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Not many 25-year-olds can reasonably claim to have changed the world. The IBM personal computer, ...
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"We’reusingthewrongword"saysSeanDrysdaleadesperatedoctorfromaruralhospitalatHlabisainnorthernKwaZulu-Natal."Thisisn’tanepidemicit’sadisaster."ArecentUNIEFreportwhichstatesthatalmostone-thirdofSwaziland’s900000peopleareinfectedwithHIVthevirusthatcausesAIDSsupportsthisdiagnosis.HIVisspreadingfasterinsouthernAfricathananywhereelseintheworld. ButisanyonepayingattentionDespitethefactthatmostoftheworld’s33.5millionHIV/AIDScasesareinsub-SaharanAfrica—withanadditional4millioninfectedeachyear—theprioritiesatlastweek’sOrganizationofAfricanUnitysummitwereconflictresolutionandeconomiesdevelopment.Yettheepidemiccouldhaveagreatereffectoneconomicdevelopment—orratherthelackofit—thanmanypoliticianssuspect. Whilebusinessleadersaremoreconcernedaboutthe2Kmillenniumbugthanthelong-termeffectofAIDSstatisticsshowthattheworkfareinSouthAfricaforinstanceislikelytobe20%HIVpositivebynextyear.Medicalofficialsandresearcherswarnthatnotasinglecountryintheregionhasacohesivegovernmentstrategytotacklethecrisis. ThewaymanagersaddressAIDSintheworkplacewilldeterminewhethertheircompaniessurvivethefirstdecadeofthe21stcenturysaysDeaneMooreanactuaryforSouthAfrica’sMetropolitanLifeInsuranceCompany.MooreestimatesthatinSouthAfricatherewillbe580000newAIDScasesayearandalifeexpectancyofjust38by2010."We’llbebacktotheMiddleAges"saysDrysdalewhosehospitalisinoneoftheareasinSouthAfricawiththehighestratesofHIVinfection."Thegraphisheadingtowardthevertical.Andyetpeoplearestillnottakingitseriously." MostsouthernAfricancountriesaresimplytoopoortosupplymorethanbasichealthservicesletalonemedicinestoconfrontthecrisis.PatientsinsomegovernmenthospitalsinHararehavetosupplytheirownbeddingfooddrugsandinsomecaseseventheirownnurses.Zimbabwe’sfraildomesticeconomydependstoalargeextentoninformalenterprisesandsmallbusinessesmanyofwhicharegoingbankruptasAIDStakesitstollonownersandemployees."Therippleeffectisdevastating"saysHarareAIDSresearcherReneLoewenson. MoreominousaretheimplicationsforSouthAfricawithasophisticatedindustrialinfrastructureaswellasawidespreadinformalsector.WhiletheSouthAfricangovernmentisactiveinpromotingAIDSeducationithasn’tthemoneymanpowerormaterialtocopewiththeattackofAIDS. BysayingThegraphisheadingtowardtheverticalPara.4Drysdalewantstotellpeople
WhatdoyouthinkofAmericanhealthcaresystemMostpeoplewouldbe1bythehighqualityofmedicine2tomostAmericans.Thereisalotofspecializationagreatdealof3totheindividuala4amountofadvancedtechnicalequipmentand5effortnottomakemistakesbecauseofthefinancialriskwhichdoctorsandhospitalsmust6inthecourtsifthey7thingsbadly. ButtheAmericansareinamess.Totheproblemisthewayin8healthcareisorganizedand9.10topubicbeliefitisnotjustafreecompetitionsystem.Totheprivatesystemhasbeenjoinedalargepublicsystembecauseprivatecarewassimplynot11thelessfortunateandtheelderly. Butevenwiththishugepublicpartofthesystem12thisyearwilleatup84.5billiondollars—morethan10percentoftheU.S.Budget—alargenumberofAmericansareleft13.Theseincludeabouthalfthe11millionunemployedandthosewhofailtomeetthestrictlimits14incomefixedbyagovernmenttryingtomakesavingswhereitcan. Thebasicproblemhoweveristhatthereisnocentralcontrol15thehealthsystem.Thereisno16towhatdoctorsandhospitalschargefortheirservicesotherthanwhatthepublicisabletopay.Thenumberofdoctorshasshotupandpriceshaveclimbed.Whenfacedwithtoothacheasickchildoraheartattackalltheunfortunatepersonsconcernedcandoistopay17.Twothirdsofthepopulationare18bymedicalinsurance.Doctorschargeasmuchastheywant19thattheinsurancecompanywillpaythebill. TherisingcostofmedicineintheU.S.A.isamongthemostworryingproblemsfacingthecountry.In1981thecountry’shealthbillclimbed15.9percent—abouttwiceasfastasprices20general. 4
Intheidealizedversionofhowscienceisdonefactsabouttheworldarewaitingtobeobservedandcollectedbyobjectiveresearcherswhousethescientificmethodtocan’youttheirwork.Butintheeverydaypracticeofsciencediscoveryfrequentlyfollowsanambiguousandcomplicatedroute.Weaimtobeobjectivebutwecannotescapethecontextofouruniquelifeexperience.Priorknowledgeandinterestinfluencewhatweexperiencewhatwethinkourexperiencesmeanandthesubsequentactionswetake.Opportunitiesformisinterpretationerrorandself-deceptionabound. Consequentlydiscoveryclaimsshouldbethoughtofasprotoscience.Similartonewlystakedminingclaimstheyarelullofpotential.Butittakescollectivescrutinyandacceptancetotransformadiscoveryclaimintoamaturediscovery.Thisisthecredibilityprocessthroughwhichtheindividualresearcher’smeherenowbecomesthecommunity’sanyoneanywhereanytime.Objectiveknowledgeisthegoalnotthestartingpoint. Onceadiscoveryclaimbecomespublicthediscovererreceivesintellectualcredit.Butunlikewithminingclaimsthecommunitytakescontrolofwhathappensnext.Withinthecomplexsocialstructureofthescientificcommunityresearchersmakediscoveries;editorsandreviewersactasgatekeepersbycontrollingthepublicationprocess;otherscientistsusethenewfindingtosuittheirownpurposes;andfinallythepublicincludingotherscientistsreceivesthenewdiscoveryandpossiblyaccompanyingtechnology.Asadiscoveryclaimworksitwaythroughthecommunitytheinteractionandconfrontationbetweensharedandcompetingbeliefsaboutthescienceandthetechnologyinvolvedtransformsanindividual’sdiscoveryclaimintothecommunity’scrediblediscovery. Twoparadoxesexistthroughoutthiscredibilityprocess.FirstscientificworktendstofocusonsomeaspectofprevailingKnowledgethatisviewedasincompleteorincorrect.Littlerewardaccompaniesduplicationandconfirmationofwhatisalreadyknownandbelieved.Thegoalisnew-searchnotre-search.Notsurprisinglynewlypublisheddiscoveryclaimsandcrediblediscoveriesthatappeartobeimportantandconvincingwillalwaysbeopentochallengeandpotentialmodificationorrefutationbyfutureresearchers.Secondnoveltyitselffrequentlyprovokesdisbelief.NobelLaureateandphysiologistAlbertAzent-Gy6rgyioncedescribeddiscoveryas"seeingwhateverybodyhasseenandthinkingwhatnobodyhasthought."Butthinkingwhatnobodyelsehasthoughtandtellingotherswhattheyhavemissedmaynotchangetheirviews.Sometimesyearsarerequiredfortrulynoveldiscoveryclaimstobeacceptedandappreciated. Intheendcredibility"happens"toadiscoveryclaim—aprocessthatcorrespondstowhatphilosopherAnnetteBaierhasdescribedasthecommonsofthemind."Wereasontogetherchallengereviseandcompleteeachother’sreasoningandeachother’sconceptionsofreason. AlbertSzent-Gydrgyiwouldmostlikelyagreethat
Directions: Writeanessayofabout160-200wordsbasedonthefollowingdrawing.Inthisessayyoushould: 1describethepicturesbriefly 2interpretthemeaningand 3giveyourcomment.
