Leadership for the next millennium: the physician executive

We continue to muddle through using tourniquets and bandaids on a health care system that is in dire straits. And the future is even less promising. There will be millions without basic health care, let alone basic health care coverage. Rural and inner-city hospitals will close, with progressive public apathy, as we focus on the marvels of expensive technologies that serve only the few. Costs will continue to rise at double digit rates, and our nation's employers will fall further behind in the global marketplace. Preventive care will be uncommonly provided and only more rarely reimbursed, while a couple more children die of measles in Mississippi. It's not a pretty picture, and it simply doesn't have to come to pass. "What we really need is leadership," the public cries. That leadership can and should come from medicine through physician executives.     

Technology and society in the last quarter of the twentieth century

Critical times are approaching for technology and society. It will be a race between improving technology and worsening labour relations at a time when the depletion of natural resources will make itself felt. Unless far-sighted governments prepare in time for a gradual change, free enterprise and democracy will be in serious danger.     

贸易自由化视角下新丝绸之路战略经济影响评估

新丝绸之路是中国当前实施的一项重大的对外战略,而贸易畅通是中国推进该战略的一项重要举措。中国已经宣布将积极与沿线国家和地区共同商建自由贸易区,激发区域合作潜力。 为探讨贸易自由化视角下新丝绸之路战略的经济影响,采用全球贸易分析模型进行定量分析,以新丝绸之路建设的核心区(中国和中亚五国)为分析对象,从实际GDP、居民福利、进出口贸易和产业结构等方面,对中国与中亚五国开展区域经济一体化合作的效果进行评估。 研究结果表明,①新丝绸之路推进会给沿线国家带来不同的经济增长效应和福利改善效果,是一个共同繁荣和发展的战略。受益于关税减免,中国和中亚五国总GDP增长0.011%,总的福利水平改善671.065百万美元。②新丝绸之路会显著提升沿线国家的经贸合作水平,改变参与国家的产业结构和贸易结构。通过推进区域经济一体化,中国向中亚五国出口增长31.402%,中亚五国向中国出口增长14.143%。③新丝绸之路战略的推进会带来复杂的行业分布效果,中国纺织业受益较大,但农业和电子设备制造业均会遭受一定的损失。与之不同,哈萨克斯坦钢铁金属业产出增幅最高,吉尔吉斯斯坦受益最大的是农业。 从贸易畅通视角推进新丝绸之路经济带建设符合互惠互利的基本原则,中国应该全面客观地了解新丝绸之路战略的影响,针对那些受损严重的行业可能需要出台一定的保护措施。     

The physician executive and the future.

In summary, physician managers have a bright future. They are working on one of the most exciting professional interfaces--medicine and management. The future of medicine is both high-tech and low-tech. It will challenge all physician executives. For a few years, health care organizations will experience turbulence and stress. The name of the game for physician managers will be organizational survival. The nation will then move into an era of abundance in medical care, and the management game will switch from survival to thrival. Managers are key players in the world of tomorrow. The physician executive is a manager and therefore a key player. One of the best things about the future of the physician is that he has one.     

The role of the coordinator of care

Regardless of the specific outcome of the current health reform debate in Washington, it is likely that major changes to the health care system are in the offering. These changes, many of which are already in place or imminent in some locations, will have a major impact on the evolving relationships between physicians and hospitals. Most expect that these changes will accelerate the development of integrated health care delivery systems that will compete in the marketplace for a mixture of public and private health insurance dollars. In this system of "managed competition," health care dollars will flow to those systems that can ensure the best clinical outcomes while using the least economic resources. In this scenario, competing collaborative health networks that can manage the continuum of care will be central to the health care delivery system. The economic and political ties between physicians and hospitals will become more closely linked as government and private payers of health care services foster the development of these integrated, value-based health care delivery systems.     

The new age of ethical marketing for the 21st century

The premise of this paper is that the strong trends toward ever increasing centralization in the agricultural producing sector of the United States in the 1980s will exacerbate in the middle-to-late 1990s. This, in turn, will lead to both radical changes in the consumer movement by the year 2000, and also to a completely redefined mission for the corporate marketing function as well. Specifically, the deliberate federal policies of the 1980s which led to a “shake-out” of the small family farm units in favor of large agri-business concerns in order to reduce federal subsidies will lead, in the 1990s, to the most noted of deleterious consequences of monopolization, namely ever increasing prices and lowered quality. The authors believe that by the late 1990s the American public will perceive this state of affairs as being intolerable and it will lead them to organize “Big Consumerism”, a cohesive, much strengthened version of the consumer movement of the 1980s. This movement will, among other major activities, establish consumer cooperatives as a way to control costs through the elimination of unnecessary middlemen. In addition, this new consumerism will demand a change in the ethical standards of business behavior which, in turn, will result in a reformation in the role of the “New Marketer”. This “New Marketer” function will be envisioned and practiced by incumbents as informational and educational, adhering to the highest standards of truthfulness concerning the products they are attempting to market. In this regard, the role of governmental agencies will be greatly strengthened and expanded to insure that the marketing profession lives up to these highest ethical standards and practices.     

