The nation’s healthcare system, balancing work and life in science and engineering careers, and governing research are among the topics included in the spring edition of Issues in Science and Technology.
Health care in the United States is “falling short on basic dimensions of quality, outcomes, cost, and equity,” reports Robert Saunders, of the Institute of Medicine, and Mark D. Smith, of the California HealthCare Foundation, in their article, “The Path to Continuously Learning Health Care.” Although the U.S. is the world’s leader in biomedical research and a model of efficiency and productivity in many industries, its health care system fails to produce the results found in Europe and Japan, despite higher spending.
The cover story's authors say models for the health care system's recovery can be found in other sectors of the U.S. economy.
The U.S. health care system is too slow to incorporate new discoveries and to share data, according to the authors. A key reason for this is the lack of effective incentives to encourage health providers to make constant improvements. The authors show how changes to the payment system and organizational structure could enable physicians, nurses, and other health care workers to deliver better services and become active participants in a health care system that promotes continuous learning. Models for reform can be found in many other sectors of the U.S. economy and in a few pioneering health care providers, they suggest.
In “Science, Gender, and the Balanced Life,” Emilie Marcus, editor-in-chief of the journal Cell, discusses her reasons for abandoning the laboratory for the world of scientific publishing. She finds that women are slowly increasing their presence in science and engineering professions, but they are encountering cultural norms that are out of step with the aspirations of today’s men and women to lead balanced lives.
She raises questions about the wisdom of the highly individualistic and competitive world of research and asks whether “science might be served better by a system that favors diversity, teamwork, balance, broad intellectualism, civic responsibility, and a healthy work/life balance.”
The Spring edition also includes two articles about how to govern research in the highly contentious field of “geoengineering” as a means to combat climate change. Other topics include boosting achievement of disadvantaged students, preserving whales and improving the performance of fuel cells.
Issues in Science and Technology is the award-winning journal of the National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and The University of Texas at Dallas.