artdiamondblog.com – Page 562 – Art Diamond's web log

A.D.A. Tries to Stop Dental Therapists from Competing with Dentists

“Aurora Johnson, left, a dental therapist, filled cavities for Paul Towarak, 10, in the village of Unalakleet, Alaska. For more involved procedures, Ms. Johnson refers patients to a dentist.” Source of caption and photo: online version of the NYT article quoted and cited below.

Clayton Christensen (and co-authors) have suggested that disruptive technologies could reduce the cost and improve the quality of health care. One pathway for this to occur is new technologies that permit effective treatment to be carried out by para-professionals with less education than MD’s.
The article below illustrates Christensen’s idea, and also highlights the main obstacle to its implementation: professional organizations asking the government to regulate and restrict competition from the lower-cost para-professionals.

(p. A1) UNALAKLEET, Alaska — The dental clinic in this village on the edge of the Bering Sea looks like any other, with four chairs, a well-scrubbed floor and a waiting area filled with magazines.
But to the Alaska Dental Society and the American Dental Association, the clinic is a place where the rules of dentistry are flouted daily. The dental groups object not because of any evidence that the clinic provides substandard care, but because it is run by Aurora Johnson, who is not a dentist. After two years of training in a program unique to Alaska, Ms. Johnson performs basic dental work like drilling and filling cavities.
Some dentists who specialize in public health, noting that 100 million Americans cannot afford adequate dental care, say such training programs should be offered nationwide. But professional dental groups disagree, saying that only dentists, with four years of postcollegiate education, should do work like Ms. John-(p. A15)son’s. And while such arrangements are common outside the United States, only one American dental school, in Anchorage, offers such a program.
. . .
(p. A15) In Alaska, the A.D.A. and the state’s dental society had filed a lawsuit to block the program that trained people like Ms. Johnson, who are called dental therapists. The groups dropped the suit last summer after a state court judge issued a ruling critical of the dentists. But the A.D.A. continues to oppose allowing therapists to operate anywhere in the lower 49 states. Currently, therapists are allowed to practice only in Alaska, and only on Alaska Natives.
. . .
Therapists are a low-cost way to provide care to people who might not otherwise have access to it, according to Dr. Ron Nagel, a dentist and consultant for the Alaska Native Tribal Health Consortium, a nonprofit group financed mostly by federal money that provides medical and dental care to tribal communities. “There’s a huge need for these basic services,” Dr. Nagel said.
. . .
Since 1990, the number of private dentists has remained roughly flat, at 150,000, even as the United States population has increased 22 percent. As a result, dentists can easily fill their appointment books without seeing people who cannot meet their fees, and patients who have decayed teeth are suffering needlessly, said Tammy Guido, 50, who is one of seven students now training in Anchorage to become a therapist.
“We’re meeting a need that is not being met,” Ms. Guido said.
Alaskan tribal organizations sponsor Ms. Guido and the other students in Anchorage for the program. To be accepted, students must have a high school diploma or equivalency degree; for the newest class, 7 of 18 candidates were accepted.
In interviews, the students in this year’s class all said they were enthusiastic about the chance to serve communities that have little access to care. All seven had quit full-time jobs and must now get by on a $750 monthly stipend during the two years of training.
“Anybody who’s ever had a toothache can tell you it hurts,” said Ben Steward, 24, the only man in this year’s class. “But talk to someone who’s had a toothache for a year.”

For the full story, see:
ALEX BERENSON. “Dental Clinics, Meeting a Need With No Dentist.” The New York Times (Mon., April 28, 2008): A1 & A15.
(Note: ellipses added.)

One source of Christensen’s views on health care can be found in a chapter in:
Christensen, Clayton M., Scott D. Anthony, and Erik A. Roth. Seeing What’s Next: Using Theories of Innovation to Predict Industry Change. Boston, MA: Harvard Business School Press, 2004.

Google Considers Creative Entrepreneur’s Trial Balloon

Source of image: online version of the WSJ article quoted and cited below.

