Genetic screening technology: ethical issues in access to tests by employers and health insurance committees

Whereas the introduction of new technologies previously has raised the ethical question of who ought to have access to a new procedure or device, genetic testing technology raises the new ethical question of to whom access to a new technology ought to be limited. In this article we discuss the implications of employers and private health insurance companies having access to genetic testing technology. Although there may be legitimate business interests in allowing employers and insurers to conduct genetic screening, there are other valid societal interests in regulating or limiting the use of this technology by third parties. Public policy developed in the area of new genetic technology must reflect such interests.     

The administrative costs of non-profit health insurers

Interest in the efficiency or inefficiency of non-profit firms has spawned research on the administrative costs of Blue Cross and Blue Shield plans. Relying on plausible implications of the property rights theory of the firm, both Blair, Ginsburg, and Vogel (1975) and Vogel (1977) noted some evidence of inefficiency in these firms. Our analysis, however, utilizing their models and more recent data, reveals little convincing evidence for the view that Blue Shield plans are inefficient.     

Characteristics of a central change programme within a governmental bureaucracy: a grounded theory study

Purpose The purpose of the paper is to present a theory of organisational change within the setting of a governmental bureaucracy. Design/methodology/approach Orthodox grounded theory is employed in the setting of a change programme in 12 Audit departments of the Dutch Ministries (public-sector). Findings The examined organisational change has specific characteristics. The Dutch ‘ministerial autonomy’ and the clearly recognizable role types of the key figures involved have a strong impact on the change programme and the realisation of its goals. Research limitations/implications Findings are derived on the basis of a substantive case study of the change programme of the Dutch Departmental Audit function. The research sheds new light on characteristics related to the occupational group of Chartered Accountants and characteristics of a governmental bureaucracy and it helps to understand change programmes within this bureaucracy. Practical implications The grounded theoretical model draws attention to the impact of key figures and circumstances on a change programme within the central government. Originality/value The paper builds on theories of organisational change but applies them in the typical context of the Dutch civil service where ministerial autonomy, on the one hand, and a move in the direction of more centrally organised activities (concern idea), on the other, require a difficult balancing act of all players in the change arena.     

A Model for Change: Legislative Advocacy to Improving Access for the Uninsured and Underinsured in New York State 1

Advocates can successfully improve access to health care for people without health insurance. This article demonstrates the success of what began as a local advocacy effort to improve access to health care on Long Island, which later grew to become a major statewide advocacy movement. It explores the process taken by local coalition members to successfully fight for monumental public health legislation—first locally then statewide—to improve access to hospital care for the medically indigent. Using New York State as a model, it includes several approaches that could facilitate the enactment of legislation in other states. The experiences of New York advocates suggest that with focused collaborative efforts it is feasible to promote significant changes to public health laws to benefit the uninsured and underinsured.     

现代消费主义的理性思考

消费是人为了生存而进行的一种基本活动,一种生活方式。但随着科学技术的发展和经济的增长,现代社会已经进入到了生产过剩的时代,这必然引起大量的挥霍性消费随之而来。为此,本来作为人的生存方式的消费就成为一种违背人类可持续生存和发展利益的消费,最终也成为人类生存的最大威胁之一,因而,再次审视现代社会的消费观的理论基础是一项迫切的任务。     

An empirical application of multidimensional scaling to advertising pretesting

One of the least-managed aspects of advertising management may well be that of effectiveness measurement. The problem of obtaining satisfactory indications of advertising effectiveness is particularly critical in pretesting since the rationale for pretesting is to evaluate advertisements before their release for broadscale media distribution. Therefore, the primary purpose of the research reported here is to provide empirical evidence of the value of multidimensional scaling methods to pretesting advertising. The article demonstrates how nonmetric methodology obviates the disadvantages of such methods as consumer jury tests and rating scales. A secondary purpose of the research project is to demonstrate the value of pretesting itself by comparing the perceptions of target market consumers with those of selected group of advertising professionals.     

Loan performance and race

Recent studies find evidence of racial discrimination in mortgage markets. Although these studies explore loan approval rates for whites versus minorities, they do not specifically consider loan performance, either in the form of default rates or loan administration costs. This study considers discrimination in the used car credit market, where the collateral is not subject to location externalities, collateral value and quality do not vary as much as in real estate, and the loan terms are shorter. We find administration costs and default rates are higher for minorities than for whites, controlling for age, income, home ownership, wealth, occupation, loan terms, and geographic location.     

Recent Changes in Male Income*

This paper explicitly defines two perspectives for investigating change: the longitudinal and the cross-sectional. After examining changes in male income between 1950 and 1970 by following cohorts through time, we identify a pattern of income changes with age which is quite different from that obtained in a cross-sectional analysis. On a longitudinal basis, it is evident that as men age to the retirement years that their income continually increases. A cross-sectional analysis leads to the conclusion that there is a decline in income during the latter working years. Two simple models (using change in the cost of living and productivity levels) are offered to help account for the patterns of income change. Although adjustments for varying costs of living and productivity levels slightly alter the pattern the two substantially different conclusions are not changed to any great degree. The implications of these conflicting statements are discussed.