Amazon.com
Celebrated economist Jeffrey Sachs has a plan to eliminate extreme poverty around the world by 2025. If you think that is too ambitious or wildly unrealistic, you need to read this book. His focus is on the one billion poorest individuals around the world who are caught in a poverty trap of disease, physical isolation, environmental stress, political instability, and lack of access to capital, technology, medicine, and education. The goal is to help these people reach the first rung on the "ladder of economic development" so they can rise above mere subsistence level and achieve some control over their economic futures and their lives. To do this, Sachs proposes nine specific steps, which he explains in great detail in The End of Poverty. Though his plan certainly requires the help of rich nations, the financial assistance Sachs calls for is surprisingly modest--more than is now provided, but within the bounds of what has been promised in the past. For the U.S., for instance, it would mean raising foreign aid from just 0.14 percent of GNP to 0.7 percent. Sachs does not view such help as a handout but rather an investment in global economic growth that will add to the security of all nations. In presenting his argument, he offers a comprehensive education on global economics, including why globalization should be embraced rather than fought, why international institutions such as the United Nations, International Monetary Fund, and World Bank need to play a strong role in this effort, and the reasons why extreme poverty exists in the midst of great wealth. He also shatters some persistent myths about poor people and shows how developing nations can do more to help themselves.
Despite some crushing statistics, The End of Poverty is a hopeful book. Based on a tremendous amount of data and his own experiences working as an economic advisor to the UN and several individual nations, Sachs makes a strong moral, economic, and political case for why countries and individuals should battle poverty with the same commitment and focus normally reserved for waging war. This important book not only makes the end of poverty seem realistic, but in the best interest of everyone on the planet, rich and poor alike. --Shawn Carkonen
Book Description
A landmark exploration of the way out of extreme poverty for the world's poorest citizens
Among the most eagerly anticipated books of any year, this landmark exploration of prosperity and poverty distills the life work of an economist Time calls one of the world's 100 most influential people. Sachs's aim is nothing less than to deliver a big picture of how societies emerge from poverty. To do so he takes readers in his footsteps, explaining his work in Bolivia, Russia, India, China, and Africa, while offering an integrated set of solutions for the interwoven economic, political, environmental, and social problems that challenge the poorest countries. Marrying passionate storytelling with rigorous analysis and a vision as pragmatic as it is fiercely moral, The End of Poverty is a truly indispensable work.
Customer Reviews:
Read with a grain of salt. .......2007-10-05
This book covers some concepts that at face value and first read - especially people like me who are not economists - seem quite enlightening. But the more you read, the more you have to question how it seems that the view he presents is a seemingly simplistic solution to what is in reality a complex problem. One of the reviews on here talked about how it is not "infrastructure" that is key to solving the problems, but rather an access to market. I'd have to agree. Companies are not flocking to sub-Saharan Africa to utilize the labor there. Companies are moving to China and India. This is not a simple matter of infrastructure, but a matter of economic policy and much more.
The book points to some villages in rural Africa where things appear to be improving - a choice village or two where Jeffrey Sachs and the Earth Institute at Columbia pour in their resources (these are subsequently called Millennium Villages to coincide with the Millennium Development Goals) - and it makes you think that he might possibly be making some sense. However, what about generalization to a whole country? Of course if you take all your resources, all the scientific knowledge accessible to you from the Earth Institute, and then some, and pour these into a village, what village will not transform? But is it sustainable? Is it generalizable to the whole country? Change needs to occur at the policy/governmental level concurrently, in order for real success and improvement.
While this book may be interesting, it is important to remember that it is not THE way; it is A way, and along with it, it has its flaws. Ask some other economist what they think - I did, and got an earful. The opinion was that Jeffrey Sachs is just recycling his ideas that he used decades back during the 80s, and that to counter this viewpoint, I must read William Easterly. I'm sure there are others out there to read. But again, one good read does not solve all the world's ills. If you don't have access to an economist, read ALL the reviews on here because there are some other points that need to be considered. And I don't appreciate the impression I get that ideas for solving poverty in places like sub-Saharan Africa comes from a simplistic seemingly-enlightened Westernized view of "this is what is wrong with Africa".
We need to end poverty.......2007-09-28
The book is great. It puts the poverty of the world, including America into light. It lets the reader know that poverty can be ended in our lifetime. It is very serious topic and book. We have the opportunity to end poverty, but will we be the generation that sits by and watches our fellow humans starve and die of disease or not?
The book got to me in a very timely manner and was inexpensive.
Using American Wealth to End Poverty.......2007-09-18
Eradicating global poverty is a concern that Christian missionaries and activists now share with a growing number of global economists and even rock stars like Bono. The gulf between incomes in the West and developing countries complicates the missionary task, yet missionaries often have little understanding of how the global economy works.
Jeffrey Sachs is well qualified to interpret globalization since he has worked in over a hundred nations, analyzing and offering advice on national economies. He was an economics professor at Harvard University and is now Director of the Earth Institute at Columbia University. He was an economic advisor to Kofi Annan, Secretary-General of the United Nations, and to Bono.