Apparently the WSJ‘s new owner, Rupert Murdoch, has not yet succeeded in killing the wonderful, quirky, inimitable front page, center column, articles that are part of what makes the WSJ great:

(p. A1) CHANDLER, Ariz. — Jerry Knoblach wants to bring wireless service to millions of rural Americans. His plan: Beam it down from balloons hovering at the edge of space.
This isn’t just hot air. His company, Space Data Corp., already launches 10 balloons a day across the Southern U.S., providing specialized telecom services to truckers and oil companies. His balloons soar 20 miles into the stratosphere, each carrying a shoebox-size payload of electronics that acts like a mini cellphone “tower” covering thousands of square miles below.
His idea has caught the eye of Google Inc., according to people familiar with the matter. The Internet giant — which is now pushing into wireless services — has considered contracting with Space Data or even buying the firm, according to one person.
. . .
Maintaining a telecom system based on gas-filled bladders floating in the sky requires some creativity. The inexpensive bal-(p. A9)loons are good for only 24 hours or so before ultimately bursting in the thin air of the upper atmosphere. The electronic gear they carry, encased in a small Styrofoam box, then drifts gently back to earth on tiny parachutes.
This means Space Data must constantly send up new balloons. To do that, it hires mechanics employed at small airports across the South. It also hires farmers — particularly, dairy farmers.
They’re “very reliable people,” says Mr. Knoblach. They have to “milk the cows 24-7, 365 days a year, so they’re great people to use as a launch crew.” Space Data pays them $50 per launch.

For the full story, see:

AMOL SHARMA “Floating a New Idea For Going Wireless, Parachute Included; Balloon Launch Gets Google’s Attention; Dairy Farmers Can Help.” The Wall Street Journal (Weds., February 20, 2008): A1 & A9.
(Note: ellipsis added.)

“A balloon being launched in Piedmont, Oklahoma.” Source of image: online version of the WSJ article quoted and cited above.

Castro’s Legacy Is Fear

“A NATION’S PHOTO ALBUM. The prospect of life without Fidel Castro is unsettling to many Cubans, who are wary of drastic change.” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. 1) We arrived not at the fine new airport in Havana I’ve used many times as a correspondent, but at a smaller, more crowded one that Cuba uses for these family visits, as if to rebuke exiles for having left.

Our reunion was delayed, however, by the surprise announcement last Tuesday that Fidel Castro — whose revolution had torn the family apart — was too ill to return to power. Suddenly, I was at work.
. . .
Still, what most surprised us was how little Cubans clamored for drastic change. Dictator or hero, Mr. Castro’s grip on power was ending, and no one seemed to care. Miriam was disappointed that the streets of Matanzas, Havana, San Agustín and Guanabacoa, the working class city across Havana Bay where she grew up, were tranquil, as if nothing at all had happened.
Of course we understood that things are not always as they seem, and that became clear when the maid in our 133-year-old hotel came to mop up the mess caused by a leaking pipe. Hearing the lilt of Miriam’s Spanish put her at ease. After chatting for a few minutes, she poked her head into the hallway to check for supervisors and shut the door. Only then did she speak from the heart.
“Nobody says it, but everybody knows that someone new could be worse than what we have now,” she whispered. It was the kind of dec-(p. 8)laration I’ve learned to trust because it stems from neither fear nor a desire to curry favor.
Despite having plenty of motivation to demand change — the frequent shortages, the decrepit housing, the cruelty of having one currency for tourists and another with far less buying power for Cubans — she said she feared change more than she feared the status quo. Then she checked the hallway again.
. . .
Truth is, things have changed since my first trip to Cuba in 1978. The heavy presence of the Soviet Union then is a faint shadow now, reflected in blue-eyed Cubans named Yuri. There seem to be more new cars on the roads, more fast food on the street, and more buildings undergoing repair. There even seem to be more buses and fewer people waiting for them since Fidel’s younger brother and temporary replacement, Raúl, publicly demanded that something be done about the pitiful mass transit system when I was here just a year ago.
But much has not changed, or has gotten worse. More families live two or three generations in the same cramped apartments. Detention, interrogation and other troubles still descend on people who dissent in ways as small as wearing a plastic wrist band embossed with the word “cambio,” which means change. The press is still controlled, and disloyalty to the Communist Party still raises the suspicion of neighbors that can lead to the loss of a job or a house. Dissidents remain enemies of the state.
. . .
The revolution itself has left many Cubans, including our relatives here, fed up with promises of change. They long ago tired of sacrificing for an ideal tomorrow; when we finally got together, three days after Fidel’s announcement, Miriam’s stepbrothers and sisters told me their main concerns are getting enough to eat, getting shoes for their children and getting to work on time each day.

