Interests Archives - Page 3 of 8 - the patient investor

August 17, 2015

What are we afraid of? Universal healthcare in market-orientated health systems

From the new IEA (Institute of Economic Affairs) report on the UK’s NHS (National Health System) by Kristian Niemietz 2 Apr 2015:

…….The NHS is often unduly eulogised for minor achievements, because it is being held to unrealistically low standards. The NHS should not be compared with the state of healthcare as it was prior to 1948, or with a hypothetical situation in which all healthcare costs had to be paid out of pocket. Rather, it should be compared with the most realistic alternative: the social health insurance (SHI) systems of Continental Europe, especially the Netherlands, Switzerland and Germany.

SHI systems are far more market-oriented, competitive and patient/ consumer-driven than the NHS. They show a much greater plurality in both provision and financing, usually with a mix of providers (public, private for-profit and private non-profit) and a mix of payers (for-profit insurance, non-profit insurance, out-of-pocket payments, supplementary insurance). For example, in Germany, fewer than half of hospitals are government-owned.

SHI systems still redistribute from the healthy to the sick, and from the rich to the poor. This happens mostly through risk-structure compensation schemes, which redistribute from insurers with a high proportion of ‘good risks’ to those with a high proportion of ‘bad risks’ and thereby make ‘cherry-picking’ of healthier clients economically unviable. Low-income earners also receive demand-side subsidies to help them pay their health insurance premiums.

SHI countries consistently outperform the NHS on measures of health outcomes, quality of healthcare provision and efficiency. Cancer and stroke survival rates are higher, fewer patients suffer from complications after a hospital operation, and the number of deaths that could have been prevented through better healthcare (‘mortality amenable to healthcare’) is lower. On the latter measure, the UK could avoid at least 14 unnecessary deaths per 100,000 inhabitants each year if it rose to the standards of the SHI countries.

SHI systems do not just outperform the NHS in terms of average outcomes, they also achieve more equitable outcomes. The extensive use of market mechanisms does not have to conflict with the aim of reducing health inequalities. According to reasonable indicators of equity, the performance of the NHS is about average amongst developed countries; the performance of SHI systems are amongst the best in the world.

The only visible advantage of the NHS model over SHI models is that it is better at containing costs. However, part of the difference is explained by the fact that SHI systems make it much easier for patients to top up and/or upgrade statutory healthcare privately if they wish. NHS patients are not allowed to do this……..

March 15, 2015

The Catch-22 of energy storage | On Line Opinion

John Morgan questions whether wind and solar are viable energy sources when one considers energy returned on energy invested (EROEI).

There is a minimum EROEI, greater than 1, that is required for an energy source to be able to run society. An energy system must produce a surplus large enough to sustain things like food production, hospitals, and universities to train the engineers to build the plant, transport, construction, and all the elements of the civilization in which it is embedded. For countries like the US and Germany, Weißbach et al. estimate this minimum viable EROEI to be about 7……

The fossil fuel power sources we’re most accustomed to have a high EROEI of about 30, well above the minimum requirement. Wind power at 16, and concentrating solar power (CSP, or solar thermal power) at 19, are lower, but the energy surplus is still sufficient, in principle, to sustain a developed industrial society. Biomass, and solar photovoltaic (at least in Germany), however, cannot. With an EROEI of only 3.9 and 3.5 respectively, these power sources cannot support with their energy alone both their own fabrication and the societal services we use energy for in a first world country.

Energy Returned on Invested, from Weißbach et al.,1 with and without energy storage (buffering). CCGT is closed-cycle gas turbine. PWR is a Pressurized Water (conventional nuclear) Reactor. Energy sources must exceed the “economic threshold”, of about 7, to yield the surplus energy required to support an OECD level society.

These EROEI values are for energy directly delivered (the “unbuffered” values in the figure). But things change if we need to store energy. If we were to store energy in, say, batteries, we must invest energy in mining the materials and manufacturing those batteries. So a larger energy investment is required, and the EROEI consequently drops…[to the buffered level].

February 10, 2015

1939 Alfa Romeo 6C 2500 Sport Berlinetta

Why don’t they make cars like this any more?

Alfa Romeo 6C Sport Berlinetta

Alfa Romeo 6-Cylinder 2500 Sport Berlinetta by Touring, gifted by Mussolini to his mistress Clara Petacci.

More photos at eXtravaganzi

December 25, 2014

Great golf swings: Adam Scott

Adam Scott, 2007. 3-Wood off the tee at St Jude.

Note how Adam anchors the left side of his body. I don’t agree that his down-swing starts with his hips. Watch his right shoulder.

November 27, 2014

Phil Hughes

We mourn the passing of Australian test cricketer Phil Hughes.

Phil Hughes

The 25-year old was struck on the neck while attempting to hook a short delivery in a Sheffield Shield game on Tuesday. The blow ruptured an artery and Hughes did not regain consciousness after collapsing on the field. He died in hospital two days later. The cricket world is devastated by his loss.

