Sublime

expertise and entrepreneurial interest in victimhood and exploitation

As a third cardinal feature, place-based changes must be sustainable, without the need for constant and conscious maintenance of positive behavior or the perpetual persuasion of individuals to be safe and healthy. Employee exercise programs, for example, require employees that are committed to volunteering and maintaining their involvement in the p

Mitch Katz directs the Los Angeles County Department of Health Services, the second-largest county health care system in the country. He described to me how economic incentives can stack up against upstream care. “Because there’s been little money toward prevention, there’s no payer or mechanism for prevention research like there is for medical res

Atul Gawande, an American surgeon and journalist, offers a metaphor for the shortfalls of such piecemeal approaches to change, “Anyone who understands systems will know immediately that optimizing parts is not a good route to system excellence.”

see the issues as systemic rather than personal, they will begin to look for the leverage points in the system (such as a tradition of protecting underperformers or centralized control) as targets of attention to effect change.

Risk is a central fact of life for the poor, who often run small businesses or farms or work as casual laborers, with no assurance of regular employment.

from David M. Lawrence, former chairman and CEO of Kaiser Foundation Health Plan Inc. and Kaiser Foundation Hospitals: