Salve Lucrum: The Existential Threat of Greed in US Health Care

Salve Lucrum: The Existential Threat of Greed in US Health Care | Health Care Economics, Insurance, Payment | JAMA | JAMA Network

In the mosaic floor of the opulent atrium of a house excavated at Pompeii is a slogan ironic for being buried under 16 feet of volcanic ash: Salve Lucrum, it reads, “Hail, Profit.” That mosaic would be a fitting decoration today in many of health care’s atria.

The grip of financial self-interest in US health care is becoming a stranglehold, with dangerous and pervasive consequences. No sector of US health care is immune from the immoderate pursuit of profit, neither drug companies, nor insurers, nor hospitals, nor investors, nor physician practices.

Avarice is manifest in mergers leading to market concentration, which, despite pleas of “economies of scale,” almost always raise costs.

Yep. Don Berwick on fine form.

And what about the reds?

Netherlands plots return to admission lotteries | Times Higher Education (THE)

Of course, I would say that wouldn’t I? I knew that lotteries had been used for medicine in the past in the Netherlands but….

The politics of admission are layered. Much media criticism has been levelled at University Medical Center Utrecht for an alleged bias towards blonde, white women. A spokeswoman said the institution was “constantly optimising [its] selection procedures, amongst others on the basis of research on bias”.

Supporters of lotteries say they could help the student body better represent Dutch society. “We do believe it would promote equity between students,” said Terri van der Velden, president of Interstedelijk Studenten Overleg (Intercity Student Consultation), the Netherlands’ largest national student organisation. “Our biggest fear with these selection instruments is that they’re chosen at random.”

The trouble with computers

“The trouble with computers is that all they give you is answers.”

Pablo Picasso

Via Ian Leslie: Answer Machines – by Ian Leslie – The Ruffian

Choose 2

After Dani Rodrik, quoted by Walter Münchau in The New Statesman(26 January 2023).

Only two of the following are compatible with one another: the nation-state, democracy and globalisation.

If you want to kill somebody….

Address issues at home before criticising Qatar over World Cup | Qatar | The Guardian

Such data bears witness to an old trade union adage – if you want to kill someone and get away with it, first set up a company, then employ them. (Steve Tombs, Emeritus professor, Open University)

By design, not bugs, in the law regarding corporations and persons.

Piece rate

Katherine Rundell on the Art of Words (Ep. 168) | Conversations with Tyler

TYLER COWEN: What’s a book you can no longer stand to read? For instance, I find it very difficult to now read Dostoevsky. I don’t think he’s a terrible author, but it somehow doesn’t click with me. It fascinated me in high school, but now it just falls flat.

RUNDELL: I still love Dostoevsky, but I can’t read Dickens anymore. I used to be wildly in love with the atmospheres that he conjured of London and smoke and smog, but I now find very vividly visible the fact that he was getting paid per word.

I used to love Dickens, often thinking the books too short. I recently reread A Tale of Two Cities, only to find the magic had left me. Even within a lifetime the language chafes.

Jeff Beck RIP: No pick needed

Legendary rock guitarist Jeff Beck dies aged 78 | Jeff Beck | The Guardian

In the mid-70s, Beck supported John McLaughlin’s jazz-rock group Mahavishnu Orchestra on tour, an experience that radically changed how he saw music. “Watching [McLaughlin] and the sax player trading solos, I thought, ‘This is me’,” he said in 2016.

Inspired, Beck embraced jazz fusion fully on the George Martin-produced Blow By Blow. A platinum-selling hit in the US which peaked at No 4, it was Beck’s most commercially successful album ever, but he later expressed regret. “I shouldn’t have done Blow By Blow,” he told Guitar Player in 1990. “I wish I had stayed with earthy rock’n’roll. When you’re surrounded with very musical people like Max Middleton and Clive Chaman, you’re in a prison, and you have to play along with that.

