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On Recent Stock Market Volatility

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Putting it All into Perspective
By Sean G. Todd, Esq., M. Tax, CFP, CPA

The US stock market has taken investors on a bumpy ride in recent years. This volatility has tested investor discipline and prompted some doctors to question their commitment to equities. While no one knows the future, looking at the past may help you gain a better view of long-term market performance and put the recent market volatility in perspective.

Historical Performance

The historical distribution of US market returns since 1926 tells us that performance years are stacked in ascending order by return range. For example:

  • Market performance over the past two years has been extreme by historical standards. In 2008, US stocks experienced their second-worst calendar return in eighty-four years. Then, in 2009, stocks rebounded strongly to deliver a return in the top quartile of the historical distribution.
  • Over the long term, the market’s positive return years have outnumbered the negative return years. Since 1926, the market has experienced a positive return in almost three-quarters of the calendar years.
  • Not only are the positive years more numerous, there is a larger concentration of performance in the higher ranges of returns.
  • The sequence of calendar returns appears random, suggesting that accurately predicting future performance is a difficult task for any investor, physician or professional manager.

Assessment

Over time, the market has rewarded investors who can bear the risk of stocks and stay committed through various periods of performance. And, professional counsel and advice goes a long way in helping you develop, implement and maintain your strategy.

Conclusion

The recent extreme market volatility has challenged many physician investors to rethink their investment strategy or to prompt them to initiate an investment strategy. And so, your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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The International Health Care Rationing Conference

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Appreciating Parallels for the Emerging US Healthcare System?

By Mahsa Ghari

Aim of the Conference

In the late 1990s, the Dutch government started to experiment with ‘regulated competition’ in social health insurance. A milestone was the new Health Insurance Act in 2006 introducing a compulsory health insurance scheme for the entire population, carried out by (for-profit) health insurers, contracting individual and institutional health professionals. Safeguarding equal access, the new health insurance scheme introduced several preconditions like compulsory insurance, a basic benefit package, the prohibition of risk selection, a risk-equalization fund, etc. The idea of competitive health insurance was combined with deregulating hospital planning and liberalizing health care tariffs. 

Merit Considerations

In the new scheme medical need is still decisive in health care access decision-making, but merit-considerations are becoming important too. Shortening waiting times, priority arrangements were considered and/or introduced, based on non-medical criteria. Simultaneously, in terms of financing, health status has become important due to own payments-arrangements, limited insurance package options, etc. At the same time, health status disparities due to socioeconomic inequalities seem to be increasing.

Under these circumstances, confronted with increased health spending, we can expect the “R” word becoming more eminent in the Dutch health care debate.

Relevant Rationing Questions

Emerging relevant questions are:

  • Who is responsible for rationing (markets, governments, bureaucrats, MDs or others)?
  • How does it function (explicit or implicit)?
  • What are relevant selection criteria (QUALYs, DALYs, health status, sex, age, etc)?
  • To what extent is current rationing just?
  • What can be done to make it more just?
  • How will health care rationing affect equal access to health care?
  • What is the relationship between rationing and differences in health status etc?

There is a wealth of literature in political theory, as well as in health care policy, economics, social medicine and law addressing these issues. What is needed is a consideration of the values involved, and the impact of, policy decisions on the expression of these values.

The Erasmus Observatory

Therefore, the Erasmus Observatory organized an international conference to discuss health care rationing from a wide range of perspectives.

Speakers

The following speakers have confirmed their contribution:

  • Dr. Bert Boer, Executive member of the Health Care Insurance Board (ethics)
  • Prof. Werner Brouwer (Erasmus University Rotterdam) (economics)
  • Prof. Norman Daniels (Harvard University) (philosophy, medical ethics)
  • Prof. Leonard Fleck (Michigan State University) (philosophy)
  • Prof. Colleen Flood (Toronto University) (law)
  • Dr. Anand Grover (Special Rapporteur United Nations) (law)
  • Prof. John Harris (University of Manchester) (bioethics)
  • Prof. Frances Kamm (Harvard University) (philosophy)
  • Prof. Johan Mackenbach (Erasmus University Rotterdam) (public health)
  • Prof. Alan Maynard (University of York) (economics)
  • Prof. Chris Newdick (University of Reading) (law)
  • Prof. Erik Nord (University of Oslo) (economics)
  • Prof. Bettina Schöne-Seifert (Münster University) (medical ethics)
  • Dr. Keith Syrett (University of Bristol) (law)

Assessment

The conference language will be in English, in Rotterdam on 9 – 10 December 2010, The Netherlands: info@erasmusobservatoryonhealthlaw.nl

Registration: CONFERENCE REGISTRATION FORM[1]

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