That is a collection of rather common ideas from 1960-era futurism, which were considered, calculated , sometimes prototyped and found massively impractical since then.
I call bull and ask for a reference to (1) education being taught in shorter units (2) movable houses on modular foundations going well with land taxes (3) separating the medical profession into diagnosticians and surgeons to enable evaluation of surgeon performance.
In Israel, the family doctors do very simple diagnosis and routine prescriptions.
Specialists are easily accessible (no referral required, generally an appointment is available within a few days) for more sophisticated diagnosis. Advanced specialists are easily available with a longer wait.
Surgeons do surgery.
Waits are shorter than many countries. Good health care is provided to everyone rich or poor, but there is also private supplementary insurance and private medical care for those who want to do the Hansonite “excess medical care as a signal” thing.
It’s not paradise, but based on experience of myself and friends and family members a heck of a lot better for members of all economic classes.
Coming from the United States originally, it’s actually quite a pleasant surprise how simple and easy to work with the Israeli health-care system is, as opposed to almost any other part of Israeli public services and to American health-care.
On the other hand, performance of family doctors is often poor, salaries in medical professions are low and the system is fraught with internal politics.
performance of family doctors is often poor, salaries in medical professions are low and
That’s good! Routine procedures should be done at low cost.
In the US, doctors get huge salaries, which is nice for them, and not nice for everyone else.
Performance may be poor—but compared to what? If routine services are cheap, quick, easy to get, then you can move on to specialized care as needed.
(I sometimes feel kind of sorry for the family doctors, whose work is completely routinized. In the US, non-physicians such as nurse practitioners and physician’s assistants sometimes do this work. But as a system, this works nicely for the patients.)
Even on a less ambitious level, I’d love to see diagnostician as a specialty. I’ve got friends who took a remarkably long time to get a diagnosis, and I think that just having doctors without a background in statistics, but with time and interest to do research would help a lot.
The closest thing I can think of to (2) is the Japanese capsule tower, but that doesn’t count since there was only one and there were no plans for there to be others—the intent was for it to be modular so that the capsules could be replaced every 25 years. (And there were design problems—it was intended for bachelor salarymen who wouldn’t be at home much except to sleep, so there was very little space, and the windows don’t open.)
That said, capsule towers seem like the perfect thing for the Bay Area, though they could never get built because of the governments down there. I’m surprised I haven’t seen them proposed yet; they at least don’t seem like they’d take long to build.
...(3) separating the medical profession into diagnosticians and surgeons to enable evaluation of surgeon performance.
During most of the Middle Ages, diagnosticians (physicians, etc...) were virtually always different people than surgeons (barbers, butchers, etc...). But yeah, that is a good thing, ceteris paribus (which the Middle Ages and now definitely are not).
Physicians and surgeons remain distint, but there is no particular reason a diagnosticician should also be a physician, since it is often a fine question whether a given problem needs surgical or chemical intervention.
So, there are things like The Great Courses, which by all accounts make terrific lecture series (I think that I’ve only listened to one, so far), and are as long or as short as they need to be, I think. The breakup of teaching and testing is routine on the lower level- think state tests, or national tests like the SAT, or international tests like the PISA- and somewhat common on the upper level- think the bar exam for law- but mostly missing on the university level.
As for shorter units, the semester system is not universal; some places use trimesters or quadmesters (which are poorly defined, as either can refer to the other); I haven’t seen anything on which leads to superior educational outcomes. As much as I like the idea of mastery-based curricula (i.e. instead of “World History” for six months, you have to pass 12 different tests on “Roman history” and “Chinese history” and so on, each of which should take about half a month to study for), it’s not obvious to me that even most students would benefit from a structure like that.
The majorly majorly system—ie if you study subject X you spend 80% or 90% of your time on it—is ubiquitous in the UK to the extent that we don’t really use the word “major” but do use the phrase “joint degree”.
(3) separating the medical profession into diagnosticians and surgeons to enable evaluation of surgeon performance
House MD has diagnostics and surgery separated, even if the diagnostician does sometime wander into the operating theatre to grab a squishy bit and wave it at people.
That is a collection of rather common ideas from 1960-era futurism, which were considered, calculated , sometimes prototyped and found massively impractical since then.
