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.     

Problem-solving in teaching/learning packages for Technology

In the project Technology in Secondary Education: Problem-solving in Teaching/learning Packages, two experiments regarding a construction problem and an explanation problem were conducted, in which two variants of a teching/learning package (strongly structuredvs. weakly structured) were compared. Only with the strongly structured instructional variant of the package for the explanation problem did the pupils come to a quick solution of the problem. In both experiments, the factors that influenced the problem-solving processes of the pupils were investigated. The results are of importance for curriculum developers and the authors of teaching/learning packages for Technology but further research into the factors influencing the problem solving process of pupils is necessary.     

Training,migration, and regional income disparities

"It is assumed that there are two regions, that production requires both skilled and unskilled labour, and that one region is innately more productive than the other. Workers, who differ in their migration or training costs, make individually rational decisions. In equilibrium the ratio of skilled workers to unskilled workers is always higher in the more productive region. Average incomes differ between regions because regional differences in wage rates are reinforced by regional differences in the structure of employment. The model is also used to analyse the effects of policies intended to equalize the distribution of income."     

“Down and out” in D.C.: How Georgetown M.B.A. students learn about leadership through service to others

This article describes a community service project in which M.B.A. students learn about and experience directly the dynamics of leadership and power. The purposes of this project are to help students better understand the social reality of powerlessness, and how they, through their political activism and influence management skills, can improve the situations and lives of powerless people in the local community. In so doing, students begin to see the connection between political action and moral ends, the fundamental learning objective of this project.Wisdom is knowing what to do next. Virtue is doing it.(David Starr Jordan) Robert J. Bies is Associate Professor Management in the School of Business at Georgetown University. He received his Ph.D. from Stanford University. His research interests include leadership and power, the delivery of bad news, the litigation mentality, and organizational justice. He edited (with S. Sitkin) the book, The Legalistic Organization (Sage Publications, 1993).