Jobs and Growth Tax Relief Reconciliation Act: Provisions Expiring in 2004

CRS_2004_Jobs_and_Growth_Tax_Relief_Reconciliation_Act.pdf: 676 downloads, before Oct. 1, 2020

West Michigan Stock Returns

West Michigan stocks have outperformed the national market indexes in 9 of the past 11 years, often by a considerable margin. That wasn’t the case, however, in 2004. Although West Michigan stock returns outperformed the Dow Jones Industrial Average, they trailed the two other major national market indexes

Uncertainty relations and possible experience

The uncertainty principle can be understood as a condition of joint indeterminacy of classes of properties in quantum theory. The mathematical expressions most closely associated with this principle have been the uncertainty relations, various inequalities exemplified by the well known expression regarding position and momentum introduced by Heisenberg. Here, recent work involving a new sort of “logical” indeterminacy principle and associated relations introduced by Pitowsky, expressable directly in terms of probabilities of outcomes of measurements of sharp quantum observables, is reviewed and its quantum nature is discussed. These novel relations are derivable from Boolean “conditions of possible experience” of the quantum realm and have been considered both as fundamentally logical and as fundamentally geometrical. This work focuses on the relationship of indeterminacy to the propositions regarding the values of discrete, sharp observables of quantum systems. Here, reasons for favoring each of these two positions are considered. Finally, with an eye toward future research related to indeterminacy relations, further novel approaches grounded in category theory and intended to capture and reconceptualize the complementarity characteristics of quantum propositions are discussed in relation to the former

Is identity per se irrelevant? A contrarian view of self-verification effects

Self-verification theory (SVT) posits that people who hold negative self-views, such as depressive patients, ironically strive to verify that these self-views are correct, by actively seeking out critical feedback or interaction partners who evaluate them unfavorably. Such verification strivings are allegedly directed towards maximizing subjective perceptions of prediction and control. Nonetheless, verification strivings are also alleged to stabilize maladaptive self-perceptions, and thereby hindering therapeutic recovery. Despite the widespread acceptance of SVT, I contend that the evidence for it is weak and circumstantial. In particular, I contend that that most or all major findings cited in support of SVT can be more economically explained in terms of raison oblige theory (ROT). ROT posits that people with negative self-views solicit critical feedback, not because they want it, but because they their self-view inclines them regard it as probative, a necessary condition for considering it worth obtaining. Relevant findings are reviewed and reinterpreted with an emphasis on depression, and some new empirical data reported

The Market for Medical Ethics

At the core of Kenneth Arrow’s classic 1963 essay on medical uncertainty is a claim that has failed to carry the day among economists. This claim—that physician adherence to an anti-competitive ethic of fidelity to patients and suppression of pecuniary influences on clinical judgment pushes medical markets toward social optimality—has won Arrow near-iconic status among medical ethicists (and many physicians). Yet conventional wisdom among health economists, including several participants in this symposium, holds that this claim is either naïve or outdated. Health economists admire Arrow’s article for its path-breaking analysis of market failures resulting from information asymmetry, uncertainty, and moral hazard. But his suggestion that anticompetitive professional norms can compensate for these market failures is at odds with economists’ more typical treatment of professional norms as monopolistic constraints on contractual possibility. If the goal of health care policy and law is to maximize the social welfare yield from medical spending, consideration of the place of professional ethics norms in health policy requires that we pose three questions. First, how can we distinguish between professional norms that enhance social welfare (even if “anticompetitive” in some sense) and therefore merit our deference (and perhaps even some legal protection) and norms that reduce welfare? Second, when we conclude that a professional norm is socially undesirable, how should we go about choosing among regulatory and legal strategies and deference to markets as means for dissolving the norm? Third, when we conclude that a professional norm is socially desirable, how should we go about preserving it? Should we defer to market outcomes—and perhaps shield select forms of professional collusion from antitrust intervention? Or should we defend this norm actively, through legal and regulatory intervention? This essay focuses on the first of these three questions, since it is the subject of Arrow’s article. From a public policy perspective, however, the second and third are just as important. It is hardly obvious that a socially undesirable norm should be targeted by judges or regulators rather than left to wither in the marketplace; nor is it clear that a socially desirable norm needs legal or regulatory support to survive

