La mitjana de visites per entitat proveïdora mostra diferències que van des de 3,6 a 8,0 en els menors de 15 anys, i de 6,6 a 10,4 en els majors de 14 anys (taula 5). En el cas dels adults, les diferències no estan relacionades amb l’edat: mitjanes baixes corresponen a pacients amb mitjana d’edat alta i viceversa.I jo em pregunto si no es relacionen amb l'edat, aleshores què passa?. Tracten millor unes entitats proveïdores que altres? .
How I wish I had earlier read Mises—the senior colleague of Friedrich Hayek and the teacher of Kirzner! It would have sped up my intellectual development by two or three decades, and given me more respect for the entrepreneur-centered thinking of my friendly opponent early in my career as an economic historian, the historian David Landes. It might have allowed me as early as the 1970s to use the Kirznerian entrepreneur to make progress on the puzzle of economic growth—instead of having to wait until the 2000s, painfully extracting myself over the decades from a Samuelsonian-Friedmanite devotion to equilibrium and routine.PS. Sobre el títol del post. Humanomics es refereix al darrer estadi del viatge intel.lectual de McCloskey als 68 anys, economia per a humans de cap a peus.(així ho explica a la p.2)
In my opinion, McCloskey's paper is required reading for all who want to understand why some nations grow rich while others languish in poverty. It is a continuation of the argument presented in her Bourgeois Dignity: Why Economics Cannot Explain the Modern World. McCloskey summarizes her argument nicely here, and she pursues the entrepreneurial element in the story in her reflections on Kirzner and Austrian economics. I have attempted to address her thesis in my essay "A Behavioral Approach to the Political and Economic Inquiry Into the Nature and Causes of the Wealth of Nations."
Many elements in McCloskey's argument remind me of the nuanced argument made by Tyler Cowen in a very underappreciated essay of his -- "Entrepreneurship, Austrian Economics, and the Quarrel Between Philosophy and Poetry."
“The key to political order, is the establishment of credible bounds on the behavior of political officials”.Douglas North. Understanding the Process of Economic Change. Princeton: Princeton University Press.2005, p. 107
In just two years, the government has cut spending on health care to $17 billion from $19.5 billion — a 13 percent decrease. And under its agreement with its creditors, Greece must find even more health care savings next year — as much as $915 million, government officials said.Si els grecs han fet retallades del 13% en dos anys, a Catalunya les fem del 14,33% en un any. Pressupost 2010+ desviament= 9875+850=10725 m€. Pressupost 2011= 9188 m€. Reducció pressupostària de 1.537 milions d'euros. I a més a més cal tenir en compte l'impacte de la centrifugadora: entre 2004-2009 ha augmentat l'endeutament financer dels hospitals concertats en un 114%.
So what do patients really want from health care, anyway? In a recent issue of JAMA, Dr. Allan Detsky, an internist and health policy expert at the University of Toronto tackled this question, based on his years of clinical and research experience. It’s a terrific, and sobering, piece, as highlighted below.
Highest priority:
Lower priority:
- Restoring health when ill – “the majority of patients focus on relieving illness and symptoms rather than disease prevention”
- Timeliness – care is wanted “immediately”
- Kindness – “in the days before health insurance, patients paid for care that consisted primarily of kindness”
- Hope and certainty – even in dire situations, patients “want to have hope and be offered options that might help”
- Continuity, choice, coordination – care from “same person or team” important
- Private room – including “their own bathroom and no roommate”
- No out-of-pocket costs – “patients want to pay as little as possible” themselves and to know that “insurance or third-party coverage is always available to them”
- The best medicine – patients want to know their doctors are “highly qualified” but do not want this information “to be statistical. They prefer testimonials from other patients or clinicians they trust”
- Medications and surgery – treatments that patients “perceive will require little effort” are strongly preferred, as are “medications and surgical procedures” compared to “clinical strategies that involve behavior changes.”
Lowest priority:
- Efficiency – patients only modestly interested in care that delivers “the most value with the least resources”
- Aggregate-level statistics – far less important to patients than treatments are likely to work “in their specific case.” Also, as before, “testimonials trump scientific evidence.”
- Equity – patients are more concerned with whether “they are receiving adequate health care services” than whether “all members of society should have a right to it, regardless of income”
- Conflicts of interest – patients are less concerned about motivation of provider in prescribing particular treatments “as long as the service helps make them better without increasing the costs they have to bear”
Implications:
- Real costs – “individual patients have virtually no interest in costs they do not bear”
- Percent GNP devoted to healthcare – “just a number and has absolutely no relevance for individual patients”
Detsky comments, “Some might say that the consumers’ preferences described in this article are irrational and unrealistic; that may be true…. However, the lack of rationality does not render these preferences irrelevant.”
En la teoria de jocs tradicional, l'estratègia anomenada tit for tat («tal faràs tal trobaràs») es resumeix en: «només coopero si l'altre coopera». És també la més simple; es comença cooperant en la primera jugada i després simplement es copia el moviment previ de l'altre jugador. Els teòrics de jocs consideren que el tit for tat reuneix quatre trets que identifiquen les estratègies guanyadores i que juntes la fan guanyar en totes les proves fetes pels experts contra estratègies molt més sofisticades i més «brutes» (egoisme no cooperatiu): és amable, clement, no envejosa i és compassiva.Com que s'ha començat al revés, de forma no amable i no pagant els 759 milions, el resultat és incert i algú dirà que potser no és d'aplicació, ja veurem.
Una estratègia amable és la que mai no és la primera a ser l'egoista. Una estratègia clement és la que pot venjar-se però té mala memòria, és a dir, tendeix a passar per alt antigues ofenses (es venja immediatament d'un traïdor o egoista, però després oblida el passat). Cal no oblidar que és amable en sentit tècnic, no moral, ja que no perdona en absolut.
L'estratègia tit for tat tampoc no és envejosa, en el sentit que l'individu no vol més recompensa que la dels altres i se sent feliç si l'altre té el mateix premi que un mateix (de fet, amb tit for tat, no guanya mai ningú un joc, com a màxim empata amb el seu oponent)
