Measuring Drug Value

2021 ◽  
pp. 95-111
Author(s):  
Neumann Peter J. ◽  
Cohen Joshua T. ◽  
Ollendorf Daniel A

As healthcare costs increased around the world in recent decades, countries incorporated health technology assessment (HTA) into their decisions about which new technologies to pay for and how much they should pay. This chapter describes approaches for drug value assessment that are part of the HTA procedures in these countries, highlighting England and Wales’ National Institute for Health and Care Excellence, perhaps the world’s most visible HTA body. We then describe efforts since the 1980s to introduce HTA in the United States, including Oregon’s Medicaid experiment and the federally funded Office of Technology Assessment. The chapter explores the roots of resistance to these efforts, including the notion of American exceptionalism—the belief that personal and economic freedom is paramount and deep resistance to the idea of healthcare rationing. The resistance, explained at least partly by these factors, ultimately led to a scaling back of HTA in the United States.

2012 ◽  
Vol 13 ◽  
pp. 15-26
Author(s):  
Nel Noddings

Increasing globalization brings with it an increased need for international cooperation and the possibility of renewed interest in cosmopolitanism. Teaching for –even about—cosmopolitanism raises problems for teachers all over the world, but it is especially difficult for teachers in the United States because of the current revival of pride in “American exceptionalism.” After a brief discussion of the possible benefits and risks in teaching cosmopolitanism, I will explore an approach that may decrease the risks and increase the benefits. This promising approach might be called “ecological cosmopolitanism” (Noddings 2012).


2020 ◽  
Vol 22 (3) ◽  
pp. 339-351
Author(s):  
Konstantin V. Blokhin

Article analyzes predictive estimates and concepts presented by the Western intellectual community, regarding prospects for development of new trends in the global economy, caused by the fourth industrial revolution. Author draws on a variety of sources, including reports from US think tanks, works by representatives of global financial and technocratic elite, and works by American intellectuals. Methodological basis of the study is a theory of the world system of I. Wallerstein, which allows to identify dynamic and conflicting lines of interaction between two geopolitical centers of the world - the United States and China. Based on an analysis of current trends, modern experts predict revolutionary changes in modern technologies that can decisively affect socio-political stability, not only in Western countries, but in developing countries as well. Author shows that the new technological structure is changing not only sector structure of the economy, but also has a strong impact on employment. According to American analysts, new technologies can destabilize socio-political stability in any country, especially in countries where cheap labor is a traditional tool. Robotization and automation of production can become a competitive advantage of the United States and Western countries in competition with China. Article notes that Russia is only at the very beginning of technological revolution, behind big five leading countries. Overcoming its lag in the field of AI and robotics requires adoption of comprehensive measures of economic, scientific and political nature. Ignoring realities of technological progress is fraught with increase in threats to national security.


Author(s):  
Heather D. Curtis

This chapter explores how American Evangelicals have employed popular media to maintain and augment their vitality in the United States during a supposedly secular age. By focusing on the story of the Christian Herald, an evangelical newspaper that greatly expanded its circulation and influence during the 1890s, it elucidates the innovative strategies publishers adopted to attract and retain the attention of a significant segment of the American Protestant public. By embracing ground-breaking printing and photographic technologies, novel approaches to popular journalism, and modern advertising techniques, the Christian Herald became the most successful religious newspaper in the world within a decade, a position it held throughout most of the twentieth century. Analysing these enterprising methods alongside the distinctive messages about American exceptionalism that the Christian Herald communicated in its columns also helps to explain why evangelicalism has continued to flourish in the USA in comparison to the UK or Europe.


Author(s):  
Aryeh Neier

This chapter illustrates that many Americans took part in struggles for rights during the period from the mid-1950s to the mid-1970s. Though it was a fertile period for those promoting rights within the United States, few Americans were concerned in those years with efforts to secure rights in other parts of the world. The emergence of a rights movement in the Soviet Union in the 1960s was little noted, and relatively few in the United States joined Amnesty International, which developed far more rapidly in Europe. Americans concerned about rights in that era could be mobilized to deal with American violations of rights, but not with rights abuses by other governments. Inattention to such matters by those deeply engaged in domestic rights struggles was, in a way, a counterpart to the disdain for international law frequently expressed by partisans of American exceptionalism.