Inmostpartsoftheworldclimatechangeisaworryingsubject.NotsoinCalifornia.Atarecentgatheringofgreenluminaries--inafilmstar’shousenaturallyforthatishowseriousnessisoftenestablishedinLosAngeles--thedominantnotewasself-satisfactionatwhatthestatehasalreadyachieved.AndperhapsnobodyismorecomplacentthanArnoldSchwarzenegger.UnlikeA1GoreapresidentialcandidateturnedprophetofenvironmentaldoomCalifornia’sgovernorsoundscheerfulwhentalkingaboutclimatechange.Aswellhemight:ithasmadehispoliticalcareer. AlthoughCaliforniahaslongbeenanenvironmentally-consciousstateuntilrecentlygreenswereconcernedaboveallwithsmogandredwoodtrees."CoastofDreams"KevinStarr’sauthoritativehistoryofcontemporaryCaliforniapublishedin2004doesnotmentionclimatechange.Inthatyearthoughthenewly-electedMr.Schwarzeneggermadehisfirsttentativecallforwesternstatestoseekalternativestofossilfuels.Graduallyhenoticedthathiseffortstotackleclimatechangemetwithlessresistanceandmoreacclaimthanjustaboutallhisotherpolicies.Thesedaysitcanseemasthoughheworksonnothingelse. Mr.Schwarzenegger’stransformationfromscreenwarriortoeco-warriorwascompletedlastyearwhenhesignedabillimposinglegally-enforceablelimitsongreenhouse--gasemissions--afirstforAmerica.ThanksmostlytoitslackofcoalandheavyindustryCaliforniaisarelativelycleanstate.Ifitwereacountryitwouldbetheworld’seighth-biggesteconomybutonlyits16th-biggestpolluter.Itsbigproblemistransport--meaningmostlycarsandtruckswhichaccountformorethan40%ofitsgreenhouse-gasemissionscomparedwith32%inAmericaasawhole.Thestatewantstoratchetdownemissionslimitsonnewvehiclesbeginningin2009.Mr.Schwarzeneggerhasalsoorderedthatby2020vehiclefuelmustproduce10%lesscarbon:intheproductionaswellastheburningsoasimpleswitchtocorn-basedethanolisprobablyout. ThanksinparttoCalifornia’sexamplemostofthewesternstateshaveadoptedclimateactionplans.WhenitcomestosettingemissiontargetsthescenecanresembleaposedownataMr.Olympiacontest.Arizona’sclimate-changescholarsdecidedtosetatargetofcuttingthestate’semissionsto2000levelsby2020.ButJanetNapolitanothegovernorwasdeterminednottobeout-muscledbyCalifornia.ShehasdeclaredthatArizonawilltrytoreturnto2000emissionlevelsby2012. Californiahasnotjustinspiredotherstates;ithascreatedavanguardthatoughttobeabletoprodthefederalgovernmentintostrongernationalstandardsthanitwouldotherwiseconsider.ButCaliforniaisfindingiteasiertoexportitspoliciesthantoputthemintopracticeathome.InonewayCalifornia’sself-confidenceisfullyjustified.Ithasdonemorethananyotherstate--letalonethefederalgovernment--tofixAmerica’sattentiononclimatechange.Ithasalsomadeitseemasthoughtheproblemcanbesolved.Whichiswhyfailurewouldbesuchbadnews.AtthemomentCaliforniaisabeacontootherstates.Ifitfailsitwillbecomeanexcuseforinaction. WhydidMr.Schwarzeneggerseemtobeworkingonnothingelse
FORthepasttwoyearsinSiliconValleythecentreofAmerica’stechnologyindustryconference-goershaveentertainedthemselvesplayingaguessinggame:howmanytimeswillaspeakermentionthephrase"longtail"ItisusuallyahighnumberthankstotheinfluenceofthelongtailtheorywhichwasfirstdevelopedbyChrisAndersontheeditorofWiredmagazineinanarticlein2004.Thoughtechnologistsandbloggerschuckleathoweverybusinesspresentationnowhastohaveitslong-tailsectionmostareenviousofMrAndersonwhosebrainwavequicklybecamethemostfashionablebusinessideaaround. Whetherablockbusterfilmabestsellingnovelorachart-toppingrapsongpopularcultureidolizesthehit.Companiesdevotethemselvestocreatingthembecausethecostofdistributionandthelimitsofshelfspaceinphysicalshopsmeanthatprofitabilitydependsonahighvolumeofsales.Butaroundthebeginningofthiscenturyagroupofinternetcompaniesrealizedthatwithendlessshelvesandanationaloreveninternationalaudienceonlinetheycouldofferahugerangeofproducts—andmakemoneyatthesametime. ThenichetheobscureandthespecialistMrAndersonargueswillgaingroundattheexpenseofthehit.Asevidencehepointstoadropinthenumberofcompaniesthattraditionallycalculatetheirrevenue/salesratioaccordingtothe80/20rule—wherethetopfifthofproductscontributefour-fifthsofrevenues.EcastaSanFranciscodigitaljukeboxcompanyfoundthat98%ofits10000albumssoldatleastonetrackeverythreemonths.ExpressedinthelanguageofstatisticstheexperiencesofEcastandothercompaniessuchasAmazonanonlinebooksellersuggestthatproductsdowninthelongtailofastatisticaldistributionaddedtogethercanbehighlyprofitable.Theinternethelpspeoplefindtheirwaytorelativelyobscurematerialwithrecommendationsandreviewsbyotherpeopleandforthosewillingtohavetheirartistictastespredictedbyapieceofsoftwarecomputerprogramswhichanalyzepastselections. Long-tailenthusiastsarguethatthewholeofculturewillbenefitnotjustcommercialenterprises.Televisionfilmandmusicaresuchbewitchingmediaintheirownrightthatmanypeoplearequitehappytowatchandlistentowhatthemainstreamprovides.Butifindividualshavetheopportunitytopickbettermoreideallysuitedentertainmentfromafarwiderselectiontheywilltakeitaccordingtothetheoryofthelongtail.Someanalystsreckonthatentirepopulationsmightbecomehappierandwiseroncetheyhaveaccesstothousandsofdocumentariesindependentfilmsandsub-genresofeverykindofmusicinsteadofbeingsubjectedtowhatMrAndersoncallsthetyrannyoflowest-common-denominatorfare.Thatmightbetakingthingsabitfar.Butthelongtailiscertainlyoneoftheinternet’sbettergiftstohumanity. Thephraselowest-common-denominatorLine9Paragraph4probablyrefersto
WhatdoyouthinkofAmericanhealthcaresystemMostpeoplewouldbe1bythehighqualityofmedicine2tomostAmericans.Thereisalotofspecializationagreatdealof3totheindividuala4amountofadvancedtechnicalequipmentand5effortnottomakemistakesbecauseofthefinancialriskwhichdoctorsandhospitalsmust6inthecourtsifthey7thingsbadly. ButtheAmericansareinamess.Totheproblemisthewayin8healthcareisorganizedand9.10topubicbeliefitisnotjustafreecompetitionsystem.Totheprivatesystemhasbeenjoinedalargepublicsystembecauseprivatecarewassimplynot11thelessfortunateandtheelderly. Butevenwiththishugepublicpartofthesystem12thisyearwilleatup84.5billiondollars—morethan10percentoftheU.S.Budget—alargenumberofAmericansareleft13.Theseincludeabouthalfthe11millionunemployedandthosewhofailtomeetthestrictlimits14incomefixedbyagovernmenttryingtomakesavingswhereitcan. Thebasicproblemhoweveristhatthereisnocentralcontrol15thehealthsystem.Thereisno16towhatdoctorsandhospitalschargefortheirservicesotherthanwhatthepublicisabletopay.Thenumberofdoctorshasshotupandpriceshaveclimbed.Whenfacedwithtoothacheasickchildoraheartattackalltheunfortunatepersonsconcernedcandoistopay17.Twothirdsofthepopulationare18bymedicalinsurance.Doctorschargeasmuchastheywant19thattheinsurancecompanywillpaythebill. TherisingcostofmedicineintheU.S.A.isamongthemostworryingproblemsfacingthecountry.In1981thecountry’shealthbillclimbed15.9percent—abouttwiceasfastasprices20general. 18
Whenthereisbloodinthewateritisonlynaturalthatdorsalfinsswirlaroundexcitedly.NowthatAmerica’shousingmarketisailingpredatorshavetheirsightsonthecountry’scredit-cardmarket.AnalystsatGoldmanSachsreckonthatcredit-cardlossescouldreach$99billionifcontagionspreadsfromsubprimemortgagestootherformsofconsumercredit.Signsofstrainareclearlyvisible.Therearerisesinboththecharge-offanddelinquencyrateswhichmeasuretheshareofbalancesthatareuncollectableormorethan30dayslaterespectively.HSBCannouncedlastmonththatithadtakena$1.4billionchargeinitsAmericanconsumer-financebusinesspartlybecauseofweaknessamongcardborrowers. Itistooearlytopanicthough.Charge-offsanddelinquenciesarestilllow.AccordingtoMoody’saratingagencythethird-quarterdelinquencyrateof3.89%wasalmostafullpercentagepointbelowthehistoricalaverage.Thedeteriorationinratescanbepartlyexplainedbytechnicalfactors.AchangeinAmerica’spersonal-bankruptcylawsin2005ledtoanabruptfallinbankruptcyfilingswhichinturnaccountforabigchunkofcredit-cardlosses;thenumberoffilingsandthuscharge-offrateswouldberisingagainwhetherornotoverallconditionsforborrowersweregettingworse. Theindustryalsoreportssolidpaymentrateswhichshowhowmuchoftheirdebtconsumerspayoffeachmonth.Andconfidenceincredit-cardasset-backedsecuritiesisprettyfirmdespiteparalysisinothercornersofstructuredfinance.DennisMoroneyofTowerGrouparesearchfirmpredictsthatissuancevolumesfor2007willendupbeing25%higherthanlastyear. Directchannelsofinfectionbetweenthesubprime-mortgagecrisisandthecredit-cardmarketcertainlyexist:consumersarelikeliertoloaduponcredit-carddebtnowthathome-equityloansaredryingup.Butcardissuerslookatcashflowratherthanassetvaluessofallinghousepricesdonotnecessarilytriggerachangeinborrowers’creditworthiness.Theymayevenworktoissuers’advantage.Theincentivesforconsumerstokeeppayingthemortgagedecreaseifpropertiesareworthlessthanthevalueoftheloan;carddebtriseshigherupthelistofrepaymentprioritiesasaresult. Cardissuersarealsoabletorespondmuchmoreswiftlyandflexiblytostormierconditionsthanmortgagelendersarebychanginginterestratesoralteringcreditlimits.Thatshouldintheoryreducetheriskofarapidrepricingofassets."Wearenotgoingtowakeuponedayandtotallyrevaluetheloans"saysGaryPerlinCapitalOne’schieffinancialofficer. Ifasuddensubprime-stylemeltdowninthecredit-cardmarketisimprobabletherisksofasustaineddownturnaremuchmorereal.IflowerhousepricesandacontractionincreditpushAmericaintorecessiontheindustrywillundoubtedlyfaceagrimmerfuture.Keepwatchingforthosedorsalfins. Accordingtothethirdparagraphwhywouldthenumberofbankruptcyfilingsberisingagain