In The End of Poverty, Sachs outlines a plan to end global poverty by 2025. He is not only a visionary but also an excellent teacher on the fundamentals of global economics. He distinguishes between three degrees of poverty: extreme poverty, representing one billion people who literally struggle for survival every day; moderate poverty, representing 1.5 billion people who live just above subsistence level; and relative poverty, representing 2.5 billion people. Sachs shows how the world economy has changed dramatically since 1980, with over half the world making economic progress. Only Africa has experienced a general increase in extreme poverty in the past 25 years. When Sachs speaks of eradicating poverty, he means primarily ending only extreme poverty by 2025.
Sachs criticizes the International Monetary Fund and the World Bank for failing to represent the interests of the poor and advocates "clinical economics" which gives a scientific diagnosis of each nation's economic problems with a prescription for improvement. He believes that if every wealthy nation committed just 0.7 percent of Gross National Product (GNP) to foreign direct assistance, global poverty would end. The United States currently gives only 0.15 percent of GNP in such aid, far below all other wealthy nations.
Sachs offers deep insights into globalization. He states that his worldview is from the Enlightenment, so he advocates "Enlightened Globalization," meaning that he believes scientific rationalism combined with compassion can solve humanity's problems. He also sees American wealth as the key to ending global poverty and discounts the effects of differing cultures as being part of the problem. Sachs does not answer all questions about the sources and solution of poverty, but he sheds some needed light on the subject.
Another impartial diagnosis of poverty.......2007-06-21
For some populist reasons, many pundits think that poverty in poor countries, notaby in Africa, is the result of the lack of investment or commitment of western nations. Unfortunately, Dr. Sachs is one of them. In this book, he only stresses the external factors deepening extreme poverty in Third World countries, not the significance of domestic variables like the obvious lack of commitment and weak incentives to eradicate poverty. The latter is a confluence of factors, both indigenous and external. Using history as our guide, one can almost certainly say that growth has failed because of weak domestic incentives. Failing to recognize that and calling for a large-scale investment in poor countries is an unadulterated promotion of utopianism. Without prior government commitments( not those based on short-term policy reforms but historical performance), all prescriptions will be worse than the desease.
i really do like it.......2007-06-16
if you think about how stinjy (stingy) the 1st world is, it makes you sad. but if you read this book, you'll at least realize that something can be done. hopefully it'll make you feel a little bit better ^_^
Product Description
Thoroughly updated, the second edition of Professional Real Estate Development explains the nuts and bolts of the real estate development industry. You will learn how to develop and manage five types of real estate products: land, residential, office, industrial, and retail uses. Focusing on small-scale projects, the authors show you practical methods for developing each major type of real estate, including feasibility analysis, design and construction, financing, marketing, and management. Photos, site plans, diagrams, and case studies provide examples of actual projects and how the process works. Information is specific and detailed, with costs, rents, and financing information included by product type.
Customer Reviews:
Academic. A text book that needs a refresher for today's issues........2006-04-24
Rick is first and foremost a professor, so the book follows an academic format best suited for the young student of development seeking a broad introduction to the process. Of course, the real world is more complex than any text book could ever capture. That said, the book has become a bit dated for the contemporary developer, whose world is increasingly governed by investors, special interest groups and oft ill-informed government officials! The book delivers fundamental building blocks in a logical, sequential process. The examples cited are, as another reviewer pointed out, on average probably 14 year old analogies. Perhaps the largest ommission is an accurate portrayal of what a developer really does - assembles a diverse team of people together to share in a singular vision, then rule over this creative, temperamental team with an iron fist in velvet gloves. A chapter called 'Cat Herding' would best summarize that world.
My recommendation is, buy the book, join the Urban Land Institute, attend your meetings, be a good listener, and dont think reading one book will set you off on your path to that infamous (maybe fictitious unless you happen to be the primary investor in an opportunity fund!)in that $100,000,000 net profit deal!
Excellent starter book.......2005-10-02
Excellent starter book. Should be required reading for every real estate professional. Wished I'd had about 5 years ago.
ULI Guide.......2004-01-28
For its high price, you may want to seriously think about your needs. If your intention is to buy a book for a broad overview of the development process with a somewhat academic approach, then this may be right for you. If you are builder or someone with prior real estate brokerage/service experience, you may find this too ivory tower and not practical. This book was a bit theoretical for my taste.
Although this book has been reprinted recently, all the data dates back to the late-1990's. Social and economic data are perhaps presented for illustrative purposes only, however, it is a bit disheartening.
There are some interesting project data, financial models and checklists, but frankly, the reader could figure those out on his/her own with some common sense and marginal experience in the industry.
Bottom line -- my suggestion is to review the book at the public library before you buy.
