Monthly Archives: December 2008

Healthy Information Technologies

This post is merely a bookmark to me to read this later…

For most doctors, who work in small practices, an investment in electronic health records looks simply like a cost for which they will not be reimbursed. That is why policy experts say any government financial incentives to use electronic records — matching grants or other subsidies — should be focused on practices with 10 or fewer doctors, which still account for three-fourths of all doctors in this country. Only about 17 percent of the nation’s physicians are using computerized patient records, according to a government-sponsored survey published in The New England Journal of Medicine.

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Filed under Health, Innovation

Madoff – Public Value Failure and Market Failure

Markets depend upon information to be efficient.  This NYT story on Madoff indicates that information was in short supply, and a disaster ensured.

The outsize impact on the industry may have resulted largely because Mr. Madoff (pronounced MAY-doff) managed his funds much the way that real estate leaders have operated successfully for decades: He provided little information and demanded a lot of trust.

So, where were the government regulators, those charged with ensuring that the market provide the necessary disclosures so that investors can rationally make their “risk” decisions?  Absent, according to a Washington Post op/ed:

Those who support regulation also say that hedge funds should disclose more of what they do. Well, Madoff did make some disclosures; it’s just that they weren’t true. As SEC Chairman Chris Cox has all but admitted, the scandal doesn’t show that his agency lacked the power to regulate; it shows that it failed to exercise it. Responding to this scandal with more regulation would be like thrusting more pills on a patient who refuses medication.

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Filed under Market Failure, public failure, public values

Inertia, Public Participation and low probability of a consensus

Our founding fathers warned of a “tyranny of the majority“.   The city of Grand Junction thought they had an idea the people would endorse — a means to fund public safety projects.  However, the voters of Grand Junction failed to endorse the measure.  Here are reasons why:

  • In focus groups, 9.6 percent said the initiative may have failed because of its tie to overturn TABOR for a nonspecific amount of time, which many said was an unpopular move in Grand Junction.
  • Another 13.7 percent said the project was misunderstood, and 7.8 percent said the poor economy didn’t help.
  • Nearly 9 percent said people who voted no distrusted the city or didn’t believe the city couldn’t find the money another way, and
  • 6.7 percent said people didn’t approve of the way the city spent money in the past, such as on roundabouts of the Seventh Street and Colorado Avenue projects.

Question : If the public can’t agree on how to fund a public value – is that a public value failure, or a market failure (lack of information)?

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Filed under Government, public failure, public values

Public Participation – A public value problem

Here’s a synopsis of the problem.  People are increasingly disengaging themselves from government (local, state, and federal).  As they become more disengaged, there is a growing dissonance between public values and public policy (i.e. policy elites command the agenda, public input is minimized, sometimes to zero).  As dissonance increases, disengagement increases until the system which supports the policy apparatus collapses in upon itself, much like a dying star.

So, how do you reverse this inertia feeding increasing dissonance?

Perhaps by encouraging students/public to ask provocative questions — as this interfiew with Jessica Fridrich states, the questions are sometimes fifty percent of the answers.  For a bio article on Jessica Fridrich see NYT “Jessica Fridrich specializes in problems that only seem impossible to solve“.

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Filed under public failure, public values

Just because you model it wrong, doesn’t mean it failed

Do markets really fail, if the failure is really in the fact that the financial system had the wrong belief?  In other words, the market does note suffer a failure simply because the model you use to predict market performance is wrong.

Interesting essay in the NYT magazine today, which leads with:

Among the most astonishing statements to be made by any policymaker in recent years was Alan Greenspan’s admission this autumn that the regime of deregulation he oversaw as chairman of the Federal Reserve was based on a “flaw”: he had overestimated the ability of a free market to self-correct and had missed the self-destructive power of deregulated mortgage lending. The “whole intellectual edifice,” he said, “collapsed in the summer of last year.”

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Market Failure, Public Value Failure

When the two failures occur simulatanously, you have a serious problem.  See What you don’t know about a drug can hurt you in the WSJ.

“What’s happening in oncology is happening in all other fields of medicine,” says study co-author health economist Scott Ramsey at the Fred Hutchinson Cancer Research Center in Seattle, who checked more than 2,000 chemotherapy trials recorded in the federal registry. “You may not get a full picture of whether a drug is effective or not. With the stakes being what they are in terms of money and human lives, this is a big problem in my view.”

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Filed under Market Failure, public failure

Books to read

Adam Frank, The Constant Fire: Beyond the Science vs. Religion Debate – examines division of science and religion — background for public values/discourse and science policy

John Kenneth Gailbraith, The Great Crash of 1929 — a classic on the causes… appropriate for today’s debates on economic/finance policy

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