WhatdoyouthinkofAmericanhealthcaresystemMostpeoplewouldbe1bythehighqualityofmedicine2tomostAmericans.Thereisalotofspecializationagreatdealof3totheindividuala4amountofadvancedtechnicalequipmentand5effortnottomakemistakesbecauseofthefinancialriskwhichdoctorsandhospitalsmust6inthecourtsifthey7thingsbadly. ButtheAmericansareinamess.Totheproblemisthewayin8healthcareisorganizedand9.10topubicbeliefitisnotjustafreecompetitionsystem.Totheprivatesystemhasbeenjoinedalargepublicsystembecauseprivatecarewassimplynot11thelessfortunateandtheelderly. Butevenwiththishugepublicpartofthesystem12thisyearwilleatup84.5billiondollars—morethan10percentoftheU.S.Budget—alargenumberofAmericansareleft13.Theseincludeabouthalfthe11millionunemployedandthosewhofailtomeetthestrictlimits14incomefixedbyagovernmenttryingtomakesavingswhereitcan. Thebasicproblemhoweveristhatthereisnocentralcontrol15thehealthsystem.Thereisno16towhatdoctorsandhospitalschargefortheirservicesotherthanwhatthepublicisabletopay.Thenumberofdoctorshasshotupandpriceshaveclimbed.Whenfacedwithtoothacheasickchildoraheartattackalltheunfortunatepersonsconcernedcandoistopay17.Twothirdsofthepopulationare18bymedicalinsurance.Doctorschargeasmuchastheywant19thattheinsurancecompanywillpaythebill. TherisingcostofmedicineintheU.S.A.isamongthemostworryingproblemsfacingthecountry.In1981thecountry’shealthbillclimbed15.9percent—abouttwiceasfastasprices20general. 2
Istronglyagreewiththecontentionthatabsenceofchoiceisararecircumstanceprimarilybecausethiscontentionaccordswithcommonsenseandoureverydayexperienceashumanbeings.Besidesthereverseclaim-thatwedonothavefreechoice-servestounderminethenotionsofmoralaccountabilityandhumanequalitywhicharecriticaltothesurvivalofanydemocraticsociety. 41.Theroleoffreewillofhumansinchoice Commonsensedictatesthathumanshavefreewillandthereforethetrueabsenceofchoiceisveryrare.Theonlypossibleexceptionswouldinvolveextremeandrarecircumstancessuchassolitaryimprisonmentoraseverementalorphysicaldeficiency—anyofwhichmightpotentiallystripapersonofhisorherabilitytomakeconsciouschoices.Yetevenunderthesecircumstancesapersonstillretainschoicesaboutvoluntarybodilyfunctionsandmovement.Thusthecompleteabsenceofchoicewouldseemtobepossibleonlyinacomatosestateorindeath. 42.Thenatureofabsenceofchoice Peopleoftenclaimthatlife’scircumstancesleavethemwith"nochoice."Onemightfeeltrappedinajoboramarriage.Underfinancialduressapersonmightclaimthatheorshehas"nochoice"buttodeclarebankruptcytakeademeaningjoborevenlieorstealtoobtainmoney.Thefundamentalproblemwiththesesortsofclaimsisthattheclaimantsareonlyconsideringthosechoicesthatarenotviableorattractive.Thatispeopleinsituationssuchasthesehaveaninfinitenumberofchoices;it’sjustthatmanyofthechoicesareunappealingevenself-defeating. 43.Choiceisbeyondourcontrol Besidesthecontentionthatwearealmostinvariablyfreetochooseisfarmoreappealingfromasociopoliticalstandpointthantheoppositeclaim.Acompletetackofchoiceimpliesthateveryperson’sfateisdeterminedandthatwealllackfreewill.Accordingtothephilosophicalschoolof"strictdeterminism"everyeventincludinghumanactionsandChoicesthatoccursisphysicallynecessarygiventhelawsofnatureandeventsthatprecededthateventorchoice.Inotherwordsthe"choices"thatseempartoftheessenceofourbeingareactuallybeyondourcontrol. 44.Thelogicalresultofstrictdeterminismandofthenew"scientificdeterminism" Howeverthelogicalresultofstrictdeterminismandofthenew"scientificdeterminism"isthatwearenotmorallyaccountableforouractionsandchoiceseventhosethatharmotherindividualsorsociety.Moreoverthroughouthistorymonarchsanddictatorshaveembraceddeterminismatleastostensiblytobolstertheirclaimthatcertainindividualsarepreordainedtoassumepositionsofauthorityortorisetothetoplevelsofthesocioeconomicinfrastructure.Finallythenotionofscientificdeterminismopensthedoorforgeneticengineeringwhichposesapotentialthreattoequalityinsocioeconomicopportunityandcouldleadtothedevelopmentofaso-called"masterrace."Admittedlythesedisturbingimplicationsneitherprovenordisprovethedeterminists’claims. 45.Insistenceoftreewill Iwouldconcedethatsciencemighteventuallydisprovetheverynotionoffreewill.HoweveruntilthattimeI’lltrustmystrongintuitionthatfreewillisanessentialpartofourbeingashumansandaccordinglythathumansareresponsiblefortheirownchoicesandactions. [A]Forexamplealmosteverypersonwhoclaimstobetrappedinajobissimplychoosingtoretainacertainmeasureoffinancialsecurity.Thechoicetoforegothissecurityisalwaysavailablealthoughitmightcarryunpleasantconsequences. [B]Ourcollectivelifeexperienceisthatwemakechoicesanddecisionseverydayonacontinualbasis. [C]HoweverthedilemmaseamstobeunavoidablewhichgivespeoplealotofPainfullyexperiencewithit. [D]Insumdespitethefactthatweallexperienceoccasionalfeelingsofbeingtrappedandhavingnochoicethestatementisfundamentallycorrect. [E]Recentadvancesinmolecularbiologyandgeneticslendsomecredencetothedeterminists’positionthatasphysicalbeingsouractionsaredeterminedbyphysicalforcesbeyondourcontrol.Newresearchsuggeststhatthesephysicalforcesincludeourownindividualgeneticmakeup. [F]Assumingthatneitherfreewillnordeterminismhasbeenproventobethecorrectpositiontheformeristobepreferredbyanyhumanistandinanydemocraticsociety. 42
WhatdoyouthinkofAmericanhealthcaresystemMostpeoplewouldbe1bythehighqualityofmedicine2tomostAmericans.Thereisalotofspecializationagreatdealof3totheindividuala4amountofadvancedtechnicalequipmentand5effortnottomakemistakesbecauseofthefinancialriskwhichdoctorsandhospitalsmust6inthecourtsifthey7thingsbadly. ButtheAmericansareinamess.Totheproblemisthewayin8healthcareisorganizedand9.10topubicbeliefitisnotjustafreecompetitionsystem.Totheprivatesystemhasbeenjoinedalargepublicsystembecauseprivatecarewassimplynot11thelessfortunateandtheelderly. Butevenwiththishugepublicpartofthesystem12thisyearwilleatup84.5billiondollars—morethan10percentoftheU.S.Budget—alargenumberofAmericansareleft13.Theseincludeabouthalfthe11millionunemployedandthosewhofailtomeetthestrictlimits14incomefixedbyagovernmenttryingtomakesavingswhereitcan. Thebasicproblemhoweveristhatthereisnocentralcontrol15thehealthsystem.Thereisno16towhatdoctorsandhospitalschargefortheirservicesotherthanwhatthepublicisabletopay.Thenumberofdoctorshasshotupandpriceshaveclimbed.Whenfacedwithtoothacheasickchildoraheartattackalltheunfortunatepersonsconcernedcandoistopay17.Twothirdsofthepopulationare18bymedicalinsurance.Doctorschargeasmuchastheywant19thattheinsurancecompanywillpaythebill. TherisingcostofmedicineintheU.S.A.isamongthemostworryingproblemsfacingthecountry.In1981thecountry’shealthbillclimbed15.9percent—abouttwiceasfastasprices20general. 12
Anawkward-lookingcharactersuchasCyranodeBergeracmightsniffatthesuggestionbutrecentscientificresearchshowsbeautybrainsandbrawnmayinfactallbealliedwritesDrRajPersaud. 46Psychologistshaveconcludedthatwemaybedrawntothestereotypicallyattractivebecauseofwhattheirfacesrevealabouttheirintelligenceandsuccessinlaterlife.InAmericanresearchledbyProfessorLeslieZebrowitzofBrandeisUniversityhasshownanassociationbetweenfacialattractiveandIQ.Strangersbrieflyexposedtoatarget’sfacewereabletocorrectlyjudgeintelligenceatlevelssignificantlybetterthanchance. Thesameteamalsoresearchedhowaperson’sattractivenessmightbearrelationtotheirintelligence.Theyfoundthatgood-lookingpeopledidbetterinIQtestsastheyaged.47Theirresearchsoughttoprovethathowapersonperceivedhimselfandwasperceivedbyotherspredictedhowintelligentheapparentlybecamemoreaccuratelythanhispastintelligence.48Perhapsbecausethemoreattractivepeopleweretreatedasmoreintelligenttheyendeduphavingmorestimulatingandthereforeintelligence-enhancinglives. DoesthismeanthatyourfacereallycouldbeyourdestinySociologistsDrUlrichMuellerandDrAllanMazuroftheUniversityofMarburginGermanyrecentlyanalyzedthefinalyearphotographsofthe1950graduatesofWestPointintheUnitedStates.Dominantfacialappearancesturnedouttobeaconsistentpredictoroflater-rankattainment: Againtheybelievedtherecouldbeaself-fulfillingeffect.49Becausesomemenlookedmoreauthoritativetheynaturallydrewrespectandobediencefromotherswhichinturnassistedtheirrisethroughtheranks. AteamattheRoyalCollegeofSurgeonsinDublinhasbeeninvestigatingthesensitivesubjectoflinksbetweenphysicalandmentalabnormalities.LedbyDoctorsRobinHennessyandJohnWaddingtontheteamusedanewlasersurface-scanningtechniquetomakea3-Danalysisofhowfacialshapemightvarywithbrainstructure.Theirfindingsshowedthatinearlyfetallifebrainandfacedevelopmentareintimatelyconnected.Fromthistheyconcludedthatabnormalitiesinbrainelaborationprobablyalsoaffectfacedevelopment. ThisaccordingtothemexplainsthestrikingfacialfeaturesofsomeonewithDown’ssyndrome.50Usingsimilartechniquestheteamalsodemonstratedhowotherdisorderslinkedtobrainaberrationscouldbeassociatedwithfacialalterations. Sotheverylatestscientificresearchsuggeststhatnobodyshouldtrytolooktooobviouslydifferentfromaverage. 50Usingsimilartechniquestheteamalsodemonstratedhowotherdisorderslinkedtobrainaberrationscouldbeassociatedwithfacialalterations.
