Deborah Stone

Deborah Stone is a fellow at the Open Society Institute and holds an investigator award in health policy from the Robert Wood Johnson Foundation.

Recent Articles

Care and Trembling

U ntil fairly recently, most caregiving was invisible to the public eye. Caring was done informally in the private sphere, mostly by women, for relatives, neighbors, and friends; and it was mostly unpaid. Gradually over the course of the twentieth century, caring has gone public. As middle-class women moved into the labor force, society responded by creating new entitlements to care for children, the sick and disabled, and the elderly. And as needs and entitlements expand, so does the provision of care. Much care is now provided by people who care for a living and by professionals who gain their work identity from caring. Caring is the business of firms that care for profit, and of nonprofit agencies that care as a mission. And much care is now paid for by public subsidies, tax credits and exemptions, and by private and public insurance plans that tightly monitor and regulate the caregiving they fund. When care goes public, there is a clash between the norms of caring in private...

Why the States Can't Solve the Health Care Crisis

One of the enduring metaphors of American federalism is that states serve as laboratories for the federal government. States are the basement tinkerers that generate ideas to solve big national problems. They are the crucibles for testing the safety and efficacy of new ideas before the whole country adopts them. State leaders, the argument goes, are closer to the people, more sensitive to local conditions, and more attuned to real social problems than are national officials. With medical costs zooming, over 60 million people uninsured at some time over a two-year period, and the federal government slow to act, many people -- state officials foremost among them -- are looking to the states to lead us out of the mess. Indeed, some states have tried to seize the initiative, and many are debating new measures. Hawaii and Massachusetts, which both have enacted mandates on employers to provide insurance, and Oregon, with its widely publicized but not yet implemented rationing plan, are...

Race, Gender at the Supreme Court

In a parody of affirmative action, the Senate failed to assess seriously Clarence Thomas's fitness for the Supreme Court. Casualties include blacks, women, Democrads, and the Court's own moral authority.

The confirmation hearings of Clarence Thomas were a great national Rorschach test. The lesson, some say, is that the United States has made great progress in race relations. Or, is it that racism is alive and well? Some concluded that women gained a new place in politics, so that even an issue as threatening to men as sexual harassment can no longer be swept under the rug. Others learned that women are still not taken seriously by a male power establishment and it doesn't pay to speak up. For a few, the Thomas affair demonstrated the strength and adaptability of our political institutions. For many, it revealed rot at the core. Whichever interpretations ultimately dominate the nation's collective self-understanding, politics after Thomas will never be the same. The hearings not only changed the way we will frame issues of race and gender, but also the institutional machinery black constituents, who strongly favored a with which we will resolve them. Lost in all the rumbling about race...

Fetal Risks, Women's Rights: Showdown at Johnson Controls

Fetal Risks, Women's Rights: Showdown At Johnson Controls by Deborah A. Stone Johnson Controls, Inc. manufactures batteries in sixteen states. Jobs on its production line are "good jobs," the kind rapidly disappearing from the American economy -- unionized, high-paying, skilled manual labor with good benefits and chances for advancement. They are also the kind of jobs that have never been widely available to women. Just as women began to gain entry into these jobs, employers discovered a medical problem: The lead used in battery production endangers not just adult workers; it can build up in human tissues, and if passed on to a fetus can cause serious mental and physical problems for the child. Starting in 1982, Johnson Controls advised its hiring offices to tell women there were no openings for women capable of bearing children. The company's fetal protection policy applies to women, right up to age seventy, who cannot provide medical evidence of their sterility, regardless of their...

AIDS and the Moral Economy of Insurance

When a blood test to detect AIDS antibodies was first announced in 1985, the ensuing controversy over the use of the tests by insurance companies seemed to take a familiar shape. On one side were civil rights advocates claiming discrimination if the insurers were permitted to use the tests to screen applicants for life and health insurance. On the other side was an industry insisting on its right to be free of government regulation. But despite the seemingly familiar pattern, the conflict over AIDS testing really concerned a novel problem with repercussions for many people who do not see themselves as having any stake in the issue. The AIDS antibody test is only one of a growing number of predictive diagnostic tests. These tests tell whether a person is highly susceptible to a disease or, very rarely, whether someone is certain to get sick. Other predictive tests include the recently identified genes and genetic markers for Alzheimer's disease, manic-depressive disorder, multiple...

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