Sociological gains and losses: The case of the national health care use and expenditure surveys

This article reflects on the role of sociological concepts and of sociologists in a series of national surveys that have proved important to national health policy in financing and access to health care. The development of the early surveys in a university setting and their migration to the government is discussed, as is the relative influence of sociologists and economists. The changing focus of health policy from access to care through expanded government programs, to cost containment and utilization control, provides an important context for understanding these developments. Areas are identified where sociologists can make significant contributions to health policy in financing and access to care. She received her PhD in Sociology from the University of Chicago. She spent six years as a Senior Sociologist at NCHSR working on all aspects of the NMCES, and three years as an analyst in the Office of Research at the Health Care Financing Administration. He received his PhD in Sociology from New York University. He joined NCHSR to conduct analyses of the NMCES data and has had major responsibilities in the design of NMES.     

Combining New Institutionalisms: Explaining Institutional Change in American Property Insurance

This article combines institutionalisms to explain fundamental change in American property insurance. During the 1950s, the industry shifted from associations to price-competitive markets and vertically integrated firms. I advance two new arguments to explain this shift: First, institutions endogenously generate conditions for change. Second, fundamental change or institutional replacement depends on a dynamic convergence of conditions—market failures, legitimacy crises, new models of order—and the culmination of this dynamic in politics and policies that admit alternatives into fields. Together, these arguments reduce indeterminacies in existing theories of change and shed new light on punctuated equilibria and the politics of transformation.     

Genetic Studies of Pathological Gambling: A Review of Methodology and Analyses of Data from the Vietnam Era Twin Registry

Twin studies represent an important and powerful approach to estimating the relative contributions of environmental and genetic factors to the expression of psychiatric illnesses. In this article, we first explain the rationale for using large populations of monozygotic and dizygotic twin pairs to estimate genetic and environmental contributions to a disorder and the statistical modeling associated with this approach. We then review results from studies of the Vietnam Era Twin Registry that use this methodology to examine the etiology of pathological gambling (PG) behaviors. The results provide strong evidence for genetic contributions to the development of PG in men and set the foundation for future studies aimed at identifying the manner in which specific genes and environmental factors individually and in conjunction contribute to PG.     

Characteristics of Older Adult Problem Gamblers Calling a Gambling Helpline

Background Few investigations have characterized groups of older adults with gambling problems, and published reports are currently limited by small samples of older adult problem gamblers. Gambling helplines represent a widespread mechanism for assisting problem gamblers to move into treatment settings. Given data from older adult problem gamblers in treatment, we hypothesized that older as compared with younger adult problem gamblers calling a gambling helpline would be less likely to report gambling-related problems.Design and methods Logistic regression analyses were performed on data obtained from January 1, 2000 to December 31, 2001, inclusive, from callers with gambling problems (N = 1,084) contacting the Connecticut Council on Problem Gambling Helpline.Results Of the 1,018 phone calls used in the logistic regression analyses, 168 (16.5%) were from older adults and 850 (83.5%) from younger adults. Age-related differences were observed in demographic features, types and patterns of gambling reported as problematic, gambling-related problems and psychiatric symptoms, substance use problems, patterns of indebtedness, and family histories of addictive disorders. Older as compared with younger adult problem gamblers were more likely to report having lower incomes, longer durations of gambling, fewer types of problematic gambling, and problems with casino slot machine gambling and less likely to report gambling-related anxiety, family problems, illegal behaviors and arrests, drug problems, indebtedness to bookies or acquaintances, family histories of drug abuse, and problems with casino table gambling.Conclusions Older as compared with younger adult problem gamblers calling a gambling helpline differ on many clinically relevant features. The findings suggest the need for improved and unique prevention and treatment strategies for older adults with gambling problems.     

Complete ranking procedures with quadratic loss

Suppose that one wishes to rank k normal populations, each with common variance σ² and unknown means θ_i (i=1,2,…,k). Independent samples of size n are taken from each population, and the sample averages are used to rank the populations. In this paper, we investigate what sample sizes, n, are necessary to attain “good” rankings under various loss functions. Section discusses various loss functions and their interpretation. Section 2 gives the solution for a reasonable non-parametric loss function. Section 3 gives the solution for a reasonable parameteric loss function.     

Who gets fired in a tight job market?

One of the peculiarities of the health care workplace right now is that while organizations are frantic to hire, they are also quicker to fire. Judging from surveys and reports from headhunters, it's obvious there are some new reasons why--and when--people get fired. The most common cause for firing is the inability to meet the boss's expectations. Three, often-documented, reasons for severance are examined: (1) not being able to produce what's needed with the culture; (2) lacking the level of technical skills required; and (3) not being emotionally committed to the role the candidate was hired to play. What can you do to protect yourself? Do your homework. Don't fall into the trap of being taken in by an over-eager hirer or by the prospect of making an inordinate difference.     

Cooperative production with unequal skills: The solidarity approach to compensation

We consider a simple production model and we assume that agents have unequal production skills which can in no way be attributed to their responsibility. We study how it is possible, if at all, to compensate for differential skills by applying Rawls's idea of a collective sharing in the benefits of skills. For this purpose, we introduce an axiom of solidarity, according to which agents should all be affected in the same direction if the profile of personal skills changes. We show that particular allocation rules are characterized be combining this axiom with a requirement of non-discrimination among preferences, or with a property capturing Nozick's idea of guaranteeing a minimal benefit from one's own skill. Received: 1 July 1996/Accepted: 25 May 1998