Anawkward-lookingcharactersuchasCyranodeBergeracmightsniffatthesuggestionbutrecentscientificresearchshowsbeautybrainsandbrawnmayinfactallbealliedwritesDrRajPersaud. 46Psychologistshaveconcludedthatwemaybedrawntothestereotypicallyattractivebecauseofwhattheirfacesrevealabouttheirintelligenceandsuccessinlaterlife.InAmericanresearchledbyProfessorLeslieZebrowitzofBrandeisUniversityhasshownanassociationbetweenfacialattractiveandIQ.Strangersbrieflyexposedtoatarget’sfacewereabletocorrectlyjudgeintelligenceatlevelssignificantlybetterthanchance. Thesameteamalsoresearchedhowaperson’sattractivenessmightbearrelationtotheirintelligence.Theyfoundthatgood-lookingpeopledidbetterinIQtestsastheyaged.47Theirresearchsoughttoprovethathowapersonperceivedhimselfandwasperceivedbyotherspredictedhowintelligentheapparentlybecamemoreaccuratelythanhispastintelligence.48Perhapsbecausethemoreattractivepeopleweretreatedasmoreintelligenttheyendeduphavingmorestimulatingandthereforeintelligence-enhancinglives. DoesthismeanthatyourfacereallycouldbeyourdestinySociologistsDrUlrichMuellerandDrAllanMazuroftheUniversityofMarburginGermanyrecentlyanalyzedthefinalyearphotographsofthe1950graduatesofWestPointintheUnitedStates.Dominantfacialappearancesturnedouttobeaconsistentpredictoroflater-rankattainment: Againtheybelievedtherecouldbeaself-fulfillingeffect.49Becausesomemenlookedmoreauthoritativetheynaturallydrewrespectandobediencefromotherswhichinturnassistedtheirrisethroughtheranks. AteamattheRoyalCollegeofSurgeonsinDublinhasbeeninvestigatingthesensitivesubjectoflinksbetweenphysicalandmentalabnormalities.LedbyDoctorsRobinHennessyandJohnWaddingtontheteamusedanewlasersurface-scanningtechniquetomakea3-Danalysisofhowfacialshapemightvarywithbrainstructure.Theirfindingsshowedthatinearlyfetallifebrainandfacedevelopmentareintimatelyconnected.Fromthistheyconcludedthatabnormalitiesinbrainelaborationprobablyalsoaffectfacedevelopment. ThisaccordingtothemexplainsthestrikingfacialfeaturesofsomeonewithDown’ssyndrome.50Usingsimilartechniquestheteamalsodemonstratedhowotherdisorderslinkedtobrainaberrationscouldbeassociatedwithfacialalterations. Sotheverylatestscientificresearchsuggeststhatnobodyshouldtrytolooktooobviouslydifferentfromaverage. 48Perhapsbecausethemoreattractivepeopleweretreatedasmoreintelligenttheyendeduphavingmorestimulatingandthereforeintelligence-enhancinglives.
Intheidealizedversionofhowscienceisdonefactsabouttheworldarewaitingtobeobservedandcollectedbyobjectiveresearcherswhousethescientificmethodtocan’youttheirwork.Butintheeverydaypracticeofsciencediscoveryfrequentlyfollowsanambiguousandcomplicatedroute.Weaimtobeobjectivebutwecannotescapethecontextofouruniquelifeexperience.Priorknowledgeandinterestinfluencewhatweexperiencewhatwethinkourexperiencesmeanandthesubsequentactionswetake.Opportunitiesformisinterpretationerrorandself-deceptionabound. Consequentlydiscoveryclaimsshouldbethoughtofasprotoscience.Similartonewlystakedminingclaimstheyarelullofpotential.Butittakescollectivescrutinyandacceptancetotransformadiscoveryclaimintoamaturediscovery.Thisisthecredibilityprocessthroughwhichtheindividualresearcher’smeherenowbecomesthecommunity’sanyoneanywhereanytime.Objectiveknowledgeisthegoalnotthestartingpoint. Onceadiscoveryclaimbecomespublicthediscovererreceivesintellectualcredit.Butunlikewithminingclaimsthecommunitytakescontrolofwhathappensnext.Withinthecomplexsocialstructureofthescientificcommunityresearchersmakediscoveries;editorsandreviewersactasgatekeepersbycontrollingthepublicationprocess;otherscientistsusethenewfindingtosuittheirownpurposes;andfinallythepublicincludingotherscientistsreceivesthenewdiscoveryandpossiblyaccompanyingtechnology.Asadiscoveryclaimworksitwaythroughthecommunitytheinteractionandconfrontationbetweensharedandcompetingbeliefsaboutthescienceandthetechnologyinvolvedtransformsanindividual’sdiscoveryclaimintothecommunity’scrediblediscovery. Twoparadoxesexistthroughoutthiscredibilityprocess.FirstscientificworktendstofocusonsomeaspectofprevailingKnowledgethatisviewedasincompleteorincorrect.Littlerewardaccompaniesduplicationandconfirmationofwhatisalreadyknownandbelieved.Thegoalisnew-searchnotre-search.Notsurprisinglynewlypublisheddiscoveryclaimsandcrediblediscoveriesthatappeartobeimportantandconvincingwillalwaysbeopentochallengeandpotentialmodificationorrefutationbyfutureresearchers.Secondnoveltyitselffrequentlyprovokesdisbelief.NobelLaureateandphysiologistAlbertAzent-Gy6rgyioncedescribeddiscoveryas"seeingwhateverybodyhasseenandthinkingwhatnobodyhasthought."Butthinkingwhatnobodyelsehasthoughtandtellingotherswhattheyhavemissedmaynotchangetheirviews.Sometimesyearsarerequiredfortrulynoveldiscoveryclaimstobeacceptedandappreciated. Intheendcredibility"happens"toadiscoveryclaim—aprocessthatcorrespondstowhatphilosopherAnnetteBaierhasdescribedasthecommonsofthemind."Wereasontogetherchallengereviseandcompleteeachother’sreasoningandeachother’sconceptionsofreason. ItcanbeinferredfromParagraph2thatcredibilityprocessrequires
WhenLiamMcGeedepartedaspresidentofBankofAmericainAugusthisexplanationwassurprisinglystraightup.Ratherthancloakinghisexitintheusualvagueexcuseshecamerightoutandsaidhewasleavingtopursuemygoalofrunningacompany.BroadcastinghisambitionwasverymuchmydecisionMcGeesays.WithintwoweekshewastalkingforthefirsttimewiththeboardofHartfordFinancialServicesGroupwhichnamedhimCEOandchairmanonSeptember29.McGeesaysleavingwithoutapositionlinedupgavehimtimetoreflectonwhatkindofcompanyhewantedtorun.Italsosentaclearmessagetotheoutsideworldabouthisaspirations.AndMcGeeisn’talone.InrecentweekstheNo.2executivesatAvonandAmericanExpressquitwiththeexplanationthattheywerelookingforaCEOpost.Asboardsscrutinizesuccessionplansinresponsetoshareholderpressureexecutiveswhodon’tgetthenodalsomaywishtomoveon.Aturbulentbusinessenvironmentalsohasseniormanagerscautiousoflettingvaguepronouncementscloudtheirreputations.Asthefirstsignsofrecoverybegintotakeholddeputychiefsmaybemorewillingtomakethejumpwithoutanet.InthethirdquarterCEOturnoverwasdown23%fromayearagoasnervousboardsstuckwiththeleaderstheyhadaccordingtoLiberumResearch.Astheeconomypicksupopportunitieswillaboundforaspiringleaders.Thedecisiontoquitaseniorpositiontolookforabetteroneisunconventional.ForyearsexecutivesandheadhuntershaveadheredtotherulethatthemostattractiveCEOcandidatesaretheoneswhomustbepoached.SaysKorn/FerryseniorpartnerDennisCarey:Ican’tthinkofasinglesearchI’vedonewhereaboardhasnotinstructedmetolookatsittingCEOsfirst.Thosewhojumpedwithoutajobhaven’talwayslandedintoppositionsquickly.EllenMarramquitaschiefofTropicanaadecadeagesayingshewantedtobeaCEO.ItwasayearbeforeshebecameheadofatinyInternet-basedcommoditiesexchange.RobertWillumstadleftCitigroupin2005withambitionstobeaCEO.Hefinallytookthatpostatamajorfinancialinstitutionthreeyearslater.Manyrecruiterssaytheolddisgraceisfadingfortopperformers.Thefinancialcrisishasmadeitmoreacceptabletobebetweenjobsortoleaveabadone.Thetraditionalrulewasit’ssafertostaywhereyouarebutthat’sbeenfundamentallyinvertedsaysoneheadhunter.Thepeoplewho’vebeenhurttheworstarethosewho’vestayedtoolong.WhenMcGeeannouncedhisdeparturehismannercanbestbedescribedasbeing
