Since the late 1980s welfare policies in France and the United States have increasingly been shaped by a strong emphasis on citizens' obligations to work and be independent, and a weakening of entitlements to income maintenance. Throughout the advanced industrialized nations, welfare reforms incorporate work-oriented measures such as financial incentives, insertion contracts, training, and requirements to search for and accept jobs. The evidence in this volume suggests that while the details may vary, welfare reforms in France and the United States have more in common than is often acknowledged. Welfare Reform provides an in-depth analysis of the development and structure of modern welfare programs and how they function. The dynamics of welfare reform are illuminated by focusing on two programs: the Revenu Minimum d'Insertion in France and Temporary Assistance for Needy Families in the United States. Taking various analytic approaches, contributors examine the relations between poverty and work, how U.S. and French models of income support have been transformed in recent times, the relative impacts of economic growth and policy reforms on rates of welfare participation, and what happens to recipients who leave the welfare rolls. Welfare Reform will help researchers and policymakers gain perspective on where they are headed and how best to get there as they journey down the highway of welfare reform. Neil Gilbert is Chernin Professor of Social Welfare at the School of Social Welfare, University of California at Berkeley, and co-director of the Center for Child and Youth Policy (CCYP). His numerous publications include 25 books and over 100 articles that have appeared in The Public Interest, Society, Commentary, and other leading academic journals. Antoine Parent is associate professor of economics at the University of Paris 8, associate researcher at MATISSE, University of Paris 1--Sorbonne, and research program manager at the Research Division of the French Ministry of Social Affairs.

The present study was undertaken for three reasons: Medicaid is a vital program-in the early 1970s it provided care for over one tenth of the American population. It is a huge program-in the same period it consumed over nine billion dollars of public funds. And Medicaid is, in many ways, the most direct involvement with the provision of medical care undertaken by either the federal government or the states. But until the publication of this book, Medicaid had not been studied in depth or in a systematic way. Welfare Medicine in America is the complete history of Medicaid. The authors carefully examine the program's historical antecedents, its strengths, and its weaknesses. In part one, "The Coming of Medicaid," the hows and whys of the establishment of Medicaid are discussed, as are the basic provisions of the program. In part two, "The Euphoric Demise: July 1965-January 1968," the focus is on how Medicaid is administered in the states. In part three, "The Storm: January 1968-July 1970," specific amendments to Medicaid, the costs involved, and other health programs are examined. And in part four, "Benign Neglect: July 1970-June 1973," the role of the courts in administering Medicaid, and its future, are the primary subjects. This history of Medicare, however, goes beyond the specific government program itself and offers a paradigm for inquiring into the problems of medical care in general and the nature and limitations of public medical services. Welfare Medicine in America is a profound analysis of Medicaid and welfare systems, and will be of great use to policymakers, students of welfare and government, and to those working within the medical profession.

Despite the increase in meditation studies, the quality remains variable; many of them are trivial, and most remain unreplicated. Research on meditation has been plagued by insubstantial theorizing, global claims, and the substitution of belief systems for grounded hypotheses. Meditation punctures some of the myths about meditation, while retaining a place of value for mediation as a normal human function. In each chapter includes discussion of the major questions addressed, followed by a detailed critique of important theoretical, clinical, and research issues. In several instances the reader may find that questions seem to beget questions: research bearing upon certain issues may be contradictory, or not yet of sufficient thoroughness. In these cases, the author suggests the specific future research necessary to resolve the questions posed, so that claims about meditation are justified, and which are not. The profession of psychology itself is, and has been, in a polarized debate between the "practitioners" and the "experimentalists." The latter accuse the former of being "soft, non-empirical, non-scientific," while practitioners accuse the experimentalists of conducting research which is essentially irrelevant to human concerns. This approach provides a bridge between research and clinical practice. Meditation provides an encompassing survey of the topic--nearly forty tables and figures; sample questionnaires, evaluations and programs and a detailed overview of a controversial field. Shapiro separates self-regulation with self-delusion, to outline questions and possible answers.

Despite the increase in meditation studies, the quality remains variable; many of them are trivial, and most remain unreplicated. Research on meditation has been plagued by insubstantial theorizing, global claims, and the substitution of belief systems for grounded hypotheses. Meditation punctures some of the myths about meditation, while retaining a place of value for mediation as a normal human function.

