discussion of various problems and tensions within Newton's own critique of this ‘nascent material‐corporeal’ project to date. Newton's paper, it is concluded, is a welcome, timely and topical contribution to these (evolving) debates, though any such ‘dispute’ is probably more apparent than real: a case, in short, of reinforcing arguments about the complexity of these relations and the consequent need to ‘tread warily’.     

Space invaders: the negotiation of teenage boundaries through the mobile phone

Drawing on interview data, this paper explores the area of child/parent negotiation. Specifically, we examine the increasing significance of the mobile phone in the way teenagers negotiate spatial boundaries with their parents. Utilising theories of time and space, especially Giddens’ concept of ‘distanciation’, we show how parents and their children use the mobile phone as a tool for negotiating curfews in public space, thus extending household discussion and negotiation outside of the home. We point out that parents are using the mobile phone to enter their children's time and space as an ‘absent Other’, and see this as a means of extending parental authority and control. Children, conversely, see themselves gaining a degree of empowerment from the mobile phone, as parents are more lenient with curfews if they posses one. The mobile phone, then, has become an important facilitator of negotiations between parents and teenagers regarding boundary setting. We conclude that the mobile phone has enabled teenagers to gain increased leverage in their negotiations with their parents, but underline that parents still hold control and authority by ‘invading’ their children's space.     

Cultural hybrids or ethnic fundamentalists? discourses on ethnicity in Singaporean SMEs

This paper examines national and ethnic discourses within Singaporean small and medium enterprises (SMEs) and the ambiguities and dichotomies characterising Singaporean national and ethnic identity. Singapore is represented officially as a multi‐ethnic state with a Chinese majority which claims to integrate minority groups such as Indians and Malays successfully, and it boasts a generalised Singaporean culture and identity that supposedly embrace the racial and ethnic diversity of the population. However, Singapore also hosts tensions and conflicts associated with such diversity. This paper examines workplace discourses which address tensions and congruencies. The paper is based on research conducted between April 2002 and May 2003, involving 50 SMEs representing various sectors of the economy and constituting various ethnicities. The research found that, while discourses on ethnicity and nationality may be characterised as somewhat ‘shifting’ and ‘fluid’, the respondents present their identities as rather fixed. Primordial ties rather than postmodern multiplicity may better characterise discourses among the workers and owners of Singaporean SMEs.