November 2007 – Page 2 – artdiamondblog.com

Incentives for Organ Donations Would Save Lives

Sally Satel is a medical doctor and a resident scholar at the Amerrican Enterprise Institute. Source of photo: http://www.aei.org/publications/filter.all,pubID.25785/pub_detail.asp

(p. A12) At the annual meeting of The American Society of Transplant Surgeons this winter a straw poll revealed that 80 to 85% were in favor of studying incentives for living donors, according to society president Arthur Matas. In 2003, the American Medical Association testified on behalf of legislation that would have permitted pilot studies of incentives for deceased organs.

The public seems receptive as well, according to a new Gallup poll on attitudes toward donation of organs after death. The most striking results were among 18 to 34 year olds wherein an impressive 34% said that incentives would make them "more likely" to donate while 6% said less likely. . . .

. . .

The idea of combining organ donation with material gain can make people queasy. Yet the mix of financial and humanitarian motives is commonplace. No one objects, for example, to a tax credit for charitable contributions–a financial incentive to complement the "pure" motive of giving to others. The great teachers who enlighten us and the doctors who heal us inspire no less gratitude because they are paid. An increase in the supply of kidneys will ameliorate suffering and prevent needless death. This is more important than whether an organ has been given freely or for material gain. . . .

For the full commentary, see:

Satel, Sally. "Doing Well By Doing Good." The Wall Street Journal (Fri, March 16 2007): A12.

(Note: ellipses added.)

The Internet Adds Value for Restaurant Consumers and Efficiency for Restaurant Owners

Source of graph: online version of the NYT article cited below.

(p. C1) SAN FRANCISCO, June 17 — Town Hall, one of the busiest restaurants in this food-crazed city, seems the very model of old-fashioned dining. Patrons who arrive to claim their reserved seats are greeted by a hostess who consults a piece of paper with the day’s reservations and leads her guests to the appointed table.

But upstairs, in the restaurant’s office, a different scene is playing out. In a veritable mission-control setting, a reservationist answers eight phone lines while seated in front of two computers that log reservations and hold an archive of past and future electronic bookings.

The software also reveals the idiosyncrasies of thousands of guests. The restaurant staff knows in advance, for instance, that a regular always insists on a table under a particular piece of artwork. They know about another person’s request for kosher food — but only when dining in certain company. And there is the guest so reliably late that staff members know to add 45 minutes to the reservation time.

After decades of relying on telephones to book tables, and piles of index cards — or a maitre d’hotel’s memory — to collect information about diners and their quirks, the restaurant business has finally gone unabashedly high-tech.

Technology may not make it any easier for diners to get a reservation at the most sought-after spots, like the French Laundry in Yountville, Calif., or Babbo in New York City. But the perseverance of a San Francisco-based company called OpenTable, which has come to dominate the business of online restaurant reservations, is making it much easier for restaurants to manage reservations and improve customer service.

. . .

(p. C5) Making a reservation through OpenTable costs the diner nothing. And it reduces the inconvenience. Say you want a table on short notice at a busy Manhattan restaurant — Danny Meyer’s Union Square Cafe. Placing a phone call there usually requires calling during business hours, enduring loud jazz for hold music, and talking with a reservationist for a while before finding an acceptable time. OpenTable might give you the same results, but it will do the work in 10 seconds.

. . .

Many of the restaurants discovered that they had to surrender to the automation because their popularity suffered if they did not.

“It was a long, long time before that was proven,” said Bill Gurley, a Silicon Valley venture capitalist whose company, Benchmark, has invested $21.6 million in OpenTable over the years.

It took three years for OpenTable to seat its one-millionth diner. But now, the company seats two million diners every month. And Zagat, the restaurant rating service, has adopted OpenTable for reservations made through its site, zagat.com

For the full story, see:

KATIE HAFNER. "Restaurant Reservations Go Online." The New York Times (Mon., June 18, 2007): C1 & C5.

(Note: ellipses added.)

"Doug Washington, left, and Mitchell Rosenthal are partners in Salt House in San Francisco, one of 7,000 restaurants using OpenTable." Source of caption and photo: online version of the NYT article cited above.

“Musing on the Sameness of Princes and Paupers”

King Edward’s suite is enjoyed by Münster, Germany resident Henriette Heussner. Source of photo: online version of the NYT article quoted and cited below.

