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"ANDREW, Kelly"
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Private Power in Public Programs: Medicare, Medicaid, and the Structural Power of Private Insurance
In 2019, nearly 70 percent of Medicaid beneficiaries received their health insurance coverage through a private, managed care organization (MCO). Twenty-five years earlier, 9.5 percent of Medicaid beneficiaries were enrolled in MCOs. This dramatic growth in Medicaid managed care enrollment represents the delegation of significant power by federal and state governments over a critical social program to private actors and market forces. Medicare, too, experienced a similar pattern of transformation. Together, Medicaid and Medicare, two critical pillars of American social policy, paid more than half a trillion dollars to private insurance companies in 2019 to provide public health insurance to 75 million people. This manuscript examines the policy consequences of building private firms directly into the structure of American social policies. In contrast to existing work on “submerged” or “delegated” policies, this manuscript highlights the structural power that such policies bestow on the government's private partners and develops a new theory of structural power in which firms are able to constrain health policy reform through their threats to disrupt the delivery of public policies and social benefits to millions of people across the United States.
Journal Article
The missing marlin
\"Mike and Kate are visiting the Miami Marlins ballpark when some rare animals from the ballpark's fish tanks go missing\"-- Provided by publisher.
Book
Welfare Implications for Hares, Lepus timidus hibernicus, Taken from the Wild for Licensed Hare Coursing in Ireland
Hare coursing is legal in the Republic of Ireland under licenses issued to coursing clubs but is illegal in other jurisdictions in the British Isles including Northern Ireland. Supporters of coursing maintain that coursing contributes to the conservation of the hare whilst opponents claim that coursing is cruel and the welfare of the hares is compromised. However, while the contribution of coursing to conservation has been considered, the impact of coursing on hare welfare has not been investigated. This paper reviews publicly available information from licensed hare coursing clubs over four coursing seasons, including the number of hares taken from the wild, numbers coursed, and numbers pinned to the ground by dogs, killed or injured during coursing events. In total, 19,402 hares were taken from the wild—98% of which were subsequently released back to the wild at the end of the coursing season. Almost 600 hares were pinned by greyhounds during coursing events and 75 were either killed or had to be euthanized as a result of their injuries. While the number of hares killed or injured is relatively small compared to the number caught, the welfare of all captured hares will have been compromised and has not been investigated. Policy makers must fill this knowledge gap or take a precautionary approach and further regulate or indeed prohibit the capture of hares which are otherwise fully protected.
Journal Article
The Fenway foul-up
Cousins Mike and Kate are at Boston's Fenway Park when the Red Sox's star hitter discovers that his lucky baseball bat has been stolen.
Book
State Politics And The Uneven Fate Of Medicaid Expansion
Under the Affordable Care Act (ACA), state governments play a central role in deciding whether millions of low-income Americans have access to Medicaid. During the early years of ACA implementation, conservative opposition stalled the expansion of eligibility for Medicaid in many Republican-controlled states, even in the face of strong fiscal incentives. Can any forces overcome this partisan divide? In this article we consider the role of several key mechanisms that have affected Medicaid expansion over the past decade, including electoral competition, ballot-box initiatives, interest-group coalitions, and entrepreneurial administrators. While each mechanism has helped place Medicaid expansion on the agenda, they have done so unevenly. In Republican-controlled states where electoral competition is weak and ballot initiatives are unavailable, Medicaid expansion remains unlikely. Even when expansion is successful at the ballot box, however, state legislatures and governors have been able to delay or reverse voter-led initiatives. Moreover, the highly salient and partisan nature of Medicaid expansion has made it difficult for interest-group coalitions and progressive administrators to play a leading role in policy change. The future of Medicaid expansion, as well as other significant portions of the ACA, will continue to depend on the character of representative democracy in the states.
Journal Article
The soccer surprise
\"A famous soccer star is coming to town, but can practice with a pro help the MVP kids score big at their next game?\"-- Provided by publisher.
Book
Habitual prospective memory in preschool children
Habitual prospective memory (PM) refers to situations in which individuals have to remember to perform a future task on a regular and frequent basis. Habitual PM tasks are ubiquitous and the ability to successfully complete these tasks (e.g., remembering to bring your lunch to school every day) is necessary for children as they begin to establish their own independence. The current investigation is the first to explore preschool children’s ability to complete this kind of task. At the end of a regular testing session during which children engaged in a variety of unrelated cognitive tasks, participants were instructed to ask for a stamp on their card, which was sitting in a box on the table. Over the course of the first experiment, participants did this 13 times, spanning a time period of several months. The results demonstrated that children initially needed prompting from the experimenter to remember, but with experience, participants were able to retrieve this intention without assistance. Experiment 2 demonstrated that removing the box from participants’ line of sight after numerous opportunities to perform the task did not negatively impact performance, although it did make a difference at the outset of this requirement to remember to ask for stamps. Together, these results indicate that with somewhat consistent and repeated practice, preschool children can fairly quickly demonstrate the ability to successfully perform future intentions that are likely to be repeated on numerous occasions.
Journal Article
The gold medal mess
\"Five friends are ready for their school's Olympics field day. But not everyone wants to play fair: someone is trying to ruin the events. Can the kids in the Most Valuable Player club solve the mystery, save the Olympics, and take home the gold?\"-- Provided by publisher.
Book
Metabolomic Profiling from Formalin-Fixed, Paraffin-Embedded Tumor Tissue Using Targeted LC/MS/MS: Application in Sarcoma
The relatively new field of onco-metabolomics attempts to identify relationships between various cancer phenotypes and global metabolite content. Previous metabolomics studies utilized either nuclear magnetic resonance spectroscopy or gas chromatography/mass spectrometry, and analyzed metabolites present in urine and serum. However, direct metabolomic assessment of tumor tissues is important for determining altered metabolism in cancers. In this respect, the ability to obtain reliable data from archival specimens is desirable and has not been reported to date. In this feasibility study, we demonstrate the analysis of polar metabolites extracted directly from ten formalin-fixed, paraffin-embedded (FFPE) specimens, including five soft tissue sarcomas and five paired normal samples. Using targeted liquid chromatography-tandem mass spectrometry (LC/MS/MS) via selected reaction monitoring (SRM), we detect an average of 106 metabolites across the samples with excellent reproducibility and correlation between different sections of the same specimen. Unsupervised hierarchical clustering and principal components analysis reliably recovers a priori known tumor and normal tissue phenotypes, and supervised analysis identifies candidate metabolic markers supported by the literature. In addition, we find that diverse biochemical processes are well-represented in the list of detected metabolites. Our study supports the notion that reliable and broadly informative metabolomic data may be acquired from FFPE soft tissue sarcoma specimens, a finding that is likely to be extended to other malignancies.
Journal Article