Congressional Record Research Articles

Political Polarization and the Dynamics of Political Language: Evidence from 130 Years of Partisan Speech

We use the digitized Congressional Record and the Google Ngrams corpus to study the polarization of political discourse and the diffusion of political language since 1873. We statistically identify highly partisan phrases from the Congressional Record and then use these to impute partisanship and political polarization to the Google Books corpus between 1873 and 2000. We find that although political discourse expressed in books did become more polarized in the late 1990s, polarization remained low relative to the late 19th and much of the 20th century. We also find that polarization of discourse in books predicts legislative gridlock, but polarization of congressional language does not. Using a dynamic panel data set of phrases, we find that polarized phrases increase in frequency in Google Books before their use increases in congressional speech. Our evidence is consistent with an autonomous effect of elite discourse on congressional speech and legislative gridlock, but this effect is not large enough to drive the recent increase in congressional polarization.

Nothing Less than War: A New History of America's Entry into World War I

Justus D. Doenecke, best known for his classic study of the anti-interventionists just before World War II (Storm on the Horizon: The Challenge to American Intervention, 1939–1941, 2000), turns his attention here to the domestic controversy leading to American participation in World War I. This is a thrice-told tale, and Doenecke does not aim to break new archival ground. Instead, he offers a comprehensive and elegantly written synthesis of existing scholarship, informed by his own use of the Woodrow Wilson Papers, the Congressional Record, and the contemporary press. In scarcely more than three hundred pages of text, Doenecke chronicles the debates over German and British violations of neutrality that persuaded President Woodrow Wilson to intervene in April 1917—not as an ally, but as a reluctant associate of the entente powers. Graduate students seeking to master the topic quickly will find Doenecke an informed and generally dispassionate guide. In an era when the United States repeatedly sends forces abroad without a formal declaration of war, Wilson's concern for the niceties of neutral rights a century ago seems anachronistic, even quaint. Yet Doenecke confirms the consensus view that, in the American public mind, violations of so-called international law by German submarines and British surface ships loomed larger than either commercial interests or the bonds of sentiment. Although Wilson made a point of not reading the newspapers, he believed in his own genius for leadership and, according to Doenecke, “possessed an uncanny ability to articulate the fears and aspirations of his people” (p. 4). This may be true; still, public discourse and Wilson's interpretation of it remained astonishingly unsophisticated. In retrospect it is astounding that the president stood convinced that “nothing in particular” except a disembodied interlacing of alliances had started the war and that the two sides sought virtually the same objectives (pp. 230, 304).

Private printers and the party press: What went on before the GPO

From the beginning of the federal government, Congress has produced a great deal of paperwork for which it has needed printers. Initially, it turned to private printers in New York, Philadelphia, and Washington, who also produced newspapers that promoted the party in power, a system known as the “party press.” These newspapers also provided the first reporters of debate in Congress, and then collected and compiled the recorded speeches into the Annals of Debate, Register of Debates, and Congressional Globe. At the same time, each presidential administration usually had an “official organ” that carried its pronouncements in return for printing contracts. The old patronage system finally ended with the creation of the Government Printing Office and publication of the Congressional Record.

Under the law, FDA must grant different standards for new dietary ingredients and food additives

The FDA’s draft Guidance on notifications for new dietary ingredients attempts to narrow the scope of “old” dietary ingredients that do not require notification to FDA and repeats some mistakes from the past by going beyond what is required or permitted by the Food, Drug & Cosmetic Act, as amended by the Dietary Supplements Health and Education Act of 1994. The draft Guidance attempts to apply the notification requirement to new supplements, not just new ingredients, and it expands the working definition of “chemically altered” to include many changes that were not foreseen in the Congressional Record in 1994. Through these misinterpretations, FDA attempts to impose a food additives-like safety standard, and gain de facto premarket approval against the overt wishes of Congress.

The Surprising Zionist: Senator Robert A. Taft and the Creation of Israel

In early 1951, the Israeli Knesset Library arranged to dedicate a series of the American Congressional Record to Senator Robert A. Taft, who “was unquestionably a major factor in the shaping of Pre...

