"This book is the best I've ever read detailing a practical theory of evaluation. It is comprehensive, beautifully written, and makes sense of the evaluation enterprise. It does so by emphasizing the major function of evaluation as sense-making about policies and programs."
--Thomas D. Cook, professor, sociology, psychology, education, and public policy, Northwestern University
Programs that serve the needs of the public continually face changes brought by social, political, and economic forces. To survive these changes, organizations must evaluate their programs wisely and realistically. This book offers a new approach to evaluation, one that will encourage all kinds of organizations and agencies to improve their contributions to social betterment. The authors draw from three decades of evaluation practice and theory to present their own framework for conceptualizing evaluation and for pragmatically assessing social policies and programs.
To build knowledge and expertise for future programs
For the practitioner, these purposes help define the approach and methods for an evaluation. The authors also enrich their discussion with four possible modes of inquiry: description, classification, causal analysis, and values inquiry. Filled with tables, charts, and figures, this resource invites organizations to make the most appropriate programming decisions based on thoughtful and systematic methods. Evaluation: An Integrated Framework for Understanding, Guiding, and Improving Policies and Programs is a tool that scholars can use to rejuvenate their view of evaluation and that practitioners can use to integrate the best techniques with a contemporary understanding of social policy and change.
Customer Reviews:
A Primer for sorting out conceptual muddles in the field.......2004-01-22
Amidst a burgeoning growth industry in policy evaluation, characterized by a plethora of approaches and non-standard language usage, editors of two prominent evaluation journals join forces with a third colleague to provide an overview and an inclusive framework that differentiates in simple language, major approaches taken to policy and program evaluation to date.
Beginning with a core definition of evaluation as assisted sense-making whose ultimate objective is social betterment, the authors distinguish four purposes of evaluation: (1) assessment of merit and worth (2) program and organizational improvement, (3) oversight and compliance, and (4) knowledge development. Conceptual clarity over purpose(s) helps avoid muddles encountered in everyday arenas of evaluation and is directly pertinent to modes of inquiry appropriate to those purposes. In the second section of the book the authors distinguish four types of evaluative inquiry and discuss how to plan corresponding evaluative methods appropriate to the purpose(s) at hand. With a view toward conceptual coherence, they spend a chapter grounding their conception of evaluation as assisted sense-making in a philosophy of common sense realism. The third and final section of the book then considers closely, uses and challenges for each of these four modes of evaluative inquiry and devotes one chapter to each: (1) "Description," (2) "Classification," (3) "Causal Analysis," and (4) "Values Inquiry." In so doing, the authors contribute toward enhanced clarity in the "evaluation jungle" at significant levels of analysis and deliver what they promise in simple common sense language: an integrated framework for understanding, guiding, and improving public and nonprofit policies and programs.
My only reservation is related to what in content is also a strength. Rich in academic references, with an adaptation in format, these references could have better been placed in endnotes rather than parentheses. This would have facilitated reading flow. The decision to keep a format that is probably more useful in journals than books accounts for a one star deduction and four star rating.
A solid well-grounded theoretical analysis that will help those engaged in policy/program evaluation sort out a lot of muddles ahead of time rather than unnecessarily being caught in the mire. Another indication that, while good theory will never get as far as accounting for all the exigencies in a complex world, good theory is helpful in avoiding unnecessary confusions and many commonplace and wholly predictable errors in advance. Highly recommended.
Aimed at both practitioners and academics.......2003-08-23
This book serves two purposes. It is a comprehensive text on evaluation aimed at both practitioners and academics, but most importantly, it is a treatise aimed at introducing a new evaluation framework. It is a textbook with a point of view. The authors begin with the premise that the fundamental purpose of evaluation is social betterment, which is "...the reduction or prevention of social problems, the improvement of social conditions, and the alleviation of human suffering." From these roots, they build a new `realistic' evaluation framework. Although aimed primarily at public and non-profit organizations, many of the lessons can be applied in the private sector as well.
