According to the paper, successful personnel management requires flexible compensation and personnel management tools that provide the following:

• performance incentives for both workers and managers

• recruitment and retention in-centives for talented personnel

• managerial discretion and accountability

• the assurance of adequate resources to implement these policies

• transparency and oversight

• stability

• limited financial uncertainty for workers.

The paper notes that the current civil service system contains some, but not all, of these characteristics. The civil service system is not ideal, because it's too cumbersome and rigid. Furthermore, federal managers don't use certain tools, such as bonuses, that offer flexibility in managing personnel. Such flexibility-related tools can be highly effective.

The paper concludes that policymakers should make greater use of existing policies that provide flexibility and should develop, implement, and monitor effective methods for managing the new agency's human resources system to ensure that it meets its goals.

For more information: Ensuring Successful Personnel Management in the Department of Homeland Security (RAND/IP-235-NSRD).
 

Threats to Children from Secondhand Smoke

The study found that 19 million American children--28 percent of everyone in the United States 17 and younger--are exposed to tobacco smoke at home on a daily basis. Children's exposure to secondhand tobacco smoke is linked to bronchitis, asthma, ear infections, sudden infant death syndrome, and school absences.

White children are more likely than others to be exposed to smoke at home, the study found. Children are also more likely to be exposed to smoke at home if they come from families that have lower incomes, less education, one or fewer parents at home, or live in the South.

"Secondhand tobacco smoke remains a serious threat to the health of a large proportion of our children, despite widespread efforts to curb the use of tobacco," said Mark Schuster, who led the study. "Children are among those most vulnerable to tobacco smoke. These findings show we still have a lot to do to protect them from this preventable hazard."
 

Asbestos Litigation Surges

Significantly for policy purposes, the study found that 65 percent of the compensation paid over the last decade went to people claiming noncancerous conditions. The increasing number of claims for noncancerous injuries explains much of the growth in the asbestos caseload. There is widespread agreement that a majority of the claimants without cancer are functionally unimpaired, meaning that their asbestos exposure has not yet affected their ability to perform activities of daily life.

Because the number and pace of asbestos lawsuits have risen dramatically in recent years and may increase even faster in the future, there could be renewed calls for reforms in the federal and state court systems that strain to handle the litigation, the study said.

"This surge challenges the notion that the litigation is manageable and raises new questions about whether there will be enough money to pay all the claims that are likely to be filed," said Stephen Carroll, who headed the study.

For more information: Asbestos Litigation Costs and Compensation (RAND/DB-397-ICJ).
 

Study Casts Doubt on Theory of Marijuana as "Gateway" Drug

The theory that marijuana use by young people causes some to progress to harder drugs, often called the "gateway effect," has been used to oppose efforts to relax marijuana laws in several states.

"The marijuana gateway effect is probably not the best explanation for the link between marijuana use and the use of harder drugs," said Andrew Morral, lead author of the study. He offered an alternative explanation: "The people who are predisposed to use drugs and have the opportunity to use drugs are more likely than others to use both marijuana and harder drugs. Marijuana typically comes first because it is more available."

Morral and coauthors Daniel McCaffrey and Susan Paddock said the study should raise questions about the legitimacy of basing national drug policy decisions on the assumption that using marijuana increases the risk of using more-dangerous drugs.

"If our model of adolescent drug use is correct, then policies aimed at reducing or eliminating marijuana availability are unlikely to make any dent in the hard drug problem. When enforcement resources that could have been used against heroin and cocaine are instead used against marijuana, this could have the unintended effect of worsening heroin and cocaine use," said Morral.

He also warned, however, against the relaxation of marijuana laws. "Relaxing marijuana prohibitions could affect the incidence of hard drug use by diminishing the stigma of drug use generally, thereby increasing adolescents willingness to try hard drugs," Morral said. "Moreover, marijuana itself can be a serious problem for those who become dependent on it."
 

Study Sheds Light on Patient-HMO Conflicts

A key source of conflict between patients and their health plans is payment for emergency medical services. Laws in California and in other states require health insurance companies to pay for emergency room visits if "a reasonable person" would think that emergency services were necessary. But patients and HMOs often interpret the standard differently.

Of the patients who filed appeals over the denial of payment for emergency room care at the two HMOs studied, 95 percent won their appeals.

Lead author Carole Roan Gresenz noted that "people denied coverage may refrain from appealing for several reasons. They may not know they can file appeals, they may just not understand the process, or they may think they have little chance of success."

Roughly 87 million Americans with private health insurance are enrolled in HMOs.