The Freedom to Spend Your Own Money on Medical Care: A Common Casualty of Universal Coverage

Most people would agree that a patient should always be able to spend his own money on the health care services he desires. Yet that freedom is often threatened or denied when government tries to provide universal health insurance coverage, as in the U.S. Medicare program, which provides health insurance to seniors and people with disabilities. Over the past 20 years, the Medicare bureaucracy -- and to a lesser extent Congress itself -- has limited the freedom of Medicare beneficiaries to purchase medical services with their own money. Those limitations violate beneficiaries' right to privacy, undermine a tool that could reduce the burden Medicare imposes on taxpayers, and may deny care to Medicare beneficiaries outright, or deny them access to the highest quality care available. Ironically, as the U.S. government has restricted the ability of patients to spend their own money on medical care, Canada's socialized health care system is moving in the opposite direction. In a landmark case handed down in 2005, the Supreme Court of Canada ruled that the province of Quebec could not prohibit its citizens from purchasing covered services through private health insurance. That ruling recognized that imposing limits on a patient's freedom to spend his own money can result in his being denied crucial and even life-saving medical services. This threat to patients' rights would grow under many proposals to have the federal or state governments provide universal coverage. Congress and the state legislatures should avoid universal coverage schemes that would undermine this fundamental human right, or tempt future legislatures and bureaucrats to do so. Instead, Congress should restore to American seniors the unfettered right to spend their own money on medical care

Nonlinearity without Superluminality

Quantum theory is compatible with special relativity. In particular, though measurements on entangled systems are correlated in a way that cannot be reproduced by local hidden variables, they cannot be used for superluminal signalling. As Czachor, Gisin and Polchinski pointed out, this is not true for general nonlinear modifications of the Schroedinger equation. Excluding superluminal signalling has thus been taken to rule out most nonlinear versions of quantum theory. The no superluminal signalling constraint has also been used for alternative derivations of the optimal fidelities attainable for imperfect quantum cloning and other operations. These results apply to theories satisfying the rule that their predictions for widely separated and slowly moving entangled systems can be approximated by non-relativistic equations of motion with respect to a preferred time coordinate. This paper describes a natural way in which this rule might fail to hold. In particular, it is shown that quantum readout devices which display the values of localised pure states need not allow superluminal signalling, provided that the devices display the values of the states of entangled subsystems as defined in a non-standard, but natural, way. It follows that any locally defined nonlinear evolution of pure states can be made consistent with Minkowski causality.Comment: References update

Confidentiality in Mediation: Status and Implications

Mediation is becoming an increasingly popular alternative to formal adjudication. Large mediation programs handling huge numbers of both civil and criminal cases have sprung up in several of the largest cities in the nation. In Tulsa, Oklahoma, when the police write a citation, they often write mediation in place of a dollar amount.\u27 The mediation program in Columbus, Ohio, handled over 9,000 cases in a one year period.2 Of those 9,000 cases, 500 ultimately resulted in criminal charges, 3 and twelve resulted in one of the disputants murdering the other.

Richard Baxter's contribution to the comprehension controversy : a study in projected church union /

Thesis (Ph. D.)--Boston University Includes abstract and vita. Includes bibliographical references (leaves 307-325). Microfilm. sThe study was conceived as an investigation of the thought and activity of Richard Baxter in the area of church union and cooperation. The dissertation is based primarily on Baxter's autobiography, the extensive writings of Baxter himself dealing with this problem, and the writings of Baxter's contemporaries. Secondarily it is based on the works of Baxter's biographers, the standard works on the history of Protectorate and Restoration England, and a number of special studies on various aspects of Restoration church life. The method has been historical and descriptive. The author has not attempted to prove a point but rather to provide a correct chronological narrative of the development of one aspect of the thought and actions of perhaps the leading English churchman of his day. In the course of the study four things appeared, which we may adopt as a means of organizing this abstract. The four are the following: (1) a descriptive historical survey of Baxter's thought and activity in the church union area; (2) the reasons for his Nonconformity; (3) the changes in Anglican usage he deemed desirable to achieve comprehension -i.e. the inclusion of the Puritans in the Establishment; (4) the terms he deemed the minimum acceptable to achieve a comprehension. Baxter resisted the narrowness of spirit which characterized his age to give expression to broad principles and an inclusive spirit. Dealing with issues which remain matters of contention, he maintained a breadth of vision and a dream of unity which would be notable in 1956, but which is altogether amazing when viewed against the backdrop of Restoration England

Toward a Phenomenology of Curriculum: The Work of Max Van Manen and T. Tetsuo Aoki.

