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Much current work in attribution theory presumes that in multicausal situations, naive attributions are often characterized by the multiple sufficient causal scheme. The present research was designed to examine whether the multiple sufficient scheme or an alternate model, the variant-effect scheme, better characterizes naive attributions. The variant-effect scheme is a generalization of Kelley's graded-effects scheme and, in contrast to the multiple sufficient scheme, reflects a belief in the conservation of causal energy. Five-to 12-yearolds received a series of social inference problems. In each problem, subjects gave base-rate estimates of an event and also made attributions of the likelihood that the event occurred after hearing that a related effect occurred in the presence of another cause. Three critical tests consistently disconfirmed use of the multiple sufficient scheme and supported use of the variant-effect scheme. The results further indicated increasing use of the variant-effect scheme with development. Preference for a variant-effect scheme over a multiple sufficient scheme suggests a picture of a naive attributor who is perceptually sophisticated but operationally naive-accepting causal simplicity rather than entertaining the possibility of causal indeterminacy.

We compared chronic care utilization in four major health systems in the U.S.: the military health system (TRICARE), the Department of Veterans Affairs (VA), Medicaid, and employer-sponsored commercial plans. Prevalence rates and key performance indicators were constructed from administrative data in federal fiscal year 2003 for eight chronic conditions: hypertension, major depression, diabetes, tobacco dependence, ischemic heart disease, severe mental illness, persistent asthma, and stroke. Continuously enrolled beneficiaries under 65 years old were studied: TRICARE (N = 2,963,987), VA (N = 2,114,739), Medicaid enrollees in five states (N = 5,554,974), and commercial insurance (N = 5,212,833). Condition-specific adjusted prevalence rates and measures were compared using the standardized rate ratio. For the majority of the conditions, the estimated prevalence rates were highest in the VA and Medicaid populations. Prevalence rates were generally lower in TRICARE and commercial plans. Medicaid beneficiaries had the highest hospitalization rates in four of the six conditions where hospitalization rates were measured. These results provide empirical evidence of differences in chronically ill patient populations in several of the major U.S. health insurance systems.