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Design it first and then cost it out
/1 Comment/in Blog, Blog: Better Government, News /byOr maybe the title should be “borne back ceaselessly into the past”. News reaches us that the Boston Convention Center Authority is looking to double its size, but ” they don’t know how much the project would cost or how it would be paid for” (from SHNS, sub req.) I’m going to go out on a limb and say that now is not a great time to be seeking additional funding, particularly with the inference of higher taxes. The planning approach reminds me of the Governor’s quote about his Readiness Project/education reform package: “We’re building a house,” he said. “You design it first and then cost it out.” The task of figuring out the details will reportedly fall to a […]
Flier and Saturday's Senate debate
/0 Comments/in Blog, News /byAs noted here last week, the Wall Street Journal opinion piece by Harvard Medical School dean Jeffrey S. Flier was going to be important. Set aside for a moment the procedural vote on Saturday by the US Senate and consider the multiple references to Flier’s piece last week. Sure, the politics of a president’s approval rating going south of 50% matters, but having the dean of HMS pull the federal reform effort limb from limb did not help. Flier gave the federal reform effort merits a “failing grade.” Reasons? The bills being considered included “no provisions to substantively control the growth of costs or raise the quality of care.” He went so far as to say the effort did not […]
Overseas Surgery
/0 Comments/in Blog, Healthcare /bySo, I’ve heard about the increase in Americans seeking expensive surgery abroad but today’s Wall Street Journal coverage of Dr. Shetty’s 1000-bed cardiac hospital in Bangalore, India was absolutely fascinating reading: (http://online.wsj.com/article/SB125875892887958111.html?mod=WSJ_hpp_MIDDLETopStories) Cardiac survey averages $2000 at Dr. Shetty’s hospital compared to between $20,000 -$100,000 here in the US. And it’s not just that India is a less expensive place to run a hospital. It’s because Dr. Shetty has such high volume that he is able to achieve economies of scale unheard of in the United States. He’s also able to drive hard bargains with manufacturers of cardiac supplies and equipment and his staff are incredibly productive. What’s the quality like you ask? Well, it has been well established that […]
Thoughts on the Route 28X Failure
/3 Comments/in Blog, Blog: Better Government, News /byUPDATE BELOW What’s Route 28X? It was MassDOT’s attempt to turn the sloooow Route 28 bus route up Blue Hill Avenue into a Bus Rapid Transit Route. Sadly, it died due to neighborhood opposition — it appears 3 things felled it: 1) Lack of Neighborhood Input on Process – This was probably unavoidable as the state had to move quickly to apply for the federal funds and tried to backfill with ‘civic engagement’ but to no avail. 2) Resistance to Tearing Up the Median Strip on Blue Hill Avenue — To create a dedicated (as in faster than sitting in traffic) bus lane, it would be built on the median strip on at least a portion of Blue Hill Avenue. […]
Dean Flier on federal health care debate
/0 Comments/in Blog, News /byFor those of you who missed today’s Wall Street Journal, Dr. Jeffrey Flier, dean of Harvard Medical School, lays out one of the smarter takes on the mess in Washington: As the dean of Harvard Medical School I am frequently asked to comment on the health-reform debate. I’d give it a failing grade. Instead of forthrightly dealing with the fundamental problems, discussion is dominated by rival factions struggling to enact or defeat President Barack Obama’s agenda. The rhetoric on both sides is exaggerated and often deceptive. Those of us for whom the central issue is health—not politics—have been left in the lurch. And as controversy heads toward a conclusion in Washington, it appears that the people who favor the legislation […]