Environmental Concerns in the Marcellus Shale

Hydraulic fracturing used to remove natural gas from the Marcellus Shale has raised environmental concerns in the region both in terms of air and water pollution. This article will examine those concerns and how the natural gas industry has responded to them. After discussing the issues related to groundwater contamination and air quality. I discuss industry responses and how the costs and harm associated with fracking could be reduced, with the knowledge that despite opposition from environmental groups, fracking will continue. The hope is that more drillers will begin to operate in a socially responsible manner that will allow companies to be profitable while limiting harm to the environment and to individuals living near drilling sites.     

Scale versus specialization: banking strategies after the euro

The euro will transform the competitive landscape of European banking. This paper discusses some of the strategic effects of the euro on banks. In particular, it explores two questions: the rationale behind mergers and acquisitions and the universal banking model. The strategic analysis of the forces for change in banking leads to some conclusions: scale will not be the key success factor in European banking, the euro will increase the role of financial specialists in Europe and the universal banking model will face numerous challenges in the new context.     

香港银行业开办人民币业务的风险评估

香港市场上人民币流通的规模变化,对于人民币业务开办的风险评估结论具有明显的影响。在渐进式的离岸业务推进模式下,当前可能会在特定的业务领域形成监管的模糊地带,但是总体上不会形成明显的风险隐患。通常而言离岸业务对于信息披露的要求较低,因而应当加强内地与香港的反洗钱合作。从当前的市场环境判断,当前香港市场上不会出现大规模的人民币对港币的替代。香港离岸的个人人民币业务的开展会对在岸的人民币业务形成一定的竞争,这种竞争压力随着香港离岸市场业务范围的扩大而继续增大。随着香港人民币离岸市场规模的不断扩大和业务范围的拓展,离岸人民币市场对于内地金融管制的冲击力会提高。从长期来看,随着人民币在香港流通规模的扩大,应及早研究人民币流通扩大背景下香港的金融体系改革战略问题。     

博弈结构对VMI模式下供应链性能的影响分析

通过建立VMI模式下供应链的多阶段博弈模型,研究分析了VMI中零售商和供应商的不同博弈结构对供应链性能的影响,结果表明,当零售商和供应商之间进行的是双方同时决策的Nash静态博弈时,供应链的性能是最低的,而在一方先决策的动态博弈结构下,供应链的性能会得到明显的改善。最后通过具体的算例分析证实了上述结论。     

从农产品价格保护程度和市场整合看入世对中国农业的影响

一、引言在过去２０年的改革过程中 ,农民收入稳定上升 ,数以亿计的人摆脱了贫困 (世界银行 ,２０００)。但是 ,就总体情况而言 ,农民收入要低于城镇人口的收入。经济发展与转型曾经带来了中国农村２０年的进步 ,同时也遗留下来一些诸如收入分配不均的问题。现在国内政策又在进一步推进贸易与投资自由化 ,从过去２０年的改革经验 ,我们不难推测 ,这一努力将同样带来积极与消极两方面的影响。一方面 ,贸易自由化可以带来效率的提高、新技术以及提升中国经济增长的机会。另一方面 ,市场与投资自由化将在所难免地加剧中国农村已经出现的一些消…     

What the new GATT trade agreement means for plastics

The recently concluded Tokyo Round of GATT trade negotiations resulted in an agreement that can considerably restructure the way nations deal with international trade problems. As in the 1967 Kennedy Round, tariffs have again been significantly cut, by about one-third on average for industrial products. But in addition to the tariff reductions, for the first time in multilateral negotiations very comprehensive agreements have been reached on the manner in which nations will deal with important non-tariff measures that affect trade, including subsidy and countervailing duties, dumping, valuation, standards, government procurement and import licensing. The result is forecast to become a new era in international trade that will be characterized as neither protectionist, nor free trade. Instead, what will be emerging will be an era of ‘managed trade’, with the historical barrier of tariffs largely removed, and the non-tariff measures that operate to distort trade managed by governments to achieve ‘fair’ conditions of international commerce. How this new era of ‘managed trade’ will work out in practice will be determined as case history develops from the national and multilateral dispute settlement procedures established by the agreements. Required will be goodwill on all sides, and an effective collaboration between industry and government.While this article is written with reference to the U.S. plastics industry, it includes data and interpretation important for all industries and for all countries.     