Part one examines why one would want to do an evaluation in the first place. The authors purport that evaluation is a fundamental part of the democratic process because it is crucial in informing policy and decision makers about the effectiveness of public policy and programs. The book reviews the four purposes of evaluation (assessment of merit and worth, program and organizational improvement, oversight and compliance, and knowledge development) and introduces the four inquiry modes (description, classification, causal analysis and values inquiry). The authors provide extensive coverage and a critique of the academic debates concerning purposes, modes and methodology. This leads to the proposal of a realistic philosophy, which aims to move beyond traditional paradigm silos. The authors argue that by focusing on the ultimate goal of social betterment and by seeking to surface underlying values, it is possible to follow a path that tailors methodology to intended purpose.
Part two covers evaluation planning and begins the practical application part of the book. Different evaluation purposes become paramount and are more aptly suited, depending on the environment (stable, competitive, shifts in funding or new policy/program). Choosing appropriate methodology and evaluation extensiveness (i.e. quality) is aided by an understanding of primary and secondary evaluation purposes; the book provides decision-making matrices as well as many examples and references. The authors expand on their notion of a `common-sense realistic' philosophy and provide an extensive overview of the supporting principles. It is a philosophy underlined by the notion of evaluation as `assisted sensemaking' that aims to build upon and extend natural human perceptual processes. In practice, it is flexible, antiformalist and rejects the fact-value and qualitative-quantitative dichotomies. In short, it aims to do what works in a given situation and contributes the most to social betterment.
Part three provides extensive detail on the four inquiry modes (description, classification, causal analysis and values inquiry). Each chapter provides a complete overview: detailed arguments about how the selected mode can be used to support the four evaluation purposes, examples of specific evaluation methodology, interactions, notable caveats and pitfalls and an overview of critical opinion. The sections on classification and causal analysis are especially extensive, full of detailed methodology and references to external sources. The authors expand on the notion of how values inquiry can be critical in a complementary role with other modes.
The authors conclude with a statement that the field of evaluation is "...moving towards yet another rite of passage." They argue that evaluators need "...to take their proper place in the policy community" and they must become "...shameless in broadly spreading their findings...." They make a final argument in support of their realistic philosophy.
The book is often dense with citations, making for difficult reading at times. In places, especially in part one, the level of detail is far beyond that needed by the average practitioner. However, this would seem to suit the academic audience, who would find the sections devoted to methodology (aimed at practitioners) unnecessary. It seems a happy compromise. Name and subject indexes facilitate use of the book as a reference text. A thorough bibliography points the reader to external sources. It is a text thoroughly worth the attention of anyone interested in the field of evaluation.
Aimed at both practitioners and academics.......2003-08-23
This book serves two purposes. It is a comprehensive text on evaluation aimed at both practitioners and academics, but most importantly, it is a treatise aimed at introducing a new evaluation framework. It is a textbook with a point of view. The authors begin with the premise that the fundamental purpose of evaluation is social betterment, which is "...the reduction or prevention of social problems, the improvement of social conditions, and the alleviation of human suffering." From these roots, they build a new `realistic' evaluation framework. Although aimed primarily at public and non-profit organizations, many of the lessons can be applied in the private sector as well.
Part one examines why one would want to do an evaluation in the first place. The authors purport that evaluation is a fundamental part of the democratic process because it is crucial in informing policy and decision makers about the effectiveness of public policy and programs. The book reviews the four purposes of evaluation (assessment of merit and worth, program and organizational improvement, oversight and compliance, and knowledge development) and introduces the four inquiry modes (description, classification, causal analysis and values inquiry). The authors provide extensive coverage and a critique of the academic debates concerning purposes, modes and methodology. This leads to the proposal of a realistic philosophy, which aims to move beyond traditional paradigm silos. The authors argue that by focusing on the ultimate goal of social betterment and by seeking to surface underlying values, it is possible to follow a path that tailors methodology to intended purpose.
