An engaging account of innovation in healthcare and why the results fall short for patients and society. The evolution of the cell phones we carry in our pockets demonstrates that quality can increase while prices fall. Why doesn't healthcare also get better and cheaper? In Why Not Better and Cheaper?, James B. Rebitzer and Robert S. Rebitzer offer an answer to this question. Bringing together research on incentives, social norms, and market competition, they argue that the healthcare system generates the wrong kinds of innovation. It is too easy to profit from low-value innovations and too hard to profit from innovations that reduce the costs of care. The result is a healthcare system that is profusely innovative yet remarkably ineffective in discovering ways to deliver increased value at lower cost. Why Not Better and Cheaper? sheds new light on the trajectory of innovation in healthcare, and how to point innovation in a better direction.
“Bessen sets out to refute the arguments of . . . techno-pessimists, relying on economic analysis and on a fresh reading of history” (The Wall Street Journal). Technology is constantly changing our world, leading to more efficient production. But where once technological advancements dramatically increased wages, the median wage has remained stagnant over the past three decades. Many of today’s machines have taken over the work of humans, destroying old jobs while increasing profits for business owners and raising the possibility of ever-widening economic inequality. Here, economist and software company founder James Bessen discusses why these remarkable advances have, so far, benefited only a select few. He argues the need for unique policies to develop the knowledge and skills necessary to implement rapidly evolving technologies. Currently, this technical knowledge is mostly unstandardized and difficult to acquire, learned through job experience rather than in classrooms, but labor markets rarely provide strong incentives for learning on the job. Basing his analysis on intensive research into economic history as well as today’s labor markets, Bessen explores why the benefits of technology can take decades to emerge. Although the right policies can hasten the process, policy has moved in the wrong direction, protecting politically influential interests to the detriment of emerging technologies and broadly shared prosperity. This is a thoughtful look at what leaders need to do to ensure success not only for the next quarter, but for society in the long term. “Everyone agrees that education is the key to wage growth. But what kind of education? . . . This enlightening and insightful book . . . shows that economic history can provide some useful and surprising answers.” —Hal Varian, chief economist at Google
Effects of Deregulation on Safety provides a comprehensive overview of the safety experiences of these three case study industries and their implications for the U.S. nuclear power industry. The treatment of the subject is not highly technical, and hence is accessible to a wide range of readers with interests in the subject matter. The book draws on literature from roughly 250 references, ranging from brief news articles to book-length studies of deregulation in a particular industry, as well as original in-depth interviews with representatives of all three case study industries. This wealth of empirical background information allows the book to go beyond mere speculation about the possible adverse safety consequences of deregulation, to identify situations in which particular adverse safety consequences actually occurred. The experience of the case study industries indicates that economic deregulation need not be incompatible with a reasonable safety record, especially in those aspects of safety that are positively related to productivity. But that safety also cannot be taken for granted after deregulation. Careful management attention is needed in order to avoid the types of safety problems that were associated with deregulation in the case study industries.
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