Mother Lode!

The Atlantic this month (12.07) is loaded with my favorite sort of analyses; namely, those that reveal counter-intuitive truths (or decent speculations, at any rate). Consider:

*SLUMS ARE GOOD. Today’s burgeoning slums are the product of people pouring into the cities from the countryside—in pursuit of jobs. (In 2008, cities’ population will surpass countryside population.) While eyesores and cause of appropriate concern, said cities are in fact the source of jobs, and overall poverty reduction is significantly attributable to the migration—burgeoning slums notwithstanding. The assertion is that no nation has grown wealthy since the start of the Industrial Revolution until the country-city migration was in full flower. (“Bright Lights, Big Cities,” Matthew Quirk)

*HOME OWNERSHIP IS BAD. There are indeed enormous benefits to home ownership. But the big drawback, especially in times of economic revolution, is that home ownership measurably slows migration from where the jobs were to where the jobs are. (“Housebound,” Clive Crook)

*WE HAVE TOO MANY DOCTORS. The supply of doctors to an area is significantly determined by the wealth and insurance coverage of the population. Hence there are more docs per capita in well-off areas—where, in fact, medical problems are less intense per capita. This also leads in particular to an excess of specialists—lots of docs prescribe lots of tests and make lots of referrals. As to the “bottom line,” healthcare, per several sound measures, is no better in places with lotsa per capita docs than in places that are doc-deprived. It gets more interesting: The more specialists, the worse the outcomes. (More or less.) Specialists trip over one another, give conflicting advice, and are notoriously bad at cross-communication. More on specialists: The glamour and pay accorded to specialists comes at the price of less and less well-paid primary care docs—it is the vanishing primary care docs who are primarily responsible for good healthcare outcomes. Dr Elliott Fisher, Center for Evaluative Clinical Sciences at Dartmouth Medical School: “If we sent 30 percent of the doctors in this country to Africa, we might raise the level of health on both continents.” (“Overdose,” Shannon Brownlee)

*Less AID, more aid.Scents & Sensibility,” by Sarah Chayes, is the saga of helping Afghans successfully build a soap and body-oil business. It’s also the umpteenth repeat of the story of how such “on the ground,” practical, human-scale efforts are slowed or halted by the ham-handedness of USAID. [Web-only slideshow]

*THE LATE-BIRD STARTS THE CREATIVE ENTERPRISE. From “How You Sleep Is Who You Are” [not available online]: “Early risers prefer to gather knowledge from concrete information. They reach conclusions through logic and analysis. Night-owls are more imaginative and open to unconventional ideas, preferring the unknown and favoring intuitive leaps on their way to reaching conclusions.” Morning people are more self-controlled, more formal, respect authority, and obsess on making a good impression. The late bunch are more independent and have less respect for authority. (Research source cited by the Atlantic: “Morning and Evening Types: Exploring Their Personality Styles,” by Juan Francisco Diaz-Morales.) (TP note: Sounds like we need a night-owl CEO matched by an early-bird CFO.)

Tom Peters posted this on November 29, 2007, in News.
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