[Excerpt] From J. Goodman's Bureaucrats vs. Entrepreneurs

[Excerpt] From J. Goodman's Bureaucrats vs. Entrepreneurs:

I used to think the biggest obstacle to getting agreement about health care reform was ideology (socialism vs. capitalism). Then I decided it was sociology (engineers vs. economists). I now am inclined to believe it ispsychology (bureaucrats vs. entrepreneurs).

• The Google Lunar X Prize offers $30 million to the first privately-funded team to land a robot on the moon.
• The Wendy Schmidt Oil Cleanup X Challenge offers $1 million to the team that is most successful at cleaning up oil spills.
• The Progressive Insurance Automotive X Prize awarded $10 million to three teams that built cars achieving 100 miles per gallon in real world driving.

What caused the shift in my thinking was a post the other day in which I recounted Atul Gwande's description of Dr. Jeffrey Brenner in The New Yorker. Brenner is a true entrepreneur. He discovered that a small number of patients were generating a very large share of medical costs and he found that he could save society millions of dollars by treating these patients in unconventional ways. By unconventional, I mean doing things that Medicare, Medicaid (and Blue Cross, for that matter) do not pay for.

To my knowledge, there is no award for any discovery in paying for or delivering health care, however, with one exception noted below. Heritage Provider Network is offering a $3 million prize "to anyone who can build the algorithm that best predicts which patients will be hospitalized and for how many days over the course of a year, based on a given data set." See the description in Slate.