I call bull and ask for a reference to (1) education being taught in shorter units (2) movable houses on modular foundations going well with land taxes (3) separating the medical profession into diagnosticians and surgeons to enable evaluation of surgeon performance.
In Israel, the family doctors do very simple diagnosis and routine prescriptions.
Specialists are easily accessible (no referral required, generally an appointment is available within a few days) for more sophisticated diagnosis. Advanced specialists are easily available with a longer wait.
Surgeons do surgery.
Waits are shorter than many countries. Good health care is provided to everyone rich or poor, but there is also private supplementary insurance and private medical care for those who want to do the Hansonite “excess medical care as a signal” thing.
It’s not paradise, but based on experience of myself and friends and family members a heck of a lot better for members of all economic classes.
Coming from the United States originally, it’s actually quite a pleasant surprise how simple and easy to work with the Israeli health-care system is, as opposed to almost any other part of Israeli public services and to American health-care.
On the other hand, performance of family doctors is often poor, salaries in medical professions are low and the system is fraught with internal politics.
That’s good! Routine procedures should be done at low cost.
In the US, doctors get huge salaries, which is nice for them, and not nice for everyone else.
Performance may be poor—but compared to what? If routine services are cheap, quick, easy to get, then you can move on to specialized care as needed.
(I sometimes feel kind of sorry for the family doctors, whose work is completely routinized. In the US, non-physicians such as nurse practitioners and physician’s assistants sometimes do this work. But as a system, this works nicely for the patients.)
Even on a less ambitious level, I’d love to see diagnostician as a specialty. I’ve got friends who took a remarkably long time to get a diagnosis, and I think that just having doctors without a background in statistics, but with time and interest to do research would help a lot.
The closest thing I can think of to (2) is the Japanese capsule tower, but that doesn’t count since there was only one and there were no plans for there to be others—the intent was for it to be modular so that the capsules could be replaced every 25 years. (And there were design problems—it was intended for bachelor salarymen who wouldn’t be at home much except to sleep, so there was very little space, and the windows don’t open.)
That said, capsule towers seem like the perfect thing for the Bay Area, though they could never get built because of the governments down there. I’m surprised I haven’t seen them proposed yet; they at least don’t seem like they’d take long to build.
During most of the Middle Ages, diagnosticians (physicians, etc...) were virtually always different people than surgeons (barbers, butchers, etc...). But yeah, that is a good thing, ceteris paribus (which the Middle Ages and now definitely are not).
Physicians and surgeons remain distint, but there is no particular reason a diagnosticician should also be a physician, since it is often a fine question whether a given problem needs surgical or chemical intervention.
Re education. I wonder if this has been tried on any scale anywhere in the world, and whether it worked. Maybe someone familiar can chime in.
So, there are things like The Great Courses, which by all accounts make terrific lecture series (I think that I’ve only listened to one, so far), and are as long or as short as they need to be, I think. The breakup of teaching and testing is routine on the lower level- think state tests, or national tests like the SAT, or international tests like the PISA- and somewhat common on the upper level- think the bar exam for law- but mostly missing on the university level.
As for shorter units, the semester system is not universal; some places use trimesters or quadmesters (which are poorly defined, as either can refer to the other); I haven’t seen anything on which leads to superior educational outcomes. As much as I like the idea of mastery-based curricula (i.e. instead of “World History” for six months, you have to pass 12 different tests on “Roman history” and “Chinese history” and so on, each of which should take about half a month to study for), it’s not obvious to me that even most students would benefit from a structure like that.
The majorly majorly system—ie if you study subject X you spend 80% or 90% of your time on it—is ubiquitous in the UK to the extent that we don’t really use the word “major” but do use the phrase “joint degree”.
House MD has diagnostics and surgery separated, even if the diagnostician does sometime wander into the operating theatre to grab a squishy bit and wave it at people.
A comment on (3): a conveyor belt eye surgery has been tried in the old Soviet Union 30 years ago: http://articles.latimes.com/1985-07-06/news/mn-9473_1_eye-surgery , not sure what came of it. Russian wiki, use Google translate.
A similar approach is in use some places in India: http://en.wikipedia.org/wiki/Narayana_Health
This is not quite what you are advocating, but in a similar vein.