Category Archives: Healthcare

Net neutrality 2.0: Perspectives on FCC regulation of internet service providers

By Stuart N. Brotman – The final outcome of this high-profile, high-impact proceeding will not be apparent until sometime late in 2017, at the earliest. Congress may also become more seriously involved at some point on the legislative front.

But without a doubt, as Chairman Pai noted in his Newseum speech, a “fierce debate” lies ahead for a number of months at least. And if past is prologue, the FCC may well receive an avalanche of comments in response to these proposed changes; the record in the Title II Order shows that over four million comments were filed by interested parties and the general public combined.

There will be no lack of political discourse, to be sure.

As we move into 2016, an unresolved national communications policy dilemma remains: whether the public-switched telephone network and the internet are parallel systems or parts of a larger ubiquitous network environment. Determining which characterization will be followed has profound consequences for regulatory treatment.

Given the emerging dominance of mobile over fixed service, if the FCC can’t regulate both, it may win the battle but lose the war. Given that a further appeal is likely regardless of which side prevails, including possible review by the U.S. Supreme Court, Congress may find itself re-emerging as the best source of guidance for the FCC. Legislative action can definitively clarify whether Congress intends for the telephone network and internet to be joined at the hip, or should continue to function in parallel with differing regulatory treatment. more> https://goo.gl/f4x8Uh

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The American healthcare system is for profit, not patients

BOOK REVIEW

An American Sickness: How Healthcare Became Big Business and How You Can Take It Back, Author: Elisabeth Rosenthal.

By Elisabeth Rosenthal – Everyone knows the healthcare system is in disarray. We’ve grown numb to huge bills. We regard high prices as an inescapable American burden. We accept the drugmakers’ argument that they have to charge twice as much for prescriptions as in any other country because lawmakers in nations like Germany and France don’t pay them enough to recoup their research costs.

But would anyone accept that argument if we replaced the word prescriptions with cars or films?

The current market for healthcare just doesn’t deliver. It is deeply, perhaps fatally, flawed.

Imagine if you paid for an airplane ticket and then got separate and inscrutable bills from the airline, the pilot, the copilot, and the flight attendants. That’s how the healthcare market works.

In no other industry do prices for a product vary by a factor of ten depending on where it is purchased, as is the case for bills I’ve seen for echocardiograms, MRI scans, and blood tests to gauge thyroid function or vitamin D levels.

The price of a Prius at a dealership in Princeton, New Jersey, is not five times higher than what you would pay for a Prius in Hackensack and a Prius in New Jersey is not twice as expensive as one in New Mexico.

The price of that car at the very same dealer doesn’t depend on your employer, or if you’re self-employed or unemployed. Why does it matter for healthcare? more> https://goo.gl/5oBK5k

Our world outsmarts us

BOOK REVIEW

A Skeptic’s Guide to the Mind: What Neuroscience Can and Cannot Tell Us About Ourselves, Author: Robert Burton.

By Robert Burton – Whether contemplating the pros and cons of climate change; the role of evolution; the risks versus benefits of vaccines, cancer screening, proper nutrition, genetic engineering; trickle-down versus bottom-up economic policies; or how to improve local traffic, we must be comfortable with a variety of statistical and scientific methodologies, complex risk-reward and probability calculations – not to mention an intuitive grasp of the difference between fact, theory and opinion.

Even moral decisions, such as whether or not to sacrifice one life to save five (as in the classic trolley-car experiment), boil down to often opaque calculations of the relative value of the individual versus the group.

If we are not up to the cognitive task, how might we be expected to respond? Will we graciously acknowledge our individual limits and readily admit that others might have more knowledge and better ideas?

Will those uneasy with numbers and calculations appreciate and admire those who are?

Or is it more likely that a painful-to-acknowledge sense of inadequacy will promote an intellectual defensiveness and resistance to ideas not intuitively obvious? more> https://goo.gl/Bjkogb

America is Regressing into a Developing Nation for Most People

BOOK REVIEW

The Vanishing Middle Class: Prejudice and Power in a Dual Economy, Author: Peter Temin.

