Voice asymmetries in ERISA litigation

ERISA’s equitable remedies limit employees’ access to the courts. The law fails to protect workers with short tenure and low wages, for example female workers, because trial costs often exceed damages. In single-employer plans, unions improve access, but in multiemployer plans they do not. The reason is that in single-employer plans unions bargain at arm’s length with plan sponsors while in multiemployer plans they do not. Plaintiffs’ win rates are approximately 50 percent in singleemployer union ERISA cases but are significantly below 50 percent in nonunion and multiemployer cases. The author thanks Ann Bartel, John Delaney, James Kuhn, an anonymous referee, Victor Goldberg, Eli Noam, Donna Sockell, Kim Ditty, and David Lewin.     

Alienation and Deviance: Strain Theory Reconsidered*

This paper proposes a way in which the concepts of alienation and anomie may be related in a single dimension of social experience and offers a refinement and expansion of traditional strain theories of deviance causation. It is argued that both alienated and anomic social actors seek a common goal–a sense of effective interaction with their environment; an experience of personal competence. Anomic persons are those who perceive the demands of primary roles as confusing and beyond their abilities and who respond by seeking to maximize certainty, security, and stability in social interaction. By contrast, alienated individuals are those who experience primary role requirements as simple but stifling and restrictive, bereft of meaningful challenges. These latter persons seek greater freedom and opportunities for creativity and self-expression. The ways in which deviance may emerge as these alienated persons adapt to the perceived discrepancy between their abilities and responsibilit ies are outlined and illustrated following the adaptive modes suggested by Merton for anomic persons.     

Two cultures: one life

Recognition of the communal nature of the culture and traditionsof many refugees who have resettled in Australia in recent years,particularly those from African countries, has urged a strongerconsideration of community-based approaches to their recoveryand resettlement. In 2004, a framework of recovery, developedto enhance the mental health and well-being of refugees duringresettlement in Australia, was applied to a community capacity-buildingprogramme among South Sudanese refugees living in an outer westernsuburb of Melbourne. This paper explores the integration ofrecovery goals into the structures and processes initiated throughoutthe programme. It assesses the contribution of this model tostrengthening the community's ability to adjust to resettlementand enable greater control in determining their lives in Australia.     

Estimating the expense of a mandatory home-and community-based personal assistance services benefit under Medicaid

Personal assistance services (PAS) are essential for many people of all ages with significant disabilities, but these services are not always available to individuals at home or in the community, in large part due to a significant bias toward institutions in the Medicaid program. This study aims to provide an estimate of the expense of a mandatory personal assistance services (PAS) benefit under Medicaid for persons with low incomes, low assets, and significant disability. DESIGN AND METHODS: We use year 2003 data from the Survey of Income and Program Participation to estimate the number of people living in households who would be eligible, based on having an institutional level of need and meeting financial criteria for low income and low assets, combined with additional survey data on annual expenditures under Medicaid programs providing PAS. RESULTS: New expenditures for PAS are estimated to be $1.4-$3.7 billion per year (in 2006 dollars), depending on the rate of participation, for up to half a million new recipients, more than a third of whom would be ages 65 and older. These estimated expenditures are a tenth of those estimated by the Congressional Budget Office for implementing the Medicaid Community-Based Attendant Services and Supports Act (MiCASSA). IMPLICATIONS: Creating a mandatory PAS benefit for those with an institutional level of need is a fiscally achievable policy strategy to redress the imbalance between institutional and community-based services under Medicaid.     

Work Choices: the low productivity road to an underclass

The passage of the Work Choices Act 2005 serves to eliminate one of the last symbols of fairness in Australian society; the judicially‐determined conciliation and arbitration system and wage‐setting machinery. In this paper we examine the flawed conceptual framework, which underpins the Government's view that reducing the rights and protections of workers will produce superior labour market outcomes. We argue that the principal failure of the Work Choices Act is that it ignores the role of macroeconomic policy in directly addressing the efficiency and equity issues that have been said to motivate its provisions. The Act also ignores the different bargaining power of workers and capital and pays no attention to the serious social repercussions that will flow when labour is treated like a commodity. The imperative to minimise labour costs under Work Choices will spur a race to the bottom and the profusion of insecure, low‐paid, poor‐quality work in an economy characterised by allocative and dynamic inefficiency.     

SOCIAL ENTREPRENEURSHIP — FALSE PREMISES AND DANGEROUS FOREBODINGS

As a reaction against neo‐liberalism, Social Entrepreneurship has been promoted as the solution to welfare problems brought about by social change and persistent unemployment. The Social Entrepreneurship Movement (SEM) proposes the reconstruction of welfare by building social partnerships between the public, social and business sectors. Major aspects of this agenda include non‐profit organisations undertaking entrepreneurial ventures and the pooling of government welfare funding under the control of local communities. In this paper we argue that the SEM literature is based on two false premises: the failure to understand the true causes of mass unemployment, and the assumption that the government faces financial constraints in the provision of welfare services. We also argue that implementation of the SEM proposals would erode the rights‐based eligibility to universal welfare services based on the principle of social justice. We also conclude that the SEM is indistinguishable from neo‐liberalism and as such does not represent a viable solution to unemployment and the welfare needs that accompany it.     

Integrating dose estimation into a decision‐making framework for model‐based drug development

Model‐informed drug discovery and development offers the promise of more efficient clinical development, with increased productivity and reduced cost through scientific decision making and risk management. Go/no‐go development decisions in the pharmaceutical industry are often driven by effect size estimates, with the goal of meeting commercially generated target profiles. Sufficient efficacy is critical for eventual success, but the decision to advance development phase is also dependent on adequate knowledge of appropriate dose and dose‐response. Doses which are too high or low pose risk of clinical or commercial failure. This paper addresses this issue and continues the evolution of formal decision frameworks in drug development. Here, we consider the integration of both efficacy and dose‐response estimation accuracy into the go/no‐go decision process, using a model‐based approach. Using prespecified target and lower reference values associated with both efficacy and dose accuracy, we build a decision framework to more completely characterize development risk. Given the limited knowledge of dose response in early development, our approach incorporates a set of dose‐response models and uses model averaging. The approach and its operating characteristics are illustrated through simulation. Finally, we demonstrate the decision approach on a post hoc analysis of the phase 2 data for naloxegol (a drug approved for opioid‐induced constipation).