Bribery or just desserts? Evidence on the influence of Congressional reproductive policy voting patterns on PAC contributions from exogenous variation in the sex mix of legislator offspring

Evidence on the relationship between political contributions and legislators’ voting behavior is marred by concerns about endogeneity in the estimation process. Using a legislator’s offspring sex mix as a truly exogenous variable, we employ an instrumental variable estimation procedure to predict the effect of voting behavior on political contributions. Following previous research, we find that a legislator’s proportion daughters has a significant effect on voting behavior for women’s issues, as measured by score in the “Congressional Record on Choice” issued by NARAL Pro-Choice America. In the second stage, we make a unique contribution by demonstrating a significant impact of exogenous voting behavior on PAC contributions, lending further credibility to the hypothesis that Political Action Committees respond to legislators’ voting patterns by “rewarding” political candidates that vote in line with the positions of the PAC, rather than affecting those same votes – at least in this high-profile policy domain.

The rise of the federal colossus: the growth of federal power from Lincoln to F. D. R

This challenging book explores the debates over the scope of the enumerated powers of Congress and the Fourteenth Amendment that accompanied the expansion of federal authority during the period between the beginning of the Civil War and the inauguration of Franklin Delano Roosevelt. The Rise of the Federal Colossus: The Growth of Federal Power from Lincoln to F.D.R. offers readers a front-row seat for the critical phases of a debate that is at the very center of American history, exploring such controversial issues as what powers are bestowed on the federal government, what its role should be, and how the Constitution should be interpreted. The book argues that the critical period in the growth of federal power was not the New Deal and the three decades that followed, but the preceding 72 years when important precedents establishing the national government's authority to aid citizens in distress, regulate labor, and take steps to foster economic growth were established. The author explores newspaper and magazine articles, as well as congressional debates and court opinions, to determine how Americans perceived the growing authority of their national government and examine arguments over whether novel federal activities had any constitutional basis. Responses of government to the enormous changes that took place during this period are also surveyed. Numerous citations of the Congressional Record and federal court opinions Scores of articles from magazines, newspapers, and scholarly journals of the period that reveal how Americans of all walks of life perceived the evolution of federal authority A select bibliography listing a wide variety of secondary works ranging from biographies to legal treatises that will aid the reader in further exploring the evolution of American federalism A helpful index that provides access to roles and views of critical figures in the evolution of federal authority during the middle period

1048 PRIDE AND PREJUDICE: MOSES SWICK AND THE DISCOVERY OF INTRAVENOUS UROGRAPHY

You have accessJournal of UrologyHistory of Urology Forum1 Apr 20111048 PRIDE AND PREJUDICE: MOSES SWICK AND THE DISCOVERY OF INTRAVENOUS UROGRAPHY Khurshid Ghani, Uday Patel, and Ken Anson Khurshid GhaniKhurshid Ghani London, United Kingdom More articles by this author , Uday PatelUday Patel London, United Kingdom More articles by this author , and Ken AnsonKen Anson London, United Kingdom More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1084AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Moses Swick was an important member of the team in Berlin that produced Uroselectan, the first non-toxic intravenous contrast medium. Never initially credited for his role in its discovery, he was prevented from presenting his findings to fellow compatriots at the AUA annual meeting in 1930. We studied the life of this unique urologist. METHODS We reviewed original publications and historical records pertaining to Dr Swick found in the archives of the Royal Society of Medicine library, Wellcome Trust History of Medicine library and British Library in London. A Medline search using the terms “Swick”, “Berlin”, “excretory urography” and “contrast medium” was also performed. RESULTS As a Jewish American doctor finding it difficult to obtain postgraduate medical education in the USA, Dr Swick went to Germany at the age of 24. Working with Professor von Lichtenburg in Berlin, he devised and conducted the first animal and human studies using the intravenous contrast material uroselectan in 1929. He was unable to present his breakthrough at the 1930 AUA meeting; the rules stated that an intern could not present a paper. Despite his urgent pleas the honour went to Professor von Lichtenberg who was accepted as the sole originator whilst Swick became to be regarded as a plagiarist. On return to the States in 1931, he worked tirelessly to improve the performance of contrast media. He produced Hippuran, the forerunner to Renograffin. He continued to be shunned by the national and international community until Professor VF Marshall's investigation led to Swick being awarded the Valentine Medal of the New York Academy of Medicine in 1966 after “30 unkind years of heartache and oblivion”. CONCLUSIONS The American Congressional Record regards Swick's work as “one of the five major contributions of an individual to medicine”. His life is a testament to the struggle for scientific integrity and fight against prejudice. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e421-e422 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Khurshid Ghani London, United Kingdom More articles by this author Uday Patel London, United Kingdom More articles by this author Ken Anson London, United Kingdom More articles by this author Expand All Advertisement Advertisement Loading ...

