6 AM Pacific

Pay for Performance is Difficult to Implement

In the current debate on healthcare I’ve started hearing something that is quite familiar – pay for performance. The notion is simple – doctors should be paid based on patient outcomes not on the volume of work (fee-for-service). Its intent is easy to agree upon, but terribly difficult to implement.

In the Consulting and IT Services we have seen performance or outcome based pricing go through the entire hype cycle without getting any adoption to speak of. It’s not that customers didn’t want it enough or that vendors dragged their feet. It is just too hard to do. As a result, whenever I have seen pay for performance in contracts they have been in the form of bonuses that have never been big enough to impact vendor profitability seriously.

Pay for performance will be difficult to achieve in US healthcare as well. For reasons that are not very different from why they didn’t work in the IT industry. Here are the challenges: More »

More on IT Unpolicy

In my previous post IT and the Role of Government I objected to Atanu Dey’s arguments against having an IT policy for India. He proposed, what I called an “IT Unpolicy” – basically, do nothing.
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IT and the Government

Atanu Dey has a series of posts that criticize the IT Vision Document released by the BJP in the runup to the Indian elections. In his latest post The Rational IT Policy, he proposes an IT policy that basically does nothing – an Unpolicy, if you will. It requires government to stay out of the way of individuals and the market which will make their own decisions about using IT or not.

To me this seems wrong-headed. I think it is important for any government that comes to power to nurture and encourage the use of IT in government, business, education and at home.
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Setting Targets or Expectation Setting

Indian Finance Minister P. Chidambaram in an interview about India’s slowing GDP growth, to the Wall Street Journal says,

“We must aim at 9%, as I will, and we must be happy if it’s between 8% and 9%.”

This begs the question “Is he setting a goal for GDP growth for the country or is he managing expectations?”

A goal, IMO, is something that is ‘actionable’, i.e. you and your team can take actions which help you achieve that goal. Much like a goal in football, you can’t score one by just being on the field. More »

Haryana and Orissa lead Investment Tables

Ila Patnaik reviews CMIE data on state wise per capita investment in 2007. The states with the leading investment per capital are Haryana and Orissa. It just happens that I am quite familiar with both states since I am Oriya and go back there to visit my folks quite often and because I grew up in Haryana and go back there once in a while as well.

Both states have able forward thinking administrations. And some help of course. Haryana’s proximity to Delhi is something they have taken advantage of. Orissa is blessed with more than its fair share of natural resources. But beyond that there is still a lot of good work going on. In Bhubaneswar, the traffic isn’t anywhere near being a problem yet. But the government is working hard to widen roads. Shows that someone is thinking ahead.

Patnaik attributes the differences and the trends in investment per capita to the quality of the state government administration. If I were to drill down a little more and ask myself the question, what would I look at if I were to set up a new center for my business my criteria would be as follows: More »

BCCI and Indian Cricket – Monopolies are Never Good

Last week the returning winners of the Twenty20 World Cup, jammed up traffic in Mumbai. Sharad Pawar, the BCCI President and also Union Minister for Agriculture, cancelled all his appointments to receive the Indian cricket team. There was a big press conference, at which he made a speech that was, it seems, more a political speech than anything else.

And why not? He is a politician in a cricket crazy country. Why shouldn’t he take advantage of the rare occurrence that is an Indian team winning a major championship? Many other politicians in various states had the same idea and showered gifts and cash upon their home state players. Everyone loves a winner. More »

Old Retail vs Farmers – Now It Gets Interesting

A couple of months back, I wrote about Kerela’s ban on organized retailing. Most readers agreed that it was wrong-headed. But there was some skepticism about my claim that organized retailing would be beneficial to the farmers. Well, here’s the tangible evidence. More »

Auto-rickshaws in Mumbai

There is much good to be said about autos in Mumbai. They are generally available in plenty at all times of the day. And to a lesser extent even in the middle of the night. They generally charge by the meter, which is more than can be said about Delhi or Bangalore. And they (again generalizing here) have a more positive attitude towards their passengers and humanity at large than their brethren in other metros. More »

Number Games – BEST TV Advertising

Among business newspapers in India, Business Standard is good and is constantly improving; Mint is new but very good too. Both have an online presence [B-S Mint] and do not have irritating pop-up ads. The B-S site is not password protected (Mint is) which makes it an ideal solution for linking to. I wouldn’t want my readers to be subjected to the advertising irritants that an Eco Times creates.

Here is my first link to B-S. An article in today’s B-S reports that BEST buses in Mumbai have installed TVs in their buses which will show ads. The idea is clever but not novel. It has been tried but has met with resistance in the US where fares are not (or less) subsidized. Bus Radio is a similar project that does radio advertising in school buses. In India where the fares have to be kept very low to remain affordable, this could be an interesting way to help keep the fares down. More »

Sound and Fury – the 123 Agreement

I’m in India right now and over the weekend have been on a forced diet of the news channels. Top of the news menu is the possible fall of the government over the 123 Agreement on civilian nuclear cooperation between India and the US.

The coverage since yesterday on NDTV seems more like a soap opera than anything else. Like a soap opera it is low on content, high on drama but the acting is terrible. At the end of an hour long program in which many pols from both CPI(M) and Congress were interviewed, I was no more enlightened about the issues as I was before the program. (thank god for Wikipedia!). To the credit of the NDTV anchor, he tried his best to get his guests to talk about the issues, but it was clearly not a top priority for them. They preferred to refer to documents and dates without talking about what was in them. Make bombastic statements about the sovereignty of India being compromised or protected. And of course throw accusations at the other party about their motivations. More »