Planos de saúde e envelhecimento populacional: um modelo viável?

O presente trabalho versa sobre a relação presente e futura dos planos de saúde com os idosos. Tem como pressupostos iniciais a existência de uma janela demográfica de oportunidades que será encerrada, conforme estimativa do IBGE, em 2020 e o fato de o modelo de atenção à saúde por planos de saúde se encontrar em expansão. Diante da realidade de envelhecimento populacional, pergunta-se: Os planos de saúde são um modelo viável para a garantia da atenção à saúde dos idosos? As respostas a essa questão foram construídas adotando-se como método de trabalho a análise de doutrina, jurisprudência, legislação e, quando necessário, fontes não tradicionais do Direito como os dados de órgãos de pesquisa demográficos e econômicos, a imprensa e as associações setoriais. Inicialmente tratou-se do funcionamento do setor de planos de saúde, desde a sua origem, indicando-se que historicamente sempre manteve uma relação simbiótica com o Estado, em especial com os recursos públicos. Para tanto, foram explorados temas como o ressarcimento ao SUS, o uso da estrutura dos hospitais públicos pelos planos de saúde e a existência de subsídios, abatimentos e outras formas de financiamento público das atividades deste setor. No capítulo seguinte se detalhou a questão do envelhecimento populacional, apresentando-se a legislação pertinente, os dados que revelam a composição presente e estimada da população brasileira, os principais problemas de saúde que afetam os idosos e os impactos da mudança de perfil demográfico para a política de saúde. No capítulo 3 evidenciou-se a já problemática relação dos planos de saúde com os idosos, permeada por discriminações na contratação, cobrança de mensalidades proibitivas e reajustes expulsivos, presença de cláusulas abusivas em contratos antigos, judicialização dos reajustes por mudança de faixa etária e conflitos decorrentes da prevalência da contratação na forma coletiva. Por fim, no derradeiro capítulo concluiu-se que o modelo de planos de saúde não é viável para a garantia da atenção à saúde do idoso, sendo urgente que haja uma discussão sobre qual modelo de saúde o país deseja sob pena de que as conquistas decorrentes da afirmação da saúde como direito fundamental se percam. Há características inerentes ao setor que o aparta dos idosos e, portanto, da nova realidade demográfica do país, como a prática da seleção de risco, a cobrança de mensalidades com preços insustentáveis para os idosos, o foco no modelo curativo de atenção à saúde e o afastamento da prevenção. Por outro lado, o cenário se agrava por conta das recorrentes falhas na regulação e na regulamentação, e pelo tratamento cindido, na prática, da política de saúde como se não fosse una e não devesse funcionar em harmonia, independentemente da fonte de financiamento. Há, portanto, um alto risco de que a situação dos idosos nos planos de saúde se torne insustentável, dando margem a medidas imediatistas ampliadoras dos subsídios públicos aos planos de saúde. A contrarreforma sanitária, entendida como o retrocesso das ações e dos serviços de saúde ao modelo anterior à Constituição Federal, é um perigo a ser considerado e combatido.

Estrutura organizacional e das tomadas de decisão em Clubes Socioesportivos de São Paulo

As Organizações chamadas de Clubes Sócioesportivos mantém um modelo de administração que as caracteriza, que é a gestão realizada por voluntários e apoiada por gestores profissionais. A literatura aponta que a estrutura organizacional de entidades esportivas é peculiar, especialmente em clubes de futebol, onde persiste a fronteira entre os gestores voluntários que representam o poder executivo e legislativo e os gestores profissionais que são os que controlam e executam o planejamento financeiro e de atividades. No entanto são escassos estudos voltados a Clubes Sócioesportivos. O objetivo do presente estudo foi de identificar, descrever e comparar aspectos do processo de gestão da área de esportes de Clubes Sócioesportivos e analisa-los à luz de teorias e modelos administrativos. A pesquisa teve abordagem qualitativa, sendo realizado estudo de campo junto a seis clubes sócioesportivos da cidade de São Paulo. Para tanto, foram construídos e aplicados dois instrumentos: questionário e entrevista semiestruturada junto aos gestores de esporte das entidades. As informações obtidas foram analisadas comparativamente entre as entidades. Verificou-se que os Clubes utilizam modelos administrativos tradicionais com desenhos organizacionais. O planejamento destas organizações é baseado estritamente no orçamento anual, não havendo um planejamento plurianual ou estratégico. A tomada de decisão tem como alicerce a experiência pessoal do gestor voluntário, apoiada na vivência do gestor profissional. Não foram encontradas técnicas apuradas de tomada de decisão. As decisões mais importantes quanto a administração do Clube mantém um rito de preocupação com as responsabilidades. Os recursos humanos são selecionados pelo gestor profissional com o aval do gestor voluntário mantendo uma linha de contratação coerente e que está voltada a atender as demandas do Clube. Conclui-se que os Clubes estudados apresentam poucos aspectos diferentes do tradicional nas suas administrações, mantém uma estrutura organizacional própria, e os processos de tomada de decisões na área de esportes são fortemente vinculados ao planejamento financeiro