(p. A4) MARIANSKE LAZNE, Czech Republic — Anybody with a little cash in this quaint and quiet spa town can take a bath fit for a king.

Edward VII of Britain visited this bucolic corner of Bohemia six times during his short reign and each time took a bath in the Royal Cabin, as his private bathroom at the Nove Lazne hotel is still called. For about $45, you can, too.

. . .

King Edward’s Royal Cabin, a spacious Turkish-bath-style suite, is outfitted with a metal alloy tub and a medieval-looking oaken chair that serves as a toilet and a scale.

. . .

The windows are as delicately painted as a church’s stained glass, and the walls richly decorated with a tropical mural, just as they were in Edwardian days. Angels wearing miters look down from the ceiling.

Lying in the bath, staring up at the same blue parrot that King Edward surely contemplated on the opposite wall, one cannot help musing on the sameness of princes and paupers and those who are somewhere in between.

Tiny bubbles like the carbonation on a soda straw collect on the skin, and larger bubbles percolate around the bather, producing a peculiarly pleasant sensation.

An archaic water heater in a corner of the room clanks contentedly, keeping the bath at what the hotel staff call an “optimal” 97 degrees. The smell of the water is sulfuric and slightly metallic.

Much history and many baths have passed since the king bathed here. In the end, everyone grabs the same metal handle that he did to hoist himself up and out of the tub.

For the full story, see:

CRAIG S. SMITH. "MARIANSKE LAZNE JOURNAL; This Year at Marienbad, They’re Still Taking the Waters." The New York Times (Tues., July 3, 2007): A4.

(Note: ellipses added.)

Source of maps: online version of the NYT article cited above.

“India is Outsourcing Outsourcing”

"Infosys employs workers in Brno, Czech Republic." Source of caption and photo: online version of the NYT article quoted, and cited, below.

(p. A1) MYSORE, India — Thousands of Indians report to Infosys Technologies’ campus here to learn the finer points of programming. Lately, though, packs of foreigners have been roaming the manicured lawns, too.

Many of them are recent American college graduates, and some have even turned down job offers from coveted employers like Google. Instead, they accepted a novel assignment from Infosys, the Indian technology giant: fly here for six months of training, then return home to work in the company’s American back offices.

India is outsourcing outsourcing.

One of the constants of the global economy has been companies moving their tasks — and jobs — to India. But rising wages and a stronger currency here, demands for workers who speak languages other than English, and competition from countries looking to emulate India’s success as a back office — including China, Morocco and Mexico — are challenging that model.

Many executives here acknowledge that outsourcing, having rained most heavily on India, will increasingly sprinkle tasks around the globe. Or, as Ashok Vemuri, an Infosys senior vice president, put it, the future of outsourcing is “to take the work from any part of the world and do it in any part of the world.”

. . .

(p. A14) Such is the new outsourcing: A company in the United States pays an Indian vendor 7,000 miles away to supply it with Mexican engineers working 150 miles south of the United States border.

In Europe, too, companies now hire Infosys to manage back offices in their own backyards. When an American manufacturer, for instance, needed a system to handle bills from multiple vendors supplying its factories in different European countries, it turned to the Indian company. The manufacturer’s different locations scan the invoices and send them to an office of Infosys, where each bill is passed to the right language team. The teams verify the orders and send the payment to the suppliers while logged in to the client’s computer system.

More than a dozen languages are spoken at the Infosys office, which is in Brno, Czech Republic.

For the full story, see:

ANAND GIRIDHARADAS. "Outsourcing Comes Full Circle As India Starts to Export Jobs." The New York Times (Tues., September 25, 2007): A1 & A14.

(Note: the somewhat different title of the online version was: "Outsourcing Works So Well, India Is Sending Jobs Abroad.")

U.S. Jobs Moving “Up the Occupational Chains” to Work that “Is Not as Rules-Based”

Source of graphic: online verion of the NYT article cited below.

(p. C1) Jeffrey Taft is a road warrior in the global high-technology services economy, and his work shows why there are limits to the number of skilled jobs that can be shipped abroad in the Internet age.

Each Monday, Mr. Taft awakes before dawn at his home in Canonsburg, Pa., heads for the Pittsburgh airport and flies to Houston for the week.

