A Better Way to Generate and Use Comparative-Effectiveness Research

President Barack Obama, former U.S. Senate majority leader Tom Daschle, and others propose a new government agency that would evaluate the relative effectiveness of medical treatments. The need for "comparative-effectiveness research" is great. Evidence suggests Americans spend $700 billion annually on medical care that provides no value. Yet patients, providers, and purchasers typically lack the necessary information to distinguish between high- and low-value services. Advocates of such an agency argue that comparative- effectiveness information has characteristics of a "public good," therefore markets will not generate the efficiency-maximizing quantity. While that is correct, economic theory does not conclude that government should provide comparative-effectiveness research, nor that government provision would increase social welfare. Conservatives warn that a federal comparative- effectiveness agency would lead to government rationing of medical care -- indeed, that's the whole idea. If history is any guide, the more likely outcome is that the agency would be completely ineffective: political pressure from the industry will prevent the agency from conducting useful research and prevent purchasers from using such research to eliminate low-value care. The current lack of comparative-effectiveness research is due more to government failure than to market failure. Federal tax and entitlement policies reduce consumer demand for such research. Those policies, as well as state licensing of health insurance and medical professionals, inhibit the types of health plans best equipped to generate comparative-effectiveness information. A better way to generate comparative-effectiveness information would be for Congress to eliminate government activities that suppress private production. Congress should let workers and Medicare enrollees control the money that purchases their health insurance. Further, Congress should require states to recognize other states' licenses for medical professionals and insurance products. That laissez-faire approach would both increase comparative-effectiveness research and increase the likelihood that patients and providers would use it

Institutions in comparative policy research

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Spatial Theorizing in Comparative and International Education Research

The authors argue for a critical spatial perspective in comparative and international education. We briefly summarize how time and space have been conceptualized within our field. We then review mainstream social science literature that reflects a metanarrative, which we critique for contributing to false dichotomies between space and place and oversimplified views of the relationship between the global and the local. We present some of the key ideas associated with the “spatial turn,” including a relational understanding and productive capacity of space. In the final part of this article, we analyze the significance of new spatial theorizing for comparative and international education by reviewing examples of both comparative and educational researchers who are engaging with critical spatial theorizing. We argue that a possible way to confront binary thinking about space and place is by shifting attention to the relational conceptions of space, through analyses of networks, connections, and flows.Fil: Larsen, Marianne A.. No especifica;Fil: Beech, Jason. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Conceptual controversies: comparing the quality of work and welfare for men and women across societies

This paper critically examines a range of typologies used in comparative employment and welfare state research. The approaches examined include the societal effect, varieties of capitalism, welfare state regimes and benchmarking approaches, and their feminist critiques. The article concludes by assessing the critical merits and implicit assumptions of using such typologies for comparative research on the quality of work and welfare for men and women

Comparative evaluation of research vs. Online MT systems

This paper reports MT evaluation experiments that were conducted at the end of year 1 of the EU-funded CoSyne 1 project for three language combinations, considering translations from German, Italian and Dutch into English. We present a comparative evaluation of the MT software developed within the project against four of the leading free webbased MT systems across a range of state-of-the-art automatic evaluation metrics. The data sets from the news domain that were created and used for training purposes and also for this evaluation exercise, which are available to the research community, are also described. The evaluation results for the news domain are very encouraging: the CoSyne MT software consistently beats the rule-based MT systems, and for translations from Italian and Dutch into English in particular the scores given by some of the standard automatic evaluation metrics are not too distant from those obtained by wellestablished statistical online MT systems

Comparative Regionalism - A New Research Agenda

After the end of the Cold War, students of International Relations observed an expansion of inter-state activities at the regional level. Regional and sub-regional groupings appeared to gain momentum as the way in which countries cooperate and should cooperate to pursue peace, stability, wealth and social justice. The surge and resurgence of regionalism has triggered the proliferation of concepts and approaches. The focus of this paper will be on processes and structures of state-led regionalism driven by the delegation of policies and political authority to regional institutions. Based on this understanding of regionalism, the existing literature will be reviewed with regard to three general questions. These questions do not only require research across regions but also allow developing a common research agenda to accumulate knowledge generated about specific regions. First, what are the outcomes of regionalism? How can we describe and compare the results of the delegation of policies and political authority? Second, what are the drivers of regionalism? Why do some governments choose to delegate policies and political authority while others do not? Finally, what are the internal effects of regionalism? How does the delegation of policies and political authority impact back on the domestic structures of the states involved?regional development; Europeanization; Europeanization