Ethical considerations in health care benefits administration

Defining the scope of coverage and limitations in various health plans has become an increasingly difficult and confusing issue. The historical shift to managed care has fundamentally altered the limitations on health care benefits. Because of the existence of "benefits exclusions," confusing issues have emerged in managed care situations. Fundamental fear of health care rationing has raised the awareness of the general public to the ethics of this issue. This article discusses the definitions and examples of certain types of health benefit exclusions and the ethical considerations related to such exclusions.     

A brief historical sketch of the Association of Life Insurance Medical Directors of America (ALIMDA), the predecessor of the American Academy of Insurance Medicine (AAIM)

This is a brief historical sketch of ALIMDA, the name of our professional organization when it was founded at a meeting of a few medical directors in New York City in 1898. The principal source for its contents is based on recollections of my own experience with ALIMDA/AAIM since I first became a member after appointment as an Assistant Medical Director of the company then known as New England Mutual Life Insurance Company, in Boston, in 1952. I was never an officer of ALIMDA or AAIM, but I attended most of its meetings, and I was involved in our mortality research activites.     

III. Weltwirtschaft und wirtschaft einzlner länderund und gebiete

Ohne Zusammenfassung     

Quantity and price controls by the firm under demand uncertainty and welfare implications

A monopoly facing an uncertain demand can affect its profit distribution through the choice of ex ante controls. This paper compares two modes of behavior - price-setting and quantity-setting - in the context of a mean-variance model. The main results are: (a) With nonlinear cost, the monopoly will not be indifferent between the two modes. In the particular case of quadratic cost, conditions for the dominance of price-setting over quantity-setting behavior are derived. (b) Whereas it is well-known that the risk averse, quantity-setting monopoly will produce less under uncertainty than under certainty (or risk neutrality), the price-setting monopoly increases its expected output when faced by uncertain demand, possibly exceeding even the competitive output under uncertainty. (c) Using expected social surplus as a welfare criterion, price-setting emerges as the welfare-dominant behavior when there is a conflict between the privately and the socially preferred modes. (d) Finally, there exist conditions where price-setting monopolies welfare-dominate a competitive industry facing the same random demand.     

Exchange-rate flexibility,inflation, and structural change: Israel Under Alternative Regimes

The paper analyses the evolution of the Israeli exchange rate regime from the application of large discrete devaluations interspersed with gradual adjustments of export subsidies and import tariffs, through the adoption of a crawling peg (1975), and culminating in exchange decontrol and a float (1977). The main issues analysed in greater detail are the problem of maintaining an export-biased trade strategy, the role of devaluations in the inflationary process and the effect of alternative exchange rate regimes on expectations and capital-account transactions.     

Interrelationships between environmental dependencies: A basis for tradeoffs to increase autonomy

General managers of large industrial plants in Israel were asked to evaluate the effects of environmental dependencies on their freedom of action. It was found that most segments of the environment were perceived as homogeneous—affecting the firms' autonomy in similar ways. Different components of government, however, were perceived as having conflicting interests both within the segment and with other segments of the environment. When a segment of the environment is heterogeneous, it is possible that managers use a tradeoff strategy, in which pressures generated by one component of the environment can be used as a means to reduce pressure of the other components.