Source of book image: http://www.mikemilken.com/fincareer.taf?page=they_made_america
Was it a difference in “innovative energies” that mattered, or was it a difference in institutions and incentives?
(p. 11) This crucial difference between invention and innovation was borne in on me on my return to England in 1957. As a young science reporter, I visited the government-funded National Physical Laboratory at Teddington, and they showed where their senior researcher Robert Watson Watt had in 1935 invented the radar system that was to help the Royal Air Force win the battle of Britain. His former colleagues remarked with chagrin on how swiftly this British invention had been taken up and exploited in the United States after 1939, laying the foundation for the great electronics industry. It was the same story with antibiotics, following Alexander Fleming’s 1928 discovery of penicillin; with Maurice Wilkes’s pioneering efforts in developing the first commercial application of the computer at the offices of J. Lyons and Company in 1951 and with the jet engine. All of these British inventions were superseded by the innovative energies of America.
Evans, Harold. They Made America: Two Centuries of Innovators from the Steam Engine to the Search Engine. New York: Little, Brown and Co., 2004.
Medical paperwork is a world of co-payments and co-insurers, deductibles, exclusions and contracted fees. Nothing is as it seems: patients receive statements that often do not reflect what is actually owed; telephone calls to customer service agents are at best time-consuming and at worst fruitless. The explanations of benefits that insurers send out — known as E.O.B.’s — are filled with unintelligible codes.
The system is so impenetrable that it mystifies even the most knowledgeable.
”I’m the president’s senior adviser on health information technology, and when I get an E.O.B. for my 4-year-old’s care, I can’t figure out what happened, or what I’m supposed to do,” said Dr. David Brailer, National Coordinator for Health Information Technology, whose office is in the Department of Health and Human Services. ”I can’t figure out what care it was related to or who did what.”
Dr. Blackford Middleton, a professor at Harvard Medical School with special training in health services research, said he did not fare much better than Dr. Brailer.
”I understand the words of diagnoses and procedures,” he said. ”But codes? No. Or how things are paid or not paid? I don’t understand that.”
Dr. Brailer said he often used an analogy to describe the current state of medical billing.
”Suppose you walk into a restaurant,” he said, ”and you don’t get a menu, you don’t get any choice of what food you’ll eat, they don’t tell you what it is when they’re serving it to you, they don’t tell you what it’s going to cost.”
”Then, weeks or months later, you get a bill that tells you all the food you ate and the drinks you had, some of which you remember and some you don’t, and although you get the bill, you still can’t figure out what you really owe,” Dr. Brailer said.
Some people make valiant efforts to sort through bills and claims, but end up throwing up their hands; others ignore them, until they are pursued by collection agencies; still others, basically healthy but weary at the prospect of a paperwork fusillade, stop going to the doctor altogether.
KATIE HAFNER. “Treated for Illness, Then Lost in Labyrinth of Bills.” The New York Times (October 13, 2005): A1.
Editorial page advice from the budget minister of France:
The choice of nuclear power dates back to the end of World War II. With insufficient fossil fuel reserves, our country very early on invested in energy alternatives. The two oil crises of the ’70s convinced us to accelerate the construction of facilities to produce safe and economically profitable nuclear energy. That strategy paid off: In 30 years, France’s energy independence has risen from 30% to 50%. While turning toward nuclear energy might have seemed unusual 60 years ago, I believe that it was an especially visionary choice. The development of nuclear energy enabled us to meet several objectives: energy independence and security of supply, and competitive, stable energy prices. This nuclear option is also an economic and commercial asset for our country, whose capabilities in this cutting-edge area are world-renowned. (p. A20)
JEAN-FRANCOIS COPE. "Energy a la Francaise." The Wall Street Journal (Weds., October 5, 2005): A20.
(Source: downloaded graphic from online version of WSJ see below, p. A13)
Booz Allen Hamilton Inc., a consulting firm, analyzed six years of financial results by 1,000 publicly traded companies responsible for the bulk of R&D spending globally. The firm found the companies that spent proportionately greater sums than their industry peers didn’t enjoy greater revenue gains or better profits.
The finding flies in the face of academic studies and accepted wisdom on the value of corporate research. It also comes as researchers warn that U.S. companies need to increase spending or risk falling behind rivals in China and India, which are rapidly industrializing.
Booz Allen concluded that once a minimum level of research and development spending is achieved, better oversight and culture were more significant factors in determining financial results. The study calculated the percentage of a company’s revenue spent on R&D and compared it with sales growth, gross profit, operating profit, market capitalization and total shareholder result.
McWilliams, Gary. “In R&D, Brains Beat Spending In Boosting Profit.” The Wall Street Journal
(Weds., October 11, 2005): A2 & A13.
Ah, so maybe the entrepreneur or R&D manager, can make a difference after all? (This is not a surprise, if you believe, as I do, that Clayton Christensen is on to something important.) Or, though less interesting, the results might just be due to diminishing returns to R&D.
