Search results

Access for the uninsured for medical care has been studied retrospectively via interviews with the uninsured and by surveys of physicians concerning acceptance of uninsured patients. In this study we simulate the experiences of uninsured persons by calling primary care physician offices seeking appointments to treat current illnesses. Callers were instructed not to volunteer uninsurance status unless requested by office staff. We find that patients can get timely appointments over half the time, insurance information is requested around half the time, and that office staff knowledge of uninsurance status did not affect the probability of obtaining an appointment. Our findings agree with physician survey rates for acceptance of uninsured patients. Our findings demonstrate that medical appointments are likely available for the uninsured, even though the out of pocket costs may be burdensome or unaffordable. Nevertheless, many uninsured persons have incomes above hospital emergency room, charity care guidelines and would be far better off financially and medically to have a medical home.

Pharmaceuticals are essential for the management of many chronic conditions. As a result, it is important to examine how the administration of pharmaceutical benefits affects physicians and pharmacists providing chronic care services. In the 1990s, HMOs and PPOs began to more aggressively manage outpatient pharmaceutical benefits, leading to the growth of pharmaceutical benefit management companies (PBMs).

In this exploratory study, 10 primary care physicians and 12 pharmacists in the San Francisco area were interviewed in 1999, and 11 more pharmacists in 2004, on how they worked with PBMs and their controls on prescribing and dispensing. Responses indicated major problems for both health professionals in negotiating with the PBM as a third party payor, in coping with switches and multiple formularies, and in added work for the health care professional. Increased risk to chronically ill patients for poorer outcomes is an important related problem with PBMs.

The Medicare drug benefit law passed in 2003 will likely result in similar problems for many beneficiaries, including those with chronic care needs. The paper proposes some policy solutions to reduce PBM problems for physicians, pharmacists and the Medicare population.

This paper aims to examine whether employee subjective well-being acts as a mediator in the relationship between perceived supervisor support and turnover intention within the context of select-service hotels.

The sample included hourly employees in select-service hotels in the Midwest USA. The significance of the relationships was assessed using regression, and both the Sobel test and bootstrapping methods were performed to test the mediating effect of subjective well-being on the relationship between perceived supervisor support and turnover intention.

The results confirm subjective well-being acted as a partial mediator in the relationship between supervisor support and turnover intention. Employees who perceive higher levels of support from their supervisors are less likely to leave their organizations. At the same time, supervisor support also positively affects subjective well-being, which reduces turnover intention.

Actions by supervisors’ impact the well-being of their employees, which in turn may influence whether an employee stays with the organization. Organizations could use management training and employee feedback on supervisor support to improve employee support mechanisms. Organizations should also pay attention to improving employee subjective well-being beyond the work place. Improving the well-being of employees and supporting employees can help reduce turnover and may increase employee satisfaction, guest satisfaction and profits.

This study is the first to show that subjective well-being mediates the relationship between supervisor support and turnover intention; and one of the few within the hospitality context to examine the constructs of subjective well-being, supervisor support and turnover together.

This chapter connects colorblind ideology to organizational processes. Despite advances in our thinking about colorblindness as the current dominant racial ideology, scholars are reluctant to tie this ideology to organizational processes – creating the impression that colorblindness is an individual attribute rather than a structural phenomenon. Because the frames of colorblindness are usually interpreted through interviews – as opposed to organizational practices – focusing on the frames reinforces the sense that ideologies are free-floating prejudices unconnected to social structures. In this theoretical piece, we draw on the organizational literature, to tie Bonilla-Silva’s colorblind frames – abstract liberalism, cultural racism, the minimization of racism, and naturalization – to organizational processes, showing how mundane organizational procedures reinforce structural inequality. We argue that organizational policies and practices rely on normative Whiteness, devaluing the cultural norms of nonwhites, and passing those practices to successive administrations. Ostensibly nonracial procedures such as hiring, promotion, and performance reviews are rife with racialized meanings.

A marked increase in the incidence of microbial food poisoning parallels increasing scientific and public concern about microbiological hazards. This literature review highlights the important pathogens involved in the increase and issues salient to developing effective risk‐benefit communication with the public about microbial food poisoning. Research into public perceptions of microbiological food hazards is reviewed, together with public attitudes towards one of the technologies that could combat food poisoning: food irradiation. Suggestions for reducing the incidence of microbial food poisoning through effective communication strategies are provided.

Cross-level analysis is a problem for mainstream approaches to organizational behavior, but not for psychoanalytic theory. The reason is that psychoanalytic theory is not so much about behavior as about the meaning of behavior, which is relatively invariant across levels. The Jayson Blair scandal at the New York Times is analyzed at the individual, the group, the intrapsychic, the interpersonal, and the organizational levels. Blair’s behavior and the behavior of the Times toward him are explained in terms of a clash between two ways in which meaning is made: the Oedipal and the anti-oedipal.

It is customary these days to denounce our society for its unconscionable neglect of the elderly, while we look back romantically to some indeterminate past when the elderly were respected and well cared for. Contrary to this popular view, old people historically have enjoyed neither respect nor security. As Simone de Beauvoir so effectively demonstrates in The Coming of Age (New York: Putnam, 1972), the elderly have been almost universally ill‐treated by societies throughout the world. Even the Hebrew patriarchs admonished their children to remember them as they grew older: “Cast me not off in time of old age; when my strength fails, forsake me not” (Psalms 71:1). Primitive agrarian cultures, whose very existence depended upon the knowledge gleaned from experience, valued their elders, but even they were often moved by the harsh conditions of subsistence living to eliminate by ritual killing those who were no longer productive members of society. There was a softening of societal attitudes toward the elderly during the period of nineteenth century industrial capitalism, which again valued experience and entrepreneurial skills. Modern technocratic society, however, discredits the idea that knowledge accumulates with age and prefers to think that it grows out‐of‐date. “The vast majority of mankind,” writes de Beauvoir, “look upon the coming of old age with sorrow and rebellion. It fills them with more aversion than death itself.” That the United States in the twentieth century is not alone in its poor treatment of the aged does not excuse or explain this neglect. Rather, the pervasiveness of prejudice against the old makes it even more imperative that we now develop programs to end age discrimination and its vicious effects.