美國前總統歐巴馬於2010年簽署之法案「病人保護暨可負擔醫療法」（Patient Protection and Affordable Care Act, PPACA）又稱「歐巴馬醫療法」（Obamacare），主要目的之一在於提升對人民醫療照顧的保障，擴大人民的醫療照顧覆蓋面，並讓醫療保險成為可負擔的，具體改革面向主要在公共醫療照顧的範圍擴大、對人民強制納保規定，與對於商業醫療保險之各種規制，而從歐巴馬醫療法內容中，得以探討美國如何在維持既有醫療照顧體系架構、商業醫療保險為主導的模式中，透過對商業醫療保險的規制來成就相當於社會保險所實現的社會安全，並與我國作比較，雖然主要採取之醫療照顧模式不同，但同樣在促成全民納保的社會國目的之達成，兩國背後的立法背景、操作上有何異同，以及會遇到之爭議與困境何在，並且進一步思考是否有讓我國在處理目前制度問題的值得參考之處。 本文先論述美國傳統對於醫療照顧的心態與背景，並介紹美國的醫療照顧制度與衍生的問題，並從中了解醫療照顧之相關權利、全民納保觀念在美國的發展狀況，接著介紹歐巴馬醫療法的發展過程與實際內容，聚焦在擴大醫療照顧覆蓋面與令醫療保險成為可負擔之相關規定，並了解幾個重要的聯邦最高法院對歐巴馬醫療法之違憲審查判決中對爭議的處理，之後觀察歐巴馬醫療法如何透過對商業醫療保險的規制來讓其能成就社會安全功能，並追蹤後續歐巴馬醫療法實施後之成效與未來可能變化。對照我國，在介紹我國全民健康保險之發展與內容後，比較兩國在促成全民納保的背景、立法與釋憲過程中的爭議為何且如何處理、全民納保的操作內容，以及醫療照顧相關權利的承認與否、商業醫療保險的角色等，也從中討論是否有我國在解決現今全民健保之問題上可參考之面向。

South Africa has a social housing delivery problem, where, despite all mechanisms, efforts and resources (including policies, enabling legislation and social housing production inputs such as planning regimes, guidelines and strategies, funding, land, buildings and human resources put in place by the government), the pace of social housing delivery is not at a point where it is measurably satisfactory across all spheres of government. There exists between the three spheres of government an intergovernmental relations framework for implementing social housing policy. The performance of government shows a lack of institutionalized arrangements, coordination, and alignment in the day to-day operations of the three spheres of government in implementing social housing policy. It is for this reason that this study assessed the current intergovernmental relations operational system in the delivery of social housing units in Gauteng Province. A mixed-methods research approach was implemented for this study based in methodological pragmatism, phenomenology, and positivism. The researcher conducted interviews with senior managers and administered research questionnaires with operational staff within the National, Provincial and Local spheres of government which included City of Tshwane, City of Johannesburg and Ekurhuleni Metropolitan municipalities in Human Settlements Departments, state agencies involved in the delivery of social housing units such as the Social Housing Regulatory Authority and municipal entities such as the Housing Company Tshwane, the Johannesburg Social Housing Company and the Ekurhuleni Social Housing Company. Private and non-governmental social housing institutions, such as the Yeast City Housing and Mannapendlo Social Housing Organisation were also included. The data were complemented by documentary content analysis, including review of annual reports, strategic human settlements plans, policies and legislation pertaining to the provision of housing, human settlements, and social housing. This study assessed the functioning of the three spheres of government in relation to the implementation of social housing policy in Gauteng Province. The three spheres of government are regarded as equally important institutions for the development of sustainable human settlements, and a sound relation between the three spheres of government must be maintained in order to achieve successful development and management of social housing. The research found evidence of poor coordination and alignment, and no integration of social housing related activities and functions between the three spheres of government. There are major risks, such as financial risk, financial planning, and project implementation risks experienced at local government level. The study identified challenges faced by the three spheres of government and state agencies in the implementation of social housing policy in Gauteng Province. The challenges included slow release of land for social housing development, uncoordinated and unplanned social housing delivery in the province. In addition, the study identified other input factors that impact negatively on the supply of social housing units which cut across all spheres of government such as political mandates, legislation, policies, strategies, plans, targets, priorities, information technology and administrative and financial constraints. The study presented and recommended social housing delivery model for Gauteng Province. The proposed model has the probability of providing an understanding of the relations between government departments, state agencies, social housing institutions, intergovernmental relations structures at national, provincial and local government level, non-governmental organizations, and community based organizations, so as to ensure there is vertical and horizontal alignment to improve and fast track the delivery of social housing in Gauteng Province. / Public Administration and Management / D. Phil (Public Administration)

Indiana University-Purdue University Indianapolis (IUPUI) / The Catholic Church is widely known for its opposition to birth control. Yet statistics show that the vast majority of American Catholics use birth control. While multiple studies have been conducted on a larger quantitative scale about the use or attitudes of American Catholics toward birth control, there have not been qualitative studies to understand the experiences of Catholics who use contraception. This study is particularly timely given the recent Catholic opposition to the Affordable Care Act’s mandate of employee healthcare provided birth control as well as, the extraordinary synod of bishops to discuss pastoral challenges to family life in October 2015. Fourteen married Catholic women were interviewed about their religious identities and experiences using contraception. Analysis demonstrated how these women constructed a religious identity by maximizing certain aspects, such as prayer and service, while minimizing other aspects, such as individual autonomy and denominational distinctions, of their religious identity. However in order to cope with the tension between their salient religious identity and their contraceptive decision making women utilizing multiple mechanisms. Specifically, they made boundaries around which types of contraception were acceptable and limits to church or individual authority; they justified their decisions based on medical necessity or betrayal they felt from the church; they legitimated their decisions by discussing God’s control and their husband’s perceptions of NFP; and they normalized their decisions through their desire to care for their children and be sexually intimate with their husbands. This research illuminates unique challenges that religious women face in their sexual decision making and sexual health practices that can help sex educators and health care providers care for women. Additionally, the Catholic Church and American Catholics make up huge forces in education, health care, charity, politics, and employment. However, not all Catholics follow the rules of the church. Those members who remain an active part of the Catholic Church, such as the practicing Catholics in this study can influence the way the church changes. By better understanding the experience of these dissenters, social researchers may be able to better understand the future of the Catholic Church.