Part two covers evaluation planning and begins the practical application part of the book. Different evaluation purposes become paramount and are more aptly suited, depending on the environment (stable, competitive, shifts in funding or new policy/program). Choosing appropriate methodology and evaluation extensiveness (i.e. quality) is aided by an understanding of primary and secondary evaluation purposes; the book provides decision-making matrices as well as many examples and references. The authors expand on their notion of a `common-sense realistic' philosophy and provide an extensive overview of the supporting principles. It is a philosophy underlined by the notion of evaluation as `assisted sensemaking' that aims to build upon and extend natural human perceptual processes. In practice, it is flexible, antiformalist and rejects the fact-value and qualitative-quantitative dichotomies. In short, it aims to do what works in a given situation and contributes the most to social betterment.
Part three provides extensive detail on the four inquiry modes (description, classification, causal analysis and values inquiry). Each chapter provides a complete overview: detailed arguments about how the selected mode can be used to support the four evaluation purposes, examples of specific evaluation methodology, interactions, notable caveats and pitfalls and an overview of critical opinion. The sections on classification and causal analysis are especially extensive, full of detailed methodology and references to external sources. The authors expand on the notion of how values inquiry can be critical in a complementary role with other modes.
The authors conclude with a statement that the field of evaluation is "...moving towards yet another rite of passage." They argue that evaluators need "...to take their proper place in the policy community" and they must become "...shameless in broadly spreading their findings...." They make a final argument in support of their realistic philosophy.
The book is often dense with citations, making for difficult reading at times. In places, especially in part one, the level of detail is far beyond that needed by the average practitioner. However, this would seem to suit the academic audience, who would find the sections devoted to methodology (aimed at practitioners) unnecessary. It seems a happy compromise. Name and subject indexes facilitate use of the book as a reference text. A thorough bibliography points the reader to external sources. It is a text thoroughly worth the attention of anyone interested in the field of evaluation.
Book Description
Hands-On Social Marketing provides a comprehensive guide to the social marketing process for professionals who wish to influence health or social behaviors using effective techniques of this emerging field. Written in a friendly, engaging style, this book leads the reader throughout the steps involved in developing, implementing, and evaluating a social marketing program. Hands-On Social Marketing also includes comprehensive worksheets and practical sidebars providing expert advice. This "how-to" book is both instructional and functional, with an emphasis on low-cost methods and do-it-yourself guidelines. After explaining the basic concepts of social marketing, Hands-On Social Marketing devotes a section to each of the five steps in the author's model of the social marketing process: Planning Message and materials development Pretesting Implementation Evaluation and feedback The main message of this book is that you yourself can do social marketing! About the Author Nedra Kline Weinreich is President of Weinreich Communications, a social marketing firm based in the San Francisco Bay Area. She has worked in the fields of social marketing and health communciations for many years for clients such as the U.S. Public Health Service Family Planning Grantees, Virginia Department of Health, U.S. Department of Energy, National Institute of Mental Health, and National Center of Child Abuse and Neglect Clearinghouse. She earned her master's degree in health and social behavior from the Harvard School of Public Health and is a certified health education specialist. In addition to conducting training and providing consultation on developing social marketing programs, she has written several articles on social marketing. She publishes a website, the Social Marketing Place, at, http://www.social-marketing.com.
Customer Reviews:
Made-to-Order for Social Marketers.......2004-12-17
This work book is chock-filled with practical help for preparing an effective social marketing plan. I enjoyed the easy-to-use forms. Many great ideas for applying social marketing too. It's so hard to find resources that relate to the unique nature and challenges of this kind of marketing. If you are a non-profit change oriented social marketer you need this book on your shelf!
Terrific resource for nonprofits.......2003-02-26
I have used this resource with clients who have few resources and little experience in social marketing. It is a well written guidebook that explains the steps in developing social marketing strategies and provides well constructed worksheets. The book is extremely enlightening for organizations who are doing this for the first time or who cannot afford high-priced consultants. As a writer without much social marketing background, it helped me help my clients. It might be worth noting that the reference is designed for U.S. use and cites resources only available here, but I still found the basic approach helpful for an overseas client.
Book Description
Using the examples of Vioxx, Celebrex, cholesterol-lowering statin drugs, and anti-depressants,
Overdo$ed America shows that at the heart of the current crisis in American medicine lies the commercialization of medical knowledge itself.
