Apples Vs. Oranges

In yesterday's entry, I mentioned that the four books on my "to be considered for a Hugo list" were three apples and an orange. (Three SF action novels and one fantasy). Jason Robertson (pyropyga) said, in effect, "it's okay to be biased to apples vs. oranges." Although I appreciate the vote of confidence, that's not exactly my problem. My problem with the decision is two-fold:

1) Oranges are not apples - what makes a good orange makes a lousy apple, and vice versa. In other words, comparing fantasy to SF can be difficult, since they are separate things. Granted, they are both novels, so it's not entirely out of the realm of possible, but still.

2) I'm not a regular shopper for oranges. Gaiman's The Graveyard Book will be only the second fantasy novel I've read this year. The first is jimhines's book The Stepsister Scheme. So, I assume that the fantasy fans like Gaiman, but I have very little basis to evaluate that assumption.

I guess what I'm thinking is that it would be nice to have the Hugos structured like the Emmys, where you vote for "best comedy" as well as "best drama." Just a thought.

Health Care

So, via Ezra Klein, I came across this wonderful (if lengthy) explanation as to why American health care is so expensive yet actually worse than in other countries. It's a beaut, and you should read it. The article's bottom line is that when doctors get paid by procedure, you get them ordering more and unnecessary procedures.

This example is dead on (pardon the pun):

Providing health care is like building a house. The task requires experts, expensive equipment and materials, and a huge amount of coördination. Imagine that, instead of paying a contractor to pull a team together and keep them on track, you paid an electrician for every outlet he recommends, a plumber for every faucet, and a carpenter for every cabinet. Would you be surprised if you got a house with a thousand outlets, faucets, and cabinets, at three times the cost you expected, and the whole thing fell apart a couple of years later? Getting the country’s best electrician on the job (he trained at Harvard, somebody tells you) isn’t going to solve this problem. Nor will changing the person who writes him the check.

Or, another quote on the "merits" of Health Savings Accounts (HSAs) which supposedly work by having the patient negotiate for lower costs:

A cardiologist tells an elderly woman that she needs bypass surgery and has Dr. Dyke see her. They discuss the blockages in her heart, the operation, the risks. And now they’re supposed to haggle over the price as if he were selling a rug in a souk? ... Dyke shook his head. “Who comes up with this stuff?” he asked. “Any plan that relies on the sheep to negotiate with the wolves is doomed to failure.”