Balansen mellan utbud och efterfrågan av bostäder har inverkan på olika gruppers möjligheter till att etablera sig på bostadsmarknaden. Trots att det byggs mer än på länge i Stockholmsregionen så tyder ändå mycket på att det blivit svårare för resurssvaga grupper att hitta bostäder. I studien framgår att nyproduktionen av bostäder inte svarar mot de bostadsbehov som finns och att arbetet med bostäder för resurssvaga grupper inte tycks stå särskilt högt upp på agendan. Frågan har uppmärksammats av flera aktörer och anses vara en av de största utmaningarna på bostadsmarknaden.  Den här studien strävar efter att undersöka vilka möjligheter som finns för kommunerna att skapa förutsättningar för en jämlik bostadsmarknad i Stockholms län genom att lyfta det regionala perspektivet inom samhällsplanering och på så sätt skapa förutsättningar för en hållbar region. Mer specifikt så avser studien att främja nybyggnation av billiga bostäder, främst i form av subventioner genom kommunal markpolitik, i syfte att underlätta möjligheterna för resurssvaga hushåll till att etablera sig på bostadsmarknaden. Tre kommuner i länet har undersökts i denna kvalitativa studie. Empirin bygger på semistrukturerade intervjuer med tjänstepersoner från dessa kommuner samt en dokumentstudie av kommunala policydokument. Slutsatsen är att det finns en diskrepans mellan utbudet och efterfrågan på bostadsmarknaden, när det kommer till bostäder för resurssvaga grupper. Hur kommunerna arbetar med att komma tillrätta med detta varierar, dels i form av generella insatser vilka strävar efter ett högt kvantitativt byggande, eller särskilda insatser som strävar efter att pressa produktions- och boendekostnader. Att generella insatser användes mer frekvent bland de kommuner som undersöktes i denna studie, i kombination med att boendekostnader problematiseras i mycket liten omfattning, ger intrycket av att nybyggnation inte är ett realistiskt alternativ för resurssvaga grupper och att tilltron till flyttkedjor således är mycket hög. Även om det framkom kritik mot de särskilda insatserna som sker i kommunerna, vilket grundar sig i att enkla boendelösningar med låga byggkostnader inte nödvändigtvis behöver leda till lägre boendekostnader, så kan ändå ett kontinuerligt tillskott av sådana bostadslösningar bidra till att priser och hyror på bostadsmarknaden hålls nere på längre sikt. Både det teoretiska och empiriska materialet visar på ett samband mellan produktionskostnader av bostäder och boendekostnader men om byggande av bostäder ska subventioneras är det viktigt att säkerställa att detta sker till rätt hushåll. Därför finns det skäl till att kombinera subventioner med olika former av klausuler som försäkrar kommunen mot att systemet utnyttjas. Detta ökar förmedlingsfrågornas betydelse. / The balance between supply and demand of housing has an impact on the ability of different groups to establish themselves in the housing market. Even though housing construction has the highest levels in many years, there are clear indications that it has become more difficult for low-income households to find housing. This study shows that new housing construction does not correspond to the current housing needs and that housing for low-income households does not appear to be on the planning agenda. The issue has been highlighted by several stakeholders in the housing market and housing for low-income households is considered to be one of the biggest contemporary challenges of the housing market. This study aims to investigate the possibilities for the municipality to create conditions for an equal housing market in the Region of Stockholm, by raising the regional perspective in planning and create conditions for a sustainable region. More specifically, the study aims to facilitate the construction of cheap housing, primarily in the form of subsidies through municipal land policy, in order to promote housing for low-income households in the housing market. Three municipalities in the region have been investigated in this qualitative study. The empirical material is based on semi-structured interviews with municipal officials from these municipalities, backed up by a document study of municipal policy documents. The conclusion is that there is a discrepancy between supply and demand in the housing market, when it comes to housing for low-income households. How the municipalities work to address this varies and can be divided into general efforts, that aim for high-quantitative construction or special efforts aimed at reducing production- and housing costs. The fact that general efforts were used more frequently among the municipalities surveyed in this study, coupled with the fact that housing costs are problematised to such a small extent, gives the impression that new construction is not a realistic alternative for low-income households, and thus that the reliance on chains of residential mobility are very high. Although there is a criticism of the special efforts that take place in the municipalities, which is on the fact that simple standard housing solutions with low construction costs do not necessarily have to lead to lower prices/rents, yet a continuous addition of such housing solutions can keep prices and rents in the housing market down in the longer term. Both the theoretical- and empirical material shows a correlation between production costs and housing prices, however if housing is to be subsidised it is important to ensure that it is directed to the intended households. Therefore, there is a reason to combine subsidies with different forms of clauses that assure the municipality against misuse of the system. This increases the importance of the distribution of housing.

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This item contains the agenda, minutes, and attachments for the Faculty Senate meeting on this date. There may be additional materials from the meeting available at the Faculty Center.

This item contains the agenda, minutes, and attachments for the Faculty Senate meeting on this date. There may be additional materials from the meeting available at the Faculty Center.