Drawing on his background in statistics, epidemiology, and health policy,
John Abramson, M.D., an award-winning family doctor on the clinical faculty at Harvard Medical School, reveals the ways in which the drug companies have misrepresented statistical evidence, misled doctors, and compromised our health. The good news is that the best scientific evidence shows that reclaiming responsibility for your own health is often far more effective than taking the latest blockbuster drug.
You -- and your doctor -- will be stunned by this unflinching exposé of American medicine.
Customer Reviews:
Overdosed America.......2007-09-03
Abramson does a well researched job of explaining why Americans take so many pills, why many of them are not necessary, and how generics are generally as effective as brand names. It is an eyeopener concerning drug research and sales practices. Very useful in most peoples' everyday life.
Exposes the REAL Drug Pushers.......2007-08-12
The author demonstrates how the drug companies have learned how to manipulate the system that approves and recommends their product. As a result, your doctor has no clue that there is very weak scientific support behind many of the expensive drugs that they are telling you to take.
The power of this book can be demonstrated by its ability to predict future events. For example, shortly after I finished reading it, a study was published in the New England Journal of Medicine regarding the popular and expensive blood sugar controlling drug Avandia. Yes, Avandia does control blood sugar, but it also increases the risk of heart attacks by 43%. Whoops!
After reading this book I now understand why the Democrats and Republicans were climbing on top of each other to be the first to pass a drug bill that no one really wanted (except the drug companies). And I know that our health care system is overly expensive and not the best.
This is one of several excellent books that explores this fascinating topic. Cholesterol Myths and Cholesterol Conspiracy are some others that come to mind. But this book is broader in scope, and gives tremendous perspective on the health care system as a whole. It is also quite empowering, because you will learn that it's good to be skeptical of doctors, whether they are pushing expensive treatments and drugs, or simply dishing out hackneyed "lifestyle" advice about changing your diet.
The bottom line is to keep fit and flexible, and you will be doing more for yourself healthwise than all the prescription pads in the world.
Patients BEWARE your doctor might be harming you with bad drugs.......2007-08-04
Thanks Dr. Abramson for being honest enough to write your book and alert the rest of us about how the drug companies have turned our physicians into legalized drug pushers. I had a feeling that this was going on for the past 10 to 15 years when drug ads began appearing on TV, drug reps began swarming around my doctor's office and my own doctor seemed to be recommending too many drugs for my ailments. This book not only made me aware but it angered me to know that there are many patients out there who are literally suffering from the serious side effects of drugs that were recommended by doctors who allowed themselves to be brainwashed by the drug companies. SHAME ON ALL OF THEM for harming us. From now on, I will never trust my doctor completely and I encourage others to do the same. Demand that your doctor recommend natural alternatives and make sure you know ALL of the side effects of a drug before taking it.
classics .......2007-08-02
Overdosed America is a classic amongst books that expose problem of America's pharmaceutical industry. This book helps expose the terrible Vioxx and Celebrex scandal whereby side effects of these drugs were known by the pharmceutical industries and to certain extent by the FDA for years before action was taken to either take the drug off the market or blacklabeled was applied. It detailed how the structure of the pharmacuetical industry (lobbist, relation to medical schools, relation to FDA, relation to doctors) lead to disincentive to reduce cost and improve healthcare industry. This book has sprawn a whole literature related to this topic. If you want to read a book related to this field, start with this one. Other books might be written by industry specialists or reporters (this author was retired family doctor), but reading this book first helps you understand what the newer books are responding to.
When will it all stop?.......2007-06-22
This book has given me reason to believe America is on a downhill spiral. No not because of our lack of Church attendance, or prayer in our schools, or even crime in our streets. No otherwise legitimate businesses are fleecing the American taxpayer, and their partner in crime is the Congress, the Senate, and the President. This to me is a very sad state of affairs. We are allowing people to die just to keep Big Pharma fat.
Revealed here are the reasons for so many of our so called incurables. Diseases for which Medical Science has no solution. At the same time Big Pharma is using it's influences to prevent scientific advances from being achieved, or at best keeping them quiet, simply because it will hurt their bottom line.
