Hi Steve, I was looking at population statistics. I do not regard a case study of one person or one firm in the health care industry as adding anything - except perhaps the basis for some careful hypothesis generation; a case study of one can never be used to test any positive hypothesis - it can only test a null hypothesis. [see Popper] One bloods testing lab's reducing staff says more about the paucity of its management's marketing efforts. In earlier days, the doctor would have done a very detailed history-taking and diagnostic work-up; now the doctor asks for FBC [full blood counts], U&Es [ureas and electrolytes], and other path tests, which leads to more path labs required rather than fewer. But, if patients are going to be expected to pay for all these tests, that may be another countervailing force. The reason doctors don't do house-calls is purely economic. First, they have more diagnostic power available - all those tests - and the cynical observation that 'the well person is one who has not been properly diagnosed yet'; this leads the average patient to have raised expectations that an answer can be provided = more demands on the doctor = less time available for prospecting. Second, the amount doctors receive via bulk billing does not provide enough cover for the life style doctors are trained to expect. So, they gather together in clinics to reduce rent costs and to share the cost of a receptionist and other office services. They may choose to roster the role of being on-call - but they are more likely to exploit a locum tenens service. The growth of the clinic has also ushered in the full medical centre where path lab tests are done on the same site. That is oligopoly. Case studies cannot be used for testing hypotheses - in spite of many journos' trying to do so. While the introduction of new technology will affect individuals, the discussion has been about whether that always results in nett benefits. I still contend that the introduction of new technology in the health care delivery field has yet to show an overall nett benefit in economic terms. I suspect that because medicos operate under 'closed shop' conditions, they are, in effect, acting as monopolists. Hence, the only economic beneficiaries of increased technological input to the health care delivery field are the producers and users, rather than the end consumers. Maybe in a few millennia, when the technology has been more fully democratised, we may see the end consumer of health care delivery as the beneficiary. Unfortunately, in Australia, we are following the American model of the haves and have-nots, as distinct from the now almost defunct British National Health Service and the similar New Zealand Social Security health system. However, the situations of cotton production in Australia and the world-wide defence industry showing population-wide economic benefits from technologic democratisation ... Hmmm. Wait a moment - I can think of one economic advantage of the defence industry - poly-tetra-fluoro-ethylene. Is there another waiting to burst upon our gaze? The recycling of mass-produced, uranium-enriched, anti-tank projectiles for our new nuclear-fuel-celled motor vehicles, perhaps? Brian. Steve said: A specific example I shall provide again, despite still waiting for one, this time in the industry you have chosen. An acquaintance of mine, Rowan Letters, was quite concerned about his employment stability about 5 years ago. <snip> His lab was downsizing. They had just brought a new blood analyser. It now meant that instead of a few guys constantly running tests on batches for several days, the machine would process the blood and produce results in a few hours. Marvellous stuff. But, it meant they no longer needed the headcount. Rowan negotiated a deal and went interstate with them to a smaller lab. Several staff voluntarily left (retired). They downsized because of an investment in technology. ************************************************** To post a message to austechwriter, send the message to austechwriter@xxxxxxxxxxxxxx To subscribe to austechwriter, send a message to austechwriter-request@xxxxxxxxxxxxx with "subscribe" in the Subject field. To unsubscribe, send a message to austechwriter-request@xxxxxxxxxxxxx with "unsubscribe" in the Subject field. To search the austechwriter archives, go to www.freelists.org/archives/austechwriter To contact the list administrator, send a message to austechwriter-admins@xxxxxxxxxxxxx **************************************************