Capacity and authority: comments on governing doctors and health care

2009 ◽  
Vol 4 (3) ◽  
pp. 367-382 ◽  
Author(s):  
JOSEPH WHITE

AbstractThis stimulating set of articles provides intriguing information and comments about medical governance in four countries. The commentary argues that the typology of governance approaches is not as useful as one would want for understanding either the political prospects or policy effects of governance measures. The politics of governance measures is distinctly related to efforts to avoid blame, and the effects of measures are better understood in terms of state capacity and a term, ‘authority’, that advocates of ‘governance’ usually avoid. Close attention to the requisites of authority provides some insight into the patterns of adoption and consequences of measures. These patterns are highlighted by comparing the four cases reviewed to experience in the United States.

2013 ◽  
Vol 6 (2) ◽  
pp. 91-97 ◽  
Author(s):  
Pamella Stoeckel ◽  
Cheryl Kruschke

This qualitative key informant study examined the emerging role of the doctor of nursing practice (DNP) degree to fill a gap in health care in the United States. Although the DNP degree was proposed to bring added value to the health care system, it is new with little research to confirm the assumption. This research addressed this need by phone interviews of 12 practicing DNPs in the United States. Questions asked of the participants focused on differences in role/practice as a DNP and challenges faced. The interviews were audiotaped, transcribed, and responses coded for themes. Five broad categories with relational themes emerged from the data of DNPs perceptions of their practices. The categories included educational preparation, practice settings, role acceptance, leadership, and challenges. The results of this study provide insight into the perceptions of practicing DNPs experiencing adjustment to practice as a DNP. These perceptions aid other DNPs and educators in preparing advance practice nurses for the future.


2014 ◽  
Vol 7 (4) ◽  
pp. 457-493 ◽  
Author(s):  
Mtendeweka Mhango

This article describes the development and current status of the political question doctrine theme in South African jurisprudence. It does this through a comparative discussion of the application of this doctrine in the United States. The purpose of this comparative examination is twofold: the first is to gain insight into the origins, trends and early application of the political question doctrine. The second is to gain insight into the challenges and best practices in relation to the application of the political question doctrine elsewhere. The paper argues that while the political question doctrine theme exists in South African jurisprudence, this has not matured into a clear and transparent doctrine. It calls for the development of a clear doctrine for South Africa and offers some recommendations.


Author(s):  
Elizabeth D. Esch

AS THE FORD MOTOR COMPANY’S PLACE in multiple national economies deepened in the decades after World War I so, too, did analysis and assessment of the political and cultural implications of Ford’s various presences. No one offered greater insight into the promise and peril represented by Ford than Antonio Gramsci, despite the stark limits imposed on him by incarceration and the multiple deprivations that attended it. In “Americanism and Fordism” Gramsci described the process through which the United States had relatively easily “made the whole life of the nation revolve around production” through a combination of “force … and persuasion.”...


Author(s):  
Nadine George-Graves

The cakewalk represents one of the most important sites of competition in African-American dance history, as indicated in one of its original names, the prize walk. An examination of the cakewalk, along with tap, disco, and breaking, for example, reveals crucial insight into the development of race and class in the United States. Using primary and secondary historical sources, as well as critical race theory, this chapter analyzes the significance of competition in a number of salient cakewalk settings and argues that the political economy that develops around cakewalk competition alters our definitions of terms such as currency, value, and worth.


1976 ◽  
Vol 6 (4) ◽  
pp. 343-355 ◽  
Author(s):  
David E. Smith

The mid 1960s was a time of political, social and cultural change. People throughout the United States were coming together expressing their new found freedoms and experimenting with alternative lifestyles. Out of a need for more relevant and adequate health care and frustration from dealing with the existing medical system, the free clinic movement was born. The Haight-Ashbury Free Medical Clinic, the first free clinic in the country, opened in June 1967 and since that time has seen over 400,000 client visits for a wide variety of medical and drug problems. The free clinic movement has had to deal with various issues over the years ranging from operational problems with licensing and malpractice insurance to pressures from mainstream medicine and the communities they serve. This paper deals with some of the more powerful issues the free clinics have had to contend with, from my own personal perspective, and provides an insight into the movement and its basic founding principle that health care is a right, not a privilege.


