Health care's power brokers in the 21st Century. Interview by Donna Vavala

Health care has undergone turbulent change in the 20th Century. In addition to dramatic pharmaceutical and technological advances, the entire health care delivery system has been significantly improved. Through all the turmoil, hospitals have been at the center of the health care universe. But, as the 21st Century approaches, that may change, too. What will become of hospitals, which for most of this century have played a commanding role? Will managed care organizations and group practices come out on top? And, once the new power broker takes over, what will be the impact on providers, insurers, and the government, and how will their relationships to each other change? Jeff Goldsmith, PhD, President of Health Futures, Inc., Bannockburn, Ill., and health care futurist, examines tomorrow's health care delivery system and makes some eye-opening predictions.     

Newspapers foretell health care's future.

This article is based on a two-months snapshot (November 1998 to January 1999) of newspaper articles addressing various health care issues. Newspaper contents reflect the changing market share of competing societal concerns. Health care issues, particularly cost and choice, now preoccupy the American people. Health care trends percolate bottom-up through the pages of newspapers, not top-down from Washington, D.C, policymakers, or health care executives. By reviewing these articles, the author provides a big picture view of the prevailing and emerging health care trends. From the new thrust of consumerism and the public backlash against managed care organizations to the demise of HMOs and PPMCs, these observations signify not only the concerns that are bubbling to the surface but also the direction that health care is headed. Consumers are in the driver's seat and physician executives need to provide them with evidence of the value they desire--and understand what they perceive as value.     

Leisure 1980 and beyond

In this article, the authors examine the characteristics of leisure that are of relevance in planning and look at some of the key leisure issues for the 1980s. The most fundamental question is how people will choose between extra income and more free time? This influences the rate of economic growth as well as the pattern of leisure activities. The authors see leisure as representing a cost, as well as an opportunity, for the U.K. in the 1980s.¹     

Computers and financial planning

This article discusses the principal application areas of models in the financial planning field together with the main reasons for adopting this approach. The various techniques available are compared with special emphasis on the now widespread ‘financial modelling systems’. Finally, an indication is given as to future developments.     

Industrial investment and financial requirements

The present period of slack investment is likely to give way to a fresh investment cycle in the next 5–10 years. Internationally the savings necessary for the provision of capital will be more abundant than ever. However, the structure of savings is changing in favour of risk-averting forms. This is true of savings of private house-holds which benefitting from rising incomes, are increasing in significance. The same applies to the provision of savings, if any, through official insurance schemes, which at least in Europe are found to invest virtually exclusively in fixed-interest securities. The agglomeration of capital in the oil-rich nations, which is also invested with a view to risk aversion, operate in the same direction. By contrast, the capability of firms to generate savings and hence risk-bearing funds is declining. This lack of risk capital threatens to create serious financial obstacles to growth. For risk-bearing corporate capital funds form the yardstick by which the banks, as intermediaries between savers and investors, assess their possibilities to assist enterprises through loans or bond issues. This situation gives rise to political and social problems which must be considered seriously in all long-term policy planning and forecasts.     

The five stages of managed care. Strategies for physicians in health care's market revolution

What are the five stages of managed care? From "Can't Spell HMO" to Managed Cooperation, each stage has predictable market events and strategic responses. At every stage, a new set of relationships evolves among the major players, including physicians and hospitals, HMOs and insurers, and employers and government. At each higher level of managed care penetration, the players restructure their relationships as they seek to control their market and their destiny.     

金融危机对金融机构的冲击及政府救助分析

使用基于非对称双指数分布的跳-扩散模型,以资产治理结构理论为框架对金融危机爆发前后以及危机中政府救助前后的债务平均到期时间、冲击到来频率以及违约资产损失率进行设定,从而对金融机构债务/资产比率在不同情况下的变化趋势进行数值模拟,以此分析金融危机对金融机构的冲击以及政府救助金融机构的效果.模拟分析结果发现,金融危机中金融机构的脆弱性主要来自债务/资产比率过高、中短期债务过多以及资产质量过低;政府对危机中金融机构的救助措施以低频大幅注资辅以购买短期债务和劣质资产最为有效.     

Understanding financial statements

In his premier column for The Physician Executive, David Tarantino takes a look at those critical "financials" that can make or break a business. If you're considering a career move, you need to know the financial condition of future employers. Learn how to read the statements and glean valuable information from the numbers.     

