Word: enthoven
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...want something that costs more, you pay the difference and you have some skin in the game," says Enthoven. In Massachusetts, which passed universal-health-insurance provisions in 2006, some 40% of residents who purchased policies through the state's exchange opted for the cheapest plans, called bronze policies, according to Trudy Lieberman, a health-policy journalist who recently reviewed that state's experience for Columbia Journalism Review...
...proposal would allow states to set up their own, and that could create problems from the outset; not only could they take longer to set up, but there is doubt about whether state or regional exchanges would be able to attract enough enrollees to leverage for lower premiums. Alain Enthoven, a leading health-care economist at Stanford University, says these conditions would make it impossible for the exchanges to reach the "critical mass" of pooled enrollees necessary to leverage insurers to offer lower premiums. Enthoven says exchanges need at least 20% of the privately insured population to be viable...
...didn't have to be this way, says Dr. Paul Ellwood, 71, the man who invented the phrase "health-maintenance organization" and who, along with Stanford University economist Alain Enthoven, developed much of the theory behind managed care. From his ranch in Wyoming, Ellwood sounds like a broken man, and in a too literal sense he is. He was thrown from a horse last month, fracturing his neck. (No, he was not paralyzed or treated by managed care.) The painful healing process has given him a lot of time to consider how disappointed he is with the system he helped...
...head of Systems Analysis, Enthoven (Smith served as his aide) was charged with supplying much of the necessary objectivity. With two years at Oxford as a Rhodes scholar and economics degrees from Stanford and M.I.T., plus a four-year Rand Corp. stint as background. Enthoven at age 30 became the prototype McNamara Whiz Kid when the new secretary began building S.A. into a powerful administrative tool. Its basic mission: to estimate the required quantity and performance of forces and weapons in relation to their mission and costs...
...Enthoven and McNamara soon ran afoul of service leaders, whose basic idea was "more of everything." How Much Is Enough? offers new evidence, if any were needed, that the military bureaucracy must have strong civilian leadership to prevent waste and duplication, and that competing interests among and within the services tend to stifle innovation. Elements in the Navy, for instance, resisted the Polaris submarine project, fearing that it would divert resources from other Navy programs. In 1961, when imaginative Army thinkers devised the airmobile concept, they got a cool reception from their own superiors until McNamara's office offered...