Sinking SCHIP: A First Step toward Stopping the Growth of Government Health Programs

Federal lawmakers are considering legislation that could result in millions more middle income families obtaining health insurance from government. Unfortunately, the debate over expansion of the State Children's Health Insurance Program is divorced from the reality of who truly needs assistance and the forces that are making health insurance increasingly unaffordable. SCHIP and its larger sibling Medicaid currently enroll many people who do not need government assistance, including some families of four earning up to $72,000 per year. That is a direct result of federal funding rules that reward states for making more Americans dependent on government for their health care. Rather than expand SCHIP, Congress should (1) make private health insurance more affordable by allowing consumers and employers to purchase less expensive policies from other states, and (2) fold federal Medicaid and SCHIP funding into block grants that no longer encourage states to open taxpayer-financed health care to nonneedy families. With more Americans able to afford private insurance and no incentive for states to expand government programs beyond the truly needy, federal and state governments could reduce spending on those programs

Does Barack Obama Support Socialized Medicine?

Democratic presidential nominee Sen. Barack Obama (IL) has proposed an ambitious plan to restructure America's health care sector. Rather than engage in a detailed critique of Obama's health care plan, many critics prefer to label it "socialized medicine." Is that a fair description of the Obama plan and similar plans? Over the past year, prominent media outlets and respectable think tanks have investigated that question and come to a unanimous answer: no. Those investigations leave much to be desired. Indeed, they are little more than attempts to convince the public that policies generally considered socialist really aren't. A reasonable definition of socialized medicine is possible. Socialized medicine exists to the extent that government controls medical resources and socializes the costs. Notice that under this definition, it is irrelevant whether we describe medical resources (e.g., hospitals, employees) as "public" or "private." What matters-what determines real as opposed to nominal ownership-is who controls the resources. By that definition, America's health sector is already more than half socialized, and Obama's health care plan would socialize medicine even further. Reasonable people can disagree over whether Obama's health plan would be good or bad. But to suggest that it is not a step toward socialized medicine is absurd

A Better Way to Generate and Use Comparative-Effectiveness Research

President Barack Obama, former U.S. Senate majority leader Tom Daschle, and others propose a new government agency that would evaluate the relative effectiveness of medical treatments. The need for "comparative-effectiveness research" is great. Evidence suggests Americans spend $700 billion annually on medical care that provides no value. Yet patients, providers, and purchasers typically lack the necessary information to distinguish between high- and low-value services. Advocates of such an agency argue that comparative- effectiveness information has characteristics of a "public good," therefore markets will not generate the efficiency-maximizing quantity. While that is correct, economic theory does not conclude that government should provide comparative-effectiveness research, nor that government provision would increase social welfare. Conservatives warn that a federal comparative- effectiveness agency would lead to government rationing of medical care -- indeed, that's the whole idea. If history is any guide, the more likely outcome is that the agency would be completely ineffective: political pressure from the industry will prevent the agency from conducting useful research and prevent purchasers from using such research to eliminate low-value care. The current lack of comparative-effectiveness research is due more to government failure than to market failure. Federal tax and entitlement policies reduce consumer demand for such research. Those policies, as well as state licensing of health insurance and medical professionals, inhibit the types of health plans best equipped to generate comparative-effectiveness information. A better way to generate comparative-effectiveness information would be for Congress to eliminate government activities that suppress private production. Congress should let workers and Medicare enrollees control the money that purchases their health insurance. Further, Congress should require states to recognize other states' licenses for medical professionals and insurance products. That laissez-faire approach would both increase comparative-effectiveness research and increase the likelihood that patients and providers would use it

Does the Doctor Need a Boss?

The traditional model of medical delivery, in which the doctor is trained, respected, and compensated as an independent craftsman, is anachronistic. When a patient has multiple ailments, there is no longer a simple doctor-patient or doctor-patient-specialist relationship. Instead, there are multiple specialists who have an impact on the patient, each with a set of interdependencies and difficult coordination issues that increase exponentially with the number of ailments involved. Patients with multiple diagnoses require someone who can organize the efforts of multiple medical professionals. It is not unreasonable to imagine that delivering health care effectively, particularly for complex patients, could require a corporate model of organization. At least two forces stand in the way of robust competition from corporate health care providers. First is the regime of third-party fee-for-service payment, which is heavily entrenched by Medicare, Medicaid, and the regulatory and tax distortions that tilt private health insurance in the same direction. Consumers should control the money that purchases their health insurance, and should be free to choose their insurer and health care providers. Second, state licensing regulations make it difficult for corporations to design optimal work flows for health care delivery. Under institutional licensing, regulators would instead evaluate how well a corporation treats its patients, not the credentials of the corporation's employees. Alternatively, states could recognize clinician licenses issued by other states. That would let corporations operate in multiple states under a single set of rules and put pressure on states to eliminate unnecessarily restrictive regulations

The Molecular Biology of the Yeast Saccharomyces Monograph 11A: Life Cycle and Inheritance; Monograph 11B: Metabolism and Gene Expression Edited by J.N. Strathern, E.W. Jones and J.R. Broach Cold Spring Harbor Laboratory; New York 1981; 1982 x + 752 pages. 75.00(75.00 (90.00 outside USA); 680 pages. 75.00(75.00 (90.00 outside USA)

Arriola, Andreu; Fiol, CarmePrimer pla d'un fanal Lampagena. L'element consta d'na columna telescópica formada per dos tubs cilíndrics d'acer inoxidable i la pantalla reflectora és circular. La llum es projectada indirectament sobre els espais públics. do

Recyclable Waste Material as Substitute Aggregate in Concrete

Trash pollution is a serious problem that the world is facing and while there are current efforts to clean up the environment, there still exists the issue of what to do with the trash once collected. Waste material, especially plastic, is littering the ocean and poses a serious threat to wildlife. The construction industry makes a good effort of trying to limit its negative impact on the environment, but it can potentially solve the problem of pollution using one specific material, concrete. The best part about concrete is that its compressive strength can be manipulated by adding or removing certain materials in the mix. There are certain aggregates, such as plastic and glass, that are not currently being used in concrete mix designs, but could be added and only slightly alter the concrete’s compressive strength. This paper explores and tests the results of adding plastic and glass into concrete mix. The results will shed light on the idea of cleaning up the environment by putting waste material into concrete and drastically altering the problem of trash pollution

The Darkest Nation: American Melancholia in Modernist Narratives of the First World War

My dissertation, entitled The Darkest Nation: American Melancholia in Modernist Narratives of the First World War, re-conceptualizes U.S. modernism by attending to how the historical event of WWI inaugurated melancholia, or sustained grief, as the cornerstone of a new form of nationalism. Scholars have focused either on how consolatory mourning bolstered patriotism or how melancholia led to the demise of such an imagined community and to the growth of cosmopolitanism. I consider, however, an American modernist commitment to the nation of loss expressed, surprisingly enough, in narratives about noncombatants. For a country that entered the military conflict near its end, noncombatancy (in the form of political neutrality and survivor\u27s guilt) shapes the literary contours of America\u27s melancholy wartime and postwar identity