Property testing for cyclic groups and beyond

This paper studies the problem of testing if an input (Γ,°), where Γ is a finite set of unknown size and ° is a binary operation over Γ given as an oracle, is close to a specified class of groups. Friedl et al. (Proc. of STOC, 2005) have constructed an efficient tester using poly(log|Γ|) queries for the class of abelian groups. We focus in this paper on subclasses of abelian groups, and show that these problems are much harder: Ω(|Γ|^1/6) queries are necessary to test if the input is close to a cyclic group, and Ω(|Γ| ^c ) queries for some constant c are necessary to test more generally if the input is close to an abelian group generated by k elements, for any fixed integer k≥1. We also show that knowledge of the size of the ground set Γ helps only for k=1, in which case we construct an efficient tester using poly(log|Γ|) queries; for any other value k≥2 the query complexity remains Ω(|Γ| ^c ). All our upper and lower bounds hold for both the edit distance and the Hamming distance. These are, to the best of our knowledge, the first nontrivial lower bounds for such group-theoretic problems in the property testing model and, in particular, they imply the first exponential separations between the classical and quantum query complexities of testing closeness to classes of groups.     

Corporate financial performance and occupational stress

Although a great deal of research has been carried out in the occupational stress field, little work has focused on the link between corporate financial performance and corporate culture on individual stress. The sample comprised senior marketing managers working in 14 electronics companies selected on the basis of their recent profit/loss performance. It was found that corporate financial performance and culture variables were more strongly associated with many of the felt stresses than were the individual and role-related predictors.     

Corporate financial performance and occupational stress

Abstract

Although a great deal of research has been carried out in the occupational stress field, little work has focused on the link between corporate financial performance and corporate culture on individual stress. The sample comprised senior marketing managers working in 14 electronics companies selected on the basis of their recent profit/loss performance. It was found that corporate financial performance and culture variables were more strongly associated with many of the felt stresses than were the individual and role-related predictors.     

Oil prices and the financial crisis

This paper aims to explain crude oil price volatility and its relationship respect to some macroeconomic and financial variables. Finding the main drivers of oil price dynamics is a crucial element for the definition of adequate monetary policies and risk management purposes. The role of macroeconomic and financial variables is analyzed in a Vector Error Correction Model framework, in order to test the existence of a long run equilibrium in the oil price dynamics. We use monthly data for crude oil prices, the Dollar/Euro exchange rate, the US interest rate, the crude oil Futures open interest, the US oil imports and the gold price over the period 1993–2009. One cointegrating relationship is found which allows to identify a long run equilibrium between the variables.     

Leading beyond the bottom line

Do physician executives approach managing and leading health care organizations like a CEO of a Fortune 100 company? Or does their training as physicians first give them a unique perspective, leading them to view organizational issues differently? The authors suggest that to be a physician executive is to be the practitioner, teacher, coach, and mentor for a new philosophy of leadership and management called Leading Beyond the Bottom Line. While the financial health of an organization is critical to its survival and its ability to fulfill its purpose, the trap is to focus on maximizing the bottom line. This new philosophy leads an organization to attend in equal measure to the (1) welfare of its patients, (2) its financial health, (3) the well-being of its employees, and (4) the building of its community. "The Optimal Organization" is one in which these four objectives are seen not only as related, but interconnected, and the goal is to maximize all of them. The legitimate role of the physician executive is to manage in search of Pareto Optimum, or the maximum benefit for all four organizational objectives. Clearly, this is a tougher job than maximizing profits or just optimizing profits and patient care.     

金融市场的标度理论

传统的金融理论假定证券资产的价格变化服从正态分布或者对数正态分布 ,并且经常是在一个固定的时间标度内讨论价格变化的概率密度函数 .近来的研究表明 ,证券资产的价格变化的尾巴比正态分布“胖”,为了刻划这种胖尾分布 ,研究不同时间标度概率密度函数之间的相似性 ,科学家们用 Lévy稳定分布来描述价格的变化 ,但发现尾巴又太胖 ,因此又引入了截尾Lévy稳定分布 ,它克服了 Lévy稳定分布的弱点 .价格变化多标度行为的发现是金融市场标度理论的一个最新的具有重要意义的进展 .本文对这些最新进展进行了评述 .