Did A Rising Tide Lift All Boats? The NIH Budget And Pediatric Research Portfolio

This paper examines National Institutes of Health (NIH) pediatric research spending in absolute terms and relative to the doubling of the NIH overall budget between fiscal years 1998 and 2003. Pediatric spending increased by an average annual rate of 12.8 percent during the doubling period (almost on par with the NIH average annual growth rate of 14.7 percent). However, the proportion of the total NIH budget devoted to the pediatric portfolio declined from 12.3 to 11.3 percent. We offer recommendations for implementing existing commitments to strengthen the pediatric research portfolio and to protect the gains of the doubling period

Descriptive and Substantive Representation in Congress: Evidence from 80,000 Congressional Inquiries

A vast literature debates the efficacy of descriptive representation in legislatures. Though studies argue it influences how communities are represented through constituency service, they are limited since legislators’ service activities are unobserved. Using Freedom of Information Act (FOIA) requests, we collected 88,000 records of communication between members of the U.S. Congress and federal agencies during the 108th–113th Congresses. These legislative interventions allow us to examine members’ “follow‐through” with policy implementation. We find that women, racial/ethnic minorities, and veterans are more likely to work on behalf of constituents with whom they share identities. Including veterans offers leverage in understanding the role of political cleavages and shared experiences. Our findings suggest that shared experiences operate as a critical mechanism for representation, that a lack of political consensus is not necessary for substantive representation, and that the causal relationships identified by experimental work have observable implications in the daily work of Congress.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/150606/1/ajps12443-sup-0001-SuppMat.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/150606/2/ajps12443.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/150606/3/ajps12443_am.pd

"Why 'non-efficiency enhancing' labor-side agreements?: global governance and labor markets: the EU, NAFTA, and the ILO"

This paper offers an explanation of why governments agree to labor side-agreements and how the delegation or transfer of regulatory authority varies across two regional agreements-the European Union (EU/Social Protocol), North America (NAFTA/NAALC), and the international system (ILO/WTO). I argue that nations agree to a social dimension or a labor side-agreement because cooperation presents a solution to domestic political problems in advanced industrialized nations. My argument is that governments must seek ways to maximize the economic efficiency gains from free trade and to minimize domestic political opposition. Thus, they strategically delegate or transfer limited authority to an alternative institution in an effort to respond to domestic differences within countries and managed the anticipated distributional conflict between nations, accepting one set of rules in one agreement and another set of rules in the others

The Rise and Fall of a Kaiser Permanente Expansion Region

Prepaid group practices (PGPs) — multispecialty groups that vertically integrate the organization, financing, and delivery of health services to a specific population—were once viewed as the most cost-effective and efficient model for achieving national health care reform (e.g., McNeil and Schlenker 1981; Saward and Greenlick 1981). Policy reformers who extolled the benefits of health maintenance organizations (HMOs) in the late 1970s and early 1980s emphasized in particular the cost and quality advantages of PGPs vis-à-vis solo and single-specialty fee-for-service (FFS) providers. A comprehensive review of comparative empirical studies (HMOs versus FFS) since 1950 concluded that the total costs for HMO enrollees were 10 to 40 percent lower than those for comparable enrollees with conventional indemnity insurance (Luft 1978). Although PGPs did not originate as a competitive response to fee-for-service indemnity health insurance, many proponents viewed them as a promising means of helping contain rising medical costs, encouraging a more rational allocation of health care resources, and improving the access to and delivery of quality services (McNeil and Schlenker 1981)