Jennifer E. DeVoe, MD, DPhil
My teaching session with the medical student at the end of the day included a discussion about patient care decisions and recommendations that go beyond ticking quality boxes and following the latest guidelines. Initially, I felt as if I was rationalizing my delivery of suboptimal care and began to doubt myself.
However, the quality reports I receive each month do not capture the complexity of many patients’ lives.4 These reports fail to reflect the individualized and shared decisions made between a patient and her physician who have known each other for 15 years; the proprietary quality score calculation formulas do not adjust for the healing power of relationships.5 Amid the mounting evidence that primary care saves lives,6 our health care system does not (yet) have a population health analytics tool that captures and tracks the progress that she and I have made together in more than a decade. When will we create better systems with capabilities to measure the emergency department visits that were prevented, the stable housing that was obtained, the increased resiliency she has built into her life, her feelings of empowerment to be a better parent, the reduction in her self-destructive behaviors, and the trusting relationship we have built over time?
By Dan Mitchell
“Communists claim that their ideology represents the downtrodden against the elite, yet the evidence from Cuba shows wretched material deprivation for most people.
In Hong Kong, by contrast, incomes have soared for all segments of the population.”
How important are key individuals in shaping the success or failure of economies? …Neil Monnery’s A Tale of Two Economies is in some sense a polemic against historical determinism, at least insofar as promoting economic reforms is concerned.It stresses the importance of two single individuals, one a great man for many, one an obscure official and political unknown to the most, in shaping the destiny of their respective countries. …Ernesto “Che” Guevara and John Cowperthwaite. …Monnery insists that both of them were “deep and original thinkers.” …The key difference between the two was perhaps that Cowperthwaite had a solid education in economics… Neither the way in which Hong Kong progressed, nor Cuba’s, were thus inevitable.
Monnery points out that Hong Kong’s success happened not because Cowperthwaite and his colleague were trying “to plant an ideological flag,” but because they were “professional pragmatists.” …Then the success of relatively libertarian arrangements in Hong Kong perpetuated itself. …Cowperthwaite tested what he knew about classical economics when he “first arrived in Hong Kong, in 1945” and “was put in charge of price control.… He soon realized the problems with attempting to set prices low enough to meet consumer needs but high enough to encourage supply, and in a dynamic environment.” He opposed subsidies that he saw as “a brazen attempt to feed at the trough of government subsidies.” …Cowperthwaite is a hero to Monnery, who emphasises his competence, and even more, his integrity.
What Advances & Virtues Do We Really Owe to the Enlightenment?
Is being “Woke” the Dark Side of Enlightenment Thinking?
Governor Bradford recorded in his diary that everybody was happy to claim their equal share of production, but production only shrank. Slackers showed up late for work in the fields, and the hard workers resented it. It’s called “human nature.”
The disincentives of the socialist scheme bred impoverishment and conflict until, facing starvation and extinction, Bradford altered the system. He divided common property into private plots, and the new owners could produce what they wanted and then keep or trade it freely.
Communal socialist failure was transformed into private property/capitalist success, something that’s happened so often historically it’s almost monotonous. The “people over profits” mentality produced fewer people until profit—earned as a result of one’s care for his own property and his desire for improvement—saved the people.
If the concept of social justice simply means justice for the individuals who make up society, then it appears the utopian socialist-progressives and the libertarian free-marketeers may have some goals in common.
However, when it comes to the ways & means to achieve those goals, the ideological divide is still wide.
So maybe rhetoric on both side should always start with…
“what is the most effective strategies or economic policies to allow people to optimize opportunity and escape poverty.”
Individual liberty is never fully realized without economic freedom, which includes strong private rights & a climate conducive to self-determination.