Whenthereisbloodinthewateritisonlynaturalthatdorsalfinsswirlaroundexcitedly.NowthatAmerica’shousingmarketisailingpredatorshavetheirsightsonthecountry’scredit-cardmarket.AnalystsatGoldmanSachsreckonthatcredit-cardlossescouldreach$99billionifcontagionspreadsfromsubprimemortgagestootherformsofconsumercredit.Signsofstrainareclearlyvisible.Therearerisesinboththecharge-offanddelinquencyrateswhichmeasuretheshareofbalancesthatareuncollectableormorethan30dayslaterespectively.HSBCannouncedlastmonththatithadtakena$1.4billionchargeinitsAmericanconsumer-financebusinesspartlybecauseofweaknessamongcardborrowers. Itistooearlytopanicthough.Charge-offsanddelinquenciesarestilllow.AccordingtoMoody’saratingagencythethird-quarterdelinquencyrateof3.89%wasalmostafullpercentagepointbelowthehistoricalaverage.Thedeteriorationinratescanbepartlyexplainedbytechnicalfactors.AchangeinAmerica’spersonal-bankruptcylawsin2005ledtoanabruptfallinbankruptcyfilingswhichinturnaccountforabigchunkofcredit-cardlosses;thenumberoffilingsandthuscharge-offrateswouldberisingagainwhetherornotoverallconditionsforborrowersweregettingworse. Theindustryalsoreportssolidpaymentrateswhichshowhowmuchoftheirdebtconsumerspayoffeachmonth.Andconfidenceincredit-cardasset-backedsecuritiesisprettyfirmdespiteparalysisinothercornersofstructuredfinance.DennisMoroneyofTowerGrouparesearchfirmpredictsthatissuancevolumesfor2007willendupbeing25%higherthanlastyear. Directchannelsofinfectionbetweenthesubprime-mortgagecrisisandthecredit-cardmarketcertainlyexist:consumersarelikeliertoloaduponcredit-carddebtnowthathome-equityloansaredryingup.Butcardissuerslookatcashflowratherthanassetvaluessofallinghousepricesdonotnecessarilytriggerachangeinborrowers’creditworthiness.Theymayevenworktoissuers’advantage.Theincentivesforconsumerstokeeppayingthemortgagedecreaseifpropertiesareworthlessthanthevalueoftheloan;carddebtriseshigherupthelistofrepaymentprioritiesasaresult. Cardissuersarealsoabletorespondmuchmoreswiftlyandflexiblytostormierconditionsthanmortgagelendersarebychanginginterestratesoralteringcreditlimits.Thatshouldintheoryreducetheriskofarapidrepricingofassets."Wearenotgoingtowakeuponedayandtotallyrevaluetheloans"saysGaryPerlinCapitalOne’schieffinancialofficer. Ifasuddensubprime-stylemeltdowninthecredit-cardmarketisimprobabletherisksofasustaineddownturnaremuchmorereal.IflowerhousepricesandacontractionincreditpushAmericaintorecessiontheindustrywillundoubtedlyfaceagrimmerfuture.Keepwatchingforthosedorsalfins. Accordingtotheauthorwhatwillthecredit-cardmarketbecome
WhatdoyouthinkofAmericanhealthcaresystemMostpeoplewouldbe1bythehighqualityofmedicine2tomostAmericans.Thereisalotofspecializationagreatdealof3totheindividuala4amountofadvancedtechnicalequipmentand5effortnottomakemistakesbecauseofthefinancialriskwhichdoctorsandhospitalsmust6inthecourtsifthey7thingsbadly. ButtheAmericansareinamess.Totheproblemisthewayin8healthcareisorganizedand9.10topubicbeliefitisnotjustafreecompetitionsystem.Totheprivatesystemhasbeenjoinedalargepublicsystembecauseprivatecarewassimplynot11thelessfortunateandtheelderly. Butevenwiththishugepublicpartofthesystem12thisyearwilleatup84.5billiondollars—morethan10percentoftheU.S.Budget—alargenumberofAmericansareleft13.Theseincludeabouthalfthe11millionunemployedandthosewhofailtomeetthestrictlimits14incomefixedbyagovernmenttryingtomakesavingswhereitcan. Thebasicproblemhoweveristhatthereisnocentralcontrol15thehealthsystem.Thereisno16towhatdoctorsandhospitalschargefortheirservicesotherthanwhatthepublicisabletopay.Thenumberofdoctorshasshotupandpriceshaveclimbed.Whenfacedwithtoothacheasickchildoraheartattackalltheunfortunatepersonsconcernedcandoistopay17.Twothirdsofthepopulationare18bymedicalinsurance.Doctorschargeasmuchastheywant19thattheinsurancecompanywillpaythebill. TherisingcostofmedicineintheU.S.A.isamongthemostworryingproblemsfacingthecountry.In1981thecountry’shealthbillclimbed15.9percent—abouttwiceasfastasprices20general. 8
"We’reusingthewrongword"saysSeanDrysdaleadesperatedoctorfromaruralhospitalatHlabisainnorthernKwaZulu-Natal."Thisisn’tanepidemicit’sadisaster."ArecentUNIEFreportwhichstatesthatalmostone-thirdofSwaziland’s900000peopleareinfectedwithHIVthevirusthatcausesAIDSsupportsthisdiagnosis.HIVisspreadingfasterinsouthernAfricathananywhereelseintheworld. ButisanyonepayingattentionDespitethefactthatmostoftheworld’s33.5millionHIV/AIDScasesareinsub-SaharanAfrica—withanadditional4millioninfectedeachyear—theprioritiesatlastweek’sOrganizationofAfricanUnitysummitwereconflictresolutionandeconomiesdevelopment.Yettheepidemiccouldhaveagreatereffectoneconomicdevelopment—orratherthelackofit—thanmanypoliticianssuspect. Whilebusinessleadersaremoreconcernedaboutthe2Kmillenniumbugthanthelong-termeffectofAIDSstatisticsshowthattheworkfareinSouthAfricaforinstanceislikelytobe20%HIVpositivebynextyear.Medicalofficialsandresearcherswarnthatnotasinglecountryintheregionhasacohesivegovernmentstrategytotacklethecrisis. ThewaymanagersaddressAIDSintheworkplacewilldeterminewhethertheircompaniessurvivethefirstdecadeofthe21stcenturysaysDeaneMooreanactuaryforSouthAfrica’sMetropolitanLifeInsuranceCompany.MooreestimatesthatinSouthAfricatherewillbe580000newAIDScasesayearandalifeexpectancyofjust38by2010."We’llbebacktotheMiddleAges"saysDrysdalewhosehospitalisinoneoftheareasinSouthAfricawiththehighestratesofHIVinfection."Thegraphisheadingtowardthevertical.Andyetpeoplearestillnottakingitseriously." MostsouthernAfricancountriesaresimplytoopoortosupplymorethanbasichealthservicesletalonemedicinestoconfrontthecrisis.PatientsinsomegovernmenthospitalsinHararehavetosupplytheirownbeddingfooddrugsandinsomecaseseventheirownnurses.Zimbabwe’sfraildomesticeconomydependstoalargeextentoninformalenterprisesandsmallbusinessesmanyofwhicharegoingbankruptasAIDStakesitstollonownersandemployees."Therippleeffectisdevastating"saysHarareAIDSresearcherReneLoewenson. MoreominousaretheimplicationsforSouthAfricawithasophisticatedindustrialinfrastructureaswellasawidespreadinformalsector.WhiletheSouthAfricangovernmentisactiveinpromotingAIDSeducationithasn’tthemoneymanpowerormaterialtocopewiththeattackofAIDS. WhatdoesthesentenceWe’reusingthewrongwordinParagraph1mean
WhenLiamMcGeedepartedaspresidentofBankofAmericainAugusthisexplanationwassurprisinglystraightup.Ratherthancloakinghisexitintheusualvagueexcuseshecamerightoutandsaidhewasleavingtopursuemygoalofrunningacompany.BroadcastinghisambitionwasverymuchmydecisionMcGeesays.WithintwoweekshewastalkingforthefirsttimewiththeboardofHartfordFinancialServicesGroupwhichnamedhimCEOandchairmanonSeptember29.McGeesaysleavingwithoutapositionlinedupgavehimtimetoreflectonwhatkindofcompanyhewantedtorun.Italsosentaclearmessagetotheoutsideworldabouthisaspirations.AndMcGeeisn’talone.InrecentweekstheNo.2executivesatAvonandAmericanExpressquitwiththeexplanationthattheywerelookingforaCEOpost.Asboardsscrutinizesuccessionplansinresponsetoshareholderpressureexecutiveswhodon’tgetthenodalsomaywishtomoveon.Aturbulentbusinessenvironmentalsohasseniormanagerscautiousoflettingvaguepronouncementscloudtheirreputations.Asthefirstsignsofrecoverybegintotakeholddeputychiefsmaybemorewillingtomakethejumpwithoutanet.InthethirdquarterCEOturnoverwasdown23%fromayearagoasnervousboardsstuckwiththeleaderstheyhadaccordingtoLiberumResearch.Astheeconomypicksupopportunitieswillaboundforaspiringleaders.Thedecisiontoquitaseniorpositiontolookforabetteroneisunconventional.ForyearsexecutivesandheadhuntershaveadheredtotherulethatthemostattractiveCEOcandidatesaretheoneswhomustbepoached.SaysKorn/FerryseniorpartnerDennisCarey:Ican’tthinkofasinglesearchI’vedonewhereaboardhasnotinstructedmetolookatsittingCEOsfirst.Thosewhojumpedwithoutajobhaven’talwayslandedintoppositionsquickly.EllenMarramquitaschiefofTropicanaadecadeagesayingshewantedtobeaCEO.ItwasayearbeforeshebecameheadofatinyInternet-basedcommoditiesexchange.RobertWillumstadleftCitigroupin2005withambitionstobeaCEO.Hefinallytookthatpostatamajorfinancialinstitutionthreeyearslater.Manyrecruiterssaytheolddisgraceisfadingfortopperformers.Thefinancialcrisishasmadeitmoreacceptabletobebetweenjobsortoleaveabadone.Thetraditionalrulewasit’ssafertostaywhereyouarebutthat’sbeenfundamentallyinvertedsaysoneheadhunter.Thepeoplewho’vebeenhurttheworstarethosewho’vestayedtoolong.Whichofthefollowingisthebesttitleforthetext
