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Wall Street Journal Original article ›
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Questions about whether the emerging market countries are looking ahead at a period of lower growth in the next decade. If the slowdown in 2013 is structural then these countries have to to make changes in economic policies that will help them return to higher rates of growth. If the slowdown is cyclical then this is temporary and emerging market countries will return to higher growth rates. Countries such as Brazil, Mexico and India need to improve infrastructure and educational systems, and invest in research and development to generate more growth. Turkey and India depend on foreign capital, which puts limits to growth, creating a need to boost domestic savings and investment for long term growth. Lower rate of about 7% compared to the 9-10% of the last decade in China are because the wave of investment in construction and infrastructure building through huge state investments is now slowing, says Peter Aslund of the Peterson Institute of International Economics. It is a positive prospect for China, according to Kalpana Kochhar, a deputy director of IMF, because of the asset bubbles developing in real estate. It is seen positively by China's new government as it tackles problems created by a rush to industrialization of widespread pollution of the environment, and lack of balanced development without attention paid to healthcare, worker wages and social security. Stephen Schwartz of BBVA bank, says urbanizaton will drive further gains, especially in India, which has lagged behind the gains made in China and is likely to follow the rapid urbanization seen in China. New elections in India in 2014 are likely to lead to more growth oriented government policies. A pause in the U.S. Federal Reserve's policy of withdrawing economic stimulus gives emerging markets, especially India, and opportunity to come up with new economic policies to restore growth....
The New York Times Original article ›
LyrArc Article Gist
This story in the NYT describes how the flawed effort to pass the Republican healthcare bill or repeal the Affordable Care Act passed under president Obama failed after another effort. Many developments killed it. In the end the president lost interest, especially when he saw Republican Senator Rand Paul of Kentucky go on talk shows on the weekend before its collapse to complain about the bill. Senator Collins of Maine was exasperated by the way the bill was being rushed through Congress, and she voiced her strong opinions about this by talking to people back home in Maine and sharing her conversations with the media. The bill pushed by Senator McConnell, the Republican leader in the Senate, imposed annual caps on Medicaid spending. And did this without any discussion, shutting out committee debate, any public discussion, or formal drafting. Once this process was set in motion in this way the Republican Senators formed camps. Senator Grassley of Iowa and Jerry Moran of Kansas, normally conservative moved to the moderate side. Moran held a town hall meeting covered in the NYT, where older people voiced their concerns. Most of the patient advocacy groups, the hospital groups such as the American Hospital Association, and other medical groups also opposed it.  After Senator McCain of Arizona said he could not return following a surgery in Phoenix, Senators Lee and Moran announced their opposition. With this the bill's support crumbled including any effort to repeal the Affordable Care Act.  ...
The New York Times Original article ›
New York Times Original article ›
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Glenn Hubbard, says Bowles and Simpson, have provided the framework for solutions to the US deficit. He says the elimination of the mortgage interest deduction and other actions such as elimination or reduction of deductions for charitable giving and employer provided healthcare subsidies, actually help reduce the marginal tax rates. Bowles-Simpson report, he says, correctly identified the problem that you need higher offsetting marginal tax rates because of these kinds of deductions to raise offsetting revenue. The two chairmen want to see government reduce marginal tax rates to a range of 8 to 23%, as opposed to 10% and 35% now, and this is a positive development. These kinds of deductions favor upper income households more than other households. He sees the co-chairmen's proposal to cut the tax rate for corporate income tax to 26% from 35%, as being a wise move, as it should not require much offsetting revenue, because OECD research has shown this to be the revenue maximizing rate. He concedes that liberals would have difficulty with the report, because the proposal accepts that maintaining a broad welfare state is inconsistent with the need to balance the country's finances through economic growth and social insurance. Yet he sees the limits on tax deduction and cutbacks in the entitlement's benefits for upper income households, as giving Bowles-Simpson proposals a progressive character....