Author(s):  
Eric Gordon ◽  
Gabriel Mugar

Public trust in civic organizations is low. And many public-serving organizations assume that greater efficiency will build trust. As a result, they are quick to adopt new technologies to enhance what they do. However, efficiency, in the sense of charting a path to a goal with the least amount of friction, can sometimes be at odds with the goal of building trust. This book is about those practices that challenge the normative applications of “smart technologies” in order to build or repair trust with publics. Based on over 60 interviews with change makers in public-serving organizations throughout the United States, as well as detailed case studies, this book provides a practical and deeply philosophical picture of civic life in transition. It is a book about design, but not necessarily about designers. Without coordinating, these civic designers embedded within organizations have adopted an approach to public engagement we call “meaningful inefficiencies,” or the deliberate design of less efficient over more efficient means of achieving some ends. This book illustrates how civic designers are creating meaningful inefficiencies in less than ideal conditions and encourages a rethinking of how innovation within public-serving organizations is understood, applied, and sought after. Different from market innovation, civic innovation is not just about invention and novelty; it is concerned with building communities around novelty, and cultivating deep and persistent trust. It involves a plurality of publics (not just a single public good); it creates the conditions for those publics to play; and it results in people caring for the world.


Author(s):  
Walter A. Friedman

American Business History: A Very Short Introduction looks at the rise of the American economy from its colonial and frontier beginnings. What made the United States an attractive testing ground for entrepreneurs? How did the United States come to have the largest business enterprises in the world by the early twentieth century? Why did business organizations gain a central place in American society? This VSI answers these questions through examining the formation of new organizational structures; the invention and commercialization of new technologies; the introduction of policymaking and regulatory frameworks; and the stories of entrepreneurs from around the world who embraced democratic capitalism in America.


1986 ◽  
Vol 16 (2) ◽  
pp. 227-242 ◽  
Author(s):  
Ruth Hubbard

Prejudices against people with disabilities, pool people, and immigrants during the nineteenth century generated a science of “race improvement” called eugenics. In the United States, a number of eugenic measures were enacted early in this century, but it was in Nazi Germany that eugenics flourished under the name of racial hygiene (Rassenhygiene). In the guise of furthering the health of the German people, German scientists and physicians initially designed programs of sterilization. Next came euthanasia and finally mass extermination of “lives not worth living.” Remembering this history, many German women oppose the new technical developments in prenatal diagnosis because they see them as yet another way to specify what kinds of people are and are not fit to inhabit the world. This paper tries to place the new technologies in the context of eugenics and to point out some of the ways in which the new, supposedly liberating, choices in fact limit women's control over our lives.


2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Donald E. Hanna

Growing demand among learners for improved accessibility and convenience, lower costs, and direct application of content to work settings is radically changing the environment for higher education in the United States and globally. In this rapidly changing environment, which is increasingly based within the context of a global, knowledge-based economy, traditional universities are attempting to adapt purposes, structures, and programs, and new organizations are emerging in response. Organizational changes and new developments are being fueled by accelerating advances in digital communications and learning technologies that are sweeping the world. Growing demand for learning combined with these technical advances is in fact a critical pressure point for challenging the dominant assumptions and characteristics of existing traditionally organized universities in the 21st century. This combination of demand, costs, application of content and new technologies is opening the door to emerging competitors and new organizations that will compete directly with traditional universities and with each other for students and learners.This paper describes and analyzes seven models of higher education organization that are challenging the future preeminence of the traditional model of residential higher education. These models are emerging to meet the new conditions and to take advantage of the new environment that has created both opportunity and risk for all organizations, and which demands experimentation of structure, form, and process.Each of the seven models discussed offers an alternative to traditional residential higher education. Several models are in their infancy. Several others operate at the margin of organizations with other core businesses or priorities. At least one of the models depends upon extensive collaborations. All of the models incorporate features that are designed to enable universities to better respond to new educational demands and opportunities at a national and international level. Taken together, these organizational models are emerging as significant forces in providing education and training, and as powerful competitors to traditional universities. They offer the prospect of rapidly changing where, when, how and for what purpose education is organized within both the corporate and the higher education communities in the United States and throughout the world. The result is a dynamic competitive environment among traditional universities that are adapting learning processes and administrative procedures, alternative nontraditional universities that are adapting technologies to better serve their existing primarily adult constituencies, and new universities that are being formed around the promise of virtual environments. The thesis of this paper is that growth in worldwide demand for learning is combining with improved learning technologies to force existing universities to rethink their basic assumptions and marketing strategies. This new digital environment is further encouraging and enabling the creation of new and innovative organizational models of that are challenging traditional residential universities to change more quickly and dynamically.


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