Inmostpartsoftheworldclimatechangeisaworryingsubject.NotsoinCalifornia.Atarecentgatheringofgreenluminaries--inafilmstar’shousenaturallyforthatishowseriousnessisoftenestablishedinLosAngeles--thedominantnotewasself-satisfactionatwhatthestatehasalreadyachieved.AndperhapsnobodyismorecomplacentthanArnoldSchwarzenegger.UnlikeA1GoreapresidentialcandidateturnedprophetofenvironmentaldoomCalifornia’sgovernorsoundscheerfulwhentalkingaboutclimatechange.Aswellhemight:ithasmadehispoliticalcareer. AlthoughCaliforniahaslongbeenanenvironmentally-consciousstateuntilrecentlygreenswereconcernedaboveallwithsmogandredwoodtrees."CoastofDreams"KevinStarr’sauthoritativehistoryofcontemporaryCaliforniapublishedin2004doesnotmentionclimatechange.Inthatyearthoughthenewly-electedMr.Schwarzeneggermadehisfirsttentativecallforwesternstatestoseekalternativestofossilfuels.Graduallyhenoticedthathiseffortstotackleclimatechangemetwithlessresistanceandmoreacclaimthanjustaboutallhisotherpolicies.Thesedaysitcanseemasthoughheworksonnothingelse. Mr.Schwarzenegger’stransformationfromscreenwarriortoeco-warriorwascompletedlastyearwhenhesignedabillimposinglegally-enforceablelimitsongreenhouse--gasemissions--afirstforAmerica.ThanksmostlytoitslackofcoalandheavyindustryCaliforniaisarelativelycleanstate.Ifitwereacountryitwouldbetheworld’seighth-biggesteconomybutonlyits16th-biggestpolluter.Itsbigproblemistransport--meaningmostlycarsandtruckswhichaccountformorethan40%ofitsgreenhouse-gasemissionscomparedwith32%inAmericaasawhole.Thestatewantstoratchetdownemissionslimitsonnewvehiclesbeginningin2009.Mr.Schwarzeneggerhasalsoorderedthatby2020vehiclefuelmustproduce10%lesscarbon:intheproductionaswellastheburningsoasimpleswitchtocorn-basedethanolisprobablyout. ThanksinparttoCalifornia’sexamplemostofthewesternstateshaveadoptedclimateactionplans.WhenitcomestosettingemissiontargetsthescenecanresembleaposedownataMr.Olympiacontest.Arizona’sclimate-changescholarsdecidedtosetatargetofcuttingthestate’semissionsto2000levelsby2020.ButJanetNapolitanothegovernorwasdeterminednottobeout-muscledbyCalifornia.ShehasdeclaredthatArizonawilltrytoreturnto2000emissionlevelsby2012. Californiahasnotjustinspiredotherstates;ithascreatedavanguardthatoughttobeabletoprodthefederalgovernmentintostrongernationalstandardsthanitwouldotherwiseconsider.ButCaliforniaisfindingiteasiertoexportitspoliciesthantoputthemintopracticeathome.InonewayCalifornia’sself-confidenceisfullyjustified.Ithasdonemorethananyotherstate--letalonethefederalgovernment--tofixAmerica’sattentiononclimatechange.Ithasalsomadeitseemasthoughtheproblemcanbesolved.Whichiswhyfailurewouldbesuchbadnews.AtthemomentCaliforniaisabeacontootherstates.Ifitfailsitwillbecomeanexcuseforinaction. JanetNapolitanoismentionedinthepassagetoshowthat
WhatdoyouthinkofAmericanhealthcaresystemMostpeoplewouldbe1bythehighqualityofmedicine2tomostAmericans.Thereisalotofspecializationagreatdealof3totheindividuala4amountofadvancedtechnicalequipmentand5effortnottomakemistakesbecauseofthefinancialriskwhichdoctorsandhospitalsmust6inthecourtsifthey7thingsbadly. ButtheAmericansareinamess.Totheproblemisthewayin8healthcareisorganizedand9.10topubicbeliefitisnotjustafreecompetitionsystem.Totheprivatesystemhasbeenjoinedalargepublicsystembecauseprivatecarewassimplynot11thelessfortunateandtheelderly. Butevenwiththishugepublicpartofthesystem12thisyearwilleatup84.5billiondollars—morethan10percentoftheU.S.Budget—alargenumberofAmericansareleft13.Theseincludeabouthalfthe11millionunemployedandthosewhofailtomeetthestrictlimits14incomefixedbyagovernmenttryingtomakesavingswhereitcan. Thebasicproblemhoweveristhatthereisnocentralcontrol15thehealthsystem.Thereisno16towhatdoctorsandhospitalschargefortheirservicesotherthanwhatthepublicisabletopay.Thenumberofdoctorshasshotupandpriceshaveclimbed.Whenfacedwithtoothacheasickchildoraheartattackalltheunfortunatepersonsconcernedcandoistopay17.Twothirdsofthepopulationare18bymedicalinsurance.Doctorschargeasmuchastheywant19thattheinsurancecompanywillpaythebill. TherisingcostofmedicineintheU.S.A.isamongthemostworryingproblemsfacingthecountry.In1981thecountry’shealthbillclimbed15.9percent—abouttwiceasfastasprices20general. 16
Istronglyagreewiththecontentionthatabsenceofchoiceisararecircumstanceprimarilybecausethiscontentionaccordswithcommonsenseandoureverydayexperienceashumanbeings.Besidesthereverseclaim-thatwedonothavefreechoice-servestounderminethenotionsofmoralaccountabilityandhumanequalitywhicharecriticaltothesurvivalofanydemocraticsociety. 41.Theroleoffreewillofhumansinchoice Commonsensedictatesthathumanshavefreewillandthereforethetrueabsenceofchoiceisveryrare.Theonlypossibleexceptionswouldinvolveextremeandrarecircumstancessuchassolitaryimprisonmentoraseverementalorphysicaldeficiency—anyofwhichmightpotentiallystripapersonofhisorherabilitytomakeconsciouschoices.Yetevenunderthesecircumstancesapersonstillretainschoicesaboutvoluntarybodilyfunctionsandmovement.Thusthecompleteabsenceofchoicewouldseemtobepossibleonlyinacomatosestateorindeath. 42.Thenatureofabsenceofchoice Peopleoftenclaimthatlife’scircumstancesleavethemwith"nochoice."Onemightfeeltrappedinajoboramarriage.Underfinancialduressapersonmightclaimthatheorshehas"nochoice"buttodeclarebankruptcytakeademeaningjoborevenlieorstealtoobtainmoney.Thefundamentalproblemwiththesesortsofclaimsisthattheclaimantsareonlyconsideringthosechoicesthatarenotviableorattractive.Thatispeopleinsituationssuchasthesehaveaninfinitenumberofchoices;it’sjustthatmanyofthechoicesareunappealingevenself-defeating. 43.Choiceisbeyondourcontrol Besidesthecontentionthatwearealmostinvariablyfreetochooseisfarmoreappealingfromasociopoliticalstandpointthantheoppositeclaim.Acompletetackofchoiceimpliesthateveryperson’sfateisdeterminedandthatwealllackfreewill.Accordingtothephilosophicalschoolof"strictdeterminism"everyeventincludinghumanactionsandChoicesthatoccursisphysicallynecessarygiventhelawsofnatureandeventsthatprecededthateventorchoice.Inotherwordsthe"choices"thatseempartoftheessenceofourbeingareactuallybeyondourcontrol. 44.Thelogicalresultofstrictdeterminismandofthenew"scientificdeterminism" Howeverthelogicalresultofstrictdeterminismandofthenew"scientificdeterminism"isthatwearenotmorallyaccountableforouractionsandchoiceseventhosethatharmotherindividualsorsociety.Moreoverthroughouthistorymonarchsanddictatorshaveembraceddeterminismatleastostensiblytobolstertheirclaimthatcertainindividualsarepreordainedtoassumepositionsofauthorityortorisetothetoplevelsofthesocioeconomicinfrastructure.Finallythenotionofscientificdeterminismopensthedoorforgeneticengineeringwhichposesapotentialthreattoequalityinsocioeconomicopportunityandcouldleadtothedevelopmentofaso-called"masterrace."Admittedlythesedisturbingimplicationsneitherprovenordisprovethedeterminists’claims. 45.Insistenceoftreewill Iwouldconcedethatsciencemighteventuallydisprovetheverynotionoffreewill.HoweveruntilthattimeI’lltrustmystrongintuitionthatfreewillisanessentialpartofourbeingashumansandaccordinglythathumansareresponsiblefortheirownchoicesandactions. [A]Forexamplealmosteverypersonwhoclaimstobetrappedinajobissimplychoosingtoretainacertainmeasureoffinancialsecurity.Thechoicetoforegothissecurityisalwaysavailablealthoughitmightcarryunpleasantconsequences. [B]Ourcollectivelifeexperienceisthatwemakechoicesanddecisionseverydayonacontinualbasis. [C]HoweverthedilemmaseamstobeunavoidablewhichgivespeoplealotofPainfullyexperiencewithit. [D]Insumdespitethefactthatweallexperienceoccasionalfeelingsofbeingtrappedandhavingnochoicethestatementisfundamentallycorrect. [E]Recentadvancesinmolecularbiologyandgeneticslendsomecredencetothedeterminists’positionthatasphysicalbeingsouractionsaredeterminedbyphysicalforcesbeyondourcontrol.Newresearchsuggeststhatthesephysicalforcesincludeourownindividualgeneticmakeup. [F]Assumingthatneitherfreewillnordeterminismhasbeenproventobethecorrectpositiontheformeristobepreferredbyanyhumanistandinanydemocraticsociety. 44