WSJ Original article ›
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US president Biden's $2 trillion Families and Workers plan, for early childhood education, paid leave, healthcare and climate change investment, is coming up for a vote in Congress. Paid leave that also includes maternity leave and leave that would help women return to the workforce, has been added back to the bill. Community college aid was earlier removed from the package with resistance from private colleges that expect to lose tuition paying students, even though male students are falling dangerously behind in attending college without government support. The Biden administration is facing resistance from just a couple of Democratic Congressmen- about five led by a Congressman from New Jersey, and 2 Senators from Arizona and West Virginia- on community college government aid that helps young American men and women from the working class and on paid leave that helps women. Many Republicans have supported taking this action for renewal of America on serious issues that face the country, making it likely that these issues will only become more pressing in the next three years. Sometimes as is happening today some isolated or eccentric situations can block major legislation for the good of the country such as the makeup of a Congressional seat in New Jersey with large pockets of conservative Republicans who oppose spending, and conservative instincts of two Democratic senators from Arizona and West Virginia. This WSJ report looks at Biden's position that deterrence when filing tax returns will generate close to $400 billion and not $150 billion that the Congressional Budget Office says is its estimate. To accomplish this Biden plans to spend $80 billon in large investments to increase the resources of America's tax collecting agency. Much of this was never done and policies geared to where large corporations never paid their fair share of taxes. The first step was to prevent outshoring of headquarters to reduce taxes- and this was achieved in the first year of the Biden Administration with over 100 countries agreeing on a corporate minimium tax. In the same way president Biden now seeks to correct other flaws in the tax system so that much needed investments can be made by generating new revenue not just in infrastructure, but for renewal of America through renewal of support for women, children, and America's working classes. Much of that was badly neglected by different  administrations over the last three decades.     ...
New York Times Original article ›
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According to the General Accountability Office inquiry, 28 drug products had price increases over 100% in 2000, in 2008 71 drug products had such large increases. Medicines like Adderall for attention deficit disorder, Inderal for chest pain, Sumycin for infections were in the list of 416 brand name drug products where makers or distributors raised prices at least once by 100% or more for period 2000-2008. As large pharmaceutical companies sold their marginally profitable drug products or small selling products to smaller companies, these smaller companies would immediately increase prices to recover the money they paid to the large pharmaceutical companies. 26 of the brand name products saw prices raised 10 fold. A third of the drugs with large price increases treat depression and disorders of the central nervous system.
WSJ Original article ›
NYTimes.com Original article ›
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This NYT report says US president Biden is different from past presidents in two ways. He is pushing for infrastructure spending on a big scale from the very beginning of his administration. He is also not interested in shrinking his plans for multi-trillion dollar infrastructure spending to win support from Republicans. A big reason is that he sees the opportunity to go ahead because the perceptions of the American people have changed in the last five years, and have changed even more in the last year with the pandemic. Health, education,  infrastructure, and competitive technology leadership resource development spending with government playing a leading role is seen as indispensable for the US as a nation if it is to play the leading role that it has played over much of the last 100 years. Government leadership is seen as indispensable including in redesigning the existing global supply chain so that the US is no longer dependent on other nations and taking on risks. ...
DW.COM Original article ›
LyrArc Article Gist
Healthcare, climate change, pensions and social benefits, are three issues uppermost in the minds of German voters. Three million new young voters most of them only about 2 years old when Merkel started 16 years in office, look for change. They are well informed and for these young voters climate change is the most important issue. DW.com shows three voters and how they plan to vote. One voter has cast a mail in ballot for The Greens party. The second voter will vote for the Greens. Both because of climate change concerns. The third voter Thurid says her mother is a geriatric nurse and is not vaccinated. She is vaccinated but had talks with her mother and understands her worries about vaccination. She will vote for the Free Democrats because they oppose compulsory vaccination. The three leading parties for young voters are the Greens party, the Free Democrats, followed by the Social Democrats all in the range of 16-18% of support. The Greens have sent out 2 million brochures to voters. Out of 60 million voters in a German population of 80  million, 3 million is only 5% of the vote. What makes a difference is that it is consistent with the general direction of voters young and old, all looking for change in Germany as the CDU party attracts only about 20% or one fifth of German voters. Social Democrats Scholz is way ahead of Christian Democrats Laschet in how voters view each candidate. Will German voters be well informed enough to make a decision based on their desire for change after 16 years of Merkel or will the CDU bringing back in the last days of the campaign the old fears that the communist Left party would somehow find its way into the government using the Greens as a way in- this is a question for German voters. In1994 during the Cold War with Soviets Kohl used this to keep the Social Democrats out and Greens out and formed a coalition with the FDP. Yet today Merkel has grown close to both Russia and China and away from the Western alliance in a way that was unimaginable under Adenauer who helped build the new Federal Republic of Germany after the war. Merkel refuses to even immediately accept a call from a new US president Biden, American president who is closest in style and temperament to Harry Truman who faced off the Soviets in Berlin in 1948.  The FDP opposes a wealth tax or any form of taxes in which the wealthier pay a fair share of what is needed to build crumbling infrastructure in Germany neglected in the Merkel years. In Germany social and economic disparities have grown during the pandemic with poverty increasing during the pandemic as has happened throughout Europe and the world. The US is already committing to increase taxes for the upper incomes. This is where voters have a choice- do nothing with infrastructure, health or climate change or do something by increasing taxes. The choice is now before the German people.  With this question comes a choice for western civilization, with the recent election in the US, and two elections in Germany and then France. Will it look with optimism to the future or will it huddle up in a deeply cautious and slightly pessimistic view of the world that is embedded in Angela Merkel's cautious vision that ended up only responding to crises- some self inflicted as in migration policy, and even self inflicted in tackling euro problems created in the euro currency's faulty design. In fiscal policy as in migration policy Merkel has reversed her position- by supporting European solidarity. Will Germans vote for optimism or never ending caution? Are lessons learned?     ...