Everyone gather around, Big Pharma, is in business to make a "PROFIT," and to keep it's share holders happy. Not I repeat, not to make you well. Again at best these drugs they produce are crutches, nearly permanent crutches. My Grandfather used insulin for nearly 35 years, up until the day of his death, and we are now finding that processed foods are the biggest reason for Diabetes. You know Factory food, instead of Farm fresh food. Even sader the drug industry has the FDA on it's side to help them to continue their ruse, over our medical schools, and our doctors, not to mention the general public. Just watch some of the commercials Big Pharma uses to convince you 'restless leg syndrom' calls for pills, and not exercise. See how Big Pharma seems to have a pill for whatever ailes you. Instead of changing your lifestyle, we have a pill for that. Got a headache, there is a pill. Indigeation, here is another pill. Oh and by the way, one of the side effects of the headache pill, is it will rot your stomache. Do not worry though, we have a pill for that as well. The nausea from the ulcer pill, we have a pill for that as well. Too fat, there is a pill, etc, etc. WHAT A JOKE.
Like most things now days, we as Americans, ask very few questions, and we believe the Government is taking care of us. Believe it or not this is why our knuckle headed president is proposing limits on who you can sue in a court of law, and what your settlement will be. So what if someone died, it controls the population, and our bottom line remains intact.
Todays medications are no better than the Snake Oil, that was sold in the times before the FDA, and we have made little, if any progress.
Please read the book, ask questions, and ask more questions. Become more proactive concerning yours and your family's health.
Average customer rating:
- OVER THE EDGE
- market s in healthcare?
- So she's no Tolstoy, but the ideas are great.
- There is no "market" in American medical care, period.
- Admirable goals,solutions ignore some regulatory constraints
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Market-Driven Healthcare: Who Wins, Who Loses in the Transformation of America's Largest Service Industry
Regina E. Herzlinger
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ASIN: 0738201367 |
Customer Reviews:
OVER THE EDGE.......2007-04-14
THE IDEA THAT " THE MARKET " CAN FIX ANYTHING HAS BEEN AROUND A LONG TIME.
AND IT CAN IF YOU ARE ON THE RECEIVING END OF THE PAYMENT SYSTEM. IT'S GREAT! HOWEVER IF YOU ARE THE " PAYER " I.E. WORKING FOR LITTLE OR NOTHING, PAYING TAXES, BUYING THREE DOLLAR GAS, GETTING YOUR RATTLE TRAP CAR FIXED SO YOU CAN GO TO YOUR EIGHT DOLLAR AN HOUR JOB...YOU REALLY CAN'T FIX ANYTHING.
VOTING DOES NO GOOD WHAT-SO-EVER AS EVERY POLITICIAN WHO HAS EVER LIVED IS ON BOARD FOR ALL THE MONEY THEY CAN GET. THE ONLY THING THAT WILL WORK, REALLY WORK IS IF THE PEOPLE OF THE USA TAKE THEIR GOVERNMENT BACK AND MAKE IT WORK IN THE BEST INTERESTS OF ALL. THIS IS NOT LIKELY TO HAPPEN SOON BECAUSE 99%
OF PEOPLE IN THIS COUNTRY ARE BRAIN-WASHED DAILY INTO BELIEVING THEY HAVE NO POWER.
GET READY FOR MORE "MARKET" DRIVEN "SOLUTIONS" FOR YOUR EVER MOUNTING PROBLEMS. AND IF YOU HAVE YOUR HEAD IN THE SAND YOU DESERVE WHAT YOU GET IN THE END...
market s in healthcare? .......2005-07-30
Herzlinger is a card-carrying member of the club that believes that markets can cure all social ills, and like all members of this club, she plays fast and loose with reality. For instance, she tries to present the vision market as an exemplar of how market forces can work in healthcare. Vision is one of the few areas of medicine where patients can appraise the value of the service, the quality of the provider, and make decisions about how much they are willing to pay. That is simply not the case when a patient is really sick with heart failure, and needs multiple medications, multiple doctors, and is probably going to be hospitalized repeatedly.