BigLaw Identity Capital: Pink and Blue, Black and White

This Article advances a new capital framework for understanding the bargain between large law firms and their lawyers, depicting BigLaw relationships not as basic labor-salary exchanges but rather as complex transactions in which large law firms and their lawyers exchange labor and various forms of capital — social, cultural, and identity. First, it builds on the work of Pierre Bourdieu regarding economic, cultural, symbolic, and social capital by examining the concepts of positive and negative capital, exploring the meaning of capital ownership by entities, and developing the notion of identity capital — the value individuals and institutions derive from their identities. Then, the Article advances a capital theory of BigLaw, in which large law firms and their lawyers engage in complex transactions trading labor, social, cultural, and identity capital for economic, social, cultural, and identity capital. Capital analysis sheds new light on the well-documented and troubling underrepresentation of diverse lawyers at BigLaw. It shows that the underrepresentation of women and minority lawyers is not solely the result of exogenous forces outside the control of large law firms such as implicit bias, but rather the outcome of the very exchanges in which BigLaw and its lawyers engage. Specifically, large law firms take into account the capital endowments of their lawyers in making hiring, retention and promotion decisions, and derive value from their lawyers’ capital, for example, by trading on the identity of women and minority lawyers in marketing themselves as being diverse and inclusive to clients and potential recruits. Yet, while BigLaw trades for the identity capital of women and minority lawyers, it fails to offer them opportunities in return to acquire the social and cultural capital necessary for attaining positions of power, resulting in underrepresentation. Moreover, these labor-capital exchanges are often implicit and made by uninformed participants, and therefore unjust. Exactly because the capital framework describes the underrepresentation of diverse lawyers at BigLaw as an endogenous outcome within the control of BigLaw and its lawyers, however, it is a cautiously optimistic model that offers hope for greater representation of diverse lawyers in positions of power and influence. The Article suggests policies and procedures BigLaw can and should adopt to improve the quality of the exchanges it offers to women and minority attorneys and to reduce the underrepresentation of diverse lawyers within its ranks. Employing the concepts of capital transparency, capital boundary, and capital infrastructure, it demonstrates how BigLaw can (1) explicitly recognize the roles social, cultural, and identity capital play in its hiring, retention and promotion apparatuses and (2) revise its policies and procedures to ensure that all of its lawyers have equal opportunities to develop the requisite capital and compete on equal and fair terms for positions of power and influence.

The Jewish Law Firm: Past and Present

The rise and growth of large Jewish law firms in New York City during the second half of the twentieth century was nothing short of an astounding success story. As late as 1950, there was not a single large Jewish law firm in town. By the mid-1960s, six of the largest twenty law firms were Jewish, and by 1980, four of the largest ten prestigious law firms were Jewish firms. Moreover, the accomplishment of the Jewish firms is especially striking because, while the traditional large White Anglo-Saxon Protestant law firms grew at a fast rate during this period, the Jewish firms grew twice as fast, and they did so in spite of experiencing explicit discrimination. What happened? This book chapter is a revised, updated study of the rise and growth of large New York City Jewish law firms. It is based on the public record, with respect to both the law firms themselves and trends in the legal profession generally, and on over twenty in-depth interviews with lawyers who either founded and practiced at these successful Jewish firms, attempted and failed to establish such firms, or were in a position to join these firms but decided instead to join WASP firms. According to the informants interviewed in this chapter, while Jewish law firms benefited from general decline in anti-Semitism and increased demand for corporate legal services, a unique combination of factors explains the incredible rise of the Jewish firms. First, white-shoe ethos caused large WASP firms to stay out of undignified practice areas and effectively created pockets of Jewish practice areas, where the Jewish firms encountered little competition for their services. Second, hiring and promotion discriminatory practices by the large WASP firms helped create a large pool of talented Jewish lawyers from which the Jewish firms could easily recruit. Finally, the Jewish firms benefited from a flip side of bias phenomenon, that is, they benefited from the positive consequences of stereotyping. Paradoxically, the very success of the Jewish firms is reflected in their demise by the early twenty-first century: because systematic large law firm ethno-religious discrimination against Jewish lawyers has become a thing of the past, the very reason for the existence of Jewish law firms has been nullified. As other minority groups, however, continue to struggle for equality within the senior ranks of Big Law, can the experience of the Jewish firms serve as a “separate-but-equal” blueprint for overcoming contemporary forms of discrimination for women, racial, and other minority attorneys? Perhaps not. As this chapter establishes, the success of large Jewish law firms was the result of unique conditions and circumstances between 1945 and 1980, which are unlikely to be replicated. For example, large law firms have become hyper-competitive and are not likely to allow any newcomers the benefit of protected pockets of practice. While smaller “separate-but-equal” specialized firms, for instance, ones exclusively hiring lawyer-mothers occasionally appear, the rise of large “separate-but-equal” firms is improbable.