For the full commentary, see:
ANTHONY DePALMA. “Future to Wince At.” The New York Times, Week in Review Section (Sun., February 24, 2008): 1 & 8.
(Note: ellipses added.)

Schumpeter on How Amphibial State Capitalism Lacks “Motive Power”

From McCraw’s summary of a brief Schumpeter essay published in 1943 in Seymour Harris’ Postwar Economic Problems:

(p. 424) Schumpeter went on to argue that both in the United States and in capitalist countries abroad, a high rate of public spending during the postwar period would likely evolve into total government control of investment. . . . Some industries might be nationalized, and if the government “should try to run the nationalized industries according to the principles of business rationality, Guided Capitalism would shade off into State Capitalism, . . . ”
. . .
The overall result would likely be “an amphibial state for the calculable future.” The amphibial state might well generate frictions among business, labor, and government and would not benefit from the “motive power” of either capitalism or socialism.

Source:
McCraw, Thomas K. Prophet of Innovation: Joseph Schumpeter and Creative Destruction. Cambridge, Mass.: Belknap Press, 2007.
(Note: ellipses added.)

Health Care Spending Takes a Large and Growing Share of Income

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

The most interesting part of the article quoted below, was the above graph, that dramatically shows health care’s large and growing share of disposable personal income.

(p. 28) Among employers, the hardest pressed may be small businesses. Their insurance premiums tend to be proportionately higher than ones paid by large employers, because small companies have little bargaining clout with insurers.

Health costs are “burying small business,” said Mike Roach, who owns a small clothing store in Portland, Ore. He recently testified on health coverage at a Senate hearing led by Ron Wyden, Democrat of Oregon.

Last year, Mr. Roach paid about $27,000 in health premiums for his eight employees. “It’s a huge chunk of change,” he said, noting that he was forced to raise his employees’ yearly deductible by 50 percent, to $750.

For the full story, see:

REED ABELSON and MILT FREUDENHEIM. “Even the Insured Feel Strain of Health Costs.” The New York Times, Section 1 (Sun., May 4, 2008): 1 & 28.

Brain-Controlled Prosthetics Within Reach

“A grid in the monkey’s brain carried signals from 100 neurons for the mechanical arm to grab and carry snacks to the mouth.” Source of caption and photos: online version of the NYT article quoted and cited below.

(p. A1) Two monkeys with tiny sensors in their brains have learned to control a mechanical arm with just their thoughts, using it to reach for and grab food and even to adjust for the size and stickiness of morsels when necessary, scientists reported on Wednesday.

The report, released online by the journal Nature, is the most striking demonstration to date of brain-machine interface technology. Scientists expect that technology will eventually allow people with spinal cord injuries and other paralyzing conditions to gain more control over their lives.
The findings suggest that brain-controlled prosthetics, while not practical, are at least technically within reach.
In previous studies, researchers showed that humans who had been paralyzed for years could learn to control a cursor on a computer screen with their brain waves and that nonhuman primates could use their thoughts to move a mechanical arm, a robotic hand or a robot on a treadmill.
The new experiment goes a step further. In it, the monkeys’ brains seem to have adopted the mechanical appendage as their own, refining its movement as it interacted with real objects in real time. The monkeys had their own arms gently restrained while they learned to use the added one.

For the full story, see:
BENEDICT CAREY. “Monkeys Think, Moving Artificial Arm as Own.” The New York Times (Thurs., May 29, 2008): A1 & A18.