An Excellent Overview Of The Development Process.......2003-04-23
I am a 66 year old developer with several successful projects under my belt. This is a fine book for beginning, intermediate, and yes, advanced developers. The best I've ever read, and I've got bookshelves full of them. Also, for a modest fee, you can download from the publisher the software used for the financial illustrations in the book. I had to learn this material the hard way, because when I started out, there weren't any good books on development. If you want to be a developer, start here. If you're an experienced developer, you'll learn a lot from this book. I congratulate the authors for putting in such an immense amount of work.
Book Description
Health Economics and Policy is a basic introduction to the microeconomics of health, health care, and health policy. This edition demonstrates how economic principles apply to health-related issues. It explains the social, political, and economic contexts of health care delivery and explores the changing nature of health care. Students learn to analyze public policy from an economic perspective. While the text was written for non-economics majors, it includes enough economic content to challenge majors.
Customer Reviews:
EXCELLENT.......2005-03-22
I had the pleasure of taking this class from the author of this class. Dr. Henderson is not only absolutely excellent teacher, he is an equally good writer. I was not an economics major, and was somewhat fearful about taking "Economics of Medicine" as a class, but this book is thorough, organized, and easy to understand. It is an excellent book for economics majors as well as those majoring in other health care related professions who have an interest in learning more about the current health care system and related policies.
Book Description
Traditionally the international economics course has primarily been aimed at students working on an economics major. Today, a broad range of courses in global economic issues and policies are drawing students from a number of disciplines, such as accounting, marketing, political science, and business. This well-known author team created Global Economic Issues and Policies to address the growing needs of students that might experience this subject for the first time. The goal of the text is to emphasize current public-policy issues, which will be used to illustrate essential concepts of international trade and finance. The authors focused their theoretical discussions by staying within the guidelines of the basic economic principles.
Book Description
"Let China sleep, for when she wakes, she will shake the world." Napoleon's words seem eerily prescient today, as the shock waves from China's awakening reverberate across the globe. In China Shakes the World, the former China bureau chief of the Financial Times, James Kynge, traces these tremors from Beijing to Europe to the Midwest as China's ravenous hunger for jobs, raw materials, energy, and food -- and its export of goods, workers, and investments -- drastically reshape world trade and politics.
Delving beyond mere recitation of by-now-familiar statistics, Kynge's on-the-ground reporting provides alternative explanations for China's explosive transformation, revealing many of the usual reasons given for its growth to be myths. Most important for the future, he details China's deep, systemic weaknesses -- rampant fraud, crippling environmental crises, a corrupt banking system, faltering government institutions, a rapidly aging population -- that threaten even greater global disruptions. And he demonstrates the profound consequences of those weaknesses for American manufacturers, oil companies, banks, and ordinary consumers.
Through dramatic stories of entrepreneurs and visionaries, factory workers and store clerks at the heart of this global phenomenon, China Shakes the World explains how China's breakneck rise occurred, the extraordinary problems the country now faces, and the consequences of both for the twenty-first century.
Customer Reviews:
MBA Mom.......2007-07-15
I am full time Mom and just recently visited Beijing with my 2 young children and husband. As a result of our travels, all the news in the media regarding China, and my own personal experience with respect to my shopping purchase power and selection in the last many year, I was very interested in the "China story." This book is an easy read, and provides a good big picture. It reminds me of the center column in the Wall Street Journal... Too boot, well written, and excellent use of vocabulary.
Mom
Well written, informative book.......2007-06-01
This book is money and time well spent if you're interested in a contemporary survey of China.
Kynge really does an outstanding job with a complex topic. He has a journalist's nose for a story, is well connected in China, and the length of time he lived in the country allows him to really portray his observations in a sophisticated cultural and historical context. He nicely weaves in statistics and facts throughout the book without distracting from the narrative.
A Journalist's Eye.......2007-05-24
I've loved the lyrical quality of this book. It looks at the many problems facing China from the ground up and individual journalist's eyes. For a big picture view that is based more on economic analysis, see my own book: The Coming China Wars: Where They Will Be Fought and How They Can Be Won
All Shook Up.......2007-05-12
The incredible economic momentum in China necessitated by the rush of the population to the cities is creating economic tidal waves throughout the world. However, their economic surge is not without problems, such as widespread pollution. An excellent and informative read.
China Shakes the World.......2007-02-28
China Shakes the World is a brief anecdotal survey of China's rise as a great economic power. I took three major themes from the book:
- Many of the Chinese government's current policies are forced upon it. China's people have come to expect sustained high growth rates, and a failure to meet this expectation would have severe consequences for China's rulers. To encourage high growth rates, and because they are not democratically accountable, China's leaders simply ignore the adverse consequences of rapid growth, such as environmental damage. Yet the long-term consequences are inescapable. In the realm of foreign policy, China's most urgent need is access to natural resources. This need forces China to engage with some unsavory regimes and use its influence in the United Nations to protect them from international pressure.
