In a previous post, I suggested public sentiment that government does too much but not enough is not contradictory.  It reflects a recognition that government does too little of what it should do, too much of what it shouldn’t.  Today’s news that retails sales were dragged down by a drop in auto purchases, a deflation [...]

The Obama administration proposes $10 billion/year for five years to encourage electronic medical record adoption. Can money be the main obstacle? The health care sector is $2.2 trillion, 1/2 of which is spent on hospital, clinic, and practices services. $10B is a drop in that bucket. The IT industry runs into the $100s of billions too. There must be some other obstacle for which money is not the solution. What do you think? (Please visit chasingtherabbitbook.com for the full post).

The feds have a higher impact policy lever than throwing more money into an underperforming system. Responsible for Medicare, Medicaid, Veterans Affairs, and the DoD health systems, Uncle Sam is singularly able to demand that provider quality be measured and that patients be assigned based accordingly. This will reward individuals and institutions learning to couple affordability with access and quality and will punish those who charge a lot but deliver little.

It is natural to think that effort determines outcome:  Try harder, invest more, and get better results.  However this is not entirely true. 
An important qualifier is that the structure and dynamics of systems can greatly magnify or dampen the impact of investments made in and through them.  Some simple examples.   If we see an [...]