WhenLiamMcGeedepartedaspresidentofBankofAmericainAugusthisexplanationwassurprisinglystraightup.Ratherthancloakinghisexitintheusualvagueexcuseshecamerightoutandsaidhewasleavingtopursuemygoalofrunningacompany.BroadcastinghisambitionwasverymuchmydecisionMcGeesays.WithintwoweekshewastalkingforthefirsttimewiththeboardofHartfordFinancialServicesGroupwhichnamedhimCEOandchairmanonSeptember29.McGeesaysleavingwithoutapositionlinedupgavehimtimetoreflectonwhatkindofcompanyhewantedtorun.Italsosentaclearmessagetotheoutsideworldabouthisaspirations.AndMcGeeisn’talone.InrecentweekstheNo.2executivesatAvonandAmericanExpressquitwiththeexplanationthattheywerelookingforaCEOpost.Asboardsscrutinizesuccessionplansinresponsetoshareholderpressureexecutiveswhodon’tgetthenodalsomaywishtomoveon.Aturbulentbusinessenvironmentalsohasseniormanagerscautiousoflettingvaguepronouncementscloudtheirreputations.Asthefirstsignsofrecoverybegintotakeholddeputychiefsmaybemorewillingtomakethejumpwithoutanet.InthethirdquarterCEOturnoverwasdown23%fromayearagoasnervousboardsstuckwiththeleaderstheyhadaccordingtoLiberumResearch.Astheeconomypicksupopportunitieswillaboundforaspiringleaders.Thedecisiontoquitaseniorpositiontolookforabetteroneisunconventional.ForyearsexecutivesandheadhuntershaveadheredtotherulethatthemostattractiveCEOcandidatesaretheoneswhomustbepoached.SaysKorn/FerryseniorpartnerDennisCarey:Ican’tthinkofasinglesearchI’vedonewhereaboardhasnotinstructedmetolookatsittingCEOsfirst.Thosewhojumpedwithoutajobhaven’talwayslandedintoppositionsquickly.EllenMarramquitaschiefofTropicanaadecadeagesayingshewantedtobeaCEO.ItwasayearbeforeshebecameheadofatinyInternet-basedcommoditiesexchange.RobertWillumstadleftCitigroupin2005withambitionstobeaCEO.Hefinallytookthatpostatamajorfinancialinstitutionthreeyearslater.Manyrecruiterssaytheolddisgraceisfadingfortopperformers.Thefinancialcrisishasmadeitmoreacceptabletobebetweenjobsortoleaveabadone.Thetraditionalrulewasit’ssafertostaywhereyouarebutthat’sbeenfundamentallyinvertedsaysoneheadhunter.Thepeoplewho’vebeenhurttheworstarethosewho’vestayedtoolong.ThewordpoachedLine3Paragraph4mostprobablymeans
Anawkward-lookingcharactersuchasCyranodeBergeracmightsniffatthesuggestionbutrecentscientificresearchshowsbeautybrainsandbrawnmayinfactallbealliedwritesDrRajPersaud. 46Psychologistshaveconcludedthatwemaybedrawntothestereotypicallyattractivebecauseofwhattheirfacesrevealabouttheirintelligenceandsuccessinlaterlife.InAmericanresearchledbyProfessorLeslieZebrowitzofBrandeisUniversityhasshownanassociationbetweenfacialattractiveandIQ.Strangersbrieflyexposedtoatarget’sfacewereabletocorrectlyjudgeintelligenceatlevelssignificantlybetterthanchance. Thesameteamalsoresearchedhowaperson’sattractivenessmightbearrelationtotheirintelligence.Theyfoundthatgood-lookingpeopledidbetterinIQtestsastheyaged.47Theirresearchsoughttoprovethathowapersonperceivedhimselfandwasperceivedbyotherspredictedhowintelligentheapparentlybecamemoreaccuratelythanhispastintelligence.48Perhapsbecausethemoreattractivepeopleweretreatedasmoreintelligenttheyendeduphavingmorestimulatingandthereforeintelligence-enhancinglives. DoesthismeanthatyourfacereallycouldbeyourdestinySociologistsDrUlrichMuellerandDrAllanMazuroftheUniversityofMarburginGermanyrecentlyanalyzedthefinalyearphotographsofthe1950graduatesofWestPointintheUnitedStates.Dominantfacialappearancesturnedouttobeaconsistentpredictoroflater-rankattainment: Againtheybelievedtherecouldbeaself-fulfillingeffect.49Becausesomemenlookedmoreauthoritativetheynaturallydrewrespectandobediencefromotherswhichinturnassistedtheirrisethroughtheranks. AteamattheRoyalCollegeofSurgeonsinDublinhasbeeninvestigatingthesensitivesubjectoflinksbetweenphysicalandmentalabnormalities.LedbyDoctorsRobinHennessyandJohnWaddingtontheteamusedanewlasersurface-scanningtechniquetomakea3-Danalysisofhowfacialshapemightvarywithbrainstructure.Theirfindingsshowedthatinearlyfetallifebrainandfacedevelopmentareintimatelyconnected.Fromthistheyconcludedthatabnormalitiesinbrainelaborationprobablyalsoaffectfacedevelopment. ThisaccordingtothemexplainsthestrikingfacialfeaturesofsomeonewithDown’ssyndrome.50Usingsimilartechniquestheteamalsodemonstratedhowotherdisorderslinkedtobrainaberrationscouldbeassociatedwithfacialalterations. Sotheverylatestscientificresearchsuggeststhatnobodyshouldtrytolooktooobviouslydifferentfromaverage. 46Psychologistshaveconcludedthatwemaybedrawntothestereotypicallyattractivebecauseofwhattheirfacesrevealabouttheirintelligenceandsuccessinlaterlife.
WhatdoyouthinkofAmericanhealthcaresystemMostpeoplewouldbe1bythehighqualityofmedicine2tomostAmericans.Thereisalotofspecializationagreatdealof3totheindividuala4amountofadvancedtechnicalequipmentand5effortnottomakemistakesbecauseofthefinancialriskwhichdoctorsandhospitalsmust6inthecourtsifthey7thingsbadly. ButtheAmericansareinamess.Totheproblemisthewayin8healthcareisorganizedand9.10topubicbeliefitisnotjustafreecompetitionsystem.Totheprivatesystemhasbeenjoinedalargepublicsystembecauseprivatecarewassimplynot11thelessfortunateandtheelderly. Butevenwiththishugepublicpartofthesystem12thisyearwilleatup84.5billiondollars—morethan10percentoftheU.S.Budget—alargenumberofAmericansareleft13.Theseincludeabouthalfthe11millionunemployedandthosewhofailtomeetthestrictlimits14incomefixedbyagovernmenttryingtomakesavingswhereitcan. Thebasicproblemhoweveristhatthereisnocentralcontrol15thehealthsystem.Thereisno16towhatdoctorsandhospitalschargefortheirservicesotherthanwhatthepublicisabletopay.Thenumberofdoctorshasshotupandpriceshaveclimbed.Whenfacedwithtoothacheasickchildoraheartattackalltheunfortunatepersonsconcernedcandoistopay17.Twothirdsofthepopulationare18bymedicalinsurance.Doctorschargeasmuchastheywant19thattheinsurancecompanywillpaythebill. TherisingcostofmedicineintheU.S.A.isamongthemostworryingproblemsfacingthecountry.In1981thecountry’shealthbillclimbed15.9percent—abouttwiceasfastasprices20general. 14
Whenthereisbloodinthewateritisonlynaturalthatdorsalfinsswirlaroundexcitedly.NowthatAmerica’shousingmarketisailingpredatorshavetheirsightsonthecountry’scredit-cardmarket.AnalystsatGoldmanSachsreckonthatcredit-cardlossescouldreach$99billionifcontagionspreadsfromsubprimemortgagestootherformsofconsumercredit.Signsofstrainareclearlyvisible.Therearerisesinboththecharge-offanddelinquencyrateswhichmeasuretheshareofbalancesthatareuncollectableormorethan30dayslaterespectively.HSBCannouncedlastmonththatithadtakena$1.4billionchargeinitsAmericanconsumer-financebusinesspartlybecauseofweaknessamongcardborrowers. Itistooearlytopanicthough.Charge-offsanddelinquenciesarestilllow.AccordingtoMoody’saratingagencythethird-quarterdelinquencyrateof3.89%wasalmostafullpercentagepointbelowthehistoricalaverage.Thedeteriorationinratescanbepartlyexplainedbytechnicalfactors.AchangeinAmerica’spersonal-bankruptcylawsin2005ledtoanabruptfallinbankruptcyfilingswhichinturnaccountforabigchunkofcredit-cardlosses;thenumberoffilingsandthuscharge-offrateswouldberisingagainwhetherornotoverallconditionsforborrowersweregettingworse. Theindustryalsoreportssolidpaymentrateswhichshowhowmuchoftheirdebtconsumerspayoffeachmonth.Andconfidenceincredit-cardasset-backedsecuritiesisprettyfirmdespiteparalysisinothercornersofstructuredfinance.DennisMoroneyofTowerGrouparesearchfirmpredictsthatissuancevolumesfor2007willendupbeing25%higherthanlastyear. Directchannelsofinfectionbetweenthesubprime-mortgagecrisisandthecredit-cardmarketcertainlyexist:consumersarelikeliertoloaduponcredit-carddebtnowthathome-equityloansaredryingup.Butcardissuerslookatcashflowratherthanassetvaluessofallinghousepricesdonotnecessarilytriggerachangeinborrowers’creditworthiness.Theymayevenworktoissuers’advantage.Theincentivesforconsumerstokeeppayingthemortgagedecreaseifpropertiesareworthlessthanthevalueoftheloan;carddebtriseshigherupthelistofrepaymentprioritiesasaresult. Cardissuersarealsoabletorespondmuchmoreswiftlyandflexiblytostormierconditionsthanmortgagelendersarebychanginginterestratesoralteringcreditlimits.Thatshouldintheoryreducetheriskofarapidrepricingofassets."Wearenotgoingtowakeuponedayandtotallyrevaluetheloans"saysGaryPerlinCapitalOne’schieffinancialofficer. Ifasuddensubprime-stylemeltdowninthecredit-cardmarketisimprobabletherisksofasustaineddownturnaremuchmorereal.IflowerhousepricesandacontractionincreditpushAmericaintorecessiontheindustrywillundoubtedlyfaceagrimmerfuture.Keepwatchingforthosedorsalfins. Whydoestheauthormentiondorsalfinswhichareirrelevanttothetopic
