Focusing the catastrophic illness debate.

Unlike other aspects of the American health experience, there is a current void of information on expensive illness experiences. This paper is designed to fill this void and prrsents an analysis of the incidence and cost of catastrophic illness in the United States. Catastrophic illness is defined as an illness episode for which a person incurs $5,000 or more of medical expenses in a calendar year. This information is used to provide a framework for focusing the debate about catastrophic and national health insurance.     

Determinants of Relationship Quality and Loyalty in Personalized Services

The study adopts a relationship perspective to examine and better understand customers' interactions with service firms' contact personnel, physical environment and customer environment and their influence on the relationship quality, that is trust and satisfaction, and consequently loyalty. The conceptual model, which integrates relational and evaluative perspectives, is validated in the Asian context of personalized service through findings from a survey of 325 respondents. The findings at the aggregate level indicate that while the physical environment is an important determinant of both trust and satisfaction in personalized service encounters, the customer environment influences only satisfaction but not trust. Service contact personnel's friendliness and knowledge of customers strongly influence relationship quality; while expertise, similarity and disclosure influence trust but not satisfaction. Both relationship trust and satisfaction were found to significantly influence loyalty to the service provider. At the disaggregate level, trust was found to be a stronger predictor of loyalty for high-end service providers while satisfaction was a stronger predictor of loyalty for low-end service providers. The implications for high-end and low-end service providers to enhance loyalty by strategically leveraging on key customer-firm antecedents of relationship trust and satisfaction are discussed.