The authors assume that costs can no longer be contained in the United States health care system and that the present system cannot be sustained beyond the near future. Three of the authors are affiliated with an applied economic research and consulting firm, and the fourth is president of the Healthcare Financial Management Association. They are trained in business and city planning. The bibliography lists articles from such journals as Hospitals, Business & Health, Business Insurance, and Medical Economics.

The book is directed to members of hospital governing boards and other hospital administrators, but it will be of interest to students of health policy. Part I highlights tensions between what the authors call the worlds of doctors and hospital administrators struggling to survive, on the one hand, and health care planners worried about spiraling costs on the other. Part II contains five chapters that suggest reasons for growing costs and that criticize cost shifting as a remedy.

In Part III the authors evaluate alternative health care systems by presenting four future scenarios: incremental change, universal access, consumer choice model, and single payer system. In these chapters they also approach the fundamental purpose of the book—to “help physicians, hospitals, and health plans take the next steps to position themselves for the future.” While not highly analytical, the book is a readable and thoughtful supplement to more abstract critiques of the impact of today's health care system on distributive justice.

In 1996, the U.S. Fish and Wildlife Service made a proposal to restore and preserve 30,000 acres of wetlands in Indiana's Kankakee River basin. Local farmers opposed this, expressing concerns about how a wildlife refuge would affect farming communities along the Kankakee River. Undergirding what seems to be a simple conflict between incompatible environmental and economic interests is a more fundamental conflict between competing ethical frameworks for evaluating public policy. One helpful approach is to examine the normative issues in the Kankakee dispute in terms of the contrast between consequentialist and non-consequentialist ethical frameworks. This article attempts to establish that a failure to recognize alternatives to the consequentialist framework has resulted in a failure of opposing parties to recognize and address each other's ethical concerns. An analysis of the Kankakee wetlands dispute will reveal why it is important for environmentalists to be cognizant of alternatives to consequentialist ethical frameworks.

We introduce the Politics and the Life Sciences special issue on Psychophysiology, Cognition, and Political Differences. This issue represents the second special issue funded by the Association for Politics and the Life Sciences that adheres to the Open Science Framework for registered reports (RR). Here pre-analysis plans (PAPs) are peer-reviewed and given in-principle acceptance (IPA) prior to data being collected and/or analyzed, and are published contingent upon the preregistration of the study being followed as proposed. Bound by a common theme of the importance of incorporating psychophysiological perspectives into the study of politics, broadly defined, the articles in this special issue feature a unique set of research questions and methodologies. In the following, we summarize the findings, discuss the innovations produced by this research, and highlight the importance of open science for the future of political science research.

When people speak, they gesture. However, is the audience watching a speaker who is sensitive to this link? We translated the body movements of politicians into stick-figure animations and separated the visual from the audio channel. We then asked participants to match a selection of five audio tracks (including the correct one) with the stick-figure animations. The participants made correct decisions in 65% of all cases (chance level of 20%). Matching voices with animations was less difficult when politicians showed expansive movements and spoke with a loud voice. Thus, people are sensitive to the link between motion cues and vocal cues, and this link appears to become even more apparent when a speaker shows expressive behaviors. Future work will have to refine and validate the methods applied and investigate how mismatches between communication channels affect the impressions that people form of politicians.

Within the next two decades, the elderly population in the United States will reach its zenith, comprising 73 million individuals, 20 percent of the nation, the baby boomers’ final surge. The process of their dying may become contentious. Should policymakers and bioethicists be satisfied with our current approach to dying, or should they begin now to reconceptualize it? We distill end-of-life discussions in the bioethics literature and popular press, paying particular attention to physician-assisted suicide and its uptake where legal. Evidence so far indicates that few of the dying opt for this alternative, suggesting that its role in assuring “death with dignity” cannot be, as may have been hoped, a leading one. The end-of-life literature on the whole lends credence to the fear that most of the dying, along with their families and physicians, will muddle through a morass of uncoordinated options, with futile medical intervention the most prominent outcome — despite more palliative strategies, such as home hospice care, being favorably described. We found no reason to recommend persistence in our current approach to dying and found good reason to urge early, conscientious, and thoroughgoing reconceptualization in policy and practice as well as in theory.

This article proposes an interactional model in which individuals may actively seek suitable environments. Rejecting either a hereditarian or an environmentalist emphasis, this approach recognizes that both genetic endowment and social background determine the mobility of the individual. The article treats the following five topics: the basic biosocial assumptions underlying the interaction model; the operation of self-selection as an integral part of this model; the capacity of individuals to envision alternative environments; an examination of three basic genotype-environment interactions; the political ramifications of these interactions both on an individual and on a societal level.