- Much of China's current economic strength is the result of starting from a low base: while China has been at least a regional power for millennia, it has not done a good job of providing for its people. As a result, its rural population in particular is willing to undergo almost any hardship to escape grinding poverty. China's rapid economic growth can also be explained, in part, as a reaction to the loosening of artificial restraints on growth: e.g., totalitarian controls that prohibited any type of private enterprise until 1978 and China's isolation from the rest of the world during much of its history.
- China is pursuing the development strategy pioneered by Japan and the Asian tigers of climbing the technology ladder from relatively undemanding manufactures that rely on cheap labor (e.g., textiles) to more capital-intensive manufactures, specifically targeting machine tool manufacturing as a strategic industry. Because of China's extremely inexpensive, disciplined, and well-educated work force, and because its manufacturers emphasize market share over profit, there is little that the West can do to compete with China in many manufacturing sectors.
On these points, I found author James Krynge, a Financial Times reporter, to be convincing and reasonably entertaining. I found him to be less so when he indulges in some Lou Dobbs-style populism in decrying the effect of China's manufacturing prowess on U.S. manufacturers.
Book Description
Now with a free SINGWIN CD-ROM, Evaluating Practice, Fourth Edition is even easier for readers to understand and apply data analysis.
Unsurpassed among human service evaluation books, Evaluating Practice, Fourth Edition, includes the innovative SINGWIN program, created by Charles Auerbach, David Schnall, and Heidi Heft Laporte of Yeshiva University. Evaluating Practice instructs readers on managing cases and charting and filling out scales. Although the authors are best known within the social work discipline, this book can also be used in other professional programs such as nursing, counseling, psychology, and psychiatry. The free supplement with practice test questions provides a number of helpful exercises.
For anyone interested in social work at both the undergraduate and graduate level. Also for those interested in psychology, counseling, psychiatry, or psychiatric nursing.
Customer Reviews:
A great text book..........2007-01-02
I ordered this textbook for an MSW course, and it's wonderful. I love all the examples and the software that comes with it.
Another Edition to a fantastic text.......2005-08-10
This new edition of the text once again proves that these authors are the masters of single subject research. I have used this text for five years in my graduate methods course and am completely satisfied with their coverage of the material of single subject research design. Just when a researcher thought it could not get any better, this new edition comes along with updates to the software.
Get this book.
enough is enough.......2005-03-22
I was pleased to hear that this text had been assigned in a graduate research course at my graduate school of social work. I'm seriously disappointed. I would not recommend this text's continued use. It is excessively repetitive, constantly restating previous material (commonly referred to as 'rehashing'), and, as a sidebar, i can't help but mention an irritating habit of unnecessary references to material yet to come ('we'll talk about that more in chapter 14.'). The writing style is terribly wordy, and in a weighted, clunky pseudo-conversational style that rarely is effective in a textbook. The actual technical information is obscured in a constant river of verbiage, usually in page after page of solid block text, the least helpful format when learning technical information (or when subsequently searching for specific information or techniques). The result? It serves as a strong sedative. Finally, the authors repeatedly express apologies, in what eventually (by page 350) feels like an obsequious and cloying manner, for putting forward an empirical and accountable approach to clinical practice. The worst, though, is the repetition of material, as if the reader were an idiot. The sheer relentlessness of it is what is so galling, and at $100 bucks, neither affordable nor worth the investment. There are other texts out there with clearer, cleaner, more articulate prose, that are more respectful of the reader, and at half the price, such as the classic and affordable: Single-Case Research Designs: Methods for Clinical and Applied Settings by Alan E. Kazdin. Ignore the pollyanna reviews above and below, and avoid this text, or if on the syllabus, protest and suggest an alternative.
A Classic in Practice Evaluation.......2003-11-13
Bloom, Fischer and Orme continue to make an unique contribution to improving practice in the human services by providing a road map by which practitioners can evaluate their effectiveness. I've been using their text book for over 15 years in teaching practice evaluation and in has been an invaluable help. The new edition has a CD Rom with SingWin, CAAP,and CAAS which I was able to install in Windows XP Home edition. You must install CAAS before CAAP for it to work. The sofware computerizes record keeping, score computation, and graph construction. I strongly reccommend this textbook for human services faculty.
Amazon.com
In Natural Capitalism, three top strategists show how leading-edge companies are practicing "a new type of industrialism" that is more efficient and profitable while saving the environment and creating jobs. Paul Hawken and Amory and Hunter Lovins write that in the next century, cars will get 200 miles per gallon without compromising safety and power, manufacturers will relentlessly recycle their products, and the world's standard of living will jump without further damaging natural resources. "Is this the vision of a utopia? In fact, the changes described here could come about in the decades to come as the result of economic and technological trends already in place," the authors write.