St Christopher's and the future

The founding vision of St Christopher's Hospice was based on a recognition that permeating mainstream health care services would be essential and an emphasis on an adaptable philosophy rather than a building. Today, demographic and disease related changes mean that need and demand for end-of-life care will inevitably outstrip professional and financial resource. Hospices must engage with the development of cost-effective models of service delivery and rational planning. Only partnership working with the National Health Service, care homes, and others will ensure that appropriate care is available to everyone wherever the bed in which they die, regardless of diagnosis. Only collaboration and active engagement will ensure that future strategy in end-of-life care retains the original insight that its focus rightly includes not only patients but also the social context that will be affected by their death. Cost and patient choice dictate an emphasis on care at home. Health-promoting, public education and family-focused strategies will be essential. At a pivotal moment for the delivery of health care generally, hospices can play a vital part by marrying the role of "insistent conscience" of the health care service with continued cost-effective clinical innovation.     

Retail competition in the fast-moving consumer goods industry: The case of France and the UK

UK retailers in the fast-moving consumer goods industry focus their strategy on building loyalty through quality ‘own’ labels. By contrast, French retailers compete aggressively on price. Judy and Marcel Corstjens, and Rajiv Lal argue that either a ‘two-tier’ or parallel system will evolve in the future or a national industry will tend to oscillate from one strategy to another. Retailers must decide which of the two strategies they will consistently adopt.     

Can corporate planning ‘Invent’ the future of the third world?

Corporate planners, accustomed to stretch their mind in time will need to distend it in geographic space as well. Seemingly unrelated events in faraway countries suddenly implicate the work of planners, their homes and their futures. Europe and Japan rely for 95 per cent of their petroleum requirements upon the Third World. Huge pipelines carrying natural gas connect Soviet Russia with the United States and Europe. One electric power grid will eventually tie Europe together. Europe depends for 10 million guest workers upon southern countries, including North Africa and the Near East. Energy and labor are weighty factors in the increasing inter-dependence of nations. The author argues that these and related demands will require creative responses from corporate planners.     

我国户籍制度下的劳动力转移

本文考虑到现在还在我国普遍实行的农村与城市分离的户口政策,根据流向城市的农村户口劳动力的去向,将城市部门分为两个部门,建立了一个哈利斯—托塔罗模式的劳动力转移模型。并用这个模型分析了农村户口劳动力向城市劳动转移的经济效果。随着经济发展、改革深化,我国现行的户口政策必将发生重大的变化,本文为加快这方面工作的进程,提供了理论依据。     

The future of the stock exchange

What is the future of the Stock Exchange? In this article the author considers the question from the point of view of the U.K. His analysis will be of interest to planners in many types of organization. He concludes that provided the British economy remains one where private enterprises, funded by private savings voluntarily dispersed, the Stock Exchange will have a central part to play. At the same time, as the business of securities trading becomes more and more international so will the business of the Stock Exchange.     

In the mush.

Approaching change, we cannot really know who we will be when we come out the other side. We can envision, plan, and sed goals, and these exercises will make a difference in how the process turns out, but we can never know exactly. When we have come through a profound change, we will have difficulty remembering how we could ever have been anything else. In the midst of profound change, we cannot see with certainty how it will turn out. We are "in the mush." Every change creates a need for learning. This change-induced learning has four phases: (1) Unconscious incompetence, (2) conscious incompetence, (3) conscious competence, and (4) unconscious competence. Health care--not just the industry, but the whole way in which we manage our health, our birth and death, our wellness and comfort--is at or approaching not just one strategic inflection point, but several at once. Physician executives need to guess correctly about this strategic inflection point, and position themselves and their organizations to take advantage of it.     

Physician-administrator cooperation in the postprofessional era.

The basic question this article seeks to explore is how to reconcile HCO interests and physician interests in a time when interdependence is as high as or higher than ever before, yet once convergent interests appear to be diverging sharply? To do this, the major trends and forces affecting both HCOs and MDs will be outlined; then the issues facing each will be discussed, together with their responses; and finally the key interface problems will be laid out, together with possible strategic approaches.     

股权制衡对并购中合谋行为经济后果的影响

以模型构建和实证检验相结合的方式,探讨股权制衡对并购活动中控股股东与高管人员合谋行为所产生的经济后果的影响。通过大股东效用模型论述股权制衡的治理功效,构建以Shapley指数计算的股权制衡度变量,以沪深A股上市公司1999年至2006年的并购事件作为样本,采用回归分析对模型推论进行检验。研究结果表明,当控股股东尝试以并购手段掏空上市公司时,将采取向高管人员提供利益回报的方式与其合谋。如果公司中存在制衡股东,高管人员获取私有收益的空间将被压缩,低效并购造成公司业绩损失的情况也会减少。实证结果显示,当控股股东与高管人员合谋时,上市公司的股权制衡程度越高,高管人员通过并购获取的私有收益越少,公司的并购绩效也越好。