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10 September 2009 • 7:00 am

Best Practice in Best Practice?

U.S. President Barack Obama delivers his speech on healthcare. REUTERS/Jason Reed

U.S. President Barack Obama delivers his speech on healthcare. REUTERS/Jason Reed

U.S. President Barack Obama gave his highly-anticipated speech on health care reform to a joint session of the U.S. Congress and a national TV audience yesterday evening. For those outside of the U.S., speeches to both houses of Congress are relatively rare (except for an annual ‘state of the union’ address), and this speech marked a crucial point in the intense health care reform debate that has been raging here for the past several months. I am sure that several other bloggers have already or will shortly provide their take on the speech itself, so I will spare you my own interpretation. But Obama used the ‘best practice’ term to describe a couple of U.S. regions in which per-capita health care costs are both significantly lower than average, while quality of care and outcomes are better than average (a theme in a New Yorker article I reviewed over the summer), in his desire to improve the cost and quality of health care across the country.

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27 June 2009 • 12:29 pm

Economist: U.S. Health Care Reform is ‘Going to Hurt’

Today’s brief (some might say lazy) Saturday post points you to a concise piece in The Economist, an esteemed publication I admire for the quality of its writing, if not always for it’s political views.

What distinguishes The Economist’s writing from all of the noise and posturing is both its incisiveness and its moderation. Their introductory piece is a worthwhile five-minute read that summarizes the key issues without getting bogged down in rhetoric. And their Photo-shopped picture of Barack Obama might make you smile.

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24 June 2009 • 8:05 am

SUVs and the Law of Unintended Consequences

SUVs have become an icon for the regret some of us share for our recent history. Their inefficient use of fuel has increased U.S. dependence on foreign oil, and shrinking demand has pushed the once mighty U.S. auto industry and economy to the brink. SUVs were popular because people felt safe in them. But they were wrong.

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11 June 2009 • 6:22 pm

Required Reading in the White House

The New York Times reported this week that a recent New Yorker article on health care spending has become required reading in the White House, and that President Obama referred to the article in a briefing on health care reform with Democratic senators. The article, which is a lengthy but very worthwhile read, was written by Atul Gawande, who is both a staff writer for the New Yorker and general and endocrine surgeon at Brigham and Women’s Hospital in Boston. Along with President Obama, I recommend this article to anyone interested in the likely changes to U.S. health care policy that is on the political horizon.

Gawande’s article follows his curiosity and research into regional disparities in health care spending; why some places spend far more (per Medicare enrollee, an approximation of overall spending) than others, without significant differences in overall public health or patient outcomes. His research focused on the town of McAllen, Texas, “the most expensive town in the most expensive country for health care in the world,” where annual Medicare spending per enrollee (in 2006) was around $15,000, almost twice the national average.

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5 June 2009 • 8:03 pm

Economist: GM was ‘Disastrously Inflexible’

I want to share with you the opening lines of the lead story in tomorrow’s Economist. With no punches pulled, the issue’s cover story disects the decline and bankruptcy of GM, once the most powerful corporation in the world. The tale of GM is a sad but effective illustration of the deadly combination of long-term avoidance of change and institutionalized support of the status quo, in this case by the U.S. goverment. The article is a very worthwhile read for those engaged in strategic planning. Your comments are welcome below.

The decline and fall of General Motors

Detroitosaurus wrecks

The lessons for America and the car industry from the biggest industrial collapse ever

The demise of GM had been expected for so long that when it finally died there was barely a whimper. Wall Street was unmoved. Congress did not draw breath. America shrugged. Yet the indifference with which the news was received should not obscure its importance. A company which once sold half the cars in America, employed in its various guises as many people as the combined populations of Nevada and Delaware and was regarded as a model for managers all over the world has just gone under; and its collapse holds important lessons about management, about government and about the future of the car industry.

GM’s architect, Alfred Sloan, never had Henry Ford’s entrepreneurial or technical genius, but he had organisation. He designed his company around the needs of his customers (“a car for every purse and purpose”). The divisional structure he created in the 1920s, with professional managers reporting to a head office through strict financial monitoring, was adopted by other titans of American business, such as GE, Dupont and IBM before the model spread across the rich world.

Although this model was brilliantly designed for domination, when the environment changed it proved disastrously inflexible…

3 June 2009 • 4:14 pm

U.S. CTO: “How many new billion-dollar businesses can we create?”

A story in today’s New York Times portrays Aneesh Chopra, the recently confirmed Chief Technology Officer of the United States. I am impressed by the weight of the job title alone: CTO of the entire country. Hmmm. The position was created by President Obama in fulfillment of a campaign promise. So how does Mr. Chopra, the former Secretary of Technology for the State of Virginia, describe his job? 

Mr. Chopra says that his top goal is economic development using government policy to create jobs and business around technology. “My job is to serve as the innovation platform champion in addressing private market opportunities in support of public priorities.”

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