They call their approach natural capitalism because it's based on the principle that business can be good for the environment. For instance, Interface of Atlanta doubled revenues and employment and tripled profits by creating an environmentally friendly system of recycling floor coverings for businesses. The authors also describe how the next generation of cars is closer than we might think. Manufacturers are already perfecting vehicles that are ultralight, aerodynamic, and fueled by hybrid gas-electric systems. If natural capitalism continues to blossom, so much money and resources will be saved that societies will be able to focus on issues such as housing, contend Hawken, author of a book and PBS series called Growing a Business, and the Lovinses, who cofounded and directed the Rocky Mountain Institute, an environmental think tank. The book is a fascinating and provocative read for public-policy makers, as well as environmentalists and capitalists alike. --Dan Ring
Book Description
In Natural Capitalism, three top strategists show how leading-edge companies are practicing "a new type of industrialism" that is more efficient and profitable while saving the environment and creating jobs. Paul Hawken and Amory and Hunter Lovins write that in the next century, cars will get 200 miles per gallon without compromising safety and power, manufacturers will relentlessly recycle their products, and the world's standard of living will jump without further damaging natural resources. "Is this the vision of a utopia?In fact, the changes described here could come about in the decades to come as the result of economic and technological trends already in place," the authors write.They call their approach natural capitalism because it's based on the principle that business can be good for the environment. For instance, Interface of Atlanta doubled revenues and employment and tripled profits by creating an environmentally friendly system of recycling floor coverings for businesses. The authors also describe how the next generation of cars is closer than we might think. Manufacturers are already perfecting vehicles that are ultralight, aerodynamic, and fueled by hybrid gas-electric systems. If natural capitalism continues to blossom, so much money and resources will be saved that societies will be able to focus on issues such as housing, contend Hawken, author of a book and PBS series called Growing a Business, and the Lovinses, who cofounded and directed the Rocky Mountain Institute, an environmental think tank. The book is a fascinating and provocative read for public-policy makers, as well as environmentalists and capitalists alike. --Dan Ring
Customer Reviews:
Great for Green Building..........2007-10-05
this is a great resource for anyone wanting to learn more about sustainable building practices and how they can affect your bottom line. I recommend it for architects, designers and developers alike.
Excellent environmental analysis, clear direction!.......2007-10-04
This book provides a wealth of environmental analysis, including well-considered advice for policymakers at every level (from federal down to county). Also there is solid information for residential/condominium owners. The section that describes and designs how low-end residential units can sell energy back to the grid and raise their standard of living was exceptionally well-written. I am still reading the rest of the book and have not stopped since I first picked it up.
Great solutions to in-depth problems.......2007-09-30
I've only read the first two chapters, but its very motivating. The authors creatively give solutions to the environmental problems of the world. They fully understand the problems at hand, analyze them completely and give valuable ideas for probably and realistic solutions.
A more complete view of the economy.......2007-09-19
This book shows how our current view of the environment is flawed. It brings us from viewing the environment as something too vast to be harmed, to understanding that technology has given humanity the ability to profoundly affect the environment. The book presents a good argument as to why we need to see nature as part of the economic cycle and factor its use into how we use and manage the earth's resources.
A better way of living.......2007-09-11
This book is a little old so some of the infomation is out dated, but the ideas are still radically new for many people. There is a lot to be take from this book on both the micro and macro models, all of which are about creating greater efficiancy in the markets, and lowering the cost to consumers, all the while creating new jobs and reducing pollution. The book tells people how to help reduce their energy costs through simple changes in everday living. It also goes into great detail about market failures, government failures, and the compounding problem of global warming. This book is about the facts no ideological stance, with the authors saying that fossil fuel use is not going to go away anytime soon, but fossil fuels are only one small part of the entire picture. You will not be bored while reading this book, and should be mad after learning how much more money we are spending on goods of lesser quality.
Average customer rating:
- Excellent analysis with some weak points
- Redefining Health Care
- A new look
- Disappointed but Some Might Find Value
- Redefining Health Care
|
Redefining Health Care: Creating Value-Based Competition on Results
Michael E. Porter , and
Elizabeth Olmsted Teisberg
Manufacturer: Harvard Business School Press
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ASIN: 1591397782 |
Book Description
The U.S. health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing costs--not to mention the stability of state and federal government budgets.
In Redefining Health Care, internationally renowned strategy expert Michael E. Porter and innovation expert Elizabeth Olmsted Teisberg reveal the underlying and largely overlooked causes of the problem and provide a powerful prescription for change. The authors argue that participants in the health care system have competed to shift costs, accumulate bargaining power, and restrict services rather than create value for patients. This zero-sum competition takes place at the wrong level--among health plans, networks, and hospitals--rather than where it matters most: in the diagnosis, treatment, and prevention of specific health conditions.
In spite of competition among these systems, the patient care cycle is poorly coordinated. The fractured system undermines both efficiency and quality of outcomes.
Redefining Health Care lays out a breakthrough framework for redefining health care competition based on patient value over the full cycle of care—from prevention and diagnosis through recovery or long-term disease management. With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move to value-based competition on results that will unleash stunning improvements in quality and efficiency.
