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This paper explores the topographical and socio-cultural developments during the Golden Age in New York, Los Angeles and San Francisco, three Beat Generation epicenters, which determined the deconstruction of traditional norms. Modifications at both city and society levels were represented by the emergence of countercultures, such as the Beat. The visibility received by urban problems, due to the increase in social demonstrations and activism, fostered the formation of a unified front that demanded equality and encouraged social and political movements, such as the Civil Rights and the Second Wave Feminism. The socio-political challenges which the American society was confronted with from the 1950s to the 1970s in these three cities, also reveal a few problems regarding the status of the Beats as well as of minorities in metropolises. [ABSTRACT FROM AUTHOR]

Objective: To investigate competing explanations for why Medicare Fee for Service (FFS) and private sector payments lead to hospital cost variations in Californian counties. Data sources: Ratios of private to Medicare hospital costs were obtained from state-based all-payer claims databases. Demographics were estimated from the U.S. Census Bureau and the California Health Interview Survey. Medicaid and Medicare spending was obtained from Kaiser Family Foundation. Medicare Advantage enrollment was obtained from the California Department of Health Care Services and market consolidation was estimated using the Herfindahl–Hirschman Index (HHI). Study design: Per capita costs, demographics, Medicaid and Medicare spending, Medicare Advantage enrollment, and HHI scores were compared for San Francisco (SF), Sacramento, Los Angeles (LA), and San Diego (SD). Principal findings: LA hospitals had the lowest per capita private insurer costs, but the highest Medicare FFS costs. The findings might be explained by a lower HHI for LA, indicating a more competitive market, than SD, SF, and Sacramento. Conclusions: Medicare FFS hospital costs do not provide an accurate representation of health care spending in Californian counties. In more competitive markets, private insurance companies can negotiate lower prices, while oversupply may allow facilities to increase volume in Medicare FFS. [ABSTRACT FROM AUTHOR]