I have just completed a paper that represents “first thoughts” arising from a project on medical innovations that I am doing with Katherine Stebbins McCaffrey and Srikant Datar. This paper draws on a case history of HIV/AIDS that Katherine has been working on, my reading of medical history and my prior work on “multi-player” innovation.
Although it is not a “policy” paper it concludes thus:
In medicine too, we should expect that an FDA that made safety its primary focus would reduce the incidence of dangerous drugs or devices brought to market. Meanwhile, scaling back the regulation of efficacy promises two important benefits. Sharply reducing the costs of regulatory compliance should foster some of the hectic, frugal innovation that we find in so many other fields. And, replacing centrally supervised randomized trials with more pluralistic evaluations (by medical associations, insurers and other third-party payers, and on-line communities of consumers) should improve the matching of treatments and patients. True, useless treatments might increase with more innovations coming to market. But, as is the case outside medicine, widespread sharing of diverse experiences of actual use, might also yield more knowledge of what works best and under what circumstances. We could sip a little more of the holy grail of personalized medicine on the cheap, simply by allowing more ad-hoc user experimentation.
We certainly should not suppress science, disdain bio-tech and Big Pharma, or replace trained physicians with Maoist barefoot doctors, but we could be less credulous about imminent research breakthroughs and offer more scope for nurse practitioners and even completely un-credentialed outsiders to innovate. Placing ever-larger bets on exclusive innovation is a poor remedy for its debilities. Harnessing the enterprise and ingenuity of the many and for the many should be the way ahead.
Download the paper here
Widespread private and public cheating in Greece is old hat. Michael Lewis documented it splendidly in Vanity Fair in 2010.
What’s “novel” in this just published piece (tho Ive made it a few times before) is that the Euro doesn’t need or can’t have “convergence” of standards of living or in the quality of governance. Rather the common currency needs rules and structures that *minimize* the supporting standardization and regimentation.
“Standardize and centralize only when necessary” is a staple of modern management. And figuring out what and how to centralize (establishing “loose tight controls as Peters and Waterman put it) are an important part of a CEOs job. (more…)
A civil libertarian and free-speech absolutist’s concern about the Charlie Hedbo demonstrations
Mass demonstrations of solidarity in favor of free speech and against the Charlie Hebdo killings are understandable, but they could inadvertently give cover to actions that subvert the very liberties the protesters cherish. Legitimate public outrage should not be channeled into declaring or escalating wars on Islamic (or any other kind of) terror. Democracies should coolly rely on existing tools and procedures against criminal conspiracies.
Excerpts from my Editorial Commentary in Barron’s November 22, 2014
“In Capital in the Twenty-First Century, Thomas Piketty announced an audacious thesis that sets his opus apart … Capitalism inevitably increases inequality, Piketty claims, because the return on capital grows faster than the economy.
June 20 2011 (Bloomberg) — Amar Bhide, a professor at Tufts University, talks about Basel III bank capital requirements and the Dodd-Frank financial regulation overhaul. Bhide speaks with Erik Schatzker on Bloomberg Television’s “InsideTrack.” (Source: Bloomberg)