Customer Reviews:
Excellent analysis with some weak points.......2007-09-01
This book has received probably disproportionate attention due to Prof. Porter's notoriety as a strategic thinking theorist. There are better overall books on healthcare policy available. In particular I recommend the Bodenheimer/Grumbach books, one on healthcare policy and one on primary care, Dr. Arnold Relman's book, A Second Opinion, Strained Mercy, an outstanding and thorough analysis of healthcare economics with particular regard to Canada's healthcare system, among others.
I find the analysis of the USA healthcare system by Profs. Porter and Teisberg to generally be excellent, although I find it wanting in regard to their disparagement of a single-payer/single-insurer system and to their description and analysis of healthcare systems outside the USA. From my perspective private health plans play only a net negative role in the system. The authors' analysis of how the health insurance market works is quite good. However their recommendation that a system of private insurers should persist is refuted by their own analysis! A single payer/insurer system will not cure the problems of the US system, as they clearly point out, but it does remove the inherently dysfunctional characteristics of private insurance, not least of which is its failure to meet the needs of the uninsured - a very large number - and its inherent propensity to exclude the very people who need coverage and care. The authors rightly point out that mandatory health insurance along with risk-pooling among insurers to spread the costs of those insured individuals who generate the highest costs is a "solution" to the current non-functioning system, but the same result, at lower cost and with much greater simplicity, can be achieved through a single payer/insurer.
The other key aspect of healthcare - how it is delivered - is ultimately more important than the financing/insurance side. The authors provide excellent analysis and recommendations in this regard. They correctly address the aspects of the healthcare market that prevent its functioning as a "competitive" market, specifically the abysmal lack of patient information on prices for services, on outcomes of actions by providers, comparative statistics on provider performance and similar. They also provide an interesting report by the Cleveland Clinic on outcomes, i.e. results, of the Clinic's heart surgery activity. They appropriately use this as an example of the kind of reporting that is needed.
The authors' analysis of healthcare systems outside the USA is skimpy and inaccurate in my opinion. The authors underplay the demonstrated efficacy of government-funded systems that outperform the USA system almost across the board in gross measures of outcomes (infant mortality and longevity) and vastly outperform the US system in regard to cost. They gloss over the fact that per capita costs in the USA are 2.5 times! the average of other OECD countries. It is not as though the costs are say 10% above the average with comparable outcomes. They are 150% higher with worse outcomes. Instead of noting this and analyzing it thoroughly, the authors assert that waiting times and rationing of care are significant problems in those countries, assertions which are simply not borne out by a closer examination of the facts. Also the fact that (mostly) single-payer/insurer systems function well universally does not fit the authors' main thesis, so rather than revise the thesis based on this evidence they choose to ignore the evidence.
As a consequence of these limitations I rate the book with 4 stars rather than 5. Too bad, because most of the book is excellent.
Redefining Health Care.......2007-05-23
Book Review
Redefining Health Care by Michael Porter
I am writing this review to help share some excellent ideas on the availability and quality of medical treatment in the United States and on the U.S. economy which is being dragged down by ever-increasing medical costs. The economic impact is not just on corporate profits and stock prices but also on U.S. employment because everything that raises costs makes it harder for U.S. manufacturers to compete with foreign suppliers and makes it harder for U.S. manufacturers to sell in foreign markets.
Unfortunately, the book is long, turgid, and full of details, which help to substantiate his conclusions and also provide guidance on implementing improved policies. I am afraid the book does not appeal to executives, politicians, or doctors. It also proposes radical changes in all aspects of the medical system and its financing and operation. Dr. Porter proposes major changes on the part of all parties involved in delivering and paying for health care.
The book begins with a review of health indexes and health care throughout the world and shows, while the U.S. has the greatest expenditures by any set of measurements, it does not have the best results.
Then, Dr. Porter introduces his most important concept: that any medical treatment should be measured by its results; how much lost time and discomfort did the patient have, is he or she completely cured, or how much disability measured over the entire span of the illness or even the life of the patient. We tend to think of an operation as being successful if the patient left the hospital in good condition. But how much additional recovery time, disability, or reoccurrence was there? If the patient doesn't come back to see him, a doctor doesn't know whether he was cured by the treatment or if the patient was so dissatisfied he went to another doctor or simply gave up on a series of treatments. The goal is to develop a scoring system for each group of illnesses that can be compared with the cost of each individual's treatment and their results to determine what is the best set of procedures and the best doctor or group of doctors to do the work can be used to guide providers and treatments. Porter has some reason to believe that the best treatments are generally less costly even though the individual item costs may be more, the greater effectiveness and the less chance of complications reduces overall cost. Included in the overall cost should be lost wages, which is a reasonable proxy for the patient's time.