Wall Street Journal Original article ›
WSJ Original article ›
International Monetary Fund IMF Original article ›
LyrArc Article Gist
Some of the statements on the IMF Blog on Inclusive Growth raises the question-Does the IMF, the International Monetary Fund, as an American institution funding developing countries, and economists, grasp what people find troubling in 2022? One of the lessons of the economic crises for families and workers in the US and other countries is that wisdom, a grasp of the soul of a country and its people through the thinking of its founders, and common sense, should drive managing of economies, with a knowledge of how economies work- not economists. Some of that is already happening. America's central bank is headed by Jerome Powell who has wide experience and has knowledge of how the economy runs, is not an economist. He was chosen by president Trump and continues to have the confidence of president Biden for this very reason. Some of the statements on the IMF economic blog are- "Why jobs are plentiful and workers are scarce" Jan 2022 "In the US and UK recent labor market the puzzle, can be partly explained by mismatch, the pandemic's effect on women and older workers leaving the work force." The Reality Wages for teachers are depressed compared to workers in the financial and economics industries, in a frighteningly disproportionate way. When it comes to logistics, hospitality, leisure and restaurants industries workers were paid poorly for what is hard work and long days. In case the IMF economists, and economists at companies, missed this it was called the Great Resignation, people simply choosing to reject the conditions that were handed down to them by the financial industry and economists who built the economic structures of recent decades. Women leaving the workforce are faced with issues of mental health coping with added responsibilities of children at home for the two years, loss of income and widespread mental health problems. The word mental health may be beyond the grasp of economists and the financial industry, yet it is the one of the biggest problems for people. Another pernicious effect noted on the pages of the WSJ is that young white men are dropping out after school because they cannot afford college in alarming numbers. Leading to the kind of discontent for workers and families that president Biden is struggling to address. On IMF Blog- "IMF Podcasts: The Year in Review" Dec. 2021 "The past year has brought us new challenges even as the old ones persist. If anything, the ongoing pandemic has taught us to think differently abut tackling the challenges and questions when it comes to thinking about big issues such as climate change, gender equality, inflation and economic measurement." The Reality Climate change lumped in with economic measurement and inflation. The floods, fires, river and reservoir water levels affecting access to basic life supporting water, drought, all over the world are of a magnitude that is missed entirely.The response to a challenge of this type requires the kind of leadership that president Biden has provided for the world with his $360 billion climate change bill as just the first step of many, and  comprehensive policies covering all aspects of the climate crisis. ON IMF bog- "How Domestic Violence is a Threat to Economic Development." "Stopping violence against women is not only a moral imperative, new evidence shows it can help the economy." The Reality Domestic violence hurts children growing up in such households. It is not so much a moral imperative as it is bad for men, women and children. So many things are wrong about it and it is made worse in conditions of low wages and poor working conditions in poor neighborhoods lacking education. These neighborhoods are also affected by lack of healthcare and the opioid crisis and mental health issues. Not investing in education and healthcare in these communities is what is simply wrong, and which the founders of America as a nation, particularly Lincoln, would find appalling.   Relationship between Capital (the Financial Industry) and Labor (Workers and Families) On the basic issue of the relationship between capital and labor, the IMF and the financial industry, economists, and the economic structure they built in recent decades, have simply got it wrong. It violates both common sense and wisdom, and violates the spirit of the founders particularly Abraham Lincoln. This is what Abraham Lincoln had to say on Upward Mobility, the ease with which each generation can do better than the one before it, as critical in the fight to save the Union. This is from the Annual Message to Congress Dec. 3, 1861, at the start of the Civil War. That upward mobility has been lost in the US with ideas that "place capital on an equal if not above labor, in the structure of government," for the last three decades in the US after the early post war period of Truman and Eisenhower, Kennedy-Johnson.  