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The Congressional Record is the official record of the proceedings and debates of the United States Congress. It is published daily when Congress is in session. The Congressional Record began publication in 1873. Debates for sessions prior to 1873 are recorded in The Debates and Proceedings in the Congress of the United States (1789-1824), the Register of Debates in Congress (1824-1837), and the Congressional Globe (1833-1873)
As more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists.
Foreword p. xi Preface to the Fifth Edition p. xix Preface to the First Edition p. xxvii Biographical Note p. xxxiii Chapter 1 Budgeting as Conflicting Promises p. 1 Budgets Are Conflicting Commitments p. 7 Tax Preferences p. 11 Appropriations: The Power of Congress and Power Within Congress p. 13 The President Is Both Rival and Partner of Congress p. 16 Conflicting Promises: The Multiple Meanings of Budgetary Control p. 19 Chapter 2 Budgets as Struggles for Power: A Historical Perspective p. 25 Colonial Origins p. 26 Turning Points: Civil War through World War I p. 30 The Executive Budget Movement p. 33 Dislocation and Continuity: Depression and War p. 40 Chapter 3 The Dance of the Dollars: Classical Budgeting p. 42 Calculations p. 44 Complexity p. 44 Aids to Calculation p. 45 Incremental Budgeting p. 46 Roles and Perspectives p. 50 The Agency p. 50 The Bureau of the Budget p. 54 The Appropriations Committees p. 56 Strategies p. 57 Be a Good Politician p. 58 Clientele p. 58 Confidence p. 60 Congressional Committee Hearings p. 62 Strategies Designed to Capitalize on the Fragmentation of Power in National Politics p. 62 Chapter 4 The Collapse of Consensus p. 68 The Growth of Entitlements p. 69 Economic Activism p. 70 Federal Credit p. 71 Priorities p. 72 Impoundment p. 73 The Budget Act: More Checks, More Balances, but Not More Control p. 75 Impoundment Again p. 75 Congressional Budget Office p. 76 Senate Budget Committee and House Budget Committee p. 76 Scheduling p. 76 Resolutions p. 77 Reconciliation p. 78 Complexity p. 78 A Congressional Budget, or Merely More Budgeting? p. 78 The Budget Process, 1975--1979: Making Totals Stick p. 79 Classical Budgeting Withers Without Quite Disappearing p. 81 Chapter 5 The Politics of Dissensus p. 83 Why Budget Decisions Became So Difficult p. 84 The Focus on Totals p. 84 The End of Economic Management p. 85 Dominance of the Deficit p. 86 Polarization of the Parties p. 87 The Congressional Budget Act in the 1980s p. 88 R and R: Resolution and Reconciliation p. 88 Deferral and Rescission Redux p. 90 The Shifting Budgetary Base p. 91 Continuing Omnibus Resolutions p. 92 OMB in an Era of Perennial Budgeting p. 93 Top-Down Policy Making p. 94 Continuous Budgeting p. 94 Negotiating with Congress p. 95 Implications for OMB p. 96 Dissensus in Congress p. 97 Role Reversal p. 97 Rolled on the Floor p. 98 Budgeting Penetrates Congress p. 100 Gimmicks p. 100 Chapter 6 The Politics of Balancing Budgets p. 103 Gramm-Rudman-Hollings p. 105 The Budget Enforcement Act of 1990 p. 106 The Clinton Budget of 1993 p. 108 The Politics of Radical Reversal 1995 p. 111 Prologue: Constitutional Amendment and Rescission p. 112 Budgets and Counterbudgets: The President's Budget and the Congressional Resolution p. 113 Incrementalism in Mirror Image: Appropriations p. 114 Confrontation: Continuing Resolutions and the Debt Limit p. 115 Reconciliation and Intransigence p. 118 The Balanced Budget Act of 1997 p. 120 Chapter 7 Entitlements p. 123 The "Ought" and "Is" of Entitlements p. 124 Entitlements and Budgeting p. 129 How Do Entitlements Start? p. 132 Why Do Entitlements Grow? p. 135 Maintaining Commitment: Social Security p. 136 Escalating Costs: Medicare p. 138 Expanding Eligibility: Medicaid p. 140 Provider Pressures: End-Stage Renal Disease p. 142 How Have Entitlements Been Controlled? p. 144 Declining Need: Black Lung Disease p. 145 Ending an Entitlement: Welfare p. 146 Entitlements and Others p. 148 Appropriations: Head Start and WIC p. 148 Tax Expenditures: Earned Income Tax Credit (EITC) p. 149 Formula Grants to States: Adoption Assistance Program, Individuals With Disabilities Education Act, and the Ryan White Care Act p. 149 Chapter 8 Budgeting for Defense p. 152 Dimensions of Defense p. 153 Defense Strategy and Funding p. 155 The Internal Budget Process p. 161 Planning, Programming, Budgeting p. 161 Acquisitions p. 165 The Congressional Budget Process p. 170 Reprogramming p. 173 Secrecy p. 175 Cuts p. 176 Contingencies p. 179 Chapter 9 Reform p. 181 Norms of Budgetary Behavior p. 181 Forms of Budgeting p. 184 Reform Without Conflict p. 184 The Politics in Budget Reform p. 186 Unit of Measurement: Cash or Volume p. 187 Time Span: Months, One Year, Many Years p. 188 Calculation: Incremental or Comprehensive p. 189 Management Reforms p. 191 Performance and Budgeting p. 191 Centralization and Decentralization: The Role of OMB p. 193 Credit Reform p. 195 Financial Management p. 196 Capital Budgeting p. 197 Limits p. 198 The Line-Item Veto p. 200 Chapter 10 From Surplus to Deficit p. 205 The Disappearing Deficit p. 205 The Politics of Budget Surplus p. 208 The End of the Surplus p. 212 Afterword p. 219 Characteristics of the Budget Process p. 219 The Budgetary Process Is Powerful Yet Impotent p. 220 The Budgetary Process Is Structured Yet Formalistic p. 220 The Budgetary Process Is Complex Yet Segmented p. 221 Budgetary Politics Are Polarized but Moderated p. 223 Glossary p. 225 Guide to Acronyms p. 230 Select Bibliography p. 231 Credits p. 245 Index.
Telemedicineâ€"the use of information and telecommunications technologies to provide and support health care when distance separates the participantsâ€"is receiving increasing attention not only in remote areas where health care access is troublesome but also in urban and suburban locations. Yet the benefits and costs of this blend of medicine and digital technologies must be better demonstrated before today's cautious decision-makers invest significant funds in its development. Telemedicine presents a framework for evaluating patient care applications of telemedicine. The book identifies managerial, technical, policy, legal, and human factors that must be taken into account in evaluating a telemedicine program. The committee reviews previous efforts to establish evaluation frameworks and reports on results from several completed studies of image transmission, consulting from remote locations, and other telemedicine programs. The committee also examines basic elements of an evaluation and considers relevant issues of quality, accessibility, and cost of health care. Telemedicine will be of immediate interest to anyone with interest in the clinical application of telemedicine.
We shall examine the validity of 16 experimental designs against 12 common threats to valid inference. By experiment we refer to that portion of research in which variables are manipulated and their effects upon other variables observed. It is well to distinguish the particular role of this chapter. It is not a chapter on experimental design in the Fisher (1925, 1935) tradition, in which an experimenter having complete mastery can schedule treatments and measurements for optimal statistical efficiency, with complexity of design emerging only from that goal of efficiency. Insofar as the designs discussed in the present chapter become complex, it is because of the intransigency of the environment: because, that is, of the experimenter’s lack of complete control.