He is one of dozens of I.B.M. services employees from around the country who are working with a Texas utility, CenterPoint Energy, to install computerized electric meters, sensors and software in a “smart grid” project to improve service and conserve energy.

Mr. Taft, 51, is an engineer fluent in programming languages and experienced in the utility business. Much of his work, he says, involves being a translator between the different vernaculars and cultures of computing and electric power, as he oversees the design and building of software tailored for utilities. “It takes a tremendous amount of face-to-face work,” he said.

What he does, in short, cannot be done overseas. But some of the programming work can be, so I.B.M. employees in India are also on the utility project team.

The trick for companies like I.B.M. is to figure out what work to do where, and, more important, to keep bringing in the kind of higher-end work that needs to be done in this country, competing on the basis of specialized expertise and not on price alone.

The debate continues over how much skilled work in the vast service sector of the American economy can migrate offshore to lower-cost nations like India. Estimates of the number of services jobs potentially at (p. C4) risk, by economists and research organizations, range widely from a few million to more than 40 million, which is about a third of total employment in services.

Jobs in technology services may be particularly vulnerable because computer programming can be described in math-based rules that are then sent over the Internet to anywhere there are skilled workers. Already, a significant amount of basic computer programming work has gone offshore to fast-growing Indian outsourcing companies like Infosys, Wipro and Tata Consultancy Services.

To compete, companies like I.B.M. have to move up the economic ladder to do more complicated work, as do entire Western economies and individual workers. “Once you start moving up the occupational chains, the work is not as rules-based,” said Frank Levy, a labor economist at the Massachusetts Institute of Technology. “People are doing more custom work that varies case by case.”

In the field of technology services, Mr. Levy said, the essential skill is “often a lot more about business knowledge than it is about software technology — and it’s a lot harder to ship that kind of work overseas.”

For the full story, see:

STEVE LOHR. "At I.B.M., a Smarter Way to Outsource." The New York Times (Thurs., July 5, 2007): C1 & C4.

Levy has co-authored a book that is relevant to the example and issues raised in the article. See:

Levy, Frank, and Richard J. Murnane. The New Division of Labor: How Computers Are Creating the Next Job Market. Princeton, NJ: Princeton University Press, 2004.

IBM engineer Jeffrey Taft (blue shirt) has "local" knowledge of the connection between computer programming and the electric utility business. Here he is on-site in Houston at the offices of CenterPoint Energy. Source of graphic: online verion of the NYT article cited above.

Religiosity Inversely Related to Per Capita GDP

Source of graph: Pew Global Attitudes Project report summary cited below.

I ran across the graph above while looking for other information at the Pew site. The graph is consistent with my belief that science contributes to economic prosperity, and that science and religion are in conflict.

But of course many questions can be raised, such as: how did they measure religiosity?

Here is there answer to that question:

Religiosity is measured using a three-item index ranging from 0-3, with "3" representing the most religious position. Respondents were given a "1" if they believe faith in God is necessary for morality; a "1" if they say religion is very important in their lives; and a "1" if they pray at least once a day.

Source:

"World Publics Welcome Global Trade — But Not Immigration." Pew Global Attitudes Project, a project of the PewResearchCenter Released: 10.04.07 dowloaded from: http://pewglobal.org/reports/display.php?ReportID=258

In Cuba, to Survive “You Have to Resort to the Black Market”

Lady Liberty is rightly aghast at life in Havana. Source of photo: online version of the NYT article cited below.

My friend Luis Locay has warned me in the past to be sceptical of articles that express optimism about Raul Castro being a friend of the free market. One such article is excerpted below. (I am hoping Luis is wrong.)

Raúl Castro has taken several small but meaningful steps over the last year that suggest that he wants to open up Cuban society and perhaps move to a market-driven system, without ceding one-party control, not unlike what has happened in China. During the 1990s, he supported limited private enterprise and foreign investment, reforms his brother reversed four years ago.

. . .

On the economic front, Raúl Castro has allowed the importation of televisions and video disc players. He has told the police to let pirate taxis operate without interference. He pledged to spend millions to refurbish hotels, marinas and golf courses. He even ordered one of the state newspapers to investigate the poor quality of service at state-controlled bakeries and other stores.