November 1, 2014

Why bees are disappearing at the rate of 30% a year

Why bees are disappearing at the rate of 30% a year http://t.co/XZ2EIpM8xx

— Colin Twiggs (@Colin_Twiggs) November 1, 2014

October 27, 2014

Solar Struggles To Compete With Other Renewables On Cost

Andy Tully discusses a study by Ecofys, a renewable energy consultancy based in Utrecht, Netherlands:

…..The Ecofys study concludes that new coal and natural gas plants in the EU, running at maximum capacity, have levelized costs of just over $64 in 2012 dollars per megawatt-hour. Onshore wind costs about $102 per megawatt-hour.

On the higher end, the Ecofys says, nuclear power costs about $115 per megawatt-hour and solar photovoltaic systems cost about $127. At the low end, the cost of hydroelectric power costs about $12.

October 23, 2014

More impressive than man’s first steps on the moon

A Bulgarian man, paralysed from the chest down when his spinal cord was severed in 2010, has taken his first steps after a team of surgeons, led by Pawel Tabakow, consultant neurosurgeon at Wroclaw University in Poland, transplanted olfactory nerve cells into the spinal cord.

“What we’ve done is establish a principle, nerve fibres can grow back and restore function, provided we give them a bridge,” said Geoff Raisman, chair of neural regeneration at University College London’s Institute of Neurology, who led the British research team working on the joint project.

“To me, this is more impressive than a man walking on the Moon. I believe this is the moment when paralysis can be reversed.”

Hat tip to Greg McKenna.

October 14, 2014

The Islamic State: Linking extremism to ill-treatment of women

From David Rothkopf:

Each year, the World Economic Forum produces a Global Gender Gap report. In 2013, it tracked 136 countries on the education, economic empowerment, health, and political empowerment of women. Consider the world’s hot spots for extremism. Some, like Somalia, Libya, and Afghanistan, don’t even make the list. But of those that do, Nigeria ranks 106, Bahrain is 112, Qatar is 115, Kuwait is 116, Jordan is 119, Turkey is 120, Algeria is 124, Egypt is 125, Saudi Arabia is 127, Mali is 128, Morocco is 129, Iran is 130, Syria is 133, Pakistan is 135, and Yemen is dead last at 136……

Not only do countries that treat women badly do badly economically, politically, and socially, but countries in which extremist ideologies have taken root frequently treat women worst of all. In each case they have twisted their religious and cultural inheritances to promote practices that are abhorrent and indefensible, or they simply fail to recognize the rights or the promise of the women and girls among them. This has been taken to extraordinary extremes by groups like the Islamic State. In its slickly produced online English-language magazine, Dabiq, the group defends its enslavement of Yazidi girls and women and the taking of them as concubines by arguing that the practice is a “firmly established aspect of the Sharia.”

I have no doubt that extremism fosters the ill-treatment of women. The more vexing question is: what fosters extremism? Poverty, politics or religion? Fareed Zakaria suggests that the common denominator is religion.

October 13, 2014

Finland proves the education lie

Hank Pellissier at GreatSchools examines the education system of over-achiever South Korea:

…South Korea is often regarded, along with Finland, as one of the two premier K-12 education systems in the world — in no small part due to the spectacular academic performance of its students. According to a 2006 survey by the Programme for International Student Assessment (PISA), which evaluates the scholastic performance of 15-year-olds in 57 nations every three years, South Koreans rank first in reading, third in math (tied with Hong Kong), and 10th in science (tied with Liechtenstein). More than 97% of South Koreans graduate from high school, the highest graduation rate in the world.

South Korea emulates the pressure-cooker classroom environment common in Japanese schools:

South Koreans attend school 220 days per year, almost two months more than the 180 days of Americans. (The Japanese enroll an astonishing 243 days per annum; South Korea abdicated first place in 2005 when its students ceased going to school half days on Saturday.) What distinguishes South Koreans from everyone else, however, is the immense number of hours they study outside the classroom. High schoolers, and even middle schoolers, in South Korea are often engaged in scholastics until midnight or 2 a.m. After taking classes in up to 11 subjects, they attend private academies called “hagwons” where they obtain supplemental learning. The bottom line? Most South Korean children spend 13 hours a day or more with their bottoms glued to a chair.

Should Western schools try to emulate this intensity in an attempt to match South Korea’s outstanding performance? The answer is a resounding NO. Finland offers a far better model.

Although these grueling schedules help South Korea’s high test scores, the nation is remarkably inefficient at another PISA criterion known as “study effectiveness.” When PISA calculates each nation’s achievement based on the number of hours spent studying, South Koreans rank only 24th out of 30 developed nations. The winner in study effectiveness is Finland, the world’s true PISA champ, placing first in science, second in math, and second in reading. Finnish students only attend school 190 days per year (two weeks more than U.S. children) and receive less than a half-hour of homework per day.

Finland is #1 in study effectiveness, achieving outstanding results with little of the “meat-grinder” approach common to so many education systems:

Never burdened with more than half an hour of homework per night, Finnish kids attend school fewer days than 85% of other developed nations (though still more than Americans), and those school days are typically short by international standards…..Finland downplays educational competition in a number of ways. Schools aren’t ranked against each other, and teachers aren’t threatened with formal reviews. At many schools, teachers don’t grade students until the fifth grade, and they aren’t forced to organize curriculum around standardized testing….

Surely this is a model worth emulating? I would be interested in the views of any readers who are employed in education.