The goal is to develop a health plan that pays for results not for treatments. In many cases, that would be a single payment to the provider for a whole series of treatments from diagnosis on through operations, post-operative care, and follow ups which could extend over a long period of time. This is a radical change from the present system which pays for treatments and tends to produce more treatments and does not have any effective means for either the insurers, or the employers, or the patients even to compare one treatment option with another. This is an extreme, radical change and would take a long time to implement, but there are pieces of the program in operation. A number of these are explained at length. Health insurance companies could hire these firms for their specialized expertise and would not have to do the work on their own. An example of what is done is how the firm studies the history of heart transplant patients and will give an insurance company a single payment for the entire course of treatment providing it is done in the manner and by people they specify. They would particularly focus on caregivers who have an outstanding record of success. It appears that for most illnesses, there are organizations that are substantially better than others and this program could be extended broadly.
Another area of development would be to have counselors which would be part of the function of the insurer to advise a company's employees with a list of particularly well qualified doctors and suggest treatment elements.
Government would seem to be poorly adapted to facilitating these changes because they are radically different from Medicare. Medicare seems to promote cheap, but not necessarily effective treatments and set arbitrary pay scales which do not allow the better providers to charge more for their services and thus encourage more providers to be in the high performance category. Companies that pay for the insurance are the ones that have to put pressure on the insurers to implement the above changes. This could not be done over a short period of time but would eliminate a lot of the wasted time that is now involved in the payments for each little step of the process and for each treatment step.
Chapter 8 is a detailed discussion of how to implement the aforementioned concepts using modifications of Medicare and other laws. This is too complex to summarize here but it appears doable if Congress and the Executive are sufficiently motivated. It is likely that few people would understand what is happening, but the benefits to cost ratio is sufficiently great that the changes would probably be supported and accepted. On the other hand, the situation is so complex, it is questionable whether lawmakers and administrators would be willing to undertake the many complex tasks required. On the other hand, the downside risk appears quite small.
Porter approaches the whole subject from the points of view of business strategy and the problems of decisions with very imperfect information. While the government frequently acts with very imperfect information, its strategy for doing so is not well developed and poorly applied.
Redefining Health Care: Creating Value-Based Competition on Results
A new look.......2007-05-20
Though a little dry, and at times repetitive, this book offers practical information. In a mess of books describing the massive problems in healthcare today, this book was at once motivating and up-lifting. I bought it for a class, but it is one of the books I'll be keeping instead of passing along at the end of the quarter.
Disappointed but Some Might Find Value.......2007-04-05
I'm a big fan of Porter, but I was somewhat disappointed by this book. Let me be frank. The first problem I have with the book is that the authors try to capture as large of an audience as possible, being careful not to place blame on certain providers within the health care system. That approach might get better reviews and sell more copies, but it is not delivering real value. One cannot escape mention of the realities of corruption and fraud by every player in health care and expect to address the problems.
The second problem I have is that Porter fails to recognize that health care is distinct from any other industry in America because it is highly politically influenced. Much of the health care system is public (government funded). This is a main reason why competition in this industry is highly ineffective. How can you have a pure competitive environment when poor performing providers continue to receive government-funded contracts? How can you have full competition when Washington merely fines providers for fraud with no jail time? How can you have competition that creates value when Washington places the burden of increasing costs upon taxpayers, letting the industry charge what it needs to deliver earnings that Wall Street expects?
Overall, by failing to address the harsh realities of politics and big money within America's health care industry, Porter's book is too idealistic and therefore falls short of offering a real solution. Regardless, it is a quality book and at least does what no other has in trying to approach the problems from a reasonable standpoint. I expected more from him, but clearly this book is a view from academia and is far detached from many realities of big industry in America. There are many good points in the book, but without addressing the main problems of a system whereby lobbyist groups who control health care policy, very little will change.
Redefining Health Care.......2007-01-09
Overall the book is a very good essay on how our healthcare system needs to evolve. From my vantage point, many of the points are relevant. It is a relatively lenghty book, being 400 pages, but the book does have a good, logical flow. It is worth reading to better understand our current healthcare system and ways to improve it.
Amazon.com
The End of Oil is a "geologic cautionary tale for a complacent world accustomed to reliable infusions of cheap energy." The book centers around one irrefutable fact: the global supply of oil is being depleted at an alarming rate. Precisely how much accessible (not to mention theoretical) oil remains is debatable, but even conservative estimates mark the peak of production in decades rather than centuries. Which energy sources will replace oil, who will control them, and how disruptive to the current world order the transition from one system to the next will be are just a few of the big questions that Paul Roberts attempts to answer in this timely book.
As Roberts makes abundantly clear, the major oil players in the world wield their enormous economic and political power in order to maintain the status quo. Of course, they get plenty of help from the tens of millions of consumers, particularly in the U.S. and Europe, who guzzle oil as if there is an unlimited supply. And this demand shows no sign of abating--nearly half of the world's population lives without the benefits of fossil fuels and they desperately want to be among the haves. In countries such as China and India, where energy systems are already breaking down, Roberts discusses how they are looking to oil to fuel their race for development, in many cases ignoring environmental considerations altogether.
