I wanted to like this book and thought I would correct the previous reviews. Unfortunately this is just bad science and not well researched. Some parts are accurate but lots suffer from the same problems he complains about. Yes predicting the future is difficult. However, anypne can selective cherry pick data to make a point. Yes there are lots of biases that may cause this problem. One which he does not seem to recoginize, despite talking about the origins early in the book is publication bias. People do not buy books that are about happy and cheerful outlooks. People want to read about disasters and problems. There are better books out there, I would pass on this one.
In the introduction he states that our health care system is expensive and not as good at delivering results as other countries. His conclusion is to introduce free market economics as the solution. So the answer to fixing the only health care system which operates on free market principles is to double down. We operate in a free market he might not like the market or the rules since he failed at running his first business.
He harps on several points but does not seem to have any knowledge of the realities.
1. Overpriced hospitals. Here he is confused by costs vs charges. Hospitals are required by law to care for all patients regardless of their ability to pay. Since at many emergency departments over a third of all patients do not pay. So the hospital must raise charges to cover these patients. As specialty hospitals grow taking away paying patients this only makes it worse. Hospitals are struggling throughout the country. Many are closing or selling themselves because they can not survive.
2. Customer satisfaction is bad because there is no free market. If you look at press ganey the largest surveyor of patient satisfaction doctors and hospitals are doing great. Over 90 percent of hospitals and 99 percent of doctors score over 4 on a 5 point scale. Much better than Airlines which have been deregulated and are more free market or restaurants as a group.
3. There is no innovation. This is just looking at the facts he wants and ignoring all others. there has been great innovation. Pick a specialty cardiology has gone from 2 weeks bed rest for myocardial infarction to stents in 90 minutes from arrival. We have better tests to find heart attacks. Surgery has gone from large incisions to laparoscopic and in some cases robotic.
4. If only people could choose things would be better. This is nonsense. When someone is sick they rely on doctors to help guide them. Also many would say that they do not feel spending 100$ more on a meal which might increase there chance of enjoyment of the meal by 1% is clearly not worth it to them however, spending money on a better chance to survive an illness? They would spend that. Also look at all the money spent on alternative medicine. Here people have the freedom to choose and they choose options that offer no benefit. The National Institute of Alternative medicine just completed a 10 year review and found no evidence to support use of anything tested as alternative medicine.
5 Choices are needed in insurance. Health insurance is not like cable TV. I do not know which illness I am going to get this year. I am sure if I do not want ESPN today I will not want it later this year. People will opt out of lots of choices then when they become ill they get covered by the either the government or the hospitals that provide the service. We removed the moral hazard. I am not advocating not treating people I am saying that if we are arguing for free markets you are arguing for letting people suffer because of their choices which we do not do.
I do agree with him when he talks about information, reducing overhead and getting rid of fee for service. A free market tries to maximize one thing and that is profit. If it can do it my delivering expensive less effective health care it will as it has proven. So eliminating fee for service is a start. Going to a single payer is another good step. Less paperwork and back office support is needed with a single payer. However, these will not reduce lawsuits which contribute to costs of healthcare. Doctors win about 90% of malpractices cases so most cases are about poor outcomes not medical care. The free market would say if we can make money by suing we will sue. Many cases are settled to avoid the years of pretrial and trial costs which only encourages more lawsutis.
I understand it is hard to write a book about a ancient ruler where little information exists but lots of myths. This book looks at an interesting character in history with all the skepticism of a big foot hunt. I do not even think they did any real research into poisons.
More critical thinking.
This book is why economics fails. We are to learn about the authors opinions about how he thinks economics works in the real world. To do this he creates a total fictitious land and then translates from the fiction to reality. This does not work. Lets start with some basics. On his island everyone not only does every one have a job this job provides for all the basic needs. Clearly this does not exist anywhere in the real world and with such a base how can you believe all that flows from this world would translate into ours. He also ignores history. He views all regulations as bad. There was a reason regulations are created and often they solve a problem. In our recent history we have deregulated banks and savings and loans both lead to huge bailouts. I could go as with his poor explanation of why the gold standard is so important. After all in his world fish do provide a real benefit to the inhabitants they can eat it and survive. How is gold similar. It only has value because others want it not. How does he explain the tulip bubble or the internet bubble? This occurred with out any government involvement. I would leave his fantasy world in fantasy land and take no useful lessons from such dribble.
The reading is so boring I could not listen to this one. I think this one is a waste of money. Even when I turned the speed up I got bored.
Parts were good but most was over reach. The idea that we create routines and tend to exeecute them is good and interesting. However, the definition of habit and reward get stretched beyond recognition. As an example the use Michael Phelps as an example, He has a set routine he does before a race. It is suggested the reason he wins is he follows this pattern. However, it is clear that there are a lot of swimmers who swim against him with there own habits and probably very similar but who do not win. A better case would be to talk about his habit of training. The book is an example of when you have a hammer everything looks like a nail. In this case everything looks like a habit.
I enjoyed parts of the book which were less science and more trivia. Lots of talk about toxins and measuring these toxins in people. Little science to show any real problem despite all the inuendo. Overall it seemed like some one with an agenda who took the word of research she felt had truthiness. I am not saying it might not be true but a more balanced view would be nice, or at least stating how she tried to find alternate opinions but these views were held by a small fringe.
The book is one big logical fallacy. To do scientific research and find out how the brain functions is great. However, taking this research then going back in time and finding some vague similarities to some artist then giving them credit for the discovery is absurd.
I thought this would be a interesting book but it failed on almost all accounts. Great opportunity to discuss rights of individuals and their genetic code. Rights of Universities to capitalize on research and restrict indivuals. The history of cloning human cells and its implications on future research. Alas the book is mostly about a poor family who loved a family member. Avoids important issues. A complete let down.
I will start off by stating I am a fan of Collins book Good to Great. It was a well research book that found ideas that have been born out by other scientific research. Great by choice is a different story. While his ideas are fun and interesting this is not research or scientific. He chose 7 companies that out performed the stock market by at least 10x. Chance would claim that there would be a small number of these companies. Of the seven none were 10xs for the last 10 years. In fact Microsoft has under performed the market while its control company apple has out performed microsoft by 1400%.
The next problem is interpretation. With no methods to determine before hand how to decide it is easy to make things fit into your preconceived ideas. Bullets then cannons. The example of apple firing bullets with the ipod by creating it for the apple first then going big by developing for windows is just not true. In Isacsons book he states jobs never wanted to make an ipod for windows, he felt it was a way to attract windows users to apple. latter he reluctantly agreed. Yet this is used as an example of bullets before cannons.Simply not true.
Another example is the idea that you can quantify luck. They use the example of Amgen hiring a key employee as an example of luck. If that is true then would you not have to look at ever employee who turns out well to see if it was luck and look at every employee who made a bad decision to see if their hire was luck? The other error inherent in this thinking is the idea that any event occurs independantly. To stick with the same example. They state that the employee hire was luck because he read the ad at a time when he was looking for a new job. Well why was he looking for a new job. Is his reason bad luck for the company he left?
In scientific terms at best this is a derivation set. It shoudl be validated on another era.
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