By Lynn Parramore – America is not one country anymore. It is becoming two, each with vastly different resources, expectations, and fates.

In one of these countries live members of what Temin calls the “FTE sector” (named for finance, technology, and electronics, the industries which largely support its growth). These are the 20 percent of Americans who enjoy college educations, have good jobs, and sleep soundly knowing that they have not only enough money to meet life’s challenges, but also social networks to bolster their success. They grow up with parents who read books to them, tutors to help with homework, and plenty of stimulating things to do and places to go. They travel in planes and drive new cars. The citizens of this country see economic growth all around them and exciting possibilities for the future.

They make plans, influence policies, and count themselves as lucky to be Americans.

The FTE citizens rarely visit the country where the other 80 percent of Americans live: the low-wage sector. Here, the world of possibility is shrinking, often dramatically. People are burdened with debt and anxious about their insecure jobs if they have a job at all. Many of them are getting sicker and dying younger than they used to. They get around by crumbling public transport and cars they have trouble paying for. Family life is uncertain here; people often don’t partner for the long-term even when they have children. If they go to college, they finance it by going heavily into debt.

They are not thinking about the future; they are focused on surviving the present. The world in which they reside is very different from the one they were taught to believe in. more> https://goo.gl/LKhYy6

Is Singapore’s “miracle” health care system the answer for America?

By Ezra Klein – This is a key difference between Singapore and America. The bulk of the American government’s intervention into the health care system is done through health insurance, and so American analysts often look at Singapore’s insurance system and stop there. But the bulk of the Singapore government’s intervention into the health care system is through the health care system itself

Take the way the two countries subsidize medical care. In America, insurance is often subsidized — by paying the bills of Medicare or Medicaid enrollees, by giving tax credits to Obamacare enrollees and employer-sponsored health plans. In Singapore, medical treatment itself is subsidized.

More than 80 percent of the hospital beds in Singapore are in public hospitals, and those hospitals are cut into different “wards” with different levels of amenities: A-class wards provide unsubsidized care but have single rooms and air conditioning, while C-class wards are overwhelmingly subsidized but are set up like shared dormitories with common toilets.

There are a number of ward levels in between, too, all with a sliding scale of comfort and subsidization. So both A-ward patients and C-ward patients are paying for their own care, but the prices they’re paying are very, very different, because the government is absorbing the direct cost of care in the C-wards. more> https://goo.gl/Gc4oy1

A world-class long jump to a more social Europe

By Patricia Scherer – Who would not like to go to a free public school in Finland or buy their groceries at a local cooperative in Italy?

Who would not want to receive quality community-based support for their grandparent suffering from dementia in some remote rural village, following the Swedish model?

Which working parent would not want to have access to all-day childcare, as in France?

And breathe in fresh air in a buzzling downtown, is the case in car-free Ljubljana, the Slovenian capital?

Who would refuse the support, rather than stigmatization, that the Danish flexicurity system provides to laid-off workers?

Would you not want to vote electronically from home, as in Estonia?

Or take part in the Irish citizens’ assembly to decide on legal and policy issues facing the society you live in today?

All that is Europe; all those are benchmarks to aspire to. more> https://goo.gl/qXmAUX

What Is Single-Payer Healthcare and Why Is It So Popular?

By Alicia Adamczyk – Single payer—or Medicare for All, as it’s sometimes referred to in the U.S.—is a system in which all healthcare financing is provided by one entity, such as (but not always) the federal government.

All residents receive core coverage regardless of income, occupation, or health status.

The U.S. is one of the only countries in the developed world that does not have such a system in place, but in other countries like Canada and England, the care itself is still provided by private organizations and doctors. But that care—everything from hospital visits to prescription drugs to mental health care—is covered for all residents by the state, via taxes determined by the state. In other words, public financing pays for private care.

Healthcare financing in the U.S. is an often complicated web of hospitals, doctors, and other care providers, middlemen like insurance and pharmaceutical companies, and public programs like Medicaid, Medicare, and state-run marketplaces. As many Americans know, it’s incredibly confusing and expensive for most parties involved.

