Zero-sum politics, the Herbert thesis, and the Ryan White CARE Act: lessons learned from the local side of AIDS.
This study examines the dynamics of grass-roots decision-making processes involved in the implementation of the Ryan White CARE Act. Providing social services to persons with HIV/AIDS, the CARE act requires participation of all relevant groups, including representatives of the HIV/AIDS and gay communities. Decision-making behavior is explored by applying a political (zero-sum) model and a bureaucratic (the Herbert Thesis) model. Using qualitative research techniques, the Kern County (California) Consortium is used as a case study. Findings shed light on the decision-making behavior of social service organizations characterized by intense advocacy and structured on the basis of volunteerism and non-hierarchical relationships. Findings affirm bureaucratic behavior predicted by the Herbert Thesis and also discern factors which seem to trigger more conflictual zero-sum behavior.
University of Alabama at Birmingham, USA.
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J
Slack
D000163:Acquired Immunodeficiency Syndrome / Q000191:economics*; D002140:California; D003659:Decision Making, Organizational; D005380:Financing, Government / Q000331:legislation & jurisprudence*; D015276:Health Care Rationing / Q000191:economics* / Q000331:legislation & jurisprudence; D006284:Health Plan Implementation; D006801:Humans; D009313:National Health Programs / Q000191:economics* / Q000331:legislation & jurisprudence; D019982:Organizational Case Studies; D011057:Politics; D012947:Social Work / Q000458:organization & administration; D014481:United States