The intervention by Congress in the private funding of federal election campaigns is fundamentally misconceived. The field should be deregulated. Proponents of intervention believe that the unregulated private financing of election campaigns subverts our representative institutions. This is because, they believe, first, that disparities in campaign spending often decide elections; second, that the pattern of campaign contributions received by a legislator significantly influences that legislator's lawmaking behavior; and, third, that the private financing of political activity injects the economic inequalities of the marketplace into the sphere of political rights. However, a whole view of the complex worlds of elections and legislation suggests that these beliefs, despite their superficial plausibility, are unsupported by reason and experience. In fact, the private market for political finance, left unregulated, should consistently deny to any discrete group of participants the market power necessary to influence elections or legislation significantly. Furthermore, the partial regulation attempted to date has been easily circumvented, and more comprehensive regulation is substantially barred by the constitutional sanctity of political speech and association. Finally, a system of private political finance, free from government intervention, is reconcilable with the legitimate operations of our representative government and with the true meaning of political equality.
The pediatric-to-adult care transition has been correlated with worse outcomes, including increased mortality. Emerging adults transitioning from child-specific healthcare facilities to adult hospitals encounter marked differences in environment, culture, and processes of care. Accordingly, emerging adults may experience care differently than other hospitalized adults. We performed a retrospective cohort study of patients admitted to a large urban safety net hospital and compared all domains of patient experience between patients in 3 cohorts: ages 18 to 21, 22 to 25, and 26 years and older. We found that patient experience for emerging adults aged 18 to 21, and, to a lesser extent, aged 22 to 25, was significantly and substantially worse as compared to adults aged 26 and older. The domains of worsened experience were widespread and profound, with a 38-percentile difference in overall experience between emerging adults and established adults. While emerging adults experienced care worse in nearly all domains measured, the greatest differences were found in those pertinent to relationships between patients and care providers, suggesting a substantial deficit in our understanding of the preferences and values of emerging adults.
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