In trying to argue that all aspects of medicine can follow market rules the way vision services do, Herzlinger conveniently ignores one critical fact: there is no true market in the healthcare industry, and there can't be. Kenneth J. Arrow, Nobel Prize winning economist pointed this out 30 years ago, and his observations are still true today. Providers (doctors and hospitals, and increasingly the drug and device industries) drive demand for their services. They are the ones who decide what patients need. The notion that patients can have suffient information to be able to determine what they need is probably only true for the 80 percent of people who consume 20 percent of healthcare costs. The 20 percent who eat up 80 percent of costs are sick with multiple conditions. Imagine your grandmother is in the hospital, sick with diabetes, and pneumonia, scared, having a hard time breathing, and she's supposed to sort through whether or not she should pay the $600 to call in the pulmonologist? The patients with chronic, multiple, debilitating disorders actually need the exerpertise of medical professionals.
Her focused factories have come to pass: they are called specialty, or even super-specialty, hospitals, which focus on one procedure, or one category of specialty. There are cardiac hospitals, for instance, that only perform by-pass surgery, cardiac catheterization,angioplasty, and stenting. Are they good at what they do? Sure, because they focus on a narrow range of procedures, they only take insured patients, and they don't take anybody with comorbidities. Of course, the really expensive patients tend to have comorbidies. The effect of the specialty hospitals on local healthcare markets? They do not bring down costs, they simply drain profit from full-spectrum community hospitals, which still have to care for all those patients with pneumonia and who don't have health insurance.
The imbalance of information between physician and patient is simply insurmoutable, and without that kind of balance, markets don't work very well.
So she's no Tolstoy, but the ideas are great........2004-03-15
No one will accuse Ms. Herzlinger of being a great writer, but her conversational style is easy to read and she does have some good ideas for how the healthcare industry should be. Ideas that still haven't been implemented even now, 8 years after it was written. She does make a fairly convincing argument for how focused factories could reduce costs. In addition, suggestions that everybody should have health insurance, that healthcare providers should not be insulated from market forces, that consumers are the ones with the real power to stop the soaring healthcare costs, and that they'll only curtail spending when given incentive to do so are good points that can't be made often enough. Points that seem even more relevant today given the continued increase in healthcare costs, the inability of the HMO system to manage them, and the spiraling problem the growing uninsured population is creating (the more uninsured people there are, the more insurance costs, which increases the number of uninsured, etc.). She has good ideas, I think it's time people listened. It's of vital importance that the healthcare system incorporate what's great about America, what has made America a leader in every other industry: innovation and sensibly regulated free markets. Ms. Herzlinger gives us a good way to get it done.
I also have to ask if some of the other reviewers actually read the book. The author gives a pretty good analysis of how focused factories would reduce costs, using that 20% of the people produce 80% of the costs as a cornerstone of her argument. Also, she cites physicians' inability to deal with market forces as a cause of the problem and gives suggestions for how to deal with it.
There is no "market" in American medical care, period........2003-12-13
Market forces cannot solve the medical crisis. No market exists. Knowledge of what is sold is inequivalent: if patients knew the difference between colonoscopy and colposcopy, they would not know the fair market value of either procedure. Unlike buying a car, where the dealer knows you can walk off, patients cannot negotiate, and can't determine the quantity of medical services needed. Eyeglasses constitute a misleading example. Physicians are the principal drivers of all expenditure on medical care. Without a medical license, nothing can be ordered or prescribed. This fact must be faced squarely: the supplier of services regulates the level of demand for medical services. Annual outlays have now reached $1.6 trillion with no end in sight to the physician-driven escalation in expenditures. This is not COST inflation, but relentless EXPENDITURE INCREASE driven chiefly by an oversupply of medical doctors. If this system is ever to be fixed, these stubborn realities must be faced. This author evidently has no clue that there is not a "market" operating in the world of medical care delivery, thus her analysis is unhelpful.