In each chapter includes discussion of the major questions addressed, followed by a detailed critique of important theoretical, clinical, and research issues. In several instances the reader may find that questions seem to beget questions: research bearing upon certain issues may be contradictory, or not yet of sufficient thoroughness. In these cases, the author suggests the specific future research necessary to resolve the questions posed, so that claims about meditation are justified, and which are not. The profession of psychology itself is, and has been, in a polarized debate between the "practitioners" and the "experimentalists." The latter accuse the former of being "soft, non-empirical, non-scientific," while practitioners accuse the experimentalists of conducting research which is essentially irrelevant to human concerns.

This approach provides a bridge between research and clinical practice. Meditation provides an encompassing survey of the topic--nearly forty tables and figures; sample questionnaires, evaluations and programs and a detailed overview of a controversial field. Shapiro separates self-regulation with self-delusion, to outline questions and possible answers.

Since the late 1980s welfare policies in France and the United States have increasingly been shaped by a strong emphasis on citizens' obligations to work and be independent, and a weakening of entitlements to income maintenance. Throughout the advanced industrialized nations, welfare reforms incorporate work-oriented measures such as financial incentives, insertion contracts, training, and requirements to search for and accept jobs. The evidence in this volume suggests that while the details may vary, welfare reforms in France and the United States have more in common than is often acknowledged. "Welfare Reform" provides an in-depth analysis of the development and structure of modern welfare programs and how they function. The dynamics of welfare reform are illuminated by focusing on two programs: the Revenu Minimum d'Insertion in France and Temporary Assistance for Needy Families in the United States. Taking various analytic approaches, contributors examine the relations between poverty and work, how U.S. and French models of income support have been transformed in recent times, the relative impacts of economic growth and policy reforms on rates of welfare participation, and what happens to recipients who leave the welfare rolls. "Welfare Reform" will help researchers and policymakers gain perspective on where they are headed and how best to get there as they journey down the highway of welfare reform. Neil Gilbert is Chernin Professor of Social Welfare at the School of Social Welfare, University of California at Berkeley, and co-director of the Center for Child and Youth Policy (CCYP). His numerous publications include 25 books and over 100 articles that have appeared in "The Public Interest, Society, Commentary," and other leading academic journals. Antoine Parent is associate professor of economics at the University of Paris 8, associate researcher at MATISSE, University of Paris 1--Sorbonne, and research program manager at the Research Division of the French Ministry of Social Affairs.

The present study was undertaken for three reasons: Medicaid is a vital program-in the early 1970s it provided care for over one tenth of the American population. It is a huge program-in the same period it consumed over nine billion dollars of public funds. And Medicaid is, in many ways, the most direct involvement with the provision of medical care undertaken by either the federal government or the states. But until the publication of this book, Medicaid had not been studied in depth or in a systematic way. "Welfare Medicine in America" is the complete history of Medicaid. The authors carefully examine the program's historical antecedents, its strengths, and its weaknesses. In part one, "The Coming of Medicaid," the hows and whys of the establishment of Medicaid are discussed, as are the basic provisions of the program. In part two, "The Euphoric Demise: July 1965-January 1968," the focus is on how Medicaid is administered in the states. In part three, "The Storm: January 1968-July 1970," specific amendments to Medicaid, the costs involved, and other health programs are examined. And in part four, "Benign Neglect: July 1970-June 1973," the role of the courts in administering Medicaid, and its future, are the primary subjects. This history of Medicare, however, goes beyond the specific government program itself and offers a paradigm for inquiring into the problems of medical care in general and the nature and limitations of public medical services. "Welfare Medicine in America" is a profound analysis of Medicaid and welfare systems, and will be of great use to policymakers, students of welfare and government, and to those working within the medical profession. Robert Stevens is master of Pembroke College, Oxford, and serves as counsel to the law firm Covington & Burling, where his practice involves international commercial law and competition law. He has also taught at Yale and Tulane Universities, and has authored many articles and books, including studies of social legislation and the legal profession in the United States and the United Kingdom. Rosemary Stevens is professor emeritus of history and sociology of science at the University of Pennsyvlania. Educated at Oxford, Yale, and Manchester, she has also taught at Yale University and Tulane University. She is the author of "American Medicine and the Public Interest" and "In Sickness and in Wealth: American Hospitals in the Twentieth Century."

