The implementation of the Affordable Care Act has undermined public trust in government

The botched roll-out of government health insurance exchanges has trained a harsh spotlight on the Affordable Care Act. While the health law’s impact on the economy remains sharply disputed, Richard B. Saltman argues that politically motivated implementation decisions – from disruptions of existing insurance coverage to special treatment for labor unions and favored industries – have deepened a legitimacy crisis for government in general. He writes that as levels of citizen trust in government reach an all-time low, the ability of either party to make policy is diminished

The financial crisis means that Europe will need to look beyond the public sector to provide its healthcare needs

The financial crisis has led to public spending cuts across most European countries. Richard B Saltman and Zachary Cahn write that even if current levels of health spending are maintained, public healthcare systems will increasingly come under strain due to projected rises in healthcare costs. They argue that the only solution left for European governments is to increase the contribution made by other sources of care, such as those in the private and voluntary sectors

In the current bitterly contested political atmosphere, theSupreme Court’s second decision on Obamacare has resolvedlittle

This week, the Supreme Court ruled in favor of subsides which support federal health insurance exchanges which operate in the states under the Affordable Care Act. Richard B. Saltman writes that the core argument over Obamacare goes beyond the role of these subsidies and that many who oppose it do so on the grounds that it is an expensive federalization of health care. He argues that the Supreme Court has clearly and intentionally misread the clear and intentional language of the Affordable Care Act, and in doing so has only moved the controversy and debate on to the 2016 Presidential election

Pragmatism is beginning to trump ideology in Europe’s ‘public-private’ debate over healthcare

The merits of public vs private healthcare have traditionally formed one of the key ideological divisions between European political parties. Richard B. Saltman writes that while this debate has often been exceptionally heated, over the last few decades a number of European countries have started to take a more pragmatic approach in terms of both the use of private healthcare and the operating philosophy adopted in public hospitals. Although the public-private debate is unlikely to ever disappear entirely, these trends and the pressures of prolonged austerity have steadily reduced its relevance to actual service delivery

There is little common ground between the two opposing moral narratives on the implementation of Obamacare

Two weeks ago on 1 October, the 2010 Patient Protection and Affordable Care Act (ACA) began implementation, despite the government’s shutdown due to disagreements between the Republican and Democratic parties over its funding. Richard B. Saltman looks at the two opposing moral narratives over the ACA: one which focusses on the program’s health benefits, and a second which argues that the ACA represents a fundamental political and bureaucratic threat to the continued decentralized governance and economic future of America. Past experience with similar clashes between completely different moral narratives indicates that the US may well be in for a long-term war of political attrition over the ACA

Lessons from the TAPS study - Management of medical emergencies

The Threats to Australian Patient Safety (TAPS) study collected 648 anonymous reports about threats to patient safety by a representative random sample of Australian general practitioners. These contained any events the GPs felt should not have happened, and would not want to happen again, regardless of who was at fault or the outcome of the event. This series of articles presents clinical lessons resulting from the TAPS study.3 page(s

Open Problems on Central Simple Algebras

We provide a survey of past research and a list of open problems regarding central simple algebras and the Brauer group over a field, intended both for experts and for beginners.Comment: v2 has some small revisions to the text. Some items are re-numbered, compared to v

Quaternion algebras with the same subfields

G. Prasad and A. Rapinchuk asked if two quaternion division F -algebras that have the same subfields are necessarily isomorphic. The answer is known to be "no" for some very large fields. We prove that the answer is "yes" if F is an extension of a global field K so that F /K is unirational and has zero unramified Brauer group. We also prove a similar result for Pfister forms and give an application to tractable fields

Stable de Sitter vacua in N=2, D=5 supergravity

We find 5D gauged supergravity theories exhibiting stable de Sitter vacua. These are the first examples of stable de Sitter vacua in higher-dimensional (D>4) supergravity. Non-compact gaugings with tensor multiplets and R-symmetry gauging seem to be the essential ingredients in these models. They are however not sufficient to guarantee stable de Sitter vacua, as we show by investigating several other models. The qualitative behaviour of the potential also seems to depend crucially on the geometry of the scalar manifold.Comment: 26 pages, v2:typos corrected, published versio

An Inflaton Mass Problem in String Inflation from Threshold Corrections to Volume Stabilization

Inflationary models whose vacuum energy arises from a D-term are believed not to suffer from the supergravity eta problem of F-term inflation. That is, D-term models have the desirable property that the inflaton mass can naturally remain much smaller than the Hubble scale. We observe that this advantage is lost in models based on string compactifications whose volume is stabilized by a nonperturbative superpotential: the F-term energy associated with volume stabilization causes the eta problem to reappear. Moreover, any shift symmetries introduced to protect the inflaton mass will typically be lifted by threshold corrections to the volume-stabilizing superpotential. Using threshold corrections computed by Berg, Haack, and Kors, we illustrate this point in the example of the D3-D7 inflationary model, and conclude that inflation is possible, but only for fine-tuned values of the stabilized moduli. More generally, we conclude that inflationary models in stable string compactifications, even D-term models with shift symmetries, will require a certain amount of fine-tuning to avoid this new contribution to the eta problem.Comment: 25 page