WhatdoyouthinkofAmericanhealthcaresystemMostpeoplewouldbe1bythehighqualityofmedicine2tomostAmericans.Thereisalotofspecializationagreatdealof3totheindividuala4amountofadvancedtechnicalequipmentand5effortnottomakemistakesbecauseofthefinancialriskwhichdoctorsandhospitalsmust6inthecourtsifthey7thingsbadly. ButtheAmericansareinamess.Totheproblemisthewayin8healthcareisorganizedand9.10topubicbeliefitisnotjustafreecompetitionsystem.Totheprivatesystemhasbeenjoinedalargepublicsystembecauseprivatecarewassimplynot11thelessfortunateandtheelderly. Butevenwiththishugepublicpartofthesystem12thisyearwilleatup84.5billiondollars—morethan10percentoftheU.S.Budget—alargenumberofAmericansareleft13.Theseincludeabouthalfthe11millionunemployedandthosewhofailtomeetthestrictlimits14incomefixedbyagovernmenttryingtomakesavingswhereitcan. Thebasicproblemhoweveristhatthereisnocentralcontrol15thehealthsystem.Thereisno16towhatdoctorsandhospitalschargefortheirservicesotherthanwhatthepublicisabletopay.Thenumberofdoctorshasshotupandpriceshaveclimbed.Whenfacedwithtoothacheasickchildoraheartattackalltheunfortunatepersonsconcernedcandoistopay17.Twothirdsofthepopulationare18bymedicalinsurance.Doctorschargeasmuchastheywant19thattheinsurancecompanywillpaythebill. TherisingcostofmedicineintheU.S.A.isamongthemostworryingproblemsfacingthecountry.In1981thecountry’shealthbillclimbed15.9percent—abouttwiceasfastasprices20general. 20
FORthepasttwoyearsinSiliconValleythecentreofAmerica’stechnologyindustryconference-goershaveentertainedthemselvesplayingaguessinggame:howmanytimeswillaspeakermentionthephrase"longtail"ItisusuallyahighnumberthankstotheinfluenceofthelongtailtheorywhichwasfirstdevelopedbyChrisAndersontheeditorofWiredmagazineinanarticlein2004.Thoughtechnologistsandbloggerschuckleathoweverybusinesspresentationnowhastohaveitslong-tailsectionmostareenviousofMrAndersonwhosebrainwavequicklybecamethemostfashionablebusinessideaaround. Whetherablockbusterfilmabestsellingnovelorachart-toppingrapsongpopularcultureidolizesthehit.Companiesdevotethemselvestocreatingthembecausethecostofdistributionandthelimitsofshelfspaceinphysicalshopsmeanthatprofitabilitydependsonahighvolumeofsales.Butaroundthebeginningofthiscenturyagroupofinternetcompaniesrealizedthatwithendlessshelvesandanationaloreveninternationalaudienceonlinetheycouldofferahugerangeofproducts—andmakemoneyatthesametime. ThenichetheobscureandthespecialistMrAndersonargueswillgaingroundattheexpenseofthehit.Asevidencehepointstoadropinthenumberofcompaniesthattraditionallycalculatetheirrevenue/salesratioaccordingtothe80/20rule—wherethetopfifthofproductscontributefour-fifthsofrevenues.EcastaSanFranciscodigitaljukeboxcompanyfoundthat98%ofits10000albumssoldatleastonetrackeverythreemonths.ExpressedinthelanguageofstatisticstheexperiencesofEcastandothercompaniessuchasAmazonanonlinebooksellersuggestthatproductsdowninthelongtailofastatisticaldistributionaddedtogethercanbehighlyprofitable.Theinternethelpspeoplefindtheirwaytorelativelyobscurematerialwithrecommendationsandreviewsbyotherpeopleandforthosewillingtohavetheirartistictastespredictedbyapieceofsoftwarecomputerprogramswhichanalyzepastselections. Long-tailenthusiastsarguethatthewholeofculturewillbenefitnotjustcommercialenterprises.Televisionfilmandmusicaresuchbewitchingmediaintheirownrightthatmanypeoplearequitehappytowatchandlistentowhatthemainstreamprovides.Butifindividualshavetheopportunitytopickbettermoreideallysuitedentertainmentfromafarwiderselectiontheywilltakeitaccordingtothetheoryofthelongtail.Someanalystsreckonthatentirepopulationsmightbecomehappierandwiseroncetheyhaveaccesstothousandsofdocumentariesindependentfilmsandsub-genresofeverykindofmusicinsteadofbeingsubjectedtowhatMrAndersoncallsthetyrannyoflowest-common-denominatorfare.Thatmightbetakingthingsabitfar.Butthelongtailiscertainlyoneoftheinternet’sbettergiftstohumanity. The80/20ruleisusedto
WhatdoyouthinkofAmericanhealthcaresystemMostpeoplewouldbe1bythehighqualityofmedicine2tomostAmericans.Thereisalotofspecializationagreatdealof3totheindividuala4amountofadvancedtechnicalequipmentand5effortnottomakemistakesbecauseofthefinancialriskwhichdoctorsandhospitalsmust6inthecourtsifthey7thingsbadly. ButtheAmericansareinamess.Totheproblemisthewayin8healthcareisorganizedand9.10topubicbeliefitisnotjustafreecompetitionsystem.Totheprivatesystemhasbeenjoinedalargepublicsystembecauseprivatecarewassimplynot11thelessfortunateandtheelderly. Butevenwiththishugepublicpartofthesystem12thisyearwilleatup84.5billiondollars—morethan10percentoftheU.S.Budget—alargenumberofAmericansareleft13.Theseincludeabouthalfthe11millionunemployedandthosewhofailtomeetthestrictlimits14incomefixedbyagovernmenttryingtomakesavingswhereitcan. Thebasicproblemhoweveristhatthereisnocentralcontrol15thehealthsystem.Thereisno16towhatdoctorsandhospitalschargefortheirservicesotherthanwhatthepublicisabletopay.Thenumberofdoctorshasshotupandpriceshaveclimbed.Whenfacedwithtoothacheasickchildoraheartattackalltheunfortunatepersonsconcernedcandoistopay17.Twothirdsofthepopulationare18bymedicalinsurance.Doctorschargeasmuchastheywant19thattheinsurancecompanywillpaythebill. TherisingcostofmedicineintheU.S.A.isamongthemostworryingproblemsfacingthecountry.In1981thecountry’shealthbillclimbed15.9percent—abouttwiceasfastasprices20general. 6
WhatdoyouthinkofAmericanhealthcaresystemMostpeoplewouldbe1bythehighqualityofmedicine2tomostAmericans.Thereisalotofspecializationagreatdealof3totheindividuala4amountofadvancedtechnicalequipmentand5effortnottomakemistakesbecauseofthefinancialriskwhichdoctorsandhospitalsmust6inthecourtsifthey7thingsbadly. ButtheAmericansareinamess.Totheproblemisthewayin8healthcareisorganizedand9.10topubicbeliefitisnotjustafreecompetitionsystem.Totheprivatesystemhasbeenjoinedalargepublicsystembecauseprivatecarewassimplynot11thelessfortunateandtheelderly. Butevenwiththishugepublicpartofthesystem12thisyearwilleatup84.5billiondollars—morethan10percentoftheU.S.Budget—alargenumberofAmericansareleft13.Theseincludeabouthalfthe11millionunemployedandthosewhofailtomeetthestrictlimits14incomefixedbyagovernmenttryingtomakesavingswhereitcan. Thebasicproblemhoweveristhatthereisnocentralcontrol15thehealthsystem.Thereisno16towhatdoctorsandhospitalschargefortheirservicesotherthanwhatthepublicisabletopay.Thenumberofdoctorshasshotupandpriceshaveclimbed.Whenfacedwithtoothacheasickchildoraheartattackalltheunfortunatepersonsconcernedcandoistopay17.Twothirdsofthepopulationare18bymedicalinsurance.Doctorschargeasmuchastheywant19thattheinsurancecompanywillpaythebill. TherisingcostofmedicineintheU.S.A.isamongthemostworryingproblemsfacingthecountry.In1981thecountry’shealthbillclimbed15.9percent—abouttwiceasfastasprices20general. 10
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