At TED2010, Bill Gates unveils his vision for the world’s energy future, describing the need for “miracles” to avoid planetary catastrophe and explaining why he’s backing a dramatically different type of nuclear reactor. The necessary goal? Zero carbon emissions globally by 2050.
About Bill Gates
(source: TED)
Bill Gates is founder and former CEO of Microsoft. A geek icon, tech visionary and business trailblazer, Gates’ leadership — fueled by his long-held dream that millions might realize their potential through great software — made Microsoft a personal computing powerhouse and a trendsetter in the Internet dawn. Whether you’re a suit, chef, quant, artist, media maven, nurse or gamer, you’ve probably used a Microsoft product today.
In summer of 2008, Gates left his day-to-day role with Microsoft to focus on philanthropy. Holding that all lives have equal value (no matter where they’re being lived), the Bill and Melinda Gates Foundation has now donated staggering sums to HIV/AIDS programs, libraries, agriculture research and disaster relief — and offered vital guidance and creative funding to programs in global health and education. Gates believes his tech-centric strategy for giving will prove the killer app of planet Earth’s next big upgrade.
In his second annual letter, released in late January 2010, Gates takes stock of his first full year with the Gates Foundation. Read Bill Gates’ annual letter for 2010. And follow his ongoing thinking on his personal website, The Gates Notes.
After scolding President Obama for continuing to push for reform despite “electoral rebukes” in Massachusetts, New Jersey and Virginia, he complains that the cost-savings in the bill are “ridiculously insignificant.” Dismissing the popular support of the insurance industry reforms that would protect most Americans from the worst predations of the health care insurance marketplace, he goes on to describe the 30 million Americans who would get health coverage as unworthy recipients of taxpayer largesse. The half trillion dollars in Medicare “cuts,” he writes, are “not to keep Medicare solvent but to pay for the ice cream, steak and flowers.”
We’re all familiar with studies showing that marital status is associated with improved health and lower mortality. However, two recent studies suggest that having a male partner is associated with being overweight for women.
A couple of weeks ago, a colleague from our sister site Epicurious.com asked me to comment on New York City’s new campaign to reduce sodium in packaged and restaurant food. I told her I thought the across-the-board movement was probably overkill. The majority of people don’t have high blood pressure–and most of those who do are not salt sensitive. In effect, we’d be “treating” a lot of people who don’t need it in order to get at those who do. On the other hand, I said, there’s no harm in reducing sodium and it would save lives.
The US is facing many challenges in controlling the childhood obesity epidemic. Despite recent efforts and some progress, one third of US children are still overweight or obese. Yet research has shown that the road to obesity begins early in life, and it is more common and difficult to address for low-income children.
That health insurance carriers were ascending to the throne of political piñata in the health care reform debate has been apparent for some time now. Last July President Barack Obama began referring to health care reform as health insurance reform. A couple of weeks later Speaker Nancy Pelosi described insurance companies as “almost immoral” for opposing the creation of a government-run health plan. That insurance companies were to be cast as the villains was pretty much inevitable. People like and trust hospitals and doctors much more than health insurance carriers. And pharmaceutical companies, while profiting far more from health care than medical carriers are a bit removed from people’s daily experience. The reality is the only group Americans trust less when it comes to health care reform than insurance companies are Republicans in Congress.
I intended for this post to be about the challenges of health reform; notably how government structure, culture and social differences, human and administrative resource capacity, corruption and other bureaucratic obstacles muddy the reform waters. Theory and empirical evidence simply isn’t enough to get a health system effectively, efficiently and equitably implemented. I planned to talk about the work of William Hsiao and other reformers with decades of real world experience dealing with such issues. Turns out I’ll get to that next week. A family friend who has been running a successful business for over 30 years wrote to me after the last post and asked sincere, critical questions about why health care markets fail and what differentiates these problems from all other industries. Because it’s a major economic topic, critical to understand and perhaps the most controversial, I’d like to devote one more post to it and other myths.
The first question is “What’s so different about information gaps between health care and all other goods, like cars?” To begin, health care deals heavily with life and death, unlike most other industries — so people aren’t necessarily rational, economic actors when they or family members are extremely sick. They’ll often do and spend whatever it takes to get cured, even when prices rise. The concept was discussed in the 2nd post and indicated that many (but certainly not all) health care procedures incite inelastic patient demand. The economic evidence for this is overwhelming. Now here’s where it gets important. Third party payers, or insurance companies, are there to help us pay for services that we can’t afford. When they foot the bill, patients don’t feel the full price tag and are more willing to buy additional services and spend more money that isn’t theirs. Coupled with inadequate information, they’re even more likely to consume extra health services when the doctor tells them it’s necessary. These two factors cause the price of health care to rise in a vicious cycle.
The second question is, “So why not have the insurance company pay a set fee to the doctor (ie capitation) and let the patients pay the rest? Doctors should charge what they want, and patients can pay out of pocket based on quality.” The answer: That’s a wonderful idea. The Mayo clinic does this successfully, provides top quality care and only takes privately insured patients. But throughout entire health care systems the quality and prices set by doctors and hospitals are very difficult to measure without transparent and sound information – which is why billions of U.S. dollars are actually being spent on this kind of research.
Posted February 26, 2010 by Ali Al-Rajhi under Guest Bloggers
Ali Al-Rajhi writes with the purpose of informing individuals in the Public Health field about pressing issues in environmental health, public health policy, epidemiology, and behavioral health. Learn more here.