Challenges and Opportunities in Managing the Aging Workforce: An Investigation of the Federal Emergency Management Agency

The aging workforce is becoming the majority of the working population in the United States. Although the literature on the aging workforce is sizable, little exists on how public agencies use the older workers. This capstone project examines the challenges and opportunities related to the employment of older workers as seen through a case study of the Federal Emergency Management Agency (FEMA). Knowledge gained from a synthesis of the literature review with survey data collected and analyzed will enable HR professionals to better understand the demographic, economic, regulatory, and intellectual influences of the aging workforce. The results from the survey of FEMA employees suggest a basis to plan and implement successful hiring and retention policies related to the aging workforce.

Los límites entre el turismo y la migración residencial: una tipología

En los procesos de movilidad internacional de jubilados desde el norte de Europa hasta las costas mediterráneas, se reconocen nuevos estilos de vida relacionados con fenómenos de naturaleza en ocasiones turística y a veces migratoria. Las sociedades que acogen a esta población requieren la definición de criterios para categorizar a estas personas como turistas o inmigrantes, pues la financiación y la gestión de sus recursos depende de ello. En este trabajo, se construye una tipología creada a partir de una encuesta realizada a 872 ciudadanos europeos en la provincia de Alicante. El empadronamiento y la forma de tenencia de la vivienda ocupada se revelan como las variables explicativas de la relación existente entre el turismo de larga estancia y la migración residencial.

La migración de retirados europeos al mercado de viviendas español: una evidencia sobre sus efectos

La migración internacional de retirados no es un fenómeno nuevo entre los países de la Unión Europea. Hay un buen número de sociólogos que han descrito el proceso y sus implicaciones en las formas de vida, especialmente en los casos de migración de los hogares de jóvenes retirados desde los países del norte de Europa hacia los soleados del sur. Muchos de estos movimientos afectan al mercado de viviendas desde el mismo momento de la llegada al país de destino y, en muchos casos, los flujos de población generados por esta migración contribuyen al cambio en las tendencias de edificación en los casos en que los destinos tienen bajos niveles de renta. Estos flujos tienen también implicaciones futuras como la necesidad de aumentar los servicios de atención a la tercera edad o en salud lo que, hoy por hoy, implican un elevado gasto público para el sistema español. Este artículo se interesa por las implicaciones en el corto plazo, así como en indagar en el fenómeno en sí. A través de la explotación de parte de los resultados de un proyecto de investigación denominado REVIcVAL (Retirados y vivienda en la Comunidad Valenciana), el artículo muestra algunas características de este flujo migratorio así como la racionalidad a la hora de tomar la decisión de comprar una vivienda. El ejercicio empírico utiliza información primaria recogida a través de un cuestionario recopilando información de retirados ingleses y alemanes en la costa de Alicante durante los años 2005 y 2006, con una base municipal, y estima la racionalidad en la toma de decisión de compra de viviendas.

Late life second move housing choices of international retiree migrants

Purpose – Many international retirement migrants are amenity movers undertaking the first move in the late life course model of migration. The purpose of this paper is to examine second moves within the retirement destination community to test whether the model of late life course migration accurately portrays the motivations and housing choices local movers make after retiring to another country. Design/methodology/approach – The paper combines secondary data and survey results to examine the composition of the retiree migrant population in the Alicante province of Spain. The socioeconomic characteristics and housing choices of those who have made a second move since retiring to Spain are compared with those who have not moved through a series of t-tests and chi-square tests. Findings – The paper finds that those who have made a second move within Spain are somewhat typical of second movers in the late life course. They are likely to cite mobility or health problems as a reason for moving and appear to recognize the need for a home that provides living area on one floor. Yet, they are choosing to move within an area that does not provide them with access to informal family care givers. Research limitations/implications – The data are restricted to retirees of two nationalities in one province of Spain. Further research is suggested in other locations and with retirees of other nationalities for comparison. Practical implications – Because many international retirees do not plan to return to their countries of origin, they will create demand for formal in-home care services and supportive retiree housing in the near future in their retirement destination countries. Originality/value – This paper provides understanding of a growing consumer housing segment in retirement destinations.

