Suchergebnisse

Résumé Cet article porte sur la régulation financière du système de santé en Angleterre. Après un rapide historique, il présente la structure institutionnelle actuelle avant de s'intéresser aux instruments de régulation et à l'organisation financière du système. Pour conclure, il propose une analyse critique de certaines des réformes en cours, en soulignant que l'Angleterre peut être une source d'inspiration pour d'autres pays cherchant à réformer leur système de santé. Toutefois, le système de santé anglais traverse actuellement une période de fortes turbulences, de nombreux éléments de son mode de financement étant en cours de redéfinition. Ces transformations rendant l'évaluation de l'impact des réformes difficile, nombre des conclusions présentées ont inévitablement un caractère hypothétique.

Social scientific theories frequently posit that multiple causal mechanisms may produce the same outcome. Unfortunately, it is not always possible to observe which mechanism was responsible. For example, IMF scholars conjecture that nations enter IMF agreements both out of economic need and for discretionary domestic political reasons. Typically, though, all we observe is the fact of agreement, not its cause. Partial observability probit models (Poirier 1980,Journal of Econometrics12:209–217; Braumoeller 2003,Political Analysis11:209–233) provide one method for the statistical analysis of such phenomena. Unfortunately, they are often plagued by identification and labeling difficulties. Sometimes, however, qualitative studies of particular cases enlighten us about causes when quantitative studies cannot. We propose exploiting this information to lend additional structure to the partial observability approach. Monte Carlo simulation reveals that by anchoring "discernible" causes for a handful of cases about which we possess qualitative information, we obtain greater efficiency. More important, our method proves reliable at recovering unbiased parameter estimates when the partial observability model fails. The paper concludes with an analysis of the determinants of IMF agreements.A member shall be entitled to purchase the currencies of other members from the Fund …[provided] the member represents that it has a need to make the purchase because of its balance of payments or its reserve position or developments in its reserves.—International Monetary Fund Articles of Agreement[IMF] negotiations sometimes enable government leaders to do what they privately wish to do, but are powerless to do domestically.—Robert Putnam (1988, p. 457)

This article focuses on the narrative identity dilemmas of four men who have experienced spinal cord injury (SCI) through playing rugby football union and now define themselves as disabled. The biographical data illustrate how body-self relationships moved from an absent presence in the lives of these men to something that was other, problematic, and alien. This transformation instigated anxieties concerning the combined loss of specific masculine and athletic identities that were formerly at the apex of the participants' identity hierarchy. In such circumstances, the desire for a restored self is highlighted, as are the limited narrative resources that frame this coping strategy. Suggestions for how this situation might be changed are then offered.