In this study an attempt was made at understanding contemporary thought and application of phenomenological research to the field of curriculum and instruction. More specifically, it sought to identify a place and need for a methodology in curriculum research that exposes and clarifies the dynamics of pedagogy as a result of investigating the existential/ontological nature of pedagogical activity. In accomplishing this, the works of two major North American phenomenological curriculum theorists, T. Tetsuo Aoki and Max van Manen were examined. The work of these two significant contemporary curriculum theorists was used due to the international recognition their seminal phenomenologically oriented research activities in curriculum has received. The work of van Manen and Aoki was not only examined for its theoretical foundations and principal themes, but was also used as the guide to a modest phenomenological investigation by the author into the interpretation given to the phenomenon of experiencing knowledge by thirty-three Developmental Reading students from Louisiana State University. This examination of the study was prefaced by a review of three theoretical emphases from which the research of reading has been approached. This examination of the field of reading included a positing by the author of the necessity and benefits a phenomenological perspective of reading can offer to its curriculum development and instruction. Based on this discussion and the work of van Manen and Aoki, the phenomenological analysis of these students\u27 written responses to the reading of the novel Flowers For Algernon provided the researcher with the basis for several recommendations to curriculum development and instructional approaches in teaching reading to developmental education students. The conclusion of this study found that phenomenology, as part of an eclectic research methodology, can uniquely contribute to curriculum research and allows for the creation of a more lifeworld sensitive pedagogical praxis

Integrating woodland caribou needs and forestry: perspectives of Alberta's forest industry

Much of Alberta's woodland caribou (Rangifer tarandus caribou) range outside protected areas is subject to commercial forest management. In this paper, I discuss some perspectives of the forest industry regarding caribou-related issues. Six forest companies holding Forest Management Agreements (FMAs) in Alberta were polled. Forest managers were most concerned about 2 aspects of caribou management: reductions of annual allowable cut (AAC) that may be necessary to provide for caribou habitat needs; and management of public access. Perceived information gaps fell into 3 categories: caribou demographics (population size, trends and densities); primary limiting factors of caribou populations (including the influence of human activity); and caribou habitat requirements (including the effects of timber harvest on caribou habitat). Increased costs associated with consideration of caribou have been incurred at the planning and operational levels. However, those costs have been low, primarily because much proposed harvest in caribou ranges has been deferred. Costs are expected to increase substantially in the future as timber from caribou ranges is required to meet harvest objectives. Other issues identified included: the desire for an adaptive management approach to caribou-forestry interactions; the need to incorporate natural-disturbance-regime models into forest planning; consideration of the cumulative effects on caribou of all industrial and recreational activities; and unmanaged harvest by First Nations people. A list of caribou-related projects conducted or supported by forest companies in Alberta during the past 5 years is provided

Comparing pre and post-surgical self-efficacy behavior changes by introducing prehabilitation exercise.

Introduction: Osteoarthritis (OA) is a clinical condition affecting over 27 million Americans. There is no known cure for OA other than replacing the diseased joint with a joint prosthesis, total knee arthroplasty (TKA). Purpose: This study compared pre and post-surgical functional ability, exercise self efficacy and outcome expectations among total knee arthroplasty (TKA) patients who did and did not receive a prehabilitation exercise program. Methods: 67 participants were eligible to participate in the study. Twenty-five participants indicated that they were not interested in participating in the study. As a result forty-two OA participants (31 female, 11 male) of the 42, 37 were interested and recruited into the study (n = 19 PRE, n = 18 CON). The analytic sample (n = 16 PRE, n= 15 CON) included 31 subjects (22 female, 9 male). Outcome Variables: self-efficacy to exercise survey (SEE), outcome expectations to exercise survey (OEE), 6-minute walk distance, number of sit-to-stand repetitions in 30 seconds, the timed get up and go (TUG) test. Results: The effect of time was non-significant for SEE,p = .655 and OEE,p = .146. There was no significant interaction effect on SEE,p = .590 or OEE,p = .933. There was a significant effect of time on the six minute walk,p \u3c.001, TUG,p \u3c .001; sit-to-stand, p \u3c .001, ascending stair, p \u3c .001 and on descending stair, p = .001. Presentation: The dissertation is divided into five chapters, covering the clinical conditions of OA, treatment, impact of the problem, and the benefits of exercise. Chapter One gives an overview of the problem, impact of the problem, its history and discusses the significant health problem as a result of OA. Chapter two uses a review of the current literature to examine the conceptual framework and theory used in this study along with the introduction of the prehabilitation exercise intervention. Chapter three discusses the methodology used in the study and chapter four gives the data analysis and reports the findings of the data collected during the study. Finally chapter five gives a brief introduction of the study followed by the conclusions of the study. These conclusions include interpretations of the findings, discussions of the research hypotheses, recommendations, future research, theory application and finally future studies, limitations and a brief summary of the study