Mortal Citizens and "We the People"

Mortal Citizens and "We the People" Jason Frank (bio) Jacqueline Stevens. States without Nations: Citizenship for Mortals. New York: Columbia University Press, 2010. US $26.50 (paper). US $35.00 (cloth). 364 pages. ISBN: 978-0-231-14876-4 We have given to the frame of polity the image of a relation in blood; binding up the constitution of our country with our dearest domestic ties; adopting our fundamental laws into the bosom of our family affections, keeping inseparable and cherishing with the warmth of all their combined and mutually reflected charities our state, our hearths, our sepulchers, and our alters. —Edmund Burke, Reflections on the Revolution in France1 In the United States, every eight seconds, there is a baby born in America, and it might be an anchor baby and a baby born to an illegal mother…every time a baby is born, an illegal walks across the border into the United States. As our population grows, half of it is an illegal population. —Congressman Steve King (R–IA), Congressional Record, July 17, 20062 Burke's famous invocation of political community patterned on familial relations of intergenerational blood ties and sanctified by religion offers a vivid contrast to the individualistic image repertoire of liberalism, as do Congressman Steve King's less-eloquent diatribes against the threat of Mexican "anchor babies." The diverse and sometimes dissonant traditions of liberal political thought are unified by their common rejection of familial models of public authority and corporatist conceptions of collective identity. Thus, the temple of Locke's social contract is built on the ruins of Filmer's Patriarcha; Kant's legal cosmopolitanism repudiates the collectivist parochialism of national sovereignty; Paine's bourgeois radicalism is elaborated as a rejection of Burke's hierarchical traditionalism; and Mill's utilitarian defense of representative government rebukes the organic cultural nationalism of the nineteenth century. Jacqueline Stevens's provocative new book explodes this familiar portrait by arguing that liberalism has relied upon disavowed principles of patriarchal authority and exclusionary birthright citizenship at every step of its historical development, right up to contemporary debates over US immigration policy in which she has been an outspoken and insightful participant (see her weblog, here). "Nationality, inheritance, and marriage," Stevens writes, "indicate a so-called liberal public's warm embrace of practices inconsistent with the liberal ethos—a form of subconscious hypocrisy" (185). The costs of this hypocrisy, as detailed in the book, are very high indeed: systematic warfare and mass violence, stateless populations without legal protections, vast and growing inequalities of wealth and resources. Cataloguing these terrible costs, Stevens urges "so-called liberals" to live up to their own principles of individualism, equality, and political majoritarianism, no matter how dramatically doing so might conflict with the deep presuppositions that institutionally, conceptually, and affectively organize contemporary political life. States without Nations envisions an alternative political world—one without nations, inheritance, marriage, or landed property—by targeting the complex tangle of laws, policies, and narrative supports that sustain these institutions and sanction the violence and injustice carried out in their name. Within the citizenship rules of every nation, Stevens argues, is a violent and exclusionary nationalism; behind familiar guest worker programs and intestacy laws lurks the death-dealing logic of the internment camp. By elaborating these underlying connections and identifying their common origin in immortalist fantasies of intergenerational kinship communities—the etymological root of "nation," Stevens reminds her readers, is the Latin nasci, meaning "birth" (42)—Stevens hopes to convert readers to a new frame of reference, wherein prevailing forms of political affiliation appear in the same repulsive light as slavery, making the work, among other things, a bracing call for a "new abolitionism" (19). While the book's learned and wide-ranging arguments do not always convince, they invariably inform and provoke, startle and rouse; States without Nations is a stunning work of radical theoretical imagination. The central charge that modern liberalism has historically relied upon what it cannot normatively avow—in various forms of violence and inequality—is a familiar one in contemporary political theory. Political theorists frequently engage arguments detailing the illegality and decision that underwrite the constitutional rule of law, for example, or examine how the...