Admirable goals,solutions ignore some regulatory constraints.......1999-03-01
The author accurately identifies a subpopulation of patients who are middle class,time constrained, and annoyed with the difficulty of obtaining quick evaluation and therapy for a variety of health problems of varying complexity. After examining a number of systems for health care delivery, she gives the nod to highly specialized and focused units such as the Shouldice Clinic for hernia surgery in Canada. There are several problems with the soultions she proposes: 1) Goverment regulatory agencies and third party payers currently refuse to pay multiple consultants for seeing a patient on the same day. 2)Patients with complex multisystem problems may be ill served in such a focused system- eg. the patient who has congestive heart failure and a hernia. 3)There would monumental problems with education of medical students and residents in such a system. While this is a secondary consideration in a market driven system in which there is a physician surplus, if we fail to adequately educate physicians for future generations the law of supply and demand will ultimately come back to haunt us.
Book Description
Promoters of multi-billion dollar land-use development megaprojects systematically misinform parliaments, the public and the media in order to get them approved and built. This book not only explores these issues, but suggests practical solutions drawing on theory and scientific evidence from the several hundred projects in twenty nations and five continents. It is of interest to students, scholars, planners, economists, auditors, politicians and concerned citizens.
Customer Reviews:
Packed with Knowledge!.......2004-03-02
Every once in a while a little book comes along that, while small in size, carries sufficient intellectual weight to strike the body politic between the eyes, thereby getting its collective attention. This may be one such book. It offers a realistic look at megaprojects - those major infrastructure endeavors that span vast bodies of water, dam natural resources to generate energy and extend rail lines to previously unreachable regions - and compares the promises of these projects to what they actually deliver. The report card isn't very good. Cost overruns are typically 25% to 100%, and sometimes 200% or more. Worse yet, studies show that the public tends to use megaprojects - be they airports or subway systems - only a fraction of the amount predicted. We strongly recommends this book to politicians, legislators and anyone who wants to know the truth behind these huge infrastructure projects, as well as to CEOs, CFOs, project managers and risk officers in the private sector - this applies to your projects, even if there is a difference of scale.
A fool, his money and the bridge that parted them..............2003-09-13
I am the first amazon.com reviewer of this short, but important book. It concerns me that this might reflect a diminished U.S. readership. That would be unfortunate. Professor Bent Flyvbjerg and his colleagues have written a book of significance to taxpayers everywhere. It's apparent that they have written this book largely for the policy-maker; yet, make no mistake about it: the ordinary taxpayer has a major stake in this book's message. The central characters in Megaprojects and Risk are three large-scale, European transportation projects: the Chunnel, the Great Belt and the Oresund. American readers unfamilar with these names (the chunnel connecting London and Paris is perhaps the most recognizable to American readers) will nonetheless recognize familiar features. Specifically, they will find project costs that exceed estimates, and revenue inflows that are below projections. The traits are not unique to these projects. In fact, cost over-runs and revenue disappointments are a familiar global refrain, according to these authors. In spite of this, the number and scale of infrastructure projects continues to grow, forming what they call the megaproject paradox. The book is stronger on documenting problems, including the lack of project post-audits, than on providing solutions. I think they have correctly identified the problem -- the lack of accountability throughout the project life-cycle -- but their solution, which largely involves ensuring a healthy segment of private capital not supported by state guarantees, together with more attention to genuine risk assessment, falls short of the mark. The risk assessment tools are firmly established and largely well-understood (Monte Carlo simulation packages are increasingly available). So is the "moral hazard" problem that rears its ugly head when projects (in this case) are "over-insured." The difficulty, which they acknowledge, is that the political interplay between state, private interests and NGOs are decisive in determining whether and to what extent the appropriate risk assessment and risk management tools are used.
This problem is inherent in the beast. Policy-makers would love for the private sector to shoulder the risk, but may not be willing to permit a commensurate return. Private players, just as understandably, are apt to seek insurance of one kind or another on the downside. The best medicine, and one that this book delivers admirably, is simply to raise our awareness of the track record from the start.
This short book has the look and feel of an academic work. It would, however, be unfortunate if it languished at the university bookstore. Global demographics dictate that larger-scale infrastructure investments are in our future. No one should pay for, promote or plan for such projects before they have digested the lessons in Megaprojects and Risk.
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