Atlas Statue “Reveals the Powerful Paradox of Strength and Despondency”

“The Atlas at Rockefeller Center has years’ worth of lacquer and wax, in addition to the weight of the heavens, to bear. The four-story-high statue will undergo a six-week cleaning.” Source of the caption and photo: online version of the NYT article quoted and cited below.

(p. 31) Of course, he’s angry. Of course, he’s disheartened. The weight of all the heavens has been on his shoulders for 71 years and, according to the mythological timetable, he has exactly forever to go.
But only a close-up view of Atlas, at the base of the International Building in Rockefeller Center, reveals the powerful paradox of strength and despondency created by Lee Lawrie and Rene Chambellan, the artists behind the four-story-high, seven-ton bronze.
. . .
“Everyone reads the substance of things through the surface,” said Jeffrey Greene, president of EverGreene Painting Studios, which is about to begin a six-week cleaning of Atlas, down to the original patina.
. . .
A snapshot staple of any visitor’s souvenir New York album shows Atlas and the 21-foot-diameter armillary sphere on his shoulders (representing the heavens with which he was burdened by Zeus as a member of the losing Titan team), silhouetted in front of the twin spires of St. Patrick’s Cathedral across Fifth Avenue.
. . .
On Monday, Mr. Greene said, a translucent scrim will be wrapped around the scaffolding. After that, the statue will get a low-pressure steam bath. Any residue will be cleaned with a gel solvent. A clear acrylic protective coating will be applied and the statue will be hand-waxed to a sheen that is more polished at sculptural highlights and flatter in the interstices.
One block south, Atlas’s popular brother, Prometheus (by Paul Manship), was restored nine years ago.

For the full story, see:
DAVID W. DUNLAP. “Bringing a Smile (Well, a Shine) to a Burdened Statue of Atlas.” The New York Times, Section 1 (Sun., May 4, 2008): 31.
(Note: ellipses added.)

FDR Turned Schumpeter into a Fan of Ludwig von Mises

From McCraw writing about Schumpeter:

(pp. 318-319) The New Deal struck him as still another prelude to authoritarianism. He became convinced that Roosevelt’s program represented a step toward either fascism or socialism, and in either case potential dictatorship. He wrote a friend that Roosevelt was like a child mindlessly breaking a machine because he didn’t understand its design. The president “is going to turn me into a fan of [Ludwig von] Mises,” his classmate at the University of Vienna who had become a free-market fundamentalist and an opponent of almost all government intervention.

Source:
McCraw, Thomas K. Prophet of Innovation: Joseph Schumpeter and Creative Destruction. Cambridge, Mass.: Belknap Press, 2007.

“The Low Prices Today Seem Almost Ridiculous”

In 2008 dollars, a basic Brooks Brothers suit cost $788 in 1998 and costs $598 in 2008. Source of photo: online version of the NYT article quoted and cited below.

(p. E1) As luxury fashion has become more expensive, mainstream apparel has become markedly less so. Today, shoppers pay the same price for a basic Brooks Brothers men’s suit, $598, as they did in 1998. The suggested retail price of a pair of Levi’s 501 jeans, $46, is about $4 less than it was a decade ago. A three-pack of Calvin Klein men’s briefs costs $21.50, only $3.50 more than in 1998. Which is the better buy?
Factoring for inflation, each of these examples is actually less expensive today. In current dollars, the 1998 suit would cost $788, the jeans would be $66 and the underwear would be nearly $24.
. . .
(p. E9) Anyone who has spent time walking along 34th Street in Manhattan recently, from Kmart to Macy’s to Forever 21 and H&M, would think that the economic outlook is rosy. Shoppers there are still laden with bags from Payless and Victoria’s Secret, and several said they perceived fashion to be a better buy, with more variety and style at lower prices, than a decade ago.
“You can buy a lot more with your money today than before,” said Joanna Eliza, a recent graduate from the Fashion Institute of Technology, shopping on 34th Street on Tuesday. “Stores like H&M and Forever 21 make it more affordable for people who want to be fashionable, and that makes me feel really good.”
Over all, apparel prices have gone down primarily because of two factors: the overwhelming movement of manufacturing to countries with cheaper labor, where the clothes are made, and increased competition between traditional retailers and discounters, where the clothes are sold.
In some cases, the low prices today seem almost ridiculous. Steve & Barry’s sells celebrity-branded shoes and dresses for $8.98 or less. Target offers a silk faille ball gown from Isaac Mizrahi on sale for $129.99. Wal-Mart, the nation’s largest retailer, promotes an Op T-shirt for 97 cents.