Congressional ambivalence: the political burdens of constitutional authority

Is the United States Congress dead, alive, or trapped in a moribund cycle? When confronted with controversial policy issues, members of Congress struggle to satisfy conflicting legislative, representative, and oversight duties. These competing goals, along with the pressure to satisfy local constituents, cause members of Congress to routinely cede power on a variety of policies, express regret over their loss of control, and later return to the habit of delegating their power. This pattern of institutional ambivalence undermines conventional wisdom about congressional party resurgence, the power of oversight, and the return of the so-called imperial presidency. In Ambivalence, Jasmine Farrier examines Congress' frequent delegation of power by analyzing primary source materials such as bills, committee reports, and the Congressional Record, Farrier demonstrates that Congress is caught between abdication and ambition and that this ambivalence affects numerous facets of the legislative process. Explaining specific instances of post-delegation disorder, including Congress's use of new bills, obstruction, public criticism, and oversight to salvage its lost power, Farrier exposes the tensions surrounding Congress's roles in recent hot-button issues such as base-closing commissions, presidential trade promotion authority, and responses to the attacks of September 11. She also examines shifting public rhetoric used by members of Congress as they emphasize, in institutionally self-conscious terms, the difficulties of balancing their multiple roles. With a deep understanding of the inner workings of the federal government, Farrier illuminates a developing trend in the practice of democracy. This title presents an in-depth look at Congress's institutional culture of ambivalence.

Commerce and Imagination: The Sources of Concern about International Human Rights in the US Congress

Do members of Congress put human rights concerns on the agenda in response to their constituents’ demands for trade protection? Humanitarian concern may be an important motive, but the normative weight of these issues also makes them a potentially powerful tool for politicians with less elevated agendas. They may criticize the behavior of countries with whom their constituents must compete economically, while overlooking the actions of countries with which their constituents have more harmonious economic relations. This paper tests several hypotheses about the salience of human rights concerns in the politics of US foreign policy using data on congressional speeches during the late 1990s gathered from the Congressional Record . We find evidence that, while humanitarian interests remain an important motive for raising human rights issues, the economic interests of their constituents influence which members of Congress speak out on these questions, and the countries on which they focus their concern.

Presidential Power, the Panay Incident, and the Defeat of the Ludlow Amendment

Presidential Power, the Panay Incident, and the Defeat of the Ludlow Amendment

Presidential War Power in the Deliberative Moment - An Empirical Study of Congressional Constitutional Deliberation and Balance of War Power

This paper examines how congressional deliberation over the constitutionality of a use of force affects the war power relationship between the president and Congress. In particular, it presents empirical data on whether and how Congress exerts its attempts to control presidential war power through deliberation, on the limits of congressional ability to regulate a war, on historical patterns of the presidential unilateral use of force, and on the institutional conditions for good congressional deliberation. My main argument is that congressional deliberation over the constitutionality of a use of force is a primary influence on Congress’s ability to exert its will through the passage of legislation to check the president’s use of force. I focus on congressional floor debates recorded in the Congressional Record (1989-2009) over different use of force events occurring from 1989 to 2003. These incidents are collected from the Correlates of War Project Dataset. I cluster 229 congressional deliberations on the constitutionality of the use of force and bills thereof into 14 military events according to the war timeline depicted by the Correlates of War Project Dataset. In response to the main research question, I present three empirical models. The first empirical model demonstrates that a higher level of congressional deliberation over a use of force influences Congress to impose a higher level of control over presidential war power. The second model demonstrates that as long as Congress imposes control over a military deployment, the president systematically resists that control. Although the second model demonstrates that congressional attempts to check presidential war power cannot prevent the president from taking unilateral military action, I argue that this result suggests that it is even more important for Congress to have better deliberation and to try to impose a check on the president, which can create an unequivocal legal and political accountability for the president. Therefore, I present the third empirical model to demonstrate that congressional rule-setting, including referral of a bill to committee, an adoption of open-rule floor debate, and deliberation over a non-annual budget bill, is the primary factor determining the quality of congressional deliberation.

Truth and opinion in climate change discourse: The Gore–Hansen disagreement

In this paper, I discuss the "inconvenient truth" strategy of Al Gore. I argue that Gore's notion of truth upholds a conception of science and policy that narrows our understanding of climate change discourse. In one notable exchange, Gore and NASA scientist, James Hansen, disagreed about whether scientific statements based on Hansen's computer simulations were truth or opinion. This exchange is featured in An Inconvenient Truth, yet the disagreement is edited from the film and presented simply as an instance of Hansen speaking "inconvenient truth". In this article, I compare the filmic representation of Hansen's testimony with the congressional record. I place their exchange in a broader historical perspective on climate change disputation in order to discuss the implications of Gore's perspective on truth.