This morning, Alan Greenspan delivered an excellent speech on “Economic Flexibility” at Georgetown before the National Italian American Foundation, Washington, D.C. Here is the part of the speech most directly relevant to the process of creative destruction:
Starting in the 1970s, U.S. Presidents, supported by bipartisan majorities in the Congress, responded to the growing recognition of the distortions created by regulation, by deregulating large segments of the transportation, communications, energy, and financial services industries. The stated purpose of this deregulation was to enhance competition, which had come to be seen as a significant spur to productivity growth and elevated standards of living. Assisting in the dismantling of economic restraints was the persistent, albeit slow, lowering of barriers to cross-border trade and finance.
As a consequence, the United States, then widely seen as a once-great economic power that had lost its way, gradually moved back to the forefront of what Joseph Schumpeter, the renowned Harvard professor, had called “creative destruction”–the continual scrapping of old technologies to make way for the innovative. In that paradigm, standards of living rise because depreciation and other cash flows of industries employing older, increasingly obsolescent technologies are marshaled, along with new savings, to finance the production of capital assets that almost always embody cutting-edge technologies. Workers, of necessity, migrate with the capital.
Through this process, wealth is created, incremental step by incremental step, as high levels of productivity associated with innovative technologies displace less-efficient productive capacity. The model presupposes the continuous churning of a flexible competitive economy in which the new displaces the old.
As the 1980s progressed, the success of that strategy confirmed the earlier views that a loosening of regulatory restraint on business would improve the flexibility of our economy. No specific program encompassed and coordinated initiatives to enhance flexibility, but there was a growing recognition that a market economy could best withstand and recover from shocks when provided maximum flexibility.
The full speech is available at the Federal Reserve web site at: http://www.federalreserve.gov/boarddocs/speeches/2005/20051012/default.htm
The New York Times devoted more than two full pages to the advantages of the melting of the Arctic ice cap. Here is a short excerpt:
(p. A1) By Mr. Broe’s calculations, Churchill could bring in as much as $100 million a year as a port on Arctic shipping lanes shorter by thousands of miles than routes to the south, and traffic would only increase as the retreat of ice in the region clears the way for a longer shipping season.
With major companies and nations large and small adopting similar logic, the Arctic is undergoing nothing less than a great rush for virgin territory and natural resources worth hundreds of billions of dollars. Even before the polar ice began shrinking more each summer, countries were pushing into the frigid Barents Sea, lured by undersea oil and gas fields and emboldened by advances in technology. But now, as thinning ice stands to simplify construction of drilling rigs, exploration is likely to move even farther north.
Last year, scientists found tantalizing hints of oil in seabed samples just 200 miles from the North Pole. All told, one quarter of the world’s undiscovered oil and gas resources lies in the Arctic, according to the United States Geological Survey.
The polar thaw is also starting to unlock other treasures: lucrative shipping routes, perhaps even the storied Northwest Passage; new cruise ship destinations; and important commercial fisheries.
“It’s the positive side of global warming, if there is a positive side,” said Ron Lemieux, the transportation minister of Manitoba, whose provincial government is investing millions in Churchill.
For the full story, see:
CLIFFORD KRAUSS, STEVEN LEE MYERS, ANDREW C. REVKIN and SIMON ROMERO. “As Polar Ice Turns to Water, Dreams of Treasure Abound.” The New York Times (Mon., October 10, 2005): A1, A10-A11.
Unfortunately some cancer tests do a lot more good for doctors’ revenues than they do for patients’ longevity:
“The improvement in long-term mortality may be due to the higher proportion of small or slow-growing tumors being detected, which means you start counting earlier,” says Dr. Jaffe. That’s why longer survival, measured from the time of diagnosis, is a misleading measure of progress against cancer, and no substitute for reductions in mortality.
The more scientists study cancers, the more indolent ones they discover. Researchers in Japan, for instance, find that CT scans detect almost as many lung lesions in nonsmokers as in smokers. But since nonsmokers have a mortality rate from lung cancer less than 10% that of smokers, the vast majority of what CT scans picked up would never have progressed to anything life-threatening. And a Mayo Clinic study found that although X-rays detect lung cancers at earlier stages, and lead to more five-year survivors, early detection does not lower death rates.
For colon cancer, the fecal occult blood test “does decrease your risk of dying of this cancer,” says Dr. Kramer. “But for colonoscopy and sigmoidoscopy, which appeal to our intuition [about early detection], the evidence is not great.” They pick up polyps earlier, but not all polyps become cancers, “and we don’t know what proportion would lead to death.”
The Pap test for cervical cancer has saved lives, but many of the abnormal cells it finds wouldn’t go on to become cancer. Most women with low-grade or even high-grade lesions would have been fine anyway. Similarly, the PSA test for prostate cancer picks up tumors that are biologically nonaggressive.
The discovery that many tumors are innocuous casts doubt on the value of new screening tests. “You may fool yourself into thinking a test is twice as sensitive,” says Dr. Kramer, “but the only extra cancers it picks up are those that wouldn’t have harmed the patient.
SHARON BEGLEY. “Early Cancer Detection Doesn’t Always Give Patient an Advantage.” The Wall Street Journal (August 26, 2005): B1.