Perhaps his most important step, however, was to pay the debts the state owed to private farmers and to raise the prices the state pays for milk and meat. Cubans still live on rations and cope with chronic shortages of staples like beef. Salaries average about $12 a month, and most people spend three-quarters of their income on food, according to a study by Armando Nova González, an economist at the Center for the Study of the Cuban Economy in Havana.

“What a person makes is not enough to live on,” said Jorge, a museum guard who asked that his last name not be used because he feared persecution. “You have to resort to the black market to get along. No, not just to get along, to survive.” He said he and his wife together made about $30 a month, just enough to support their family of four.

But Raúl Castro has disappointed many Cubans who had expected significant changes once he took power. He has always deferred to his brother, and he seems to lack the political power to take major actions until Fidel either gives up total control or dies, experts on Cuba said.

For the full story, see:

JAMES C. McKINLEY, Jr. "Cuba’s Revolution Now Under Two Masters." The New York Times (Fri., July 27, 2007): A3.

The top photo shows Raúl Castro giving the annual speech celebrating the Cuban revolution. (Fidel Castro became ill after the previous year’s speech.) The lower photo shows the reaction to Raúl’s speech from the crowd.

Strong Global Support for Free Markets

Source of table: "World Publics Welcome Global Trade — But Not Immigration." Pew Global Attitudes Project, a project of the PewResearchCenter. Released: 10.04.07 dowloaded from: http://pewglobal.org/reports/display.php?ReportID=258

(p. A10) WASHINGTON, Oct. 4 — Buoyed and battered by globalization, people around the world strongly view international trade as a good thing but harbor growing concerns about its side effects: threats to their cultures, damage to the environment and the challenges posed by immigration, a new survey indicates.

In the Pew Global Attitudes Project survey of people in 46 countries and the Palestinian territories, large majorities everywhere said that trade was a good thing. In countries like Argentina, which recently experienced trade-based growth, the attitude toward trade has become more positive.

But support for trade has decreased in recent years in advanced Western countries, including Germany, Britain, France and Italy — and most sharply in the United States. The number of Americans saying trade is good for the country has dropped by 19 percentage points since 2002, to 59 percent.

“G.D.P. growth hasn’t been as dramatic in these places as in Latin America or Eastern Europe,” said Andrew Kohut, president of the Pew Research Center, referring to gross domestic product, the total value of the goods and services produced in a country. “But worldwide, even though some people are rich and some are poor, support for the basic tenet of capitalism is pretty strong.”

For the full story, see:

BRIAN KNOWLTON. "Globalization, According to the World, Is a Good Thing. Sort Of." The New York Times (Fri., October 5, 2007): A10.

Unintended Consequences of Health Privacy Law

Source of graphic: online version of the NYT article cited below.

(p. A1) An emergency room nurse in Palos Heights, Ill., told Gerard Nussbaum he could not stay with his father-in-law while the elderly man was being treated after a stroke. Another nurse threatened Mr. Nussbaum with arrest for scanning his relative’s medical chart to prove to her that she was about to administer a dangerous second round of sedatives.

The nurses who threatened him with eviction and arrest both made the same claim, Mr. Nussbaum said: that access to his father-in-law and his medical information were prohibited under the Health Insurance Portability and Accountability Act, or Hipaa, as the federal law is known.

Mr. Nussbaum, a health care and Hipaa consultant, knew better and stood his ground. Nothing in the law prevented his involvement. But the confrontation drove home the way Hipaa is misunderstood by medical professionals, as well as the frustration — and even peril — that comes in its wake.

Government studies released in the last few months show the frustration is widespread, an unintended consequence of the 1996 law.

. . .

(p. A12)

Most common are seat-of-the-pants decisions made by employees who feel safer saying “no” than “yes” in the face of ambiguity.

. . .

Ms. McAndrew said there was no way to know how often information was withheld. Of the 27,778 privacy complaints filed since 2003, the only cases investigated, she said, were complaints filed by patients who were denied access to their own information, the one unambiguous violation of the law.

Complaints not investigated include the plights of adult children looking after their parents from afar. Experts say family members frequently hear, “I can’t tell you that because of Hipaa,” when they call to check on the patient’s condition.

That is what happened to Nancy Banks, who drove from Bartlesville, Okla., to her mother’s bedside at Town and Country Hospital in Tampa, Fla., last week because Ms. Banks could not find out what she needed to know over the telephone.