The Evolution of the Conservation Movement, 1850-1920, http://lcweb2.loc.gov/ammem/amrvhtml/conshome.html. Created and maintained by the Library of Congress. Reviewed May-June 2009

This astonishingly rich web-based archive captures some of the central issues shaping the American conservation movement from the mid-nineteenth to the early twentieth centuries. Expansive, like its subject, the Web site draws on the voluminous records at the Library of Congress (loc), linking readers to “62 books and pamphlets, 140 Federal statutes and Congressional resolutions, 34 additional legislative documents, excerpts from the Congressional Globe and the Congressional Record, 360 Presidential proclamations, 170 prints and photographs, 2 historic manuscripts, and 2 motion pictures.” This multimedia array of primary sources and the accompanying “critical thinking” exercises provide a wide-angle perspective on the federal government's commitment to conservation and what the site editor Jurretta Jordan Heckscher calls the “generative cultural milieu” that nurtured the conservationist ethos. First, some caveats: for all of its range, The Evolution of the Conservation Movement does not include key data in the loc archives. As...

Making Deliberation Cooler

Making Deliberation Cooler Lynn M. Sanders (bio) What better time than the summer of 2009 for James Fishkin's newest book to arrive on the scene?1 Our hot August featured one raucous town hall meeting after another, generating several arrests; members of Congress hung in effigy; a reported death threat against North Carolina Democratic Representative Brad Miller; and—last but not least—a vow by the longest serving Representative in the House, Michigan Democrat John Dingell to talk happily about health care except with anyone who wanted to "demagogue the discussion." Lest you think as I did at first that Dingell had indulged in verbing—changing a noun into a verb—know that the Oxford English Dictionary already considers "demagogue" a verb, though chiefly one in the U.S., citing some usage from the 1897 Congressional Record. Speaking of distinctive American inventions: for some years now—almost a quarter century, in fact—James Fishkin has spearheaded an ambitious project to marry the modern science of opinion polling with the ideal of democratic discussion rooted, at least in our imaginations, in the Athenian polis.2 This combination of ancient ideal and modern technology creates an institutional framework for "deliberative democracy," a familiar term that Fishkin reserves for the quite rare conjunction of actual political equality and "good" conditions for the development of "thoughtful" opinions. Fishkin aims to make this conjunction of egalitarianism and thoughtfulness a more regular occurrence, via an invention called Deliberative Polling.3 When the People Speak is the latest formal enunciation of this new methodology. It is not Fishkin's first book on the topic, but it is the most theoretically ambitious and comprehensive one to date.4 The project of Deliberative Polling has already succeeded impressively in terms of frequency. When the People Speak includes a chart detailing the Deliberative Polls conducted between 1994 and 2008: there have been scores of them already, in twenty-seven countries and on the Internet, and the numbers are building. Yet this burgeoning empirical record is available via other media;5 Deliberative Polling is widely covered by news outlets. So why write an old-fashioned, university press book about Deliberative Polling? Fishkin's primary aim is normative and philosophical. This is a book about the democratic theory of "deliberative democracy," interlocuted with evidence from deliberative polling. The main point though is the normative rationale. (He notes that more empirical discussions of the findings from deliberative polling, generated with his collaborator Robert Luskin, will be presented later.) Philosophically, Fishkin buttresses the normative argument with the received wisdom of political thinkers, especially the American Founders. As we would expect in a book with the word deliberation in its subtitle, Habermas is invoked here, but not nearly as often as are the authors of the Federalist Papers, Madison in particular. This is because Fishkin, like the Federalists, is a proponent of the power of institutional design. And he is, like other institutional designers, a reformer. This raises the question: what is the object of the reform? The Deliberative Poll is indisputably a clever idea, but its real power emerges not from its cleverness but from how it compares to, and might improve upon, what else is on offer as a mechanism for discovering public opinion. To qualify as democratic, deliberations must meet egalitarian standards.6 To qualify as deliberative, opinion must be generated under "good" conditions conducive to thoughtfulness and characterized by balanced consideration of alternative information and perspectives. To both ends, deliberative democracy needs to be a well-managed, safe encounter, so that it will not discourage, and will motivate to participate, the ordinary citizens who do not already feel driven to express their intense political views. Not surprisingly for such a long-standing and substantial enterprise as Deliberative Polling, exactly which aspects of deliberative democracy Fishkin advertises as most improving—better thinking via "good conditions," fuller participation in deliberation of more representative citizens, or better managed, less raucous public encounters—has shifted over time. Originally, Fishkin adopted and attempted to respond to the worries emerging from the tradition of political behavior research, from students of public opinion and voting led by Philip Converse. When the People Speak not only still addresses...

