Pecunia vincit omnia4/2/2023 They sure knew how to tally up the performance points. Ask not for what the bell tolls - it tolls for fee.īut what if we're just learning, and eventually get it right, particularly if we learn from our masters in the private sector? You're doubtless as inspired as I am by the corporate CEOs with incomes almost entirely driven by the value of their (occasionally back-dated) stock options and the quarterly earnings statements. So it's hardly any wonder that British GPs are walking away with the dough. All nuance and complexity are obliterated by the basic algebra of the payout. Moreover, the game will inevitably lack sophistication, because to dole out the rewards, the goals must be clear and simple the results easily measurable and immediate and the reach modest (no one will play if it's too hard to win). Set up the game and people will learn the rules and play accordingly. Adopt its assumptions and fund or pay accordingly and you will indeed turn civilized people into econocentric shadows of their selves. So let's tell them what to accomplish, ring the economic bell and watch the Pavlovian throng stampede to improvement via the cash-stuffed trough.ĭishearteningly, P4P writ large becomes a self-fulfilling prophesy. Managers and practitioners are hardened cynics for whom pecunia vincit omnia - cash conquers all. It is a profoundly pessimistic concept of what makes people tick in health care: we can't rely on organizational culture, professionalism, devotion to public service, or commitment to excellence to get the desired results, so let's just concede that it's all about the money. On examination, the very essence of P4P is troubling. But the number of complaints per practice - one reasonable measure of satisfaction - varies considerably. The average GP practice scores 95% of the bonus-triggering points available and virtually all get 90% or more. In the UK, the vaunted GP bonus schemes - which can add tens of thousands of pounds to physician incomes - have turned into base pay. The Hay Group believes that even 5% to 10% of income at risk is insufficient to produce a significant effect, let alone the 1% to 2% typically on the table in such arrangements. Renowned British health economist Alan Maynard found lots to be cautious about in his review of experiences to date. This was the Executive Committee of the Communist International (ECCI).Well, yes, if you overlook the P4P track record. international proletariat with the Russian Revolution’.4 At its second congress in July-August 1920, the Comintern therefore set itself the objective of becoming ‘the fighting organ of the international proletariat’, able to provide a centralized, supra-national form of organization with the authority to intervene directly in the affairs of movements in different countries.5 Far from discouraging the Bolsheviks, the ebbing of the first wave of revolution in Europe - from Germany to Poland, passing through Hungary, Austria and then Bohemia and Italy - strengthened their desire to constitute a true general staff of the world revolution a disciplined army answering to a centralized command. On its formation in 1919, the president of the Communist International (Comintern), Grigori Zinoviev, described it as being no more than a ‘propaganda association’.3 For its secretary, Karl Radek, it was ‘merely a symbol’, while the chairman of the German Communist Party (Kommunistische Partei Deutschlands KPD), Paul Levi, called the Comintern an ‘expression of the solidarity of the.
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