The distinctive mixing and continuous remixing of public and private roles is a defining feature of health care in the United States. The Public-Private Health Care State explores the interweaving of public and private enterprise in health care in the United States as a basis for thinking about health care in terms of its history and its continuing evolution today. Historian and policy analyst Rosemary Stevens has selected and edited seventeen essays from both her published and unpublished work to illustrate continuing themes, such as: the flexible meanings of the terms "public" and "private," and how useful their ambiguity has been and is; the role of ideology as ratifying rather than preordaining change; and the common behavior of public leaders and corporate entities in the face of fiscal opportunity. The topics--covering the period of 1870 through the twenty-first century--represent Stevens' research interests in hospital history and policy, the medical profession, government policy, and paying for health care. The volume also considers her involvement with policy questions, which include health services research, health maintenance organizations, and physician workforce policy. Section I demonstrates the long history of state government involvement with private not-for-profit hospitals from the 1870s through the 1930s. Section II examines the federal role in health care from the 1920s through the 1970s, including the establishment of veterans' hospitals and the implementation of Medicaid. Section III shows how shifting governmental roles require constantly changing organizing rhetoric, whether for inventing a federal role for health services research and HMOs, "regionalization" in the 1970s, or defining civil rights and "equity" as mobilizing vehicles in the 1980s. Section IV examines growing concerns from the 1970s through the present about the traditional "public" role of the largely "private" medical profession. Section V returns to the ambiguous public-private status of not-for profit hospitals, buffeted in the 1980s and 1990s by assumptions about the efficiency of the market.

The distinctive mixing and continuous remixing of public and private roles is a defining feature of health care in the United States. "The Public-Private Health Care State "explores the interweaving of public and private enterprise in health care in the United States as a basis for thinking about health care in terms of its history and its continuing evolution today. Historian and policy analyst Rosemary Stevens has selected and edited seventeen essays from both her published and unpublished work to illustrate continuing themes, such as: the flexible meanings of the terms "public" and "private," and how useful their ambiguity has been and is; the role of ideology as ratifying rather than preordaining change; and the common behavior of public leaders and corporate entities in the face of fiscal opportunity. The topics--covering the period of 1870 through the twenty-first century--represent Stevens' research interests in hospital history and policy, the medical profession, government policy, and paying for health care. The volume also considers her involvement with policy questions, which include health services research, health maintenance organizations, and physician workforce policy. Section I demonstrates the long history of state government involvement with private not-for-profit hospitals from the 1870s through the 1930s. Section II examines the federal role in health care from the 1920s through the 1970s, including the establishment of veterans' hospitals and the implementation of Medicaid. Section III shows how shifting governmental roles require constantly changing organizing rhetoric, whether for inventing a federal role for health services research and HMOs, "regionalization" in the 1970s, or defining civil rights and "equity" as mobilizing vehicles in the 1980s. Section IV examines growing concerns from the 1970s through the present about the traditional "public" role of the largely "private" medical profession. Section V returns to the ambiguous public-private status of not-for profit hospitals, buffeted in the 1980s and 1990s by assumptions about the efficiency of the market.

"This rich array of essays shows how the lens of history can clarify contemporary health-policy dilemmas and enable the reader to see ahead more clearly." --Harvey V. Fineberg, President, Institute of Medicine "A refreshing antidote for those finding it difficult to envision a better future for health care in America. . . . This excellent book helps us all to better understand the subtle relationship among values, institutions, economics, and medicine that shapes our health system." --Stuart M. Butler, Vice President for Domestic Policy, The Heritage Foundation "An important book for those wrestling with the appropriate role of markets in U.S. health policy." --Karen Davis, President, The Commonwealth Fund In this book, seventeen leading scholars make the case for the usefulness of history in evaluating and formulating health policy today. In looking at issues as varied as the consumer economy and the plight of the uninsured, the contributors uncover the ways we think about technology, the role of government, and contemporary medicine. They show how historical perspectives can help policy makers avoid the pitfalls of partisan, outdated, or merely fashionable approaches, as well as how knowledge of previous systems can offer alternatives when policy directions seem unclear. Rosemary A. Stevens is DeWitt Wallace Distinguished Scholar in social medicine and public policy at Weill Cornell Medical College and professor emerita of the history and sociology of science at the University of Pennsylvania. Charles E. Rosenberg is a professor of the history of science and Ernest E. Monrad Professor in the social sciences at Harvard University. Lawton R. Burns is the James Joo-Jin Kim Professor of Health Care Systems at the University of Pennsylvania. A volume in the Critical Issues in Health and Medicine series, edited by Rima D. Apple and Janet Golden