For the full story, see:
ERIC WILSON. “Dress for Less and Less.” The New York Times (Thurs., May 29, 2008): E1 & E9.
(Note: ellipsis added.)

Bad Guys Might Think Twice, If More Good Guys Had Guns

“State Senator Karen S. Johnson of Arizona is the sponsor of a bill permitting firearms on campuses.” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. A10) PHOENIX — Horrified by recent campus shootings, a state lawmaker here has come up with a proposal in keeping with the Taurus .22-caliber pistol tucked in her purse: Get more guns on campus.
The lawmaker, State Senator Karen S. Johnson, has sponsored a bill, which the Senate Judiciary Committee approved last week, that would allow people with a concealed weapons permit — limited to those 21 and older here — to carry their firearms at public colleges and universities. Concealed weapons are generally not permitted at most public establishments, including colleges.
Ms. Johnson, a Republican from Mesa, said she believed that the recent carnage at Northern Illinois University could have been prevented or limited if an armed student or professor had intercepted the gunman. The police, she said, respond too slowly to such incidents and, besides, who better than the people staring down the barrel to take action?

For the full story, see:

RANDAL C. ARCHIBOLD. “Arizona Weighs Bill to Allow Guns on Campuses.” The New York Times (Weds., March 5, 2008): A10.

Post Office Wastes Money on 30,000 Ethanol Capable Vehicles

“A General Motors Corp. Chevrolet Uplander flexible fuel vehicle customized for the U.S. Postal Service (USPS) is shown in this handout photo taken on April 22, 2008. The USPS bought more than 30,000 ethanol-capable trucks and minivans from 1999 to 2005, making it the biggest American buyer of alternative-fuel vehicles.” Source of caption and photo: Bloomberg.com article quoted and cited below.

I saw a great CNN video clip on 8/11/08 showing some of the specially designed Post Office vehicles that were expensive, but that were mainly running on regular gasoline because it was too difficult to fill them with the high-ethanol blend that they were converted to use.
Before I finally found the clip on CNNMoney.com, by searching for it using the TRUVEO video search engine, I discovered that a version of the story had run back in May on Bloomberg.com. I quote from the story below.

May 21 (Bloomberg) — The U.S. Postal Service purchased more than 30,000 ethanol-capable trucks and minivans from 1999 to 2005, making it the biggest American buyer of alternative-fuel vehicles. Gasoline consumption jumped by more than 1.5 million gallons as a result.
The trucks, derived from Ford Motor Co.’s Explorer sport- utility vehicle, had bigger engines than Jeeps from the former Chrysler Corp. they replaced. A Postal Service study found the new vehicles got as much as 29 percent fewer miles to the gallon. Mail carriers used the corn-based fuel in just 1,000 of them because there weren’t enough places to buy it.

For the full story, see:
Peter Robison, Alan Ohnsman and Alan Bjerga. “Ethanol Vehicles for Post Office Burn More Gas, Get Fewer Miles.” Last Updated: May 21, 2008 00:01 EDT Downloaded on August 8, 2008 from:
http://www.bloomberg.com/apps/news?pid=20601072&refer=energy&sid=aj.h0coJSkpw

On the CNN Money video clip:
Jason Carroll was the reporter on the CNN Money clip that was added to CNNMoney.com on August 12, 2008, under the title “Snail Mail by Ethanol,” and is viewable at http://money.cnn.com/video/#/video/news/2008/08/12/news.usps.081108.cnnmoney

Reporter Jason Carroll talks with mail carrier Richard Malik, who says he has never used ethanol in his expensive mail truck that had been specially designed to use ethanol. Source of photo: screen capture from the CNN Money video clip discussed above.