Her 82-year-old mother had had a stroke. When Ms. Banks called her room she heard her mother “screaming and yelling and crying,” but conversation was impossible. So Ms. Banks tried the nursing station.

Whoever answered the phone was not helpful, so Ms. Banks hit the road. Twenty-two hours later, she arrived at the hospital.

But more of the same awaited her. She said her mother’s nurse told her that “because of the Hipaa laws I can get in trouble if I tell you anything.”

In the morning, she could speak to the doctor, she was told.

The next day, Ms. Banks was finally informed that her mother had had heart failure and that her kidneys were shutting down.

“I understand privacy laws, but this has gone too far,” Ms. Banks said. “I’m her daughter. This isn’t right.”

A hospital spokeswoman, Elena Mesa, was asked if nurses were following Hipaa protocol when they denied adult children information about their parents.

She could not answer the question, Ms. Mesa said, because Hipaa prevented her from such discussions with the press.

For the full story, see:

JANE GROSS. "Keeping Patients’ Details Private, Even From Kin." The New York Times (Tues., July 3, 2007): A1 & A12.

(Note: ellipses added.)

After nurses refused to tell her what was wrong over the phone, Nancy Banks (left) drove 22 hours to find out that her mother Lourene Trusler (right) had had a stroke. Source of photo: online version of the NYT article cited above.

Texas Shows Tort Reform Works

"Dr. Donald W. Patrick, executive director of the Texas Medical Board, with applications for medical licenses sent to it." Source of caption and photo: online version of the NYT article quoted, and cited, below.

HOUSTON, Oct. 4 — In Texas, it can be a long wait for a doctor: up to six months.

That is not for an appointment. That is the time it can take the Texas Medical Board to process applications to practice.

Four years after Texas voters approved a constitutional amendment limiting awards in medical malpractice lawsuits, doctors are responding as supporters predicted, arriving from all parts of the country to swell the ranks of specialists at Texas hospitals and bring professional health care to some long-underserved rural areas.

The influx, raising the state’s abysmally low ranking in physicians per capita, has flooded the medical board’s offices in Austin with applications for licenses, close to 2,500 at last count.

“It was hard to believe at first; we thought it was a spike,” said Dr. Donald W. Patrick, executive director of the medical board and a neurosurgeon and lawyer. But Dr. Patrick said the trend — licenses up 18 percent since 2003, when the damage caps were enacted — has held, with an even sharper jump of 30 percent in the last fiscal year, compared with the year before.

“Doctors are coming to Texas because they sense a friendlier malpractice climate,” he said.

For the full story, see:

RALPH BLUMENTHAL. "After Texas Caps Malpractice Awards, Doctors Rush to Practice There." The New York Times (Fri., October 5, 2007): A21.

Buying the Prius as an Advertisement of One’s Political Correctness

Source of graphs: online version of the NYT article cited below.

(p. A1) A riddle: Why has the Toyota Prius enjoyed such success, with sales of more than 400,000 in the United States, when most other hybrid models struggle to find buyers?

One answer may be that buyers of the Prius want everyone to know they are driving a hybrid.

The Prius, after all, was built from the ground up as a hybrid, and is sold only as a hybrid. By contrast, the main way to tell that a Honda Civic, Ford Escape or Saturn Vue is a hybrid version is a small badge on the trunk or side panel.

The Prius has become, in a sense, the four-wheel equivalent of those popular rubber “issue bracelets” in yellow and other colors — it shows the world that its owner cares.

In fact, more than half of the Prius buyers surveyed this spring by CNW Marketing Research of Bandon, Ore., said the main reason they purchased their car was that “it makes a statement about me.”

Only a third of Prius owners cited that reason just three years ago, according to CNW, which tracks consumer buying trends.

“I really want people to know that I care about the environment,” said Joy Feasley of Philadelphia, owner of a green 2006 Prius. “I like that people stop and ask me how I like my car.”

For the full story, see:

MICHELINE MAYNARD. "Say ‘Hybrid’ and Many People Will Hear ‘Prius’." The New York Times (Weds, July 4, 2007): A1 & A11.

Peter Darnell describes himself as a "granola-crunching liberal." He and his wife Karen (right) own a Prius. Source of quote and photo: online version of the NYT article cited above.