Race and Discretion in American Medicine

The author’s focus in this article is on racial disparities in medical care provision--that is, on differences in the services that clinically similar patients receive when they present to the health care system. Racial disparities in health status, which is not greatly influenced (on a population-wide basis) by medical care, are beyond his scope here. Disparities in medical care access-potential patients\u27 ability, financial and otherwise, to gain entry to the health care system in the first place, are also outside his focus. The author begins this article by putting the problem of racial disparities in medical care provision within the larger context of disparities in health status and medical care access. In Part I, the author concedes: (1) that medical care is almost certainly less important as a determinant of health than are social and environmental influences, and (2) that inequalities in Americans\u27 ability to gain entry to the health care system probably play a larger role in medical treatment disparities than do racial differences in the care provided to people who succeed in gaining entry. He then briefly examines the moral politics behind the appearance of racial disparity in health care provision on the national policy agenda, ahead of disparities in health status and medical care access. In Part II, the author considers the links between clinical discretion and racial disparities in health care provision. He argues that pervasive uncertainty and disagreement, about both the efficacy of most medical interventions and the valuation of favorable and disappointing clinical outcomes, leave ample room for discretionary judgments that produce racial disparities. Neither existing institutional and legal tools, nor prevailing ethical norms, impose tight constraints on this discretion. As a result, provider (and patient) presuppositions, attitudes, and fears that engender racial disparities have wide space in which to operate. In Part III, the author refines this argument, pointing to a variety of extant organizational, financial, and legal arrangements that interact perniciously with psychological and social factors to potentiate racial disparities. Part IV considers the impact of the managed care revolution, contending that its cost containment strategies both contribute to racial differences in health care provision and creates opportunities for reducing some of these disparities. Part V closes with some recommendations as to how health care institutions and the law might respond pragmatically to racial disparities even as they pursue other important policy goals

Obesity and the Struggle Within Ourselves

The author argues that we ought to treat our eating, exercise habits, and girth as personal matters, for the most part, but that law can and should make a contribution, as an ally of our longer-term will against our immediate cravings. Law can be our ally in this fashion without command-and-control intrusion into our private lives. Such intrusion is at odds with our core beliefs and unlikely to produce public health success. It is more likely to provoke popular backlash--one reason why some who stand to gain from our unhealthy dining choices try to cast government efforts to inform these choices as heavyhanded interference in our lives. Public policy and law should support our beleaguered self-restraint in the face of potent social cues and pressured life circumstances that make us more responsive to our short-term, unreflective intentions. Policymakers should also look for opportunities to set our cravings against each other. From a public health perspective, for example, safe sex is better than reckless eating. To the extent that erotic feelings suppress snacking or inspires regular exercise, they are a potential ally in campaigns against overeating. Through such strategies, the state can promote health without eroding its citizens\u27 sense of freedom in the private sphere. The author proceeds as follows. First, he disentangles the debates over: (1) the causes of obesity (and overweight) and (2) the reasons for its recent, rapid increase in incidence. A health problem\u27s underlying causal mechanisms are typically distinct from the reasons for the problem\u27s epidemic surge. But in the case of obesity, these two issues are often conflated. Commentators opposed to state intervention tend to argue that various proposed causal mechanisms cannot explain obesity\u27s epidemic surge and therefore should not become foci of government action. Proponents of robust public intervention tend to point to a broad array of causal mechanisms, citing each as justification for action. Both approaches are misguided. The question of what might work as a remedy, in terms of both efficacy and consonance with our cultural and legal values, is distinct from the question of cause. Not all causes imply viable remedies. And, conversely, effective remedies (be they clinical or legal) need not operate via the causal pathways that explain obesity\u27s epidemic surge. Second, he considers the varied causal accounts with an eye toward remedies that might yield health benefits (at reasonable cost) and fit with enduring American legal and cultural norms. The author rejects black box accounts of personal choice that treat consumers\u27 current eating habits as sovereign expressions of preference. But he eschews government measures that would override people\u27s expressed preferences and thus be experienced by Americans as oppressive. Instead, he urges efforts to encourage healthier eating and exercise choices by better informing consumers and sharpening their awareness of risks and benefits. Public health activism along these lines can succeed by forging alliances with our longer-term selves against our immediate cravings. It will fail (and bring about a backlash) if it is widely seen as an attempt to foreclose dietary choices that large numbers of Americans continue to make