HIV and AIDS--employers grapple with difficult issues

HIV infection and AIDS pose special challenges to employers. Myriad laws affect how the employer must respond when an applicant or employee is infected with HIV or is ill due to AIDS. An overall compliance strategy should include thorough knowledge of those laws and a policy on HIV and AIDS, put in place before a crisis occurs.     

Health care purchasing alliances--a Michigan multiemployer trust funds' approach

A group of multiemployer trust funds in Michigan has formed a coalition that eventually will offer its members an integrated managed health care program. As the first step toward this goal, the coalition recently implemented a managed pharmaceutical program.     

Making competition in health care work

Health care reform in the United States is on a collision course with economic reality. Most proposals focus on measures that will produce one-time cost savings by eliminating waste and inefficiency. But the right question to ask is how to achieve dramatic and sustained cost reductions over time. What will it take to foster entirely new approaches to disease prevention and treatment, whole new ways to deliver services, and more cost-effective facilities? The answer lies in the powerful lessons business has learned over the past two decades about the imperatives of competition. In industry after industry, the underlying dynamic is the same: competition compels companies to deliver constantly increasing value to customers. The fundamental driver of this continuous quality improvement and cost reduction is innovation. Without incentives to sustain innovation in health care, short-term cost savings will soon be overwhelmed by the desire to widen access, the growing health needs of an aging population, and the unwillingness of Americans to settle for anything less than the best treatments available. The misguided assumption underlying much of the debate about health care is that technology is the enemy. By assuming that technology drives up costs, reformers neglect the central importance of innovation or, worse yet, attempt to slow its pace. In fact, innovation, driven by rigorous competition, is the key to successful reform.     

Finding a lasting cure for U.S. health care

In "Making Competition in Health Care Work" (July-August 1994), Elizabeth Olmsted Teisberg, Michael E. Porter, and Gregory B. Brown ask a question that has been absent from the national debate on health care reform: How can the United States achieve sustained cost reductions while at the same time maintaining quality of care? The authors argue that innovation driven by rigorous competition is the key to successful reform. A lasting cure for health care in the United States should include four basic elements: corrected incentives to spur productive competition, universal insurance to secure economic efficiency, relevant information to ensure meaningful choice, and innovation to guarantee dynamic improvement. In this issue's Perspectives section, eleven experts examine the current state of the health care system and offer their views on the shape that reform should take. Some excerpts: "On the road to innovation, let us not forget to develop the tools that allow physicians, payers, and patients to make better decisions." I. Steven Udvarhelyi; "Health care is not a product or service that can be standardized, packaged, marketed, or adequately judged by consumers according to quality and price." Arnold S. Relman; "Just as antitrust laws are the wise restraints that make competition free in other sectors of the economy, so the right kind of managed competition can work well in health care." Edward M. Kennedy "Biomedical research should be considered primarily an investment in the national economic well-being with additional humanitarian benefits." Elizabeth Marincola.     

Ethical issues confronting travel agents

This article provides an overview of current and prospective ethical issues facing commercial (as opposed to leisure) travel agents. Industry wide ethical issues include conflicting pressures from suppliers and clients, competency requirements for agents and misleading advertising and sales claims (vaporware in industry jargon). Issues with travel suppliers include calculation and payment of commissions, fare loopholes, frequent flyer plans and the use and abuse of benefits directed to individual employees. Issues with corporate clients of travel agents include hidden preferred carriers or suppliers, client pressure to use fare loopholes and hidden relationships with corporate travel consultants. Future issues include protecting client privacy, free riding, and divergent international business practices. Thomas W. Dunfee is the Kolodny Professor of Social Responsibility at The Wharton School of the University of Pennsylvania. His current research interests focus on social contract theory and business ethics and on developing ethical standards for business transactions. He has published articles in the Business Ethics Quarterly,the Journal of Business Ethics,the Business and Professional Ethics Journal,and the Journal of Social Philosophyin addition to a variety of business and legal journals. He has consulted to a number of corporate clients and to several trade associations.Bruce M. Black is founder and president of McCord Travel Management. Since founding the company in 1980, he has led its growth to one of the 30 largest travel management firms in the United States, with annual sales of more than $100 million. Black is one of the inaugural members of the University of Illinois at Chicago Entrepreneurship Hall of Fame and is on the board of the International Theatre Festival of Chicago. He is also active in the exploration of a variety of industry related issues on behalf of the Super Regional Group of agencies.     

The dynamics of role interaction

Success in our respective business environments is not totally dependent on technical expertise; we must be able to also effectively interact with people. The necessity of successful leadership is assumed; however, we often fail to recognize the value of strategically subordinating ourselves to others. Both roles must be emphasized with the knowledge that preferred individual styles are valid.     

Materiel management reengineering: value creation through innovation

By reengineering their department's core processes, materiel managers can expand their role in the health care setting while realizing significant cost savings. Using a team model, Inova Health System materiel management staff integrated their processes for vendor selection, purchasing, inventory reduction, and utilization across three hospitals and ancillary services. An integrated approach at all levels of the organization gained buy-in from administrators and staff systemwide.     

Survival strategies in the era of managed care

The era of managed care has forced an unprecedented restructuring of the health care environment. As hospitals downsize in response, materiel managers should consider adopting strategies that may help ensure their survival, including innovative approaches to supply management and the development of individual responses that will best position them to succeed in this new reality.