Examining retirement housing preferences among international retiree migrants

Housing demand models based on individual consumer’s utility function reflect preferences about the structure and lot, neighborhood, and location as related to socioeconomic characteristics of the occupants. As a growing proportion of aging residents in many countries are undertaking late life moves, their preferences will have an influence on destination housing markets. We examine the characteristics, attitudes and preferences about retirement housing among immigrant retirees currently living in traditional housing in a retirement destination in Alicante, Spain. Using results from a survey of German and British retirees living in the region, we find through logistic regression that preference for retirement housing is associated with aging and gaining access to in-home support services.

Linking tourism, retirement migration and social capital

A general trend in the study of international retirement migration has been the increased attention paid to the social contacts and network connections of the migrants in both the destination and the origin areas. These studies have examined the extent to which migrants build social relationships with their neighbours and the host society while also maintaining social links with their countries of origin, addressing the central role that leisure travel plays in sustaining increasingly dispersed social networks and maintaining the social capital of these networks and of the individuals involved in them. Using a case study approach to examine British retirement migration to Spain, we explore the relevance of transnational social networks in the context of international retirement migration, particularly the intensity of bidirectional visiting friends and relatives (VFR) tourism flows and the migrants’ social contacts with friends and/or family back in their home country. Building on the concept of social capital and Putnam's distinction between bonding and bridging social capital, we propose a framework for the analysis of the migrants’ international social networks. The results of a study conducted based on a sample of 365 British retirees living in the coast of Alicante (Spain) show both the strength of the retirees’ international bonding social capital and the role of ‘VFR's travel and communication technologies in sustaining the migrants’ transnational social practices and, ultimately, their international bonding social capital. It also provides evidence for the reinforcing links between tourism-related mobility and amenity-seeking migration in later life.

Annotated almanac, 1747

Almanac containing calendar pages with sporadic annotations of unidentified measurements and interleaved pages with short handwritten entries about Winthrop's daily activities, and astronomical and meteorological observations. The entries include personal notes about travel, the weather, deaths in the community, and the hiring and dismissal of servants.

Annotated almanac, 1748

Almanac containing calendar pages with sporadic annotations of unidentified measurements and interleaved pages with short handwritten entries about Winthrop's daily activities, and astronomical and meteorological observations. The entries include personal notes about travel, his wife's travels, the weather, vegetable planting, the hiring and dismissal of servants, and the birth of Winthrop's son Adam (November 1748).

An account of my quarter bills, charges &c from July 11th 1743 to July 13th 1748 at Harvard College

Handwritten account book kept while Storer was a student at Harvard College. The well-organized volume is arranged by expense type and then date and was updated periodically, usually quarterly. The information offers a glimpse at the expenses of a Harvard student and provides information about the larger community that supported student life. The precise entries indicate the lifelong habits of Storer as a careful and methodical financial manager that would prove so valuable when he served as Harvard's treasurer more than thirty years later. Storer documents accounts with the steward, butler, sweeper, glazier, barber, and lists these individuals by name. The volume also includes notes on expenses for boarding, transportation, wood, and pocket expenses. While most entries do not list specific purchases, Storer provides details on the cost of a Harvard Commencement in 1747 (including the cost of a diploma, money to the President, hiring a house, a boat, a woman, and "2 Negroes"), and a specific accounting of the different food purchased for the event; Storer also lists expenses for an 1748 "supper for the graduates."

Letters from William Tudor to John Thornton Kirkland,

Four letters written from Birmingham, England, in which Tudor suggests changes to Harvard’s grounds and facilities, hiring practices for tutors, and university publications. He also alludes to the War of 1812.

Account book of Andrew Croswell, 1794-1802

Andrew Croswell kept this account book while an undergraduate at Harvard College. It contains entries from 1794, the year he entered, until his graduation in 1798. There is also one entry on the back cover apparently made in 1802. The entries, divided by school term, are very detailed. Croswell indicates the cost of the following, among many other expenses and purchases: transportation, most often to Hingham and Plymouth; payment for "passing the bridge"; candles; hiring a horse; wood and having it cut; laundry; quills and pencils; paper and ink; razors, haircuts, hair ribbons; a trunk; clothing and cloth for trousers; furniture; tickets to the theater; door locks; a bowl and spoon; "batts and balls" and "other necessaries"; tobacco; toothbrushes; shoe and boot repair; fruit; wine, brandy and rum; cheese; coffee and tea; butter; lemons; sugar; and wafers. There are also entries for college-related costs, including the payment of quarter bills, buttery bills, Hasty Pudding Club dues, and a fee to the President of Harvard College related to Croswell's graduation. There are also entries pertaining to the cost of celebrating various special occasions, including Election Day, Christmas Eve, "Independent Day," and George Washington's birthday.