And Lincoln says this about a hired laborer being fixed in that condition for life, or of future generations of that hired laborer facing disabilities and burdens, similar to the loss of upward mobility for the people today. "Now there is no such relation between capital and labor as assumed, nor is there any such thing as a free man being fixed for life in the condition of a hired laborer. Both these assumptions are false, and all inferences based on them are groundless." "Labor is prior to, and independent of capital. Capital is only the fruit of labor, and could never have existed, if labor had not first existed. Labor is the superior of capital, and deserves much the higher consideration. Capital has its rights, which are worthy of protection as any other rights." "Again: there is not, of necessity, any such thing as the free hired laborer being fixed to that condition for life. Many independent men everywhere in these states, a few years back in their lives, were hired laborers. The prudent penniless beginner in the world, labors for wages awhile, saves a surplus with which to buy tools or land for himself, then labors on his own account another while, and at length hires another new beginner to help him. This is the just, and generous, and prosperous system, which opens the way to all- gives hope to all, and consequent energy, and progress, and improvement of condition to all." Lincoln even offers this warning- No men living are more worthy to be trusted than those who toil up from poverty- none less inclined to take, or touch, aught which they have not honestly earned. Let them beware of surrendering a political power which they already possess, and which if surrendered, will surely be used to close the door of advancement against such as they, and to fix new disabilities and burdens upon them, till all of liberty shall be lost." US president Biden has these ideas in mind as he struggles with one piece of legislation after another to restore what once was, to open the door of advancement, to remove these disabilities and burdens that Lincoln speaks of, and in so doing restoring liberty.   ...
The New York Times Original article ›
New York Times Original article ›
LyrArc Article Gist
The NYT Editorial Board on efforts in the U.S. Senate by lobbying groups to have the 2.3% tax on medical devices- to pay for medical coverage of the uninsured in the Obama health Care law- repealed.
New York Times Original article ›
New York Times Original article ›
LyrArc Article Gist
This NYT editorial on June 26, 2015, says the arguments of the plaintiffs before the U.S. Supreme Court for the Affordable Care Act were specious, based as they were on a reading of four words phrase in the Act leaving ambiguity about what exchanges were covered by health care subsidies. It says the plaintiffs with strong emotions on the subject decided to pull their argument out of thin air. That only one Justice acted as the swing vote, Justice Anthony Kennedy, shows the Supreme Court like the rest of the nation is not above emotion- Justice Scalia called the 6-4 decision based on "jiggery-pokery" and not "honest jurisprudence"- and needed Chief Justice Roberts to provide the larger view in 2015 as he did in 2012.
The Indian Express Original article ›
LyrArc Article Gist
Modifications proposed for Agnipath recruitment to the Indian armed services include full healthcare benefits and pension benefits for the scheme. The government has presented a fact vs. myth explanation to provide a clear understanding of the intent of the scheme to reflect a younger population and integrated India without the regimental bias towards caste and region present since British times. Job security is always a concern in India. The better technically trained and better financed Agniveer recruit would have more opportunities for education and training after 4 years and become an attractive asset for the private and public sector. A program of this kind was the GI Bill in the US that Franklin Roosevelt signed in 1944 and the Veteran Act of 2008 that continued educational benefits for free college. These programs have resulted in benefit of great value to the US economy and to the military veterans who used these benefits. In India's fast growth period after 2025 the Indian economy would be 50% larger and be easily able to take in these graduates from the armed services with technical training and advanced courses just as the US economy did decades ago. During the days following the pandemic there is a sense of pessimism in some sections and the government can enhance the package with added pension benefits and healthcare and still keep the financial aspects in good shape. ...
New York Times Original article ›
LyrArc Article Gist
Increasingly hospitals in the U.S. are buying independent medical practices of physicians and writing the contracts in their favor. This is part of a general consolidation of health care services in the U.S. In 2012 about 39% of physicians are in independent medical practices compared to 50% in 2000, according to consulting firm Accenture.