About the last sentence, I get it. But I suspect he knew his guitar better than his own mind. Somebody once said that apart from a three year period when Hendrix ruled, Beck was the most inventive rock guitarist of his lifetime. Maybe.

I first saw him around the time of the album Live at Ronnie Scott’s. (youtube link here). Two favourites: Stratus, a Billy Cobham tune with that funky rhythm that keeps catching you after you think you have it (but you never do), which precedes his signature version of the Stevie Wonder song Cause We’ve Ended as Lovers (the latter ~10:40 in). Yes, the rest of us should give up our guitars, shut up, and just listen.

Then there is the matter of Tal Wilkenfeld, who, it appears, picked up a guitar one day and then via Chick Corea was playing on the above gig a few days later. I took some convincing she was even old enough to be in high school.

Politics and medicine

China’s Covid patients face medical debt crisis as insurers refuse coverage | Financial Times

Echoing Rudolf Virchow, frequent bedfellows. The spectrum includes the UK.

A doctor at Shanghai No 10 Hospital said staff had been instructed by the city’s health commission to limit Covid diagnoses. “We are advised to label most cases as respiratory infection,” the doctor said.

“What is certain is that the government can’t afford to treat everyone for free.”

China’s National Healthcare Security Administration said on Saturday that it would fully cover hospitalisation for Covid patients, but continued to exclude complications. Hospitals are also under pressure to reduce medical costs after the national insurance fund was strained by the costs of the sprawling zero-Covid apparatus.

In the eastern city of Hangzhou, Frank Wang, a marketing manager who bought a Covid insurance plan early last year, was refused proof of illness after he developed lung and kidney infections after testing positive for the virus.

“The hospital made it clear that Covid proof is not easy to obtain as the disease diagnosis has been politicised,” said Wang, who paid more than Rmb20,000 for treatment. “That makes patients like me a victim.”

The deserving and the undeserving sick redux; more crony capitalism.

Miracle man

Pelé went from poverty to football superstardom :TheEconomist

As a forward he was not that tall, but he was strong, fast and had thighs as thick as his waist. He could read the game like a book, and control the ball as if it was drawn to him like a magnet. He could also tell exactly where he was needed, and when, and what the opposition might have in mind to try to block him. All this seemed to make him a natural captain, but he never wanted that role officially.

Dribbling was his great skill, flummoxing defenders with feints and sudden stops and starts. He could shoot for goal powerfully with either foot and despite his height, or lack of it, was a spring-heeled header of the ball. He jumped so easily over Tarcisio Burgnich, the Italian marking him in the 1970 World Cup final, that Burgnich doubted he was flesh and bone at all. Then he scored the first goal. He knew he was the best player in that tournament and, with the next World Cup four years away, he declared he wouldn’t play any more.

The nickname “Pelé”, a classmate’s tease, annoyed him at first (“Edson” was more serious, after Thomas Edison), but he liked it better when he learnt it meant “miracle” in Hebrew.

Memories 1970, Mexico city, gold shirts, all from the comfort of home.

More magic from the Economist’s obituary writer.

All dressed up and nowhere to go

How I Got Here | No Mercy / No Malice

Tenure is a guild, only more inefficient and costly. However, the workmanship is worse. It’s meant to protect academics from the dangers of provocative, original thinking (e.g. Galileo). But in my field, marketing, it’s hard to imagine anybody needs protection, as nobody is really saying anything.

…

I’m home after traveling, and I’ve put my sons to bed. My oldest puts in his Invisalign, lies down next to me, and drifts off in my arms. I can’t help but stare at this thing that sort of looks, smells, and feels like me, but so much newer and better. Suddenly he stirs and begins to smile. He opens his eyes and tells me he and his buddies did an improv play at school and it was “hilarious.” He drifts back to sleep. He is warm, safe, loved, and next to a dad who wonders if he (like his dad) is unremarkable, but might still (like his dad) have remarkable opportunities.

The article is worth reading in full even if you only have a passing interest in higher education; or the future.