How to Analyze Political Attention with Minimal Assumptions and Costs

Previous methods of analyzing the substance of political attention have had to make several restrictive assumptions or been prohibitively costly when applied to large‐scale political texts. Here, we describe a topic model for legislative speech, a statistical learning model that uses word choices to infer topical categories covered in a set of speeches and to identify the topic of specific speeches. Our method estimates, rather than assumes, the substance of topics, the keywords that identify topics, and the hierarchical nesting of topics. We use the topic model to examine the agenda in the U.S. Senate from 1997 to 2004. Using a new database of over 118,000 speeches (70,000,000 words) from the Congressional Record, our model reveals speech topic categories that are both distinctive and meaningfully interrelated and a richer view of democratic agenda dynamics than had previously been possible.

Congress and freedom of information: A retrospective and a look at a current issue

When Congress refined and finally enacted the Freedom of Information Act during the mid-1960s, there were various reasons why this new law was not made applicable to the Senate and the House of Representatives. One of these was the long and impressive congressional record of publishing information regarding the activities and operations of the House, the Senate, and their officers and committees. There has been of late, however, evidence of some lapses in this tradition. Moreover, the availability to the public of the reports of the Congressional Research Service has also recently become a heightened issue. These matters are examined in this overview.

Geriatric Education Today: Studies From a University Hospital

Are we prepared to meet current challenge of caring for an aging population? The current national conversation suggests that we are not, that we are not training geriatricians in sufficient numbers to meet needs of aging postwar generation, and that quality of care we now provide to elderly patients could be greatly improved (Zingmond, Wilber, MacLean, & Wenger, 2007). In fact, history of aging in America prompts this question: Has our nation ever been willing to provide goodquality care for elderly? During first two centuries of European settlement in America, older persons accounted for less than 2% of population (Fleming, Evans, & Chutka, 2003). Survival beyond seventh decade remained rare into late 19th century, reflected in only modest growth of their numbers. The pace of industrialization during this period led to a new social order that included a new concept of age. Ironically, while well-being of elderly improved through industrialization and technological expansion and their numbers increased, view of old age as a period of obsolescence or even ill health gained currency as age-based education, employment, retirement, and social welfare became norm. Longevity and comfort in old age have been historically experience of wealthy. Failure to save sufficiently for retirement, let alone for catastrophic care, is not an invention of a profligate babyboomer generation. By eve of World War II, vast majority of elderly lived in poverty, and medical costs had become a significant source of dependency in old age. Certainly, Depression had a profound influence on extent of poverty among aging, but provision for support and care in later life had always been viewed as an individual rather than a societal responsibility. The commonly held view equated failure of breadwinners to provide for themselves and their families with moral or character failure. Whether led by Tom Paine, Theodore Roosevelt, Franklin Roosevelt, or trade union movement, efforts to provide assurnce of health care in old age have succumbed to opposition from disparate political and professional interest groups. MEDICARE AND MEDICAID Before passage of Older Americans Act ( Congressional Record, 1965), which mandated Medicare and Medicaid more than 40 years ago, burden of care for elderly lay on their own shoulders and on hospitals and other providers that assumed care. Since then, Medicare has become a $200-billion-per-year enterprise and remains at center of an enduring political struggle in United States over redistribution of wealth (Vladeck, 1999). Federally financed old-age health insurance became politically viable in 1960s in part because of a growing elderly population with mounting political impact. Despite highly publicized aging of America and projections of lax preparation for coming crisis, the debate increasingly consists of high-sounding arguments cloaking relatively narrow, traditional regional and local issues ( Vladeck, 1999, p. 34). The repercussions of decisions made by state and federal governments affect well-being of Medicare beneficiaries and in fact entire architecture of health care system. Politics at local, state, and federal levels plays a major role in process of dividing and distributing a very large pie. Lobbyists from all corners of medical-industrial complex advocate vigorously for their particular stakeholders. There is little question that programs have dramatically improved health status of older and indigent Americans, but with progress has come a big dose of scandal, greed, and corruption that has done little to promote appeal of an expansion of benefits among key political constituencies. Clinicians generally accept that a thorough understanding of patient's history is essential to process of developing a differential diagnosis and achieving best outcome for patients. …

Schatzberg Met Disclosure Requirements, Stanford Says

Schatzberg Met Disclosure Requirements, Stanford Says