Though there is much to be pessimistic about, Roberts does uncover some positive developments, such as the race for alternative energy sources, notably hydrogen fuel cells, which could help to ease us off of our oil dependence before a full-blown energy crisis occurs. No one book could cover every aspect of what Roberts calls "arguably the most serious crisis ever to face industrial society," but The End of Oil is a remarkably informative and balanced introduction to this pressing subject. --Shawn Carkonen
Book Description
You live in this world. You use oil. You must read this book. The situation is alarming and irrefutable: within thirty years, even by conservative estimates, we will have burned our way through most of the oil that is readily available to us. Already, the costly side effects of dependence on fossil fuel are taking their toll. Even as oil-related conflict threatens entire nations, individual consumers are suffering from higher prices at the gas pump, rising health problems, and the grim prospect of long-term environmental damage. In this frank and balanced investigation, Paul Roberts offers a timely wake-up call. He talks to both oil optimists and oil pessimists, delves deep into the economics and politics of oil, and considers the promises and pitfalls of alternatives such as wind power, hybrid cars, and hydrogen. A new afterword brings the book up to the minute. Brisk, immediate, and accessible, this is essential reading for anyone who uses oil, which is to say every one of us.
Customer Reviews:
Fair minded and objective overview of big energy.......2007-09-23
Very readable....Roberts does an excellent job of presenting opinions fairly and from many pro/contra angles. He has fully immersed himself in his topic and the book is chocked-full of fascinating energy facts.
What to do about our energy future has become as politically polarized as abortion - Conservatives favor fossil fuels and the Moderate - Liberal folks want to go Renewable.
Roberts is bare-knuckled about what he feels the agendas are behind the current debate, which leads him to a (slightly) reserved pessimism about our chances of making it out of the mess we've made, by putting all our energy eggs in one basket. He does not hide his contempt for later-day politicians who can't see the forest for the trees and won't take action to avert the coming energy drought.
A must read, but with lots of salt........2007-08-14
This book is both well-written and well-researched. The analysis is sound, in so far as I understand this complex set of issues.
But I have serious doubts. First, I found the writing hysterical and humorless. Granted, he's a journalist, and this is subject is serious, but my first instinct on reading a book written like this is to call BS. I've seen too many books over the years on subjects like Japanese industrial dominance, the death of the whales, economic collapse, etc., to believe that mankind won't self-adjust somehow. To forecast the "end of civilization" in re: Diamond's Collapse, is to make lots of dubious assumptions about causation.
That is not to trivialize the real dangers he exposes with regard to our energy supply. The trifecta of petro-terrorism, climate change, and the energy lobby in DC is surely dangerous. Danger, however, does not spell Mad Max: Beyond Thunderdome. It spells real problems, that may limit our taste for luxury, but I don't think it's a given that a coming "perilous new world" will make Austin, TX the new Camden, NJ. (Camden's not even that bad).
I think it's instructive to look back to the two basic views on human nature undergirding our liberal legal system: Hobbes and Locke. Roberts seems to believe that a constrained energy supply will lead us to the war of all against all. I'm not so sure we're all that anti-social, and humankind's seen this discussion around 1550-1700. So, if the end of oil poses a crisis in wealth, we will all have to cope, but I'm not sure we'll all become like "dogs fighting in the street over pieces of meat", to quote from the oilman in Syriana.
Wake up call for Americans.......2007-04-15
A lot of these reviews are very good. I think the book is very informative and deeply researhed. I also recommend reading "Blood Oil", look it up.
Great book, but a little scary.......2007-03-15
An excellent, thorough and fair review of the global energy situation and the options for our future. It's just a little scary and frustrating that we really aren't doing anything about the challenges the author presents.
Fantastic! Eye-opening, timely, and useful guide for these times!.......2007-03-09
This book gives you a thorough history of our relationship to energy sources, and prepares us for the bumpy roads ahead. Highly recommended. I can now dive into current oil/global warming/energy issues and headlines with a greater understanding of the overall picture. Thankfully, since this was written, the Inconvenient Truth movie was released, and people are getting clued in to the realities of climate change.
Customer Reviews:
Excellent Introduction to EE concepts.......2006-01-21
Tietenberg is a big player in evironmental economics, and clearly lays out the fundamentals of environmental and natural resources economics accessible to those without significant economics training.
Out of Date.......2004-04-28
The book is hopelessly out of date. Although it carries a 2003 publication date, it still refers to the USSR and Czechoslovakia in the present tense. It consistently refers to studies done in the 1980s as recent and less than 25% of the examples, charts. etc. use data from 1990 or later. For example, only 5 out of 37 references in the chapter on Economic Justice are more recent than 1990, and the most recent is 1994. This is typical of just about every chapter. One gets the feeling that the publisher never reviewed this revided edition.
Good for Graduate School.......2001-06-06
I used this book for graduate school. Its a textbook and little more. But, it is a well written textbook.
good.......1999-03-15
goo
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