2017 ◽  
Vol 22 ◽  
pp. 4-35 ◽  
Author(s):  
Kenneth D. Lehman

James Malloy’s 1970 study, still one of the most systematic analytical attempts in English to understand Bolivia’s 1952 National Revolution, argued that the revolution remained “uncompleted.”  However, the election and subsequent policies of the Morales government after 2005 moved Bolivia much closer to completing two important stated objectives of the revolution, as yet unfulfilled when Malloy wrote: inclusion of all Bolivians in the political system and increased national autonomy.  While it is premature to call Bolivia’s revolution “completed,” the shift in the locus of power from Europeanized elites to more broadly popular forces and the growing independence of Bolivia from outside influence and direction under Morales are key achievements of what might be called Bolivia’s “Long Revolution.”   Giving close attention to these two fundamental achievements—inclusion and autonomy—this paper provides a preliminary examination of the complicated and often paradoxical role the United States has played in Bolivia’s long historical trajectory since April 1952.  Directly and indirectly, through imposition and suggestion, purposefully and unintentionally, by providing assistance and at the same time stimulating fierce nationalist resistance, through design and through the twists and turns of historical contingency—the United States has contributed to Bolivia’s slow revolutionary transformation.  But patterns of imposition and resistance continue and this paper argues that it is time for the United States to examine its assumptions so that the two nations can escape the cyclical patterns of the past.El trabajo que James Malloy publicó en 1970 (hasta hoy día uno de los esfuerzos analíticos más sistemáticos que se han hecho en inglés para entender la Revolución Nacional de 1952), argumentaba que la revolución permanecía "incompleta". Las elecciones y subsiguientes políticas del gobierno de Morales después de 2005 llevaron a Bolivia mucho más cerca de completar dos de los objetivos importantes que buscaba la revolución y que todavía no se habían cumplidos cuando Malloy publicó su trabajo: la inclusión de todos los bolivianos en el sistema político y el incremento de autonomía nacional. Si bien es prematuro pensar que la revolución boliviana esté "terminada", el cambio operado en el lugar del poder, que de elites europeizads se ha desplazado a fuerzas más ampliamente populares, y la creciente independencia de Bolivia respecto a influencias y direcciones externas, son logros clave de lo que podría llamarse la "larga revolución" boliviana. Prestando atención a esos dos logros fundamentales (la inclusión y la autonomía), este artículo ofrece un examen preliminar del  complicado y a menudo paradójico rol que Estados Unidos ha desempeñado en la larga trayectoria histórica de Bolivia desde abril de 1952. Directa e indirectamente, a través de la imposición y la sugerencia, de manera deliberada y no intencional, proporcionando asistencia y al mismo tiempo estimulando una feroz resistencia nacionalista, mediante programas diseñados y giros de la contingencia histórica, Estados Unidos ha contribuido a la lenta transformación revolucionaria en Bolivia. Pero los patrones de imposición y resistencia continúan, y este artículo sostiene que ha llegado la hora de que los Estados Unidos examinen sus supuestos para que las dos naciones puedan evitar la repetición de patrones cíclicos del pasado. 


Author(s):  
John Alderdice ◽  
Michael Cowan

This article explores the possibility that an analysis of racism in the United States and sectarianism in Northern Ireland inspired by literary, psychotherapeutic, religious and philosophical conceptions of metaphor might yield new insight into the two situations by attending carefully to similarities and differences between them. Following brief summaries of the current state of racism in the U.S. and sectarianism in Northern Ireland, the article offers two perspectives from the field of psychotherapy that seem particularly germane to both situations. Then we turn to the political philosophy of Hannah Arendt for a reflection on the unpredictability and irreversibility of human action, and what can be done within the limits of those conditions. Finally, we find in contemporary broad-based community organizing in the tradition of Saul Alinsky our closing metaphor: interracial and interfaith citizens organizations as crucibles that enable citizens and people of faith to imagine a way forward in societies struggling with racist and sectarian histories.


2014 ◽  
Vol 9 (3) ◽  
pp. 273-294 ◽  
Author(s):  
Gwyn Bevan ◽  
Lawrence D. Brown

AbstractThis article considers how the ‘accidental logics’ of political settlements for the English National Health Service (NHS) and the Medicare and Medicaid programmes in the United States have resulted in different institutional arrangements and different implicit social contracts for rationing, which we define to be the denial of health care that is beneficial but is deemed to be too costly. This article argues that rationing is designed into the English NHS and designed out of US Medicare; and compares rationing for the elderly in the United States and in England for acute care, care at the end of life, and chronic care.


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