Suchergebnisse

Much public discussion about health care assumes, explicitly or implicitly, that only by denial of potentially beneficial care (called "rationing") can cost containment be achieved. This piece critically examines the various current usages of "rationing," and argues that it is being misapplied. Fur‐ ther, the call for rationing may be deflecting us from fruitful exploration of non‐rationing alternatives to cost control. Two of these are briefly sketched as examples: physician fee controls and practice guidelines.

ABSTRACTFrom the Truman presidency through that of Carter, the United States worked fitfully toward the development of an energy policy. Now, consistent with the "free market — get government off the backs of the people" philosophy of the Reagan Administration, the 1981 National Energy Policy Plan proposes that "individual choices" and "reliance on market decisions" replace regulations and subsidies in the nation's strategy for energy.This paper starts from the assumption that the Spring, 1982 oil "glut" may turn out to be a rather temporary thing. If one therefore wants to pursue a policy strategy that will protect us in the case of sudden short‐term supply disruptions and also work toward long‐term energy supply diversification, how far will market reliance carry us? What is a range of policies and programs that might usefully supplement the market? What are the externalities for which compensatory actions may still be needed if one would like to employ the market strategy as a basic thrust?The scope of the paper includes contingency planning, synthetic fuel development, renewables (especially solar energy), conservation, equity issues, environmental externalities, and the conceptualization of policies differentiated as "energy,""environmental," or "economic."

After a brief review of the forces which shaped the general revenue sharing legislation, this article investigates thoroughly various pro and con arguments about the program. While there may be a variety of theoretical "pro" arguments, the primary argument in favor of general revenue sharing is that is is politically popular with the public officials who are recipients of the funds. This article also explores the arguments that general rev enue sharing leads to increased citizen participation and fewer administrative requirements for recipient units, and that it increases the strength of the central administration. It urges caution in interpreting the preliminary research results which are available. On the "con" side, it considers a variety of theoretical arguments, but the main emphasis must be on the inequities in the existing legislation. These include the reduction in categorical aid programs, the failure to provide adequately for the largest cities, the inapplicability of fiscal crisis arguments, and the absence of important "side benefits"—institution building, for example—from general revenue sharing legislation. Finally, there is a discussion of the discriminatory provisions and enforcement procedures of the legislation. The dilemma which revenue sharing and the former categorical grant programs were designed to meet is best resolved by strengthening and expanding the block grant approach to federal aid.