Posts Tagged ‘Washington’

Five Million Jobs

A few years ago, I co-chaired the National Academies Healthy America Initiative.  The members of this committee came from both the Institute of Medicine and the National Academy of Engineering.  Our assignment was to wrestle with issues surrounding the effectiveness and costs of healthcare delivery.  However, we wanted to put this in a larger context.  […]

Patterns of Change

Invention or ideas lead to innovation and change, often championed by someone other than the originator – think of Carnegie, Morgan, Rockefeller and Vanderbilt.  The change agent builds an empire around the innovation, typically aspiring to monopolize the commercial value of the innovation.  The empire becomes exploitive of customers, employees, and the environment.  Eventually, the […]

The Current Communicator

I recently visited the Ronald Reagan Presidential Library.  One can question the whole “City on the Hill” imagery, but the Great Communicator was undoubtedly able to evoke a positive emotional response from me three decades after the original narrative. How does this compare to the Current Communicator? Both Presidents inherited troubled economies– one could easily […]

A Small Transformation Experiment

On November 15th of 2010, I began a small experiment.  The lease on my car ended that day, and I just turned the car in and took the bus home.  I decided to see what life would be like without a car. My office is close to a subway stop and there is a bus […]

Collaborative Networks

I am at the IEEE Workshop on the Future of Information at the National Academy of Engineering in Washington, DC.  The purpose of the workshop is to consider how engineers and scientists will access and use information in 2020, including what types and sources of information they will seek and find available. Yesterday was the […]

Valuing the Future

I once asked an Assistant Secretary and Chief Financial Executive of a government agency whether he preferred to be in control of all the budget of his agency or to be in control of how the money was counted.  He responded, “If I can control how the money is counted, I don’t need to control […]

Value of Prevention

Last August, the Director of the Congressional Budget Office (CBO), Douglas W. Elmendorf, sent a letter to Congress informing them that most preventative health interventions tend to expand utilization of services with costs that far exceed the eventual cost savings due to avoiding disease or detecting it earlier.  In other words, he reported that prevention […]

Unintended Consequences

Medicare limits reimbursement for healthcare procedures, often below the cost of delivery of these procedures.  Not surprisingly, healthcare providers figure out ways to compensate for these price controls.  They may, for example, bundle other, profitable services with those that they are forced to provide at a loss to get the overall profit margin to be […]

Transforming the Debate

The debate in Washington seems stuck in partisan positioning and sound bites.  We have lost track of the fundamental objectives that need to be pursued.  I think the overarching objective should be quite simple – we want a healthy, educated, and productive population that is competitive in the global marketplace. We do not really want […]