According to Friedman’s report, Americans spend nearly four times as much on billing and insurance-related activities as doctors in Ontario do, where a single entity is in charge of billing and repayments. more> https://goo.gl/hdH62x

Updates from GE

School’s In: GE’s New “Brilliant Learning” Program Will Train Workers For Jobs Of The Future
By Tomas Kellner – Jesse Schrimpf didn’t study additive manufacturing in school. But when a 3D printer showed up at his plant in Waukesha, Wisconsin, the GE Healthcare engineer decided to give the machine a whirl.

Normally, Schrimpf would design a new master mold, order a wooden mold prototype costing as much as $20,000 from a supplier and wait as long as four weeks for the delivery. He would test it, make tweaks and repeat the process. The costs quickly added up.

But with the 3D printer at his disposal, he could print a mold that performed better than the wooden kind in just two days on-site and for $1,000. The printer, which creates 3D objects directly from a computer file, enabled him to incorporate changes into the next design version with his keyboard and a mouse.

Schrimpf is in many ways the poster child for GE’s new “brilliant learning” program the company is launching for employees around the world this week. It includes “massive open online courses” in several languages, workshops, “immersion boot camps on lean manufacturing” and other training designed to help employees get ready for the arrival in the factory of 3D printing, big data, robotics, digital and lean manufacturing and other advanced technologies.

GE is launching “brilliant learning” to change things. The model feeds into the company’s idea of the Brilliant Factory, a plant that uses big data, software sensors, new manufacturing methods and robotics to increase productivity. GE businesses are busy rolling out the concept at 17 sites in Japan, India, Italy, Mexico and also the U.S, and more are in the pipeline. more> https://goo.gl/1jmbjf

Brexit – A Lose-lose Proposition

By Per Wijkman – The UK government hopes to limit its losses by negotiating a new trade agreement giving what EU membership now offers apart from the free movement of labor and trade subject effectively to the European Court of Justice.

This will be difficult. The UK’s negotiating position is weak since the EU Commission plans to start negotiations on a new trade agreement only after the UK has withdrawn from the EU. The UK thus leaves the EU without knowing what will replace membership. Deprived of a secure fall-back position, it will have little leverage.

Border controls, rather than tariffs, generate the major costs involved in cross-border trade, especially when cross-border supply chains are extensive. In order to avoid border controls between the EU and the UK, they must apply a common set of rules concerning technical standards, sanitary and phytosanitary standards, rules of origin, rules for financial services, etc. In addition, they must apply a common legal system in order to guarantee application of the common rules. The less extensive the common legal system, the more shallow the economic integration must be.

Since one of Prime Minister May’s key objectives with Brexit is to re-establish UK sovereignty over its legal system, a common legal system is ruled out. more> https://goo.gl/pCEs57

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Updates from Georgia Tech

New Projects Create a Foundation for Next-Gen Flexible Electronics
By Josh Brown – Four projects set to move forward at the Georgia Institute of Technology aim to lay the groundwork for manufacturing next-generation flexible electronics, which have the potential to make an impact on industries ranging from health care to defense.

Researchers at Georgia Tech are partnering with Boeing, Hewlett Packard Enterprises, General Electric, and DuPont as well other research institutions such as Binghamton University and Stanford University on the projects.

Flexible electronics are circuits and systems that can be bent, folded, stretched or conformed without losing their functionality. The systems are often created using machines that can print components such as logic, memory, sensors, batteries, antennas, and various passives using conductive ink on flexible surfaces. Combined with low-cost manufacturing processes, flexible hybrid electronics unlock new product possibilities for a wide range of electronics used in the health care, consumer products, automotive, aerospace, energy and defense sectors.

“Flexible electronics will make possible new products that will help us address problems associated with food supply, clean water, clean energy, health, infrastructure, and safety and security,” said Suresh Sitaraman, a professor in the George W. Woodruff School of Mechanical Engineering, who is leading Georgia Tech’s flexible electronics activities. more> https://goo.gl/qjx3UT

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