MANAGED COMPETITION IN HEALTH INSURANCE

Rising healthcare costs have sparked debate about the best way to provide high‐quality affordable health insurance. We discuss the potential for regulated insurance markets to outperform single‐payer public insurance. We use as an example the private Medicare plans that now provide insurance to almost a third of seniors in the United States. The evidence suggests that private plans can limit costs and potentially appeal to enrollees, and that well‐designed risk adjustment can mitigate market failures due to adverse selection. However, fostering competition between insurers, especially in smaller markets, is difficult. We discuss how future research might illuminate the relative advantages of public and private health insurance.     

Integrating commercial and residential pickup and delivery networks: A case study

This paper presents a strategic analysis of the network design problem faced by pickup and delivery companies operating in metropolitan areas and serving two or more classes of customers. The focus is on a division that treats commercial and residential customers separately, a situation motivated by their respective geographic densities and the size and frequency of their demand. In constructing driver work areas, it is necessary to take into account expected demand, vehicle capacity, time on the road, and the aspect ratio of the individual territories. This leads to a capacitated clustering problem with side constraints that has been the subject of intense research over the last decade.     

Rough-cut capacity planning for remanufacturing firms

Capacity planning is a critical element of any successful production planning and control system. A method of rough-cut capacity planning is developed, based on the bill-of-resources approach, that can be used to plan for capacity required for firms in a remanufacturing including overhaul repair operations environment. The modified bill-of-resources approach developed takes into account two major stochastic elements inherent in this environment; probabilistic material replacement factors and probabilistic routing files. A detailed example from an actual repair overhaul operation is presented to illustrate the technique.     

Reading Skills in Children with Multichannel Cochlear-lmplant Experience

Forty children with prelingual, profound deafness who received the Nucleus multichannel cochlear implant between the ages of 2 and 13 years participated in this study. The children had an average of 63.3 months (SD=24 months) of experience with their cochlear implants. A majority of the children used simultaneous communication and attended public-school programs at the time of testing. Reading achievement was assessed using the Paragraph Comprehension subtest of the Woodcock Reading Mastery Test-Revised, Form G (1987). This study compared the reading-achievement levels of this group of cochlear-implant users with the results of previous studies of children with profound hearing losses who did not have the benefit of cochlear implants. Results indicated that nearly one half of the children in this study were reading at or within 8 months of their grade level. The reading-grade quotient of .74 was calculated based upon the slope of the regression line for the plot of years in school and reading grade-level achieved. This finding indicates that using a cochlear implant has a positive effect on reading achievement level.     

Identity Agents: Parents as Active and Reflective Participants in Their Children's Identity Formation

The paper introduces the concept of identity agents. This concept refers to those individuals who actively interact with children and youth with the intention of participating in their identity formation, and who reflectively mediate larger social influences on identity formation. This contrasts with the focus of mainstream research in the identity field that tends to portray adolescents as the sole reflective agents involved in mature identity development. The paper presents a theoretical analysis presenting the importance of the concept for the formulation of a comprehensive contextual theory of identity formation. The particulars of this concept are illustrated through the presentation of a qualitative report of religious parents actively encouraging their children's processes of identification, co‐participating in their children's identity's formation, and reflectively deliberating their parental roles and goals in regards to this process.     

Self,Emotions, and Extreme Violence: Extending Symbolic Interactionist Theorizing

Extreme violence revolves around actions of individuals who are emotionally aroused and willing to kill themselves, if need be, to inflict harm on enemies. Terrorism, gangbanging, and genocide are conspicuous examples of extreme violence. This violence is ultimately driven by repressed negative emotions about self that are transmuted into variants of anger and combinations of anger with satisfaction‐happiness to produce emotions such as hatred, righteous anger, and vengeance. This theory combines symbolic interactionism's emphasis on identity and self with key ideas from gestalt theories, psychoanalytic theories, and interaction ritual theory as well as data from primatology, evolutionary biology, and neurology. I explain extreme violence as the outcome of several converging forces: the neurological capacity for humans as evolved apes to experience and express a large palate of high‐intensity emotions, the experience of shame in key institutional spheres, the repression of shame (and, at times, guilt and alienation as well as other highly charged negative emotions), the intensification and transmutation of these repressed emotions into variants and elaborations of anger, the making of external attributions blaming external targets for negative experiences, the portrayal of these targets in highly negative terms, and the charging up of positive emotions in interaction rituals directed at inflicting harm on external enemies.