Washington Post Original article ›
NYTimes.com Original article ›
LyrArc Article Gist
 This message from Pope Francis is especially relevant today during coronavirus. Francis says of the mistaken priorities of today away from healthcare, education, infrastructure and "coherence" in society and the pain and hardship this is causing in society, there is much that can give people thought to reflect on. Francis  new book, "Let us Dream: The Path To a Better Future" will be out December 1. "If we are to come out of this crisis less selfish than when we went in, we have to let ourselves be touched by others’ pain." He cites a line in Friedrich Hölderlin’s “Hyperion” that speaks to him, about how the danger that threatens in a crisis is never total; there’s always a way out, that where the danger is, also God plants the saving power, a way out. And not simply a way out, God also gives human beings a chance to grasp for and hold onto renewal if only one makes the endeavour. As it says in the Bhagavad Gita God gives man a chance to warm himself near the fire, only those who make the effort to go to the fire can feel the warmth, it is a choice man has to make. And again God says in the Bhagavad Gita that he is not partial to any man. Ever since the global financial crisis hurt working families in the middle and lower classes hard in 2009 because of banks misbehaviour and greed, Pope Francis has called for countries in the western world to heed his warnings about the dangers of greed and corruption to us all. Even George Washington warned of this in his inaugural address, so the warnings are not new. Reminding people once again he says "we cannot return to the false securities of the political and economic systems we had before the pandemic. We need economies that give to all access to the fruits of creation, to the basic needs of life: to land, lodging and labor. We need a politics that can integrate and dialogue with the poor, the excluded and the vulnerable, that gives people a say in the decisions that affect their lives. We need to slow down, take stock and design better ways of living together on this earth." The pandemic has exposed the paradox that while we are more connected, we are also more divided. Francis is never tired of warning that the present political and economic structures and people who staff them have not felt others pain, so he reminds us it is hard to build a culture of encounter in which we meet as people with a shared dignity, within a throwaway culture that regards the well-being of the elderly, the unemployed, the disabled and the unborn as peripheral to our own well-being. Where only self preservation counts. Francis reminds us of the Christian concept that no one is saved alone. This is not just an abstract concept. When Francis was only 18 years and a second year student he was admitted to a Buenos Aires hospital for a severe respiratory disease, so severe that he lost a part of his lungs. He remembers the day August 13, 1957. He understands this pandemic from personal experience. He knows what it is like to be on a ventilator. Surgeons removed the upper right lobe of his lung. Francis struggled to breathe. He was  saved Francis says not even by the doctors, but by a Dominican sister, a senior ward matron, who had been a teacher in Athens before being sent to Buenos Aires. She understood that Francis was dying and after the doctors left asked the nurse to double the prescription dose of penicillin and streptomycin. Sister Cornelia Caraglio, knew better than the doctors from her regular contacts with sick people what they needed, and she had the courage to act on that knowledge.      ...
Wall Street Journal Original article ›
NYTimes.com Original article ›
LyrArc Article Gist
The US needs good manufacturing jobs for the jobs and income that it brings into communities, and also because of the tax revenues from the companies making products in America that provide the basis for local governments to provide good public services in healthcare, education, and transportation. To say comparitive advantage that helped first Japanese and now Chinese manufacturers is real and how society gains is to deny some basic facts that are self evident from observation that contradict textbook ideas in economics. Comparitive Advantage is a textbook economics concept that says countries are proficient in what they make best and should specialize in that product. But it is a static concept that exists only in textbooks. If Japan in 1960, China in 1980 and India in 2000 were each presented with this idea they would have turned down the idea of making steel and remained makers of lower end products such as footwear and textiles. If Japan in 1980, China in 2000, and India in 2020 were each presented with this idea they would have turned down the idea of making semiconductors and remained makers of lower end products such as steel. A senior vice president of US Steel in the late 1960's even told this writer a graduate student at Northwestern in Chicago- as the US can make steel better than India or China let us keep making it for you. He and much of the business faculty at Northwestern also could not understand in 1970 why Airbus was being setup to compete with Boeing who by the concept of comparitive advantage should have had the whole market to itself for commercial aircraft . By this kind of thinking Airbus would not exist today because it did not have the lowest cost or the manufacturing technologies Boeing had through its vast manufacturing operation. America would be still the only one making aircraft in 2023 if textbook concepts ruled the day. By indirect methods such as hidden preferential arrangements, provision of inputs such as land, capital and labor, tax relief, the costs can be represented in a way that shows it is cheaper to manufacture overseas. The lack of a level playing field is what president Biden is correcting by doing what first Japan, then South Korea, then China and now India are doing since the 1960's. By 1974 in four years after its founding in 1970 Airbus came up with its first model the A-300 using advanced technologies. America will regain its leadership in the cost and manufacturing of many products through Biden policy and the efforts of American companies by 2030, and do this in a transformative way that will benefit the world as a whole.  It is an enormous error to say the US does not need good manufacturing jobs, that local governments do not need the tax revenues from manufacturing plants to build services for communities where manufacturing workers live, and the US does not need the manufacturing experience curve that leads to reduced costs. It is this loss of the manufacturing experience curve that is the most vital aspect for understanding the need for the US government to compete effectively with the governments of Asian countries to keep manufacturing healthy and strong at home. Economics experts ignorant of how important this science and engineering principle is fail to grasp this. Related to this is the idea of a virtuous cycle in manufacturing- whoever braves the hard years of moving up the learning and experience curve gets rewarded because once that country has mastered that skill it gets better an better as the technology advances- making it harder and harder to prevent a new monopoly in manufacturing by the country (Japan, China or Taiwan) that had the highest costs and the least advantage ten or 20 years earlier but just persevered through it all with the government's help to gain cost competitiveness. This part does not make it into the economics textbooks which are mostly theory and much of it outdated by the time they are written. Observation is the best teacher and guide as it is in science, to guide policy and action. Obsessive attachment to theory that ignores observation becomes the enemy of progress. Comparitive advantage is one concept that needs to be retired even from the textbooks. Overseas manufacturing then is a piece of the overall picture that fits into what is good for the US. Macroeconomic principles determine microeconomic outcomes as opposed to microeconomic principles with companies out on their own being forced to compete without a level playing field, or handing out technology for special status in a recipient country as some do putting the US at a macroeconomic disadvantage. This is also healthy for the recipient country overseas, as recrimination with loss of manufacturing jobs in the US inevitably leads to the kind of recrimination that does not serve either country well as in the case of China today, and worse still can lead to conflict, even war. After the egregious situation of loss of manufacturing communities across the US leading to destabilizing the social fabric, it is hard to see such thinking prevail about the US not needing manufacturing as a vital part of its social fabric and industrial strength. China, it can be said, would have developed, and developed well over the past two decades without overconcentration of US and EU manufacturing in China. Without aggravating the problems of climate change and contamination of air, land and water, and destabilizing the social fabric in the US hurting workers and communities across the US, if macroeconomic policy was made to manage this process in the US government without it being left entirely to individual companies to decide. Instead China faces today a difficult situation through events such as destabilizing the social fabric in the US (the Trump tariffs), advanced economies in G-7 resistance to sharing of technologies, the damage to its environment from microeconomic locally determined policy at individual companies, and the global effects of climate change from climate unsustainable levels of growth since 2000.  ...
New York Times Original article ›
NYTimes.com Original article ›
LyrArc Article Gist
The problems of vaccine access in Africa affect us all - this is the simple truth. Here the NYT gives letters from people on the frontlines, healthcare workers in Africa who in one situation in the Sudan had over 4000 people arrive some by canoe through floods and had only 545 vaccines. Africa Centers for CDC show 79% of people in Africa will take the vaccination. Vaccine access for Africa is something that should be on the top of the list for Biden in the US, Johnson in UK, Modi in India, Scholz in Germany, and for all world leaders.

 

New York Times Original article ›
LyrArc Article Gist
Using the design-build method under which architects and construction experts work together as a team, Orange Medical Centre, a new 374 bed hospital in Middletown, New Jersey, has reduced the construction costs by one third. Only 9% of the total square footage of hospitals built in the USA used this method according to Modern Healthcare an industry publication, so this is one more area in which health care savings can be found- and there may be many more areas like this- which goes to show that ingenuity, experimenting with new ways and asking questions about old ways of doing things, can generate large savings, especially when it becomes a necessity. As the old proverb says, necessity is the mother of invention. Design-build differs from traditional construction in that the architect and the construction company come from the same company. They understand each other so well that they can finish each other's sentences. This cuts out the waste and back and forth that goes on with changes that are made, as the changes are minimal. This is a big source of the savings. This is similiar to the integration of design and manufacturing experts into one team in the auto and other industries. HBE Corporation of St Louis is the company that handled this work. Its asmall outfit with 500 people and this is the largest hopital it has built, so there is potential for doing alot more in this field for health care savings....

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