A Quote by Atul Gawande
As economists have often pointed out, we pay doctors for quantity, not quality. As they point out less often, we also pay them as individuals, rather than as members of a team working together for their patients. Both practices have made for serious problems.
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The lower the family income, the higher the probability that the mother must work. Today, 1 out of 5 of these working mothers has children under 3. Two out of 5 have children of school age. Among the remainder, about 50 percent have husbands who earn less than $5,000 a year-many of them much less. I believe they bear the heaviest burden of any group in our Nation. Where the mother is the sole support of the family, she often must face the hard choice of either accepting public assistance or taking a position at a pay rate which averages less than two-thirds of the pay rate for men.
Pay-for-procedure or fee-for-service reimbursement rewards doctors and hospitals for volume - not keeping patients healthy or being efficiency. Pay-for-Performance is clearly one tool that can change the incentives to reward quality.
Energy and bitcoin work really well together because you can pay out in micro-transaction units. As the energy gets used, they pay out, and it's by the kilowatt rather than by the month.
Economists specialize in pointing out unpleasant trade-offs - a skill that is on full display in the health care debate. We want patients to receive the best care available. We also want consumers to pay less. And we don't want to bankrupt the government or private insurers. Something must give.
Cleaning companies often pay their employees less than a living wage and offer no sick days or health insurance. My years of working for them still made me grimace every time I saw a little yellow car with 'Merry Maids' written on the side.
Quality in a product or service is not what the supplier puts in. It is what the customer gets out and is willing to pay for. A product is not quality because it is hard to make and costs a lot of money, as manufacturers typically believe. This is incompetence. Customers pay only for what is of use to them and gives them value. Nothing else constitutes quality.
The president doesn't get an automatic pay raise, so they can't freeze it for him. But it also does extend the pay rate - they pay increases or pay freeze for pay increases for members of Congress. They've had a pay freeze since 2009, but most civil servants will see a small pay bump in 2016 thanks to a separate order from President Obama.
Eventually we have to "settle up" and pay the price for our ethical violations. Just remember the old line that says, "You can pay me now . . . or you can pay me later." Often you can buy some time, but when you "pay later" you'll probably have to pay more.
Often when you are starting out in comedy, you will find that people will laugh at the things you didn't think were funny. It's important to pay attention also to what people are laughing at when you are just talking in regular conversation. Often that is when you are truly being yourself.
The friends of tabloid newspapers often point out that their journalism exists only because millions of people pay money to read it.
Run focus groups. Do whatever you need to do to get 8 to 10 people together in a room and put your product in front of them. Ask them how much they would pay for it and whether they would pay for it. It's really important to get user validation early and often.
I learned you pay for your happiness. That's why I don't expect to be happy all the time. I'd rather be surprised by one moment every so often to remind me that joy is possible, even if I have to pay for it later.
By the standards of honest, if unorthodox, accounting, government workers don't pay taxes, but are paid out of taxes. In other words, they pay taxes out of money confiscated from taxpayers, who, in turn, pay taxes twice: on their own income and on the income of members of the bureaucracy. At the very least, this should disqualify state workers from voting.
Students often approached me about state-paid tuition while I was out campaigning. After I explained to them that if the state pays their tuition now, they will pay higher taxes to pay other people's tuition for the rest of their lives, most of them ended up agreeing with me.
I learnt from an early age this need to delegate responsibility out to other team members as there is just too much for one person to do themselves. What is the point of hiring talented team members if you don't give them the freedom to make the most of the chance you have given them?
A central notion in the Affordable Care Act was we had an inefficient system with a lot of waste that didn't also deliver the kind of quality that was needed that often put health care providers in a box where they wanted to do better for their patients, but financial incentives were skewed the other way... We don't need to reinvent the wheel